Aims To determine what extent are workplace empowerment, New Graduate Nurses’ (NGN) perceptions of nurse leaders, trust in management, and areas of worklife predict coworker incivility experiences? Background NGNs’ perceptions of nursing leaderships’ control over workload contribute to coworker incivility experiences were tested. The relationship between workplace empowerment, authentic leadership, and areas of work life (workload control and fair resource allocation) to coworker incivility experiences were examined. Design Secondary analysis of Starting Out, national survey, Time 1 dataset. Select factors of workplace empowerment, authentic leadership, areas of worklife, trust in management and NGNs’ co- worker incivility experiences were situated within an ecological approach. Multiple linear regression was used to test whether a negative relationship of workplace empowerment, areas of worklife and authentic leadership to NGNs co-worker incivility experiences and important new findings were discovered. Results First, NGNs’ perceptions of workplace empowerment predict coworker incivility experiences when controlling for authentic leadership and trust in management. Second, NGNs’ perceptions of areas of worklife predict coworker incivility experiences when controlling for authentic leadership, trust in management, and workplace empowerment. Third, NGNs’ perceptions of authentic leadership do not predict coworker incivility experiences when controlling for workplace empowerment and trust in management. Finally, NGNs’ perceptions of authentic leadership do predict coworker incivility experiences when trust in management and workplace empowerment are not controlled. Conclusions NGNs’ perceptions of authentic leadership would benefit from workplace empowerment of the nurse leader in workplace environments to mitigate coworker incivility experiences.

Aim To explore how an ecological approach be used to explore relationships among workplace empowerment, authentic leadership, trust in management, areas of work life and co-worker incivility experiences of new graduate nurses. Design Key concepts related to new graduate nurses' incivility experience informed the research question building on the findings of our first author's integrative review. Second, relevant theories and concepts were identified by conducting a literature review. Third, the themes build on prior theories and factors to propose a hypothetical model. Data Sources (2016-2019) CINAHL, OVID, PSYCINFO, PUBMED, EBSCO, ERIC, SCOPUS, Cochrane Library; PROQUEST and Google Scholar. Review Methods (a) Constructs identified in an IR (Blackstock et al., 2018) guided a literature review on predictive variables linked to new graduate nurse's co-worker incivility experiences; (b) an ecological approach was explored; and (c) we demonstrate how multidimensional organizational factors related to incivility experiences of new graduate nurses can be situated in an ecological model. Results Structural and organizational factors, and nurse leaders influencing new graduate nurses' experiences are situated in an ecological model. Placing new graduate nurses' co-worker incivility experiences in the microsystem and close to the mesosystem (nurse supervisor) and exosystem (workplace empowerment) of our ecological model provides new insights into their incivility experiences and informs future research. Conclusion The ecological approach and operational definition of incivility help to clarify incivility behaviours as not merely individual behaviours observed by others needing corrective cognitive behaviours, nor support in a graduate transition program, but rather a symptom of work environment factors contributing to multidimensional work environments of new graduate nurses' and influence incivility behaviours. Impact New graduate nurse co-worker incivility research could measure change across time and across system domains informed by this ecological approach and can shape new ways of thinking about how to prevent and mitigate incivility.

Abstract Objective Gamification is an increasingly popular instructional strategy in nursing. The purpose of this integrative review is to explore gamification as it has been applied in nursing literature. This integrative review seeks to ask the question – What aspects of gamification have been explored in nursing literature and what aspects require further exploration? Method Whittemore, R., & Knafl, K. (2005). The integrative review: Updated methodology. Methodological Issues in Nursing Research, 52(5), 546–553 integrative review framework guided this review. Seventeen articles were reviewed and a quality appraisal tool (developed by Hawker, S., Payne, S., Kerr, C., Hardey, M., & Powell, J. (2002). Appraising the evidence: Reviewing disparate data systematically. Qualitative Health Research, 12(9), 1284–1299) was also used to evaluate the articles. Results Following the data analysis stage outlined in Whittemore and Knafl’s integrative review framework, six themes emerged: construct conceptualization; relationship between engagement, satisfaction, and knowledge retention; knowledge translation, motivation, role of technology, and gamification elements. Conclusion Gamification is of interest to the nursing profession. More study is needed to better ascertain the relationship between gamification and several of the main themes identified in this review.

Background and objectives: First year students experience a significant transition when entering nursing school. The purpose of this research was to explore first year nursing students’ experiences to enhance and innovate the undergraduate nursing program at a large public Canadian university. Methods: The Faculty of Nursing approached their curriculum redesign process utilizing a Developmental Evaluation (DE) framework. Nineteen first year students participated in semi structured interviews and focus groups where they discussed their personal experiences as well as the perceived strengths and weaknesses of the program. After thematic analysis of the data, recommendations were provided to the faculty administration to guide changes made to the new curriculum. Results: Students appreciated opportunities where they could apply their knowledge to real-world situations. Students also expressed many sources of stress, such as inconsistency within and between courses, differing expectations, content, instruction style, and evaluation. They also voiced that there was a lack of communication and support from the Faculty and identified issues with grading systems. Conclusions: The findings from this study highlighted the need to revise the nursing curriculum to provide more student support and foster a positive student-faculty relationship. The current structure of nursing programs has created competition among students, causing a greater focus on obtaining higher grades than on meaningful learning. Integrated learning with authentic experiences was best received by first year students and provided for a collaborative environment. Finally, the findings from this study highlight the opportunities created by utilizing a DE approach to evaluate and innovate nursing curricula.

In the early twentieth century, surveys were an innovative and neoteric methodology. Collected in-person or by mail, researchers could ascertain the thoughts and opinions of a small sample, which could then be applied to the general population. Almost one hundred years later, the use of surveys has become pervasive in society due to digital technological advancement. However, while the digital evolution has not only altered the possibilities of how, when, and where surveys may be administered, the threats to this methodology has also evolved. While issues related to previously known errors (i.e. sampling error, non-response error, etc.) remain and have also evolved, new threats regarding confidentiality and privacy, design issues, and others, have emerged in response to this digital advancement. Novice and experienced researchers alike should be cognizant of the impact digital technologies have had on survey data collection to ensure high quality research findings. This paper explores the threats to survey methodology due to digital technological changes and discusses how novice researchers and students can mitigate these challenges.

The COVID-19 outbreak in Winter (2020) has caused widespread disruption for health sciences students un-dergoing clinical placements-vital periods of experiential learning that cannot be substituted with distance alternatives. For students placed in rural areas, already coping with isolation, precarious supply chains and shortages of essential personnel, the effects of the COVID-19 outbreak may have far-reaching implications for psychosocial wellness, self-efficacy and clinical judgment. Four nursing and eight medical students (n = 12) supplied photographs and commentary documenting the experience of withdrawing suddenly from clinical sites in rural Alberta. Collaborative, thematic analysis revealed continuities between preand post-outbreak life, both for the students and their rural hosts. Social determinants of health such as seclusion, environmental hazards, and health-seeking behaviors carried over and compounded the effects of the outbreak on the placement communities and clinical sites. Other continuities included the reliance on technology for clinical and social connectivity, and capitalizing on natural settings to cope with isolation and confinement. Prolonged liminality, lack of closure, and the loss of team identity were the greatest stressors brought on by the suspension of clinical activities. However, the participants felt well equipped to deal with these circumstances through the resilience, adaptability, and community ethos acquired during their placements.

AIM:Health care administrators provided information through semi-structured interviews as to how one faculty of nursing (FoN) was preparing students for practice.BACKGROUND:There is a long-standing disconnect between the nursing education and the clinical arena known as the theory-practice gap. The FoN wanted to redevelop their curriculum to better prepare students for practice and bridge the gap.METHOD:Using developmental evaluation, 36 administrators were interviewed and asked about their expectations of newly graduated nurses, the FoN curriculum, and changes to be made.RESULTS:Four themes were identified: entry to programme; curricular content, delivery and structure; clinical recommendations; and stronger relationships.CONCLUSION:Strong academic-practice partnerships are still needed. The current lack of communication and partnership has compromised students' quality of education and their transition into the workforce.IMPLICATIONS FOR NURSING MANAGEMENT:Leaders in both the education and practice settings can better prepare newly graduated nurses and bridge the theory-practice gap by co-creating a joint committee and creating more touchpoints with one another. A joint committee can develop appropriate entry-to-programme guidelines, discuss relevant trends in practice and shape the curriculum. Clinical experiences for students may also act as extra touchpoints whereby the two groups can discuss clinical mentorship needs and build stronger academic-practice relationships.

BACKGROUND:An authentic learning environment fosters socialization of nursing students to a particular community context and unique culture of the individuals who reside in that culture. The final preceptorship provides an extended clinical practice experience allowing for this immersion, while providing consolidation of learning as preparation to enter practice.METHOD:PhotoVoice was used as an innovative data collection method to engage participants throughout the research process. Participants self-selected photographic images that represented the unique rural preceptorship experience through their eyes.RESULTS:Rurality was described by participants as more than a geographic location, but as a sense of place, or a way of being and doing, that represented rural life. Rurality was depicted more specifically by participants in terms of community spirit and cultural contexts.CONCLUSION:Rural practice placements have the potential to enrich undergraduate nursing education and to expose undergraduate nursing students to the role of the rural nurse. More research is needed about rural health to understand the cultural and contextual factors that uniquely affect the health status of rural Canadians. [J Nurs Educ. 2019;58(3):144-151.].

Introduction: Travel safety culture is a vital aspect of nursing in rural western Canada, where long distances and severe weather are commonplace. However, this culture is poorly understood owing to the absence of official policy, and the tendency of rural nurses to take travel risks and burdens in stride, rather than advocating for change. Travel risks and burdens include extreme weather events such as tornadoes and blizzards; unmarked routes and hazards; distance, time and expense; and driver fatigue. In such rural settings, the safety and health of visitors, novices and students are of particular concern. The researchers sought to elicit the tacit knowledge of rural registered nurses, and their students undertaking rural nursing preceptorships, pertaining to rural travel issues and best practices for safety and wellbeing. Methods: Through purposive and snowball sampling, the researchers recruited seven senior nursing students and five nurse preceptors. Seven rural acute and community care sites, between 42 km and 416 km distant from the students' primary place of study, were covered by the study. Photovoice, a participant action modality, was employed to collect photographic and qualitative interview data from participants over 10 weeks, between February and April 2016. The data were analyzed thematically, in collaboration with participants, who in turn validated the results. A digital storytelling initiative was attempted, to further involve participants in dissemination of findings, but only one participant took part in this phase of the project. Results: The central finding of the study was that nursing students learn to accept and manage limitations - and to recognize and capitalize on opportunities - when undertaking rural preceptorships. With regard to road safety, the students were found to be particularly vulnerable to long distances, hazardous conditions, fuel and cellular data expenses, and fatigue. These issues were compounded by the students' reluctance to speak up, or to miss shifts, when they felt unsafe or unwell. Their preceptors role modeled autonomy and community ethos as the foundations of a frontline, extemporaneous road safety culture. This entailed personal safety measures borne from rural experience and background, familiarity with the countryside, and community connectedness with other healthcare sites in place of any official public alert system. The preceptors furthermore benefited from strong union protection for occupational health and safety concerns, but students being taught in rural settings had no such advantage. Conclusions: Nursing students should have the same occupational health and safety protections as their rural preceptors, especially the right to refuse travel, without penalty, in unsafe circumstances. Better travel subsidies and road safety measures during rural preceptorship may help increase the likelihood of students considering a rural career path. Furthermore, the frontline, community-based road safety experience of rural nurses is an untapped source of information for educators and policymakers. Such information will become more and more vital as a diminishing number of rural nurses are called upon to care for an aging client base.

Background The purpose of this study was to explore the basic psychosocial process of undergraduate nursing student moral development in clinical preceptorship. Method A grounded theory approach was used to explore the process within the context of clinical practice and the student–preceptor–faculty member relationship. Results Socializing for authentic caring engagement in nursing practice emerged from the data as the basic psychosocial process of nursing student moral development in preceptorship. This process included four key categories: (a) distinguishing nursing and moral identity in practice, (b) learning to recognize the patient’s experience, (c) identifying moral issues in practice and creating meaning of practice encounters, and (d) becoming an advocate and reconciling moral issues in practice. Conclusion Findings emerging from this study illustrate the processes of how nursing students work through moral issues and the role of faculty and preceptors in engaging students with moral encounters in the context of preceptorship.

Background: Rural health care sites struggle to attract new nurses, owing to a widespread perception that the hardships of rural practice far outweigh the benefits. Preceptorships are a key means of recruiting nursing staff to rural locations, but innovative, firsthand messaging is needed to promote rural preceptorships and nursing careers. Objectives: The researchers sought to elicit compelling, multimedia, firsthand accounts of the challenges and opportunities of rural preceptorship through participant action. Additional goals were to explore the ways in which participants reify their experiences through digital media, and the potential for digitally-based participant action research to empower participants. Methods: The study was designed to engage participants in all phases of research: data collection, analysis, and dissemination of findings. It comprised three phases, each employing participant action methodology: photovoice data collection, collaborative thematic analysis, and authorship of digital stories. Participants: Through purposive and snowball sampling, the researchers recruited seven nursing students and five rural, registered nurses assigned to precept them. Inclusion criteria for the students were enrolment in the senior (final) preceptorship course prior to graduation, and the choice of a rural, semirural or suburban site. No exclusion criteria were warranted owing to the limited cohort of participants. Settings: Data were collected at six acute care sites and one community care site. The sites were rural, semi-rural and suburban, serving populations ranging from 800 to 18,000, between 42 km and 416 km distant from the students' primary place of study. Results: It was found that rural preceptorships teach students to accept and manage limitations, while appreciating and capitalizing on opportunities; this finding was equally true for nominally suburban and semi-rural sites included in the study. Emerging from the interviews, challenges, being more concrete, were reflected in photographic data, while opportunities were more abstract and relational. Citing time constraints, most participants declined to author their own digital stories. Conclusions: Digitally-based participant action enables nurse preceptors and their students to make a compelling case for rural preceptorships and rural careers. However, digital media may also distort these participants' experiences, and their involvement in all phases of research may be more burdensome than empowering.

•Build authentic relationships inside and outside of the classroom to be more supportive.•Model attributes of caring rather than just saying that we care.•Practice mutual respect, in words and in actions to reduce uncivil behaviours.•Consider that diversity does not refer only to culture.

Post-secondary institutions, especially those with a research focus, face a challenge in ensuring consistent and high-quality teaching, in part because many members of the teaching faculty have backgrounds in research instead of teaching. A common part of meeting this challenge is the presence of Centres for Teaching and Learning (CTLs) on university campuses. This study examines the situations of CTL directors at research and teaching-intensive post-secondary institutions across Canada, with an aim to develop an understanding of the current context in which Canadian CTLs are operating, as well as the experiences of those who lead the CTLs. The qualitative study consisted primarily of 60- to 90-minute individual semi-structured interviews. The findings of these interviews were coded into four main categories: the evolving purpose of CTLs, key drivers of change, common challenges, and future trends. The implications for this research are two shifts: one mirroring a shift in education development to embracing Boyer’s work and secondly moving from a service to a leadership orientation. A thriving CTL is an indication of a university culture that values teaching, learning and scholarship. Les établissements d’enseignement post-secondaire, en particulier ceux dans lesquels l’accent est mis sur la recherche, doivent faire face au défi d’assurer un enseignement cohérent et de haute qualité, en partie du fait qu’un grand nombre de professeurs ont des antécédents en recherche plutôt qu’en enseignement. Pour relever ce défi, un des éléments communs est la présence de centres d’enseignement et d’apprentissage (CEA) sur les campus universitaires. Cette étude examine la situation des directeurs de ces centres dans des établissements d’enseignement post-secondaire canadiens où la recherche et l’enseignement sont intenses, dans le but de comprendre le contexte actuel dans lequel les CEA canadiens fonctionnent, ainsi que les expériences de ceux qui dirigent ces CEA. L’étude qualitative a consisté principalement d’entrevues individuelles semi-structurées de 60 à 90 minutes. Les résultats de ces entrevues ont été codés selon quatre catégories principales : l’évolution de l’objectif des CEA, les principaux moteurs de changement, les défis communs et les tendances futures. Les implications de cette recherche sont de deux sortes : la première reflète les variations dans le développement de l’éducation afin d’adopter le travail de Boyer, et la seconde indique le passage d’une orientation de service à une orientation de leadership. Un CEA florissant est le signe d’une culture universitaire qui accorde de l’importance à l’enseignement, à l’apprentissage et à l’avancement des connaissances.

Despite the ubiquity of interprofessional education (IPE) in the health sciences, cultural barriers to collaboration and socialization across disciplines are pervasive and persistent. The Interprofessional Rural Preceptorship Pilot (IPRPP) was implemented over 18 months between 2014 and 2015, to deliver mutual, practice-based, collaborative experiences to students of nursing and medicine, and to capitalize on the multidisciplinary team ethos of rural settings in socializing these students into an interprofessional culture. Students; precepting nurses and physicians; unit managers; and faculty supplied qualitative research data through semistructured interviews and focus groups, to help determine the effectiveness of the IPRPP in achieving its ends. Thematic analysis of transcripts, field notes and memos revealed that the pilot: 1) induced all participants to reflect on cultural barriers to IPE, particularly in light of the more experienced, male physicians’ apparent reluctance to buy into the pilot or the research study; 2) sensitized medical students to the scope of practice, roles and knowledge base of registered nurses and nursing students, whom they came to value as collaborators and teachers; and 3) inspired nursing students to take the lead in arranging interprofessional experiences, and to assert their viewpoints as equals within the multidisciplinary team. It was found that liminal (transitional) spaces and the frontline relaxation of traditional hierarchies—both widely acknowledged features of rural health care settings—contributed to these outcomes. The findings show that clinical settings have a significant impact on the interprofessional socialization of nursing and medical students, with implications for the design of future IPE initiatives.

Introduction: Canadians living in rural and remote areas experience lower health outcomes and life expectancy than their urban counterparts. Registered nurses employed in rural and remote areas are often the sole health care provider and are crucial to the delivery of high quality health care. Adequate preparation of future nurses who will work in rural and remote communities is thus essential to ensure access to safe, competent nursing care. Nursing preceptorship is the vehicle through which nursing students become immersed in a particular setting over an extended period of time. The purpose of this literature review is to determine the state of knowledge regarding rural nursing preceptorship. Methods: An integrative review of the literature was conducted using the SPIDER Tool for analysis of qualitative evidence. From a limited pool of relevant articles, over 40 were retrieved published between 2004 and 2015. Of these, 19 articles met the inclusion criteria and were included in the review and analysis. Each article was evaluated for adherence to the criteria of ethics and rigor using the Research Appraisal Checklist (RAC) tool of appraisal. Results: Of the 19 articles reviewed, various definitions of rural practice were provided. Standard definitions of rurality and rural practice is currently lacking. Four main themes emerged from the review of the literature around the nature of the rural experience interprofessional collaboration, recruitment and retention of nurses to rural communities and student performance evaluation and feedback. Conclusions: Preparation of future nurses who are competent and confident to practice in rural settings is crucial. Support and preparation required by faculty advisors and preceptors to ensure successful preceptorship experiences is not clearly understood. Recruitment and retention strategies aimed at the shortage of the nursing workforce in rural settings should highlight the unique nature of rural practice. Future research should focus on the challenges experienced by nursing students that may prevent them from seeking employment in rural communities. Keywords: rural nursing, preceptorship, rural preceptorship, rurality DOI: http://dx.doi.org/10.14574/ojrnhc.v17i1.430

Faculty learning communities (FLCs), whether they are topic or cohort-based, are a form of professional development that promote scholarship and collegiality among faculty members. This article describes how a number of FLCs were initiated in a Faculty of Nursing (FoN). Members who participated described the FLCs as scholarly, creative and morale enhancing. One of the most significant impacts in the topic-based FLCs was having members create a scholarly product such as articles, letters, theatrical performances, books, faculty modules, briefs and paintings. For the cohort-based FLC the product was preparing pre tenure faculty for tenure. It is recommended FLCs be voluntary, include meals, ask members to commit to attending each session and have expert facilitation. This article describes several examples of FLC's and best practices around development and facilitation for effective FLC's.