Magister Curationis - MCur / Background: Nursing as a profession is based on firm knowledge, values, clinical skills and attitudes. In the current dynamic healthcare systems, all nurses are challenged to be insightful and have robust clinical reasoning and psychomotor skills in order to integrate theory into practice. Therefore, they need to be accountable in ensuring that they perform optimally to meet the extensive demands of clinical settings. Theory-practice integration is a major element that sustains quality and drives best nursing practice. One of the barriers to theory-practice integration is the gap between theory and practice in nursing education. Therefore, if sound theory is the basis for understanding the reality of the clinical setting, then every effort should be made to reduce the gap between theory and practice. Aim: The aim of the study was to explore and describe the challenges experienced by second and third-year nursing students when integrating theory into practice in a selected clinical setting in the Western Cape. Method: A qualitative approach, using an explorative, descriptive and contextual design, was employed. The target population of the study was the second and third-year nursing students who were registered for the Bachelor of Nursing Degree in the academic year of 2016. The selected non probability sample comprised of 14 participants. Data were collected using semi-structured focus group interviews, with an interview guide and probing to gain detailed information during the process of data collection. Interviews were audio recorded to ensure that no information would be lost and the researcher could review it when necessary. The content analysis method was used to analyse the data. Permission to conduct the study using the nursing students was obtained from the registrar of the University of the Western Cape and the HOD of Son. The research ethics committee granted ethics approval related to the study. All participants were involved in the study on a voluntary basis. Informed consent and focus group confidentiality binding forms were completed by participants to ensure confidentiality. Results: Four themes emerged from the findings namely: Theory verses practice, lack of role models, inadequate support structures and communication. The study highlighted that nursing students still experience a challenge with integrating theory into practice in the clinical settings. In addition the study highlighted that clinical guidance from the preceptors a crucial role in the professional development of students. The results of the study also showed that a new structure of facilitating nursing students in clinical settings must be in place. This structure should include proper orientation and supervision of the nursing students. The preceptors who facilitate clinical guidance must be equipped with the necessary knowledge and skills to ensure that they are able to facilitate and monitor the competence of the nursing students. Conclusion: Clinical nursing education is vital and indispensable in nursing education. It is very complex consisting of many aspects and situations, which can be challenging and demanding for a nursing student. Due to its complexity, it is essential for nursing students to be exposed to a variety of real life situations within their training in order to better prepare them for quality practice. Nursing students therefore require sufficient support from the clinical preceptor and the nursing educators, to acquire the necessary skills, knowledge and attitude to perform nursing duties with competence, when placed in the clinical settings. This calls a lot of attention from the higher learning institutions and the clinical settings to have standardised goals and expectation for the students, providing quality clinical accompaniment that will socialise the nursing student optimally in the profession and attempt to bridge the gap between theory and practice.

Yes / Since the 1980 s, changes in nursing education have inadvertently led to diminishing anatomy and physiology content in curricula (Taylor et al., 2015). The need for nurses to have a thorough grounding in these subjects is undisputed; however, the pedagogical principles for anatomy and physiology education have been under scrutiny (Perkins, 2019). Anatomy and physiology are typically incorporated as part of bioscience, which also encompasses genetics, microbiology, pharmacology, and pathophysiology (Horiuchi-Hirose et al., 2023). Registered nurses and nursing students often express anxiety about studying bioscience and its perceived difficulty, largely due to difficulties in applying theory to practice (Craft et al., 2013, Craft et al., 2017, Meedya et al., 2019). Despite this, there remains a recognition that bioscience knowledge is important for effective nursing practice (Danielson and Berntsson, 2007, Horiuchi-Hirose et al., 2023). / The full-text of this article will be released for public view at the end of the publisher embargo on 15 Dec 2024.

Den svenska sjuksköterskeutbildningen har genomgått flera förändringar under historien. Idag får lärosätena själva utforma utbildningen så länge målen uppfylls. Efter examen förväntas den nyutexaminerade sjuksköterskan ha den kunskap som sjuksköterskearbetet kräver. Sjuksköterskans arbete innebär ett stort ansvar för andra människor i relation till liv och hälsa. Dock har inte nyutexaminerade sjuksköterskor tillräckligt med kunskap för alla situationer de kan förväntas möta. Ett bra stöd kan underlätta övergången. Dock visar forskning att nyutexaminerade sjuksköterskor fortfarande upplever hög arbetsbelastning och stress. Övergången från student till sjuksköterska kan således ses som problematisk. Studenter upplever blandade känslor inför att anta rollen som sjuksköterska. Syftet med studien var att belysa sjuksköterskestudenters förväntningar inför kommande yrkesroll. Data samlades in genom åtta semistrukturerade intervjuer. Informanterna var sjuksköterskestudenter i termin fem på högskolan i Borås. Intervjuerna analyserade utifrån en innehållsanalys med induktiv ansats. Resultatet presenterades genom två huvudkategorier; Positiva förväntningar och Negativa förväntningar, med sex subkategorier; Mötet med människan, Rollen som sjuksköterska, Utveckling av kunskap, Brist på erfarenhet, Hög arbetsbelastning och Brist på stöd. Resultatet visar att sjuksköterskestudenters förväntningar till stor del stämmer överens med nyutexaminerades upplevelser. De negativa förväntningarna ses kunna bero på omfattande problem avseende sjuksköterskeprofessionen i förhållande till sjuksköterskeutbildningen samt vårdverksamheten. Författarna uppmanar till att stärka forskning om sjuksköterskestudenters förväntningar. Såväl sjuksköterskeutbildningen som vårdverksamheten har ett ansvar för att gemensamt hitta en lösning. Politiker måste också ta sitt ansvar. Sjuksköterskestudenter måste ges optimala förutsättningar för en god hälsa i övergången samt anständiga arbetsvillkor, vilket också kan öka förutsättningarna för en patientsäker vård.

Graduate nurses are being employed to provide care in high acuity care areas, and this becomes a problem of significance as the literature suggests that graduate nurse's experience a deficit in integrating theoretical concepts in the clinical environment, described as the theory-practice gap; which can result in a risk to patient safety and the potential for negative outcomes. Cognitive constructivism was the conceptual framework that guided this study. A qualitative phenomenological design was used to explore the lived experiences of 13 graduate nurses employed at a community hospital in northern New Jersey. After recruiting the participants through purposive sampling, semi-structured interviews were conducted with them utilizing a researcher-developed interview protocol based on the Casey-Fink Graduate Nurse Experience Survey. The research questions addressed the graduates' clinical experiences and their perceptions of simulation in facilitating the integration of theory to practice. Interviews were transcribed verbatim, coded, and analyzed to identify 4 themes: (a) the theory-practice gap, (b) effective educational pedagogy, (c) theory-practice integration, and (d) simulation-based learning. The crucial finding was that graduate nurses perceived the theory-practice gap could be reduced through the use of high-fidelity simulation utilizing scenario-based learning exercises in prelicensure programs prior to entry to practice. Based on these findings, the recommendations presented in a white paper will help the administration of the school of nursing at the local site make informed decisions to effect curricular changes that promote the students' integration of theory into practice. Further, the results of this study impact social change by serving as a model for similar programs to improve the preparation of graduate nurses to provide care to optimize positive patient care outcomes.

Yes / Pregnant women seeking asylum in the United Kingdom appear particularly vulnerable, having complex health and social care needs and could benefit from a woman centred approach to midwifery care. This article is the second of three parts and reports on the findings from one objective of a wider doctorate study. It focuses on exploring midwifery students' perceptions of how to approach the care of pregnant women seeking asylum. Although the design of the study is explored in article one, in this context, the data was subject to critical discourse analysis to meet this objective. Key words and phrases were highlighted which appeared to reveal power and ideology implicit in the language used when discussing midwifery care of the pregnant woman seeking asylum. Dominant discourses were identified which appeared to influence the way in which care was approached and the possible sources of these discourses critically analysed. The findings suggest an underpinning ideology around following policies and guidelines to meet the physical needs of the woman at the expense of her other holistic needs. Despite learning to adopt a woman centred approach in theory, once in practice some students appear to be socialised into (re)producing these dominant medical and managerial discourses with “midwifery discourse” being marginalised. In addition, some students appeared to have difficulty understanding how to adopt a woman centred approach and the importance of considering the woman's context and its impact on care. These findings have implications for midwifery educators and this article identifies that the recent Nursing and Midwifery Council requirement for students to undertake a caseloading activity could provide the opportunity for them to adopt a consistent woman centred approach in practice, rejecting dominant medical and managerial discourses. However, these discourses appear to influence midwives caring for women more widely and will be difficult to challenge.

This work examines and presents evidence for the existence of a gap in epistemological views between academic and practice marketers. Few if any academics would seem to challenge the ‘gap’ premise but the importance of any gap and its nature are issues about which little agreement exists. The intractable nature of the academic practitioner gap has a long history of interesting and diverse debate ranging from Dewey’s argument about the true nature of knowing to contributions based on epistemic adolescence, ontological differences and more pragmatic suggestions about different tribes. Others include the rigour versus relevance issue, failures in curriculum or pedagogy and a clash between modernist and postmodernist epistemologies. Polanyi’s description of tacit versus explicit knowledge further extends the debate as do issues of knowledge creation and dissemination in particular through Nonaka. Irrespective of approach actual evidence for a gap was largely based on argument rather than empirical proof. This work address that lack. The intractability of the gap suggests that it is at root, epistemic. To identity the existence of a gap in such terms a domain specific epistemic questionnaire developed by Hofer was used. A factor analytic process extracted a common set of factors for the domain of marketers. Five epistemic factors were identified. Three of these showed significant difference in orientation between practitioners and academics confirming that the theory practice gap is tangible and revealing an indication of its nature Broadly results from factor analysis with interpretation informed by factor item structure and prior theoretical debate suggests that academics and practitioners views on knowledge and how they come to know share similarities and differences. Academics are more likely to see knowledge as stable, based on established academic premise legitimized from academy. Practitioners are more likely to see knowledge as emerging from action, as dynamic and legitimised by results. Other significant findings included the emergence of dialogue as a means of closing the gap, and the emergence of a group of academics with significant practice experience termed here as, hybrids, who are located in the Academy but mostly share their epistemic views with practitioners. Correlation analysis showed that academic propensity to engage in dialogue with practice moved academic factor scores towards practitioners. This shows that dialogue has a clear role in both perpetuating the gap in its absence or reducing it. Fundamentally dialogue plays a clear role in bridging the two epistemologies and in providing for additional epistemic work. Finally a solution to bridging the gap has been proposed. The model called dialogic introspection melds dialogue and introspection to create epistemic doubt, the volition to change and a means of resolution. The model avoids prescription of what form knowledge should take but instead adopts a stance similar to more mature disciplines like medicine in which the status of academic work is enhanced in line with its relevance to practice which itself is embodied in dialogue. This approach recognizes the centrality of epistemology as shaping the conditions necessary for recognizing epistemologies as hierarchies in which the epistemology most capable of additional epistemic work is the most desirable. Such an epistemology would have the capacity to add epistemic work and reinforces Nonaka’s call for epistemology to be recognized as central to knowledge creation.

One of the major challenges associated with nursing education in this 21st century is the practice preparation of student nurses in this complex healthcare environment to ensure their fitness to practice. Practice training relies largely on mentoring which is central to the professional development of student nurses. In the local context of Mauritius, the clinical mentoring of students is service-led rather than education-driven. In the context of the current debate, it is becoming evident that the clinical mentoring system in Mauritius needs rethinking in order to respond to the emerging training and education needs of nurses. The aim of the study was to develop a contextually relevant clinical mentoring framework for student nurses in Mauritius in order to enhance the standard of student nurses’ training during clinical placements. A descriptive exploratory sequential mixed method with a cross-sectional design was used in this study. The sample for the qualitative phase consisted of eight nurses, while there were 255 nurses and 115 students in the quantitative phase. Data were collected through face-to-face semi-structured interviews and a self-administered questionnaire, respectively. The findings were synthesised using Dickoff et al’s (1968) survey list to develop the clinical mentoring framework for student nurses. The findings of the qualitative phase indicated that the current learning support system for students in the clinical settings did not reflect what mentoring should be about. Mentoring per se was not practiced, but rather a form of clinical accompaniment resulting in the practice being less effective for its purpose. A variety of activities/roles were described that nurses fulfil in everyday clinical practice that included some aspects of a mentoring approach. Participants provided a number of pre-requisites needed for the mentoring process. The results of the quantitative phase revealed that both students and nurses recognised that the mentoring system was informal. They also shared the same views regarding barriers to mentoring, such as staff shortage, lack of resources, and inadequate support from management and the Central School of Nursing (CSN). Along with mentoring competencies, teaching, assessing, communication, managerial and leadership skills, were identified as core competencies for mentors. Effective clinical mentoring requires an understanding of the mentoring process from a broader perspective. Mentors should be equipped with core competencies. Successful mentoring outcomes are dependent on a conducive clinical learning environment (CLE) and the approach used to mentor. The framework on mentoring could guide and provide a holistic approach to mentoring students in CLEs. However, emphasis must be placed on the collaboration between the management, the clinical setting and the CSN. The clinical framework developed from this study can be tested for its effectiveness. / Health Studies / Ph. D. (Nursing)