OBJECTIVES:This study aimed to investigate student transfer of medication administration safety competencies to initial clinical practice after passing standardized, supervised laboratory validation check-offs. METHODS:A repeated measures observational design was used to collect performance scores with a validated tool. Researchers collected scores during lab validation, initial clinical medication administration, and first medication administration during the following semester. RESULTS:No statistically significant differences in performance scores were observed across settings. Consistent performance was observed, with minor challenges in patient identification and timing of medication administration. CONCLUSIONS:This study addressed a gap in the literature on the transfer of learning between educational and clinical environments and demonstrated that appropriate scaffolding and replication of key practice elements may support transfer of clinical competencies. These results inform nursing education strategies to enhance safe medication administration.
OBJECTIVES:This study aimed to explore the most impactful clinical practice experiences of final-year nursing students and the future-oriented actions developed in response to these experiences. METHODS:A retrospective descriptive qualitative design was used. Following reflection training in the internship practice course, 134 final-year nursing students were asked to describe the experience that affected them most during clinical practice. A total of 123 written reflections were analyzed using content analysis. RESULTS:Three themes emerged: near-miss events, incivility behaviors, and positive preceptoring roles. Negative experiences were mainly related to patients, relatives, and nurses and often led students to feel fear and inadequacy. Students reported action plans focused on effective communication, safe patient care, and becoming positive role models. CONCLUSIONS:These findings highlight the importance of supportive clinical learning environments and positive professional socialization during the transition from student to nurse. IMPLICATIONS FOR INTERNATIONAL AUDIENCE:Nursing students worldwide may encounter incivility and near-miss events during clinical practice, potentially adversely affecting their learning experiences and professional development.
OBJECTIVES:This scoping review will aim to identify the pedagogical methods used to prepare entry-level nursing students for telehealth practice and to describe how these methods integrate the concept of therapeutic relational connection. DESIGN:The proposed scoping review will adhere to the methodology guide by (Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs 2021;77:2102-13) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review extension checklist. METHODS:Five key databases will be searched; grey literature will also be explored. Results will be analyzed and categorized thematically for pedagogical methods and therapeutic relational connection. DISCUSSION:This protocol demonstrates how the steps outlined in the (Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs 2021;77:2102-13) guide are implemented to establish a robust methodology. The scoping review will enhance understanding of the pedagogical methods used for teaching telehealth in entry-level nursing programs and the integration of the therapeutic relational connection. This protocol is registered in the Open Science Framework (https://doi.org/10.17605/OSF.IO/MT5JC).
BACKGROUND:Critical thinking (CT) among nursing students is crucial for delivering high-quality nursing care to patients. Concept mapping (CM) is one of the evidence-based pedagogies that helps to improve CT in individuals. OBJECTIVES:The objective of this review and meta-analysis was to evaluate the impact of concept mapping on CT abilities, academic achievement, and clinical skills in nursing students. METHODS:This systematic review and meta-analysis aimed to identify published articles on the effect of CM on CT in nursing students, written in English and published from 2011 to 2024. The articles were sourced from SCOPUS, Web of Science (WoS), ScienceDirect, Google Scholar, and PubMed databases. To ensure a comprehensive and relevant search, the following MeSH terms were used: "Effectiveness" OR "Impact," AND "Concept Mapping," AND "CT," AND "Nursing Student," AND "RCT" OR "Randomized Controlled Trials" OR "Quasi-Experimental." This study used the Cochrane Collaboration's Risk of Bias (RoB) tool and Standardized Mean Difference (SMD) for outcome measurement, with results analyzed using RevMan Web. RESULTS:This study analyzed 14 RCTs and quasi-experimental studies involving 1,747 participants (E=870, C=877). The meta-analysis found that concept mapping enhanced nursing students' CT skills (MD=4.86, 95 % CI [2.16 to 7.56], p=0.0004), academic achievements (MD=3.38, 95 % CI [0.76 to 5.99], p=0.01), and performance in clinical practice (MD=5.94, 95 % CI [3.22 to 8.65], p<0.0001) when compared to routine instructional methods. CONCLUSIONS:CM provides valuable insights into enhancing CT and clinical skills in nursing students, eventually preparing them to become excellent nursing professionals in the healthcare system.
The development of clinical competence in nursing education requires theoretically grounded approaches that integrate learning processes with professional progression. This paper presents the Experiential Competency Progression Framework (ECPF), a novel conceptual model that systematically integrates Kolb's Experiential Learning Theory with Benner's Novice to Expert Model to advance competency-based nursing education. While Kolb's theory explains how learners acquire knowledge through cyclical experiential processes (Concrete Experience, Reflective Observation, Abstract Conceptualization, and Active Experimentation), Benner's model describes the progressive development of clinical expertise through five developmental stages (Novice, Advanced Beginner, Competent, Proficient, and Expert). The ECPF aligns Kolb's experiential learning cycle with each of Benner's competency levels, providing a structured, evidence-based approach to designing simulation-based learning, clinical placements, reflective practice, and curriculum development. This integration addresses a significant gap in nursing education literature by moving beyond prior simulation-focused applications to offer comprehensive guidance across all educational contexts. The framework demonstrates how experiential learning occurs recursively at each developmental stage with increasing sophistication as learners progress toward expertise. The ECPF contributes to nursing education by offering a practical, theory-informed model that enhances reflective learning, clinical reasoning, and skill acquisition. It provides actionable guidance for curriculum design, faculty development, learner assessment, and institutional implementation, supporting the preparation of competent, practice-ready nursing graduates across diverse educational settings worldwide.
Nurse practitioners (NPs) often lead interprofessional healthcare teams, yet many receive little or no formal leadership training. As healthcare systems grow in complexity and demand greater accountability, the need for strong and effective NP leadership has intensified. However, leadership development within NP education remains poorly defined and often lacks theoretical grounding. This systematic review explores interventions designed to build NP leadership skills. Following PRISMA and BEME Guide No. 13 guidelines, a search (July 2022, updated April 2024) identified peer-reviewed English-language articles from 1980 onward. Studies involving NPs at any training or practice stage were included if they described a leadership intervention. Of 3,058 articles, eight met inclusion criteria. Most studies originated in the U.S., featured isolated leadership interventions, and lacked NP clinical faculty involvement. Experiential learning and mentorship were common. Leadership domains emphasized cognitive and emotional intelligence, with little focus on leader character development. Evaluation of leadership interventions were limited. Overall, few theoretically informed, robust NP leadership interventions exist. Future efforts should prioritize comprehensive, longitudinal, and theory-based approaches to strengthen leadership capacity within NP education and practice.
OBJECTIVES:To examine nurse faculty perceptions on undergraduate nursing student notetaking. METHODS:A descriptive correlational survey was administered via Qualtrics to nurse faculty. The survey included 21-items designed in consideration of the aims and literature in the field. RESULTS:There were 128 completed surveys. There were correlations between faculty demographics, teaching practices, and notetaking strategies. CONCLUSIONS:Nurse faculty use a variety of teaching methods in the classroom and are aware of multiple notetaking strategies. Faculty who are aware of multiple strategies encourage students to use multiple notetaking methods. IMPLICATIONS FOR INTERNATIONAL AUDIENCE:Findings emphasize a gap in nurse faculty knowledge regarding the three-step process of notetaking: Record, Revise, Review for deeper student learning. Future professional development should focus on this.
OBJECTIVES:To explore how students navigate the emotional, relational, and structural dimensions of learning the nursing profession within a concept-based curriculum (CBC). METHODS:Guided by Husserlian phenomenology and Wenger's Social Theory of Learning, van Manen's hermeneutic approach informed conversational interviews with eight final-year nursing students. FINDINGS:Becoming a nurse emerged as a process fueled by reciprocity of care and marked by personal transformation, reflected in evolving experiences of personhood, understanding, and growth. Five experiential structures shaped the learner's lifeworld: Being Evaluated, The Cohort Thing, Educational Choice, Experiencing Nursing, and The Presentation of Nursing. IMPLICATIONS FOR AN INTERNATIONAL AUDIENCE:As CBCs expand, pedagogical care is central to nurse formation across contexts. The experiential structures offer a lens for educators and academic leaders to examine how learning environments shape professional identity. CONCLUSIONS:Learning the nursing profession is a process of formation, revealing nursing education as a site of meaning-making and professional becoming.
Nursing students face various stressors during clinical practice that can negatively impact mental health and academic performance. This study aims to validity and reliability of the Indonesian version of the perceptions of clinical stressors scale (NSPCSS). The study used a cross-sectional design with clinical nursing students in Indonesia. Construct validity was assessed using confirmatory factor analysis (CFA), and reliability was analysed using Cronbach's alpha. The CFA results showed that the three-factor model had a good model fit (X=588.053, df=222, p=0.001, CMIN/DF=2.649, NFI=0.90, RFI=0.90, IFI=0.93, TLI=0.92, CFI=0.93, RMSEA=0.08). Cronbach's alpha value was 0.945. The NSPCSS is proven to be valid and reliable. It can be used to identify the main sources of stress experienced by nursing students during clinical practice in Indonesia.
Objectives Immersive Virtual Reality Simulation (IVRS) has been reported to improve clinical judgment, communication, and competency in nursing psychomotor skills. The purpose of this study was to determine if IVRS implemented in a senior-level undergraduate medical-surgical didactic course improved student engagement and clinical judgment.Methods IVRS was executed in three class sessions for one cohort of students. Clinical judgment was compared in two cohorts of students [IVRS, n=39 Fall 2023; no IVRS, n=36 Spring 2024]. Engagement theory served as the framework for this study. Only students in the IVRS cohort completed the Student Course Engagement Questionnaire (SCEQ) at the end of the course to measure course engagement. Clinical judgement was measured using the six cognitive domains on the Kaplan (R) Med/Surg Comprehensive NGN Integrated Test for both cohorts of students (IVRS and no IVRS).Results There was no statistical difference in clinical judgment scores between the two cohorts. IVRS as measured by the SCEQ increased engagement by motivating students to take good notes (47 %) and review notes between class (44 %), listen carefully, apply content to clinical, and ask questions on unclear concepts (47 %). Students reported that IVRS was fun (53 %).Conclusions IVRS is a novel educational tool that contributes to student engagement with medical/surgical content and can easily be accommodated in a classroom setting. IVRS is an engaging active learning strategy that can be implemented internationally by schools of nursing.
OBJECTIVES:This study examined differences in declarative knowledge acquisition between a hybrid educational escape room and traditional lecture-based learning (LBL), and explored students' experiences with the gamified intervention. METHODS:A quasi-experimental pre-test/post-test design was conducted with 152 second-year nursing students. The experimental group completed a hybrid escape room combining on-site and digital tasks, while the control group received LBL. Declarative knowledge was assessed in both groups, and game-related experiences were measured in the experimental group. RESULTS:Students in the experimental group showed significantly greater improvements in learning outcomes compared to those in the control group. Participants also reported positive experiences, including enjoyment, activation, creative thinking, autonomy and absorption. CONCLUSIONS:Hybrid educational escape rooms can enhance learning outcomes while fostering positive learning experiences. Implications for international audience: Hybrid escape rooms may be effective across diverse educational systems, suggesting that knowledge gains can occur independently of changes in motivation or subjective enjoyment.
OBJECTIVES:Clinical judgment is a foundational competency for nursing students but difficult to assess in nursing education. The Lasater Clinical Judgment Rubric can evaluate clinical judgment competence among prelicensure nursing students. METHODS:A simulation-based intervention was implemented across three campuses at a United States college of nursing. Prelicensure nursing students (N=113) completed a simulation followed by a self-evaluation of clinical judgment competence using the Lasater Clinical Judgment Rubric. RESULTS:Simulation can influence competent behavioral performance and is an effective pedagogy to cultivate clinical judgment skills in nursing students. Students self-reported advanced or exemplary competency levels for clinical judgment behaviors assessed. CONCLUSIONS:Simulation-based self-assessment using the Lasater Clinical Judgment Rubric may be a feasible approach to evaluating nursing students' perceptions of clinical judgment competence; however, further research using objective measures is recommended. IMPLICATIONS FOR INTERNATIONAL AUDIENCE:Clinical judgment is a universal competency required by nurses across practice settings internationally.
OBJECTIVES:Nurse educators play a vital role in supporting disadvantaged nursing students, especially in rural areas. This project implemented innovative strategies including full scholarships, academic support, and mentorship panels featuring rural nurse leaders role models to improve student success at a rural public university in the Midwest U.S. METHODS:Disadvantaged students-including those from low-income households, first-generation college backgrounds, and rural underserved communities-encounter substantial barriers to successfully completing nursing programs. To address these challenges, targeted interventions are essential to support their admission, retention, graduation, and transition into employment, particularly in rural and medically underserved communities (MUCs). This study analyzed admission, retention and graduation outcomes of 73 scholarship recipients. An online survey evaluated the effectiveness of various support strategies. RESULTS:Admission and retention outcomes for disadvantaged nursing students improved substantially over the course of the project. Admission rates increased more than fourfold, rising from a baseline of 5 % in 2019 to 24.3 % by 2025. Among the 73 disadvantaged scholarship recipients, the retention rate reached 88 %, and all graduates achieved a 100 % pass rate on the RN licensure examination. Student feedback also reflected that 95.2 % of participants rating the mentorship panels as "very effective". CONCLUSION:Scholarships and structured academic and social support programs improved disadvantaged students' success, contributing to a more diverse and competent nursing workforce. Holistic support, equity-focused access, and alignment with underserved community needs offer a practical framework for international nursing education to strengthen workforce diversity and reduce health disparities.
OBJECTIVES:The Intercultural Competence (IC) program, an interactive, technology-enhanced educational intervention, was developed to advance nursing students' cultural competence. This longitudinal pretest and posttest study examined its effectiveness. METHODS:A convenience sample from three sequential cohorts participated voluntarily. Guided by simulation pedagogy, the IC program integrated 2D, 3D, and virtual reality technologies to provide a flexible, low-risk environment for deliberate, repeated practice. Participants completed a demographic questionnaire and the Intercultural Competence Scale after each program level. RESULTS:All cohorts demonstrated consistent improvement in cultural competence following each level compared with baseline. CONCLUSIONS:The IC program effectively enhances cultural competence and reflects rigorous, interprofessional scholarship with community partners to prepare nursing students for culturally responsive care.
OBJECTIVES:The study aims to identify and summarize existing knowledge on how information literacy (IL) is demonstrated among health students in higher education. METHODS:A scoping review approach with a systematic search of scholarly databases. RESULTS:Of the 3,770 results obtained, 14 studies were included in this review. Two main approaches to IL were identified: (1) perceived, and (2) applied IL among health education students. IL was commonly measured using eight previously validated instruments and three purpose-designed instruments. Perceived IL skills ranged from moderate to high levels, while applied skills appeared to be moderate. Perceived IL was significantly associated with students' self-perception of importance; whereas, applied IL was significantly associated with age and academic seniority in nursing. CONCLUSIONS:The IL of higher education health students seems to range from moderate to high levels. However, the vast number of IL instruments used indicates the need for further scale standardization and validation. IMPLICATIONS FOR INTERNATIONAL AUDIENCE:In education, greater emphasis should be placed on integrating (IL) aspects into the curriculum across all levels, rather than treating it as a separate, conceptual entity.
OBJECTIVES:Nursing students encounter a myriad of challenges as they prepare for licensure. This study aims to identify specific needs and mentoring preferences of pre-licensure nursing students at various stages to inform faculty-led mentoring. METHODS:A needs assessment of 224 pre-licensure nursing students gathered quantitative and qualitative data on students' perceived needs, mentoring preferences, and mentorship settings. RESULTS:The majority expressed strong interest in faculty mentorship, preferring in-person, informal meetings with mentors, and opportunities for electronic interactions. Students identified needs related to licensure exam preparation, study strategies, and balancing academics with personal responsibilities. CONCLUSIONS:Faculty-led mentoring may help address academic and personal challenges faced by pre-licensure nursing students. Institutions should consider formal faculty-led mentorship programs based on student-identified needs to enhance student success. IMPLICATIONS FOR AN INTERNATIONAL AUDIENCE:Findings can inform global pre-licensure nursing programs' faculty-led mentorship initiatives tailored around student-identified needs, and preferences for faculty mentoring.
OBJECTIVES:To analyze nurse faculty perceptions of student notetaking and generate insight for future practice and research. METHODS:As part of larger cross-sectional study, nurse faculty completed an online survey from November 2024 to January 2025. RESULTS:Among 120 responses to the prompt "Students take notes to…," thematic analysis identified five key themes: A way to manage important course information, Helps students with studying, Reinforces student learning, Prepares students for class and exams, and Guides students to faculty expectations. CONCLUSIONS:These findings emphasize the importance of fostering effective notetaking skills in nursing students and have broad implications for nursing education practices globally. IMPLICATIONS FOR INTERNATIONAL AUDIENCE:The findings highlight the importance of effective notetaking in various contexts which is applicable for national and global educators.
OBJECTIVES:To assess CT, SE, and perceptions of EE of nursing students in Greece, and explore the potential associations between them. METHODS:This cross-sectional study was conducted in a Nursing department from February to May 2024. We used the Dundee Ready Education Environment Measure (DREEM), the Critical Thinking Disposition Scale (CTDS), and the Rosenberg Self-Esteem Scale (RSE) questionnaires. RESULTS:A total of 185 nursing students participated. EE was generally positive, with moderate CT disposition and positive self-esteem. Robust regression showed a positive association between EE and CT disposition. Structural equation modeling indicated that SE mediates this association between EE and the Reflective Skepticism sub-scale of CTDS. CONCLUSIONS:Suitable interventions could be implemented to enhance the CT of nursing students through the utilization of SE and EE.
OBJECTIVES:The global nursing shortage and increasing international migration of nurses highlight the urgent need for greater harmonization in nursing education. Variations in curricula worldwide pose significant challenges to the integration of internationally educated nurses (IENs). Therefore, the objective is to examine how disparities in nursing education between Nepal and Australia - particularly regarding curriculum structure, clinical hours, program length, and licensure requirements - affect the global mobility of IENs. METHODS:A descriptive qualitative study was conducted using three online focus group discussions with 14 final-year nursing students from Nepal and Australia. Data analysis employed a two-cycle coding process, guided by a constructivist paradigm, to identify key themes. RESULTS:Five major themes emerged: 1) Clinical Hours and Hands-on Experience; 2) Differing Program Lengths; 3) Curriculum Content and Specialization; 4) National Licensure Examination; and 5) Global Mobility Prospects. CONCLUSIONS:This study reveals that variations in nursing education between Nepal and Australia create significant barriers to the global mobility of IENs, affecting both their perceived readiness for practice and the recognition of their qualifications. These findings underscore the critical need for a globally harmonized nursing curriculum framework. Incorporating core competencies yet allowing for contextual adaptation, this framework is essential for facilitating nurse mobility, improving the quality and comparability of nursing qualifications, and addressing the global nursing shortage.
The purpose of this study was to determine whether integrating ethical simulation-based education (SBE) into prelicensure nursing students' curriculum would impact moral distress levels. A longitudinal mixed methods design was used to measure moral distress levels and collect qualitative data related to the SBE. In the final sample (n=48), there was no statistically significant difference among moral distress scores over the three measured time points. Thematic analysis revealed four primary themes: (1) powerlessness as a student; (2) students have a basic moral understanding; (3) discomfort in speaking up with integrity; and (4) students understand the importance of emotional intelligence. The final and lowest survey score, combined with the results of the thematic analysis, indicates that integrating ethical SBE throughout curriculum could impact moral distress. In addition, training educators in maintaining psychologically safe environments can empower students and potentially reduce burnout.
