Clinical placements expose nursing students to patient safety incidents and provide important opportunities for learning about safe care. This study explored how nursing students in four countries recognized and interpreted patient safety incidents encountered or witnessed during clinical practice, including perceived contributing factors. A secondary qualitative content analysis was conducted using narrative data from 1442 undergraduate nursing students in the Czech Republic, Italy, Slovakia, and Türkiye. In total, 287 incident descriptions and 263 explanations of perceived reasons were analyzed using an inductive-deductive approach supported by descriptive frequency counts. Medication safety incidents and patient falls were most frequently reported, alongside infection prevention breaches, missed or inadequate care, communication failures, adverse outcomes, and environmental hazards. Students described incidents as multifactorial, involving patient and contextual factors, organizational and system conditions, and human and professional factors. Cross-country differences reflected patterns within the analyzed narratives rather than differences in incident prevalence or quality of care. The findings support practice-integrated patient safety education, effective supervision, structured reflection and debriefing, clear reporting pathways, and psychologically and emotionally safe, nonpunitive learning environments.
Nursing in critical careKeiko Mori, Miina Yamazaki, Yoshiyuki Haruna
BACKGROUND: Disasters increasingly challenge healthcare systems, highlighting the need to strengthen preparedness among future healthcare professionals. Although disaster risk awareness is important, it does not consistently translate into preparedness behaviours, reflecting the awareness-action gap. Immersive virtual reality (VR) may enhance experiential disaster learning, but how it influences preparedness processes remains insufficiently understood, particularly in healthcare and critical care education. AIMS: To explore how immersive VR-based disaster simulations influence disaster risk perception and preparedness among nursing students, with particular attention to the awareness-action gap and implications for future healthcare and critical care practice. STUDY DESIGN: A qualitative descriptive study using immersive VR-based disaster simulations followed by semi-structured interviews. Twelve undergraduate and graduate nursing students in Japan experienced immersive VR simulations depicting floods and landslides. Individual semi-structured interviews explored emotional responses, disaster risk perception, preparedness awareness and anticipated behavioural responses. Data were analysed using Krippendorff's content analysis with researcher triangulation. RESULTS: Five categories were identified: (1) heightened vulnerability and psychological burden through immersion; (2) persistence of the awareness-action gap despite increased risk perception; (3) enhanced risk recognition and preparedness intentions; (4) recognition of the need for social and structural support systems; and (5) emerging responsibility accompanied by perceived limitations. VR transformed abstract disaster risk into emotionally salient experiences, strengthening threat appraisal and preparedness awareness; however, awareness did not consistently translate into preparedness behaviours, reflecting insufficient coping appraisal and self-efficacy. CONCLUSIONS: Immersive VR may strengthen disaster risk perception and preparedness awareness, but immersive experiences alone may be insufficient to bridge the awareness-action gap. Combining VR with reflective learning, skills-based training and collaborative simulation may strengthen coping appraisal and preparedness action. RELEVANCE TO CLINICAL PRACTICE: Immersive VR combined with reflective and skills-based learning may support psychological readiness, situational awareness and disaster preparedness competencies among future nurses, including those preparing for critical care practice.
International journal of nursing education scholarshipTeresa Martins, Ana Paula Cantante, Pedro Melo, Sílvia Silva, Marta Valadar, Paula Santos, Carlos Pinto, Marta Sá, Diana Rodrigues, Elisabete Borges
OBJECTIVES: To develop and examine the content validity of a competency assessment tool for clinical teaching in community nursing, essential for high-quality nursing education, while addressing the lack of clarity and consistency in existing methods. METHODS: A qualitative, iterative methodological development and validation study was conducted with 10 clinical teachers. The process included: (1) identification of competency domains and competencies based on national nursing regulations and Vygotsky's sociocultural perspective (71 criteria); (2) refinement of the competency assessment criteria via focus groups (20 criteria); (3) development of a 5-point Likert scale with behavioural descriptors; and (4) creation of methodological guidelines for evaluators. RESULTS: The tool comprises 6 competency domains and 20 criteria, described across five performance levels (poor to excellent), considering performance quality, autonomy, and application in complex contexts. CONCLUSIONS: The instrument enhances fairness, consistency, and feedback, clarifies expectations, promotes student self-regulation, and provides a transparent tool for formative and summative assessment, with potential for adaptation in diverse community nursing settings involving individuals, families, groups, communities, and populations. Implications for an International Audience: Although developed within a Portuguese educational context, the tool addresses competencies relevant to community nursing education internationally. Its structured competency domains and behavioural descriptors provide a framework that can be adapted to different educational and clinical contexts to support transparent, consistent, and development-oriented assessment of nursing students.
BACKGROUND: The undergraduate stage is critical for developing nursing students' disaster nursing competencies; however, traditional lecture-based teaching often fails to promote active learning, and innovative instructional models remain underused in this field. The BOPPPS (Bridge-in, Objective, Preassessment, Participatory Learning, Postassessment, and Summary) model is a student-centered, closed-loop instructional framework that emphasizes active participatory learning and real-time feedback. OBJECTIVE: This study aimed to evaluate the effects of a BOPPPS-based blended teaching model on disaster nursing competencies and academic outcomes among undergraduate nursing students. METHODS: This study used a quasi-experimental design with 77 undergraduate nursing students allocated to 3 groups: an experimental group receiving BOPPPS-based blended teaching (n=27), a control group with traditional lecture-based teaching (n=25), and a comparison group without systematic instruction (n=25). Questionnaires were used to assess students' self-perceived disaster nursing knowledge, professional operational skills, and overall comprehensive competencies. The final examination assessed students' mastery of theoretical knowledge and applied reasoning. RESULTS: All 3 groups showed significant within-group improvements in disaster competence (all P<.001, n=77). Intergroup comparisons revealed significant differences (H=8.843, P=.01, η²=0.093); post hoc analysis showed that the experimental group (mean rank=48.79) scored significantly higher than the comparison group (mean rank=29.76, Padj=.009), but not significantly higher than the control group (mean rank=38.32, Padj=.34). The experimental group had a significantly higher overall course score than the control group (86.93, SD 5.08 vs 81.60, SD 6.90; t50=-3.186, P=.002). CONCLUSIONS: The implementation of a disaster nursing curriculum positively impacts students' disaster nursing competency. Since the BOPPPS-based blended teaching model promotes active student engagement and improves teaching quality, we recommend its integration into disaster nursing education.
JMIR nursingMariana Luisa Firmiano, Ana Paula Assunção Moreira, Flaviana Vely Mendonça Vieira, Carla Sa-Couto, Alexandrina Cardoso
BACKGROUND: Technologies such as virtual reality (VR) and augmented reality (AR) have been increasingly incorporated into nursing education to support the development of cognitive, psychomotor, and behavioral competencies. In midwifery, immersive environments offer opportunities to simulate high-risk or low-frequency clinical scenarios, strengthening students' confidence and preparedness for professional practice. However, there is still significant variability in how VR and AR are pedagogically implemented, with limited understanding of their theoretical grounding, instructional design, and educational outcomes. OBJECTIVE: This systematic review aimed to synthesize and critically evaluate the characteristics of educational programs using VR and AR to develop competencies among nursing and midwifery students and professionals. METHODS: This review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 and Synthesis Without Meta-Analysis (SWiM) guidelines and was registered in PROSPERO (International Prospective Register of Systematic Reviews). A comprehensive search was conducted in August 2024 across PubMed, Web of Science, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Eligible studies were experimental, quasi-experimental, or observational, and involved undergraduate or postgraduate students in nursing, obstetric nursing, or midwifery, as well as certified midwives or nurse-midwives. Two independent reviewers conducted screening, data extraction, and quality appraisal using Joanna Briggs Institute (JBI) tools and the Medical Education Research Study Quality Instrument (MERSQI) scale. Data were synthesized narratively according to predefined thematic categories. RESULTS: Four studies published between 2021 and 2024 met the inclusion criteria, encompassing 634 participants (360 midwifery students and 274 midwives or nurse-midwives). Two randomized controlled trials and 2 quasi-experimental studies were included. Interventions used VR in 3 studies and AR in one, simulating scenarios such as normal and complicated childbirth, neonatal resuscitation, and emergency obstetric procedures. Most interventions focused on developing technical competencies, while one also addressed teamwork and communication. Only 2 studies explicitly reported theoretical or pedagogical frameworks, and 2 mentioned alignment with the INACSL Healthcare Simulation Standards of Best Practice. Structured briefing or debriefing was rarely described. All studies assessed learning outcomes (Kirkpatrick level 2), and 3 included participants' satisfaction (level 1). Methodological quality, measured by MERSQI, ranged from 10.0 to 14.5, with a mean score of 12.9 (SD 2.0), indicating moderate to high quality. CONCLUSIONS: Evidence suggests that VR and AR can enhance learning in obstetric nursing and midwifery education by providing safe, experiential, and interactive learning environments. However, the limited use of theoretical frameworks and structured instructional design highlights the need for more pedagogically grounded interventions. Future research should prioritize the integration of learning theories, validated assessment tools, and best-practice simulation standards to strengthen the educational impact and curricular integration of immersive technologies in nursing and midwifery education.
Nursing openÅsa Tjulin, Julia Cederlund, Åsa Chaikiat Ståhl, Emma Brulin, Bodil J Landstad, Maritha Jacobsson, Maria Härgestam, Ann Rudman
AIM: To explore how nursing students perceive and construct the notion of workplace attractiveness in healthcare during clinical placements. DESIGN: Qualitative explorative research design. METHOD: Thirteen final-year undergraduate nursing students from four Swedish universities participated in seven semi-structured interview sessions between February and May 2025: three individual interviews and four small-group interviews involving two to three participants. An interview guide, organised around main themes, directed the conversations. Interviews were digitally recorded and transcribed verbatim. Data analysis was performed using reflexive inductive thematic analysis, characterised by an iterative, flexible, and interpretive approach rooted in a constructionist epistemology. RESULTS: Clinical placements shaped nursing students' perceptions of workplace attractiveness, forming the basis for future career choices. The overarching theme, Looking Ahead, captured how students evaluated healthcare as a potential workplace while envisioning their professional future. Four interrelated themes emerged: Becoming-gaining confidence and identity as a nurse through hands-on experience; Belonging-the importance of relationships and social climate for inclusion; Balancing-concerns about managing work-life integration and sustainable conditions; and Beyond-seeking opportunities for continued growth and development. Together, these themes illustrate workplace attractiveness as relational and temporal, emerging from immediate experiences and long-term aspirations. CONCLUSIONS: Workplace attractiveness is a dynamic, relational process shaped by interactions between individuals and organisations, not a fixed attribute. It evolves through everyday practices, social identity, and belonging. Effective strategies must address relational and symbolic dimensions, fostering inclusion, identity formation, and meaningful participation alongside structural improvements. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Understanding workplace attractiveness as a dynamic process highlights the need for healthcare organisations to prioritise supportive onboarding, inclusive social climates, and opportunities for professional growth. Strengthening belonging, identity formation, and sustainable working conditions can enhance nurse retention, reduce turnover, and ultimately improve continuity and quality of patient care. NO PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement in its design, conduct, reporting, or dissemination since it focused on nursing students' perceptions during clinical training rather than on patient experiences. IMPACT: Problem addressed: Limited understanding of how nursing students construct perceptions of workplace attractiveness during clinical placements and how these perceptions influence future career choices. MAIN FINDINGS: Workplace attractiveness emerged as a dynamic, relational process shaped by five themes: Looking Ahead, Becoming, Belonging, Balancing, and Beyond. Clinical placements were pivotal in forming these perceptions. IMPACT: The findings inform healthcare organisations, educators, and policymakers to strengthen onboarding processes, foster a sense of belonging, and promote sustainable working conditions. This can improve nurse recruitment, retention, and ultimately the quality and continuity of patient care. Highlights the of clinical placements in shaping nursing students' perceptions of workplace attractiveness, which can inform global strategies for improving nurse recruitment and retention. Introduces a relational and dynamic understanding of workplace attractiveness, emphasising identity formation, belonging, and professional growth-key factors for creating supportive and sustainable healthcare environments worldwide. Provides actionable insights for healthcare organisations and educators, encouraging inclusive onboarding, social integration, and career development opportunities to enhance workforce stability and patient care quality globally.
The journal of nursing research : JNRWen-Ling Chen, Siriluk Winitchayothin, Chun-Hung Cheng, Santo Imanuel Tonapa, Fan-Hao Chou, Peta-Anne Zimmerman
BACKGROUND: Nursing education requires innovative approaches to develop core competencies in knowledge, skills, and attitudes. Gamified learning interventions offer promising alternatives to traditional teaching methods for enhancing outcomes in undergraduate nursing education. PURPOSE: This systematic review and meta-analysis was conducted to evaluate the effectiveness of gamified learning interventions on knowledge acquisition, skill performance, and attitude enhancement among undergraduate nursing students and to investigate the differences in effects achieved across different gamification categories. METHODS: Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, a comprehensive search was conducted across six databases (A+ Education, CINAHL, Embase, ERIC, PubMed, and Web of Science) on March 18, 2025. This search targeted randomized controlled trials designed to compare gamified learning with traditional teaching methods in undergraduate nursing education. Study quality was assessed using the Cochrane Risk of Bias 2.0 tool, and evidence certainty was evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) methodology. RESULTS: The findings of randomized controlled trials involving a total of 1,698 participants demonstrated significantly positive effects favoring gamified learning across all key domains, including knowledge acquisition (standardized mean difference [SMD]=0.81, 95% CI [0.55, 1.07]), skill performance (SMD=1.64, 95% CI [0.96, 2.32]), and attitude enhancement (SMD=0.54, 95% CI [0.07, 1.00]). The subgroup analysis revealed differential effectiveness across gamification categories, with serious games demonstrating large and consistent effects on knowledge acquisition (SMD=0.84, 95% CI [0.43, 1.25], I2=61%), while gamified web and mobile learning interventions showed moderate effects with greater variability (SMD=0.55, 95% CI [0.23, 0.87], I2=70%). Skill performance exhibited the largest overall effect sizes, although substantial heterogeneity was observed across all outcome domains (I2=82-95%). The results of the GRADE assessment support moderate-certainty evidence for all learning outcomes. CONCLUSIONS: The results of this systematic review and meta-analysis provide robust evidence that gamified learning interventions significantly enhance undergraduate nursing education across the knowledge, skills, and attitudes domains. Serious games demonstrated superior consistency for knowledge acquisition, while the strongest overall effects were identified for skill performance. The substantial heterogeneity observed underscores the critical importance of selecting appropriate gamification approaches based on specific educational objectives, institutional technological capabilities, and implementation contexts. These findings support the strategic integration of evidence-based gamified learning into nursing curricula as an effective supplement to traditional teaching methods. Future research should focus on assessing long-term competency retention and developing standardized implementation frameworks to guide the widespread adoption of effective gamified learning approaches in nursing education.
Nursing philosophy : an international journal for healthcare professionalsMaria Efstathiou, Mary Gouva, Elena Dragioti
Active learning and professional citizenship are widely discussed in nursing education, yet the conditions under which they converge have not been theoretically specified. In this paper, we advance a structural account of that relation, drawing on deliberative theory, philosophy of education, and nursing scholarship. The relation we describe is one of shared enabling conditions rather than causal production: active learning and professional citizenship converge not because one produces the other, but because each depends on arrangements that require public justification through reasons, engagement with competing claims, and answerability for the consequences of action. We trace a conceptual movement from professional accountability to professional citizenship, and from participatory learning to deliberative practice, specifying a set of conditions that can be instantiated in nursing education but have rarely been theorised as the basis of this relation. In doing so, we give theoretical form to a relation more often enacted than articulated.
Journal of continuing education in nursingNingning Guo, Kathleen Bradley, Hannah Nicklas, Lia Pinell, Grissel Hernandez
The use of technology enhances learning modalities. A multimodal technology platform transformed the user experience by providing a blended learning environment with flexible access to didactic content, use of reflective tools, and project support for immediate application of learning. Facilitator benefits included dashboards, resource repositories, artificial intelligence integration, and logistical infrastructure efficiencies.
AIM: To explore the perspectives of nursing students, clinical nurses, and nurse educators on electrocardiography (ECG) education and identify strategies to bridge the theory-practice divide and prepare nurses for future-oriented learning environments. DESIGN: A qualitative descriptive study employing the consensual qualitative research (CQR) method. METHODS: Group interviews were conducted with 27 participants divided into student, nurse, and nursing educator groups. Data were analysed using the CQR method. RESULTS: Four major themes and corresponding subthemes were identified: (1) clinical significance of ECG and expanding nursing roles, (2) educational barriers and disconnects between theory and practice, (3) motivation and growth through experiential learning, and (4) strategies for educational innovation, including integrated curricula, simulation-based learning, and digital approaches such as AI-assisted learning and gamification perceived as effective for sustaining engagement, repeated practice, and ongoing development of ECG competency. CONCLUSION: Bridging the gap in ECG education requires context-integrated training with organisational support. Enhancing educator expertise and promoting learner engagement are critical for ensuring the successful clinical application of ECG interpretation skills. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Inadequate ECG education may delay patient assessments, increase nurse stress, and create communication breakdowns in clinical teams. These findings highlight the need for nursing curricula and continuing professional education to incorporate structured, simulation-enhanced, and AI-supported training that supports repeated practice and progressive ECG competency development. Such educational strategies can improve clinical decision-making, strengthen interdisciplinary teamwork, and ultimately enhance patient safety, particularly in high-acuity or resource-constrained healthcare settings.
Impostor phenomenon (IP) is widely recognised among doctoral candidates but remains insufficiently understood, particularly within nursing academia. It is commonly framed as an individual deficit, overlooking the broader social and linguistically mediated experience that shapes scholarly identity. This discursive exploration draws on Fairclough's Critical Discourse Analysis (CDA) to examine micro, meso and macro social orders across diverse textual sources and reflexive accounts, exploring how language and institutional norms position nursing doctoral candidates as impostors. Findings reveal tensions between professional, social and ideological expectations and the formation of a doctoral nurse identity, where dominant discourses individualise systemic constraints, reproduce hierarchies and marginalise nursing expertise through gendered, caring and knowledge-ownership narratives. Doctoral preparation can disrupt these dynamics by fostering visibility, authority and knowledge production, yet limited support and persistent hierarchies intensify impostor subjectivities. Shifting from deficit framings to critical discourse perspectives enables supervisors, institutions and candidates to cultivate relational, reflective and inclusive practices that mitigate impostor experiences and strengthen nurse-academic identity. Doctoral education thus becomes a vehicle for structural transformation, advancing nursing's research leadership, policy influence and patient care outcomes.
Nursing philosophy : an international journal for healthcare professionalsSeyyedehmahdiyeh Khastar, Jess Dillard-Wright
Nursing education has long operated within humanistic and anthropocentric epistemological frameworks that centre the autonomous rational human subject as both the object and agent of care. While these foundations have shaped core professional values, they increasingly fail to account for the relational, sociomaterial, and more-than-human conditions that characterise contemporary nursing practice. This paper draws on critical posthumanism, particularly as theorised by Rosi Braidotti, to examine what a posthumanist reorientation of nursing education might look like and what it might demand. The paper proceeds in three moves. First, it traces the philosophical lineage of secular liberal humanism in nursing, showing how its normative image of 'the human' has historically marginalised feminine, racialized, non-Western, and non-human forms of agency contradicting nursing's own commitments to social justice and equity. Second, it uses Braidotti's key concepts subjectivity-as-process, monism, and autopoiesis to reconceptualize nursing's four metaparadigmatic concepts: person, environment, health, and nursing itself. Within this framework, the person is understood as embodied, embedded, and relationally constituted rather than self-contained; the environment becomes an agential ecology rather than passive context; health emerges as a relational outcome shaped by biological, technological, and sociomaterial forces; and nursing is reframed as care work distributed across more-than-human assemblages that include technologies, institutions, infrastructures, and microbial ecologies. Third, the paper translates these reconceptualizations into concrete implications for curriculum design, pedagogical practice, assessment, policy, and research arguing that posthumanist nursing education must move beyond competency-based, patient-centred models that under-theorise the entangled realities nurses navigate daily. This paper contributes to an emerging body of scholarship applying posthuman frameworks to professional nursing education. It argues that a critical posthumanist curriculum is not a rejection of nursing's ethical foundations, but their necessary expansion one capable of preparing nurses for the ecological, technological, and sociopolitical transformations that define 21st-century care.
Japan journal of nursing science : JJNSCongcong Wang, Akiko Kondo, Kazuko Naruse, Kosuke Niitsu, Dingyi Long
AIM: To examine and compare global nursing education content, institutional support, and workload-related factors among nurse educators in Japan and China. "Global nursing education" refers to educational interventions that enable nursing students to develop the knowledge, skills, practical experience, and cultural competence needed to provide high-quality care across diverse cultural, social, and healthcare contexts. METHODS: A cross-sectional international comparative study was conducted using an online survey between October and December 2023. Nurse educators from 587 universities in Japan and China were invited to participate. Data from 445 educators with experience in global nursing education were analyzed. Hierarchical linear regression analyses were performed to examine factors associated with workload in each country. RESULTS: Educators in Japan delivered a broader range of global nursing education content, whereas Chinese universities provided greater institutional support for educators. Educators in Japan reported higher workloads; however, these differences were largely explained by non-native language use and proficiency, intercultural sensitivity, and institutional support. In Japan, higher intercultural sensitivity, broader global nursing content coverage, and greater perceived institutional support were associated with lower workload, with notable regional variations. In China, more frequent use of non-native languages and employment in western regions were associated with lower workload. CONCLUSION: Determinants of workload in global nursing education differed across national contexts. Institutional support, intercultural sensitivity, and non-native language-related factors were associated with workload, although the specific patterns varied by country. These findings highlight the importance of considering national and regional contexts when supporting nurse educators involved in global nursing education.
Nursing openHao Zhang, Yuan Mei, Chun-Ling Zhang, Jie Liu, Xu-Jue Ma
AIM: To assess nursing students' participation and perceptions of teaching effectiveness at clinical teaching bases and to identify the improvements students themselves prioritize. DESIGN: A cross-sectional, descriptive survey. METHODS: During the 2023-2024 academic year, a self-developed eight-item questionnaire, together with a single overall-satisfaction item, was administered to 366 final-year students in 3-year associate degree nursing programmes at two clinical teaching bases in Chongqing, China; 318 valid responses (86.9%) were analysed. Analyses comprised descriptive statistics, between-centre comparison, effect-size estimation and content analysis of open-ended suggestions. RESULTS: About two-thirds of students reported active participation in class discussions (64%), whereas far fewer joined extracurricular academic activities (31%) or a study group (28%). About half considered teaching methods diverse (53%) or felt encouraged to express their opinions (50%). Written suggestions centred on interdisciplinary case teaching, emergency care training, and more diverse assessment. No item differed significantly between the two centres. CONCLUSIONS: Participation clustered in timetabled sessions and appeared to fall sharply for activities requiring students' own time, and the interactive quality of teaching was rated below its content. Routinely collecting and acting on student feedback may offer clinical teaching bases a practical way to address both. IMPLICATIONS FOR THE PROFESSION: Participation was consistently higher for timetabled activities, pointing to scheduling as a lever educators can act on, and fewer than one-third of students volunteered a concrete suggestion. Nurse educators and clinical teaching administrators may draw on these student-derived priorities when adjusting curricula, training preceptors and designing feedback mechanisms. IMPACT (ADDRESSING): What problem did the study address? ○ Evidence on students' clinical teaching participation was limited. What were the main findings? ○ Participation was high for scheduled activities, lower for voluntary ones. Where and on whom will the research have an impact? ○ Findings may guide scheduling and preceptor training at teaching bases. REPORTING METHOD: Reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
AORN journalRebecca Vortman, Joanne D Muyco, Daphny Peneza, Ray-An B Talatala
Surgical care is becoming more complex, and hospitals are under amplified pressure to improve quality and prevent harm. Ongoing sentinel events, such as wrong-site surgery and retained surgical items, indicate that important safety errors persist and require system-level solutions. Doctor of nursing practice (DNP)-prepared perioperative nurses are well positioned to lead system-level improvements by using evidence-based practice, quality improvement, and implementation science to translate research into practice and develop sustainable improvements over time. This article describes how DNP-prepared perioperative nurses lead and strengthen safety and quality initiatives in the perioperative practice setting. This article applies The Essentials: Core Competencies for Professional Nursing Education by the American Association of Colleges of Nursing, with a focus on Domain 5 (Quality and Safety), to connect DNP scholarly project work to measurable perioperative safety outcomes. Practical guidance is provided to support alignment of DNP-led scholarly projects with the strategic priorities of the organization.
Nursing openMneera Alshammari, Kaye Rolls, Steven Frost, Peta Drury
AIM: To examine institutional documents on Student Evaluation of Teaching implementation in nursing schools and explore how policy frameworks influence their governance and use: DESIGN: A qualitative document analysis. METHODS: Institutional documents related to student evaluation of teaching implementation, quality assurance and programme evaluation were purposively selected from two nursing schools. Documents produced between 2023 and 2024 and relevant to student evaluation of teaching processes in nursing education were included. Data were systematically extracted using a structured analytical framework and thematically analysed. DATA SOURCES: Six institutional policy and quality documents from two nursing schools were analysed. RESULTS: Five themes were identified: enhancing educational quality, fostering continuous improvement, promoting accountability, adopting inclusive evaluation approaches, and aligning with accreditation-driven strategic planning. Policies positioned student evaluation of teaching primarily as instruments for accountability and accreditation, often prioritising compliance over direct teaching enhancement. CONCLUSION: SETs function as policy tools supporting quality assurance and institutional performance. However, their current use may limit their potential to enhance teaching practice and faculty development. Strengthening feedback mechanisms and promoting faculty engagement in evaluation processes may enable SETs to contribute more meaningfully to educational improvement. IMPLICATIONS FOR NURSING PRACTICE AND EDUCATION: Integrating student evaluation findings into faculty development and curriculum design can strengthen teaching quality and support student-centred learning in nursing education. These improvements contribute to preparing a competent nursing workforce capable of addressing complex healthcare needs. The findings highlight the need for balanced policy approaches that support both accountability and pedagogical development, with relevance for nursing education systems internationally. IMPACT: This study highlights how policy, governance and accreditation shape Student Evaluation of Teaching in nursing education. The findings may inform nursing schools, academics and policymakers in strengthening evaluations for both accountability and teaching improvement. REPORTING METHOD: This study adhered to the Standards for Reporting Qualitative Research (SRQR). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution was involved in this study.
Nursing philosophy : an international journal for healthcare professionalsChristopher Kahle, Miriam Bender, Lissi Hansen
In the United States context, incivility in nursing education is widely studied as a behavioral problem to be measured and remedied. In contrast, civility has been conceptualized as a professional virtue that is foundational to nursing identity. Together, these civility and incivility orientations sustain a moral binary for nursing education in which civility functions as virtue and incivility as its violation. This paper re-orients the discourse by reading incivility through camp. Drawing on Susan Sontag and Fabio Cleto, camp serves as an analytic lens to show how exaggerated seriousness, affective escalation, and performative staging produce incivility as a violation of moral authority. We offer a synthesis of how civility and incivility are written in the nursing education literature and reflect on their conceptual asymmetry. Then, we present and examine a three-scene vignette featuring two behaviors codified in the Incivility in Nursing Education-Revised (INE-R) scale: lateness and eye-rolling. Through a camp analysis of the vignette, we trace moral regulation via policy, surveillance, affective escalation, and racialized cultural coding. What can appear as a behavioral violation according to the literature is shown through camp and contextualization to be instead affective attachments to normative expectations of comportment and professionalism. We show how incivility and its associated behaviors function as performative judgments of disposition within a moral binary. Camp transforms how incivility is perceived by revealing how ordinary behaviors become moralized in nursing education. By unsettling the civility/incivility binary, this conceptual analysis invites greater reflexivity in scholarship and pedagogy and opens space for more contextually attentive engagement with professional identity.
Journal of continuing education in nursingCarey B R Yarbrough, Sheri Cosme
Nurses are likely to change roles and settings multiple times in their careers; these changes can involve different specialty areas, organizations, advanced practice, or leadership roles. As nurses' roles change, they experience some of the same challenges that newly licensed nurses face. These challenges can be addressed by implementing a transition-to-practice program.
Journal of continuing education in nursingSylvain Trepanier
Every day, nursing professional development specialists shape culture through hundreds of conversations. They welcome new graduate nurses, coach experienced clinicians, facilitate difficult debriefings, mentor emerging leaders, and provide reassurance during moments of uncertainty. Although these conversations may seem routine, each represents a leadership intervention. Every word has the potential to build confidence, strengthen trust, encourage learning, or unintentionally diminish it.
Nursing openThomas Aaron Ricks, Elisabeth Jacob, Louisa Lam
BACKGROUND: Internationally, sessional nursing staff play an important role in meeting the teaching requirements for the increased demand in nursing student enrolment. In Australia, pre-registration nursing programmes are university programmes that prepare students for initial registration as registered nurses. Little research has been undertaken to understand their experiences to ensure a sustainable nurse education workforce. OBJECTIVE: To explore the experiences of sessional staff working in pre-registration nursing programmes in Australia. DESIGN: A cross-sectional online survey. SETTING AND PARTICIPANTS: Sessional nursing staff working in pre-registration nursing programmes in Australia for at least 12 months. METHODS: Participants were invited to complete an online survey using the Copenhagen Psychosocial Questionnaire version III (COPSOQ-III) middle-length version. Participants were recruited via email and online platforms. Data were analysed using descriptive and non-parametric techniques including determining correlations between different subscales. RESULTS: A total of 84 participants were included. Most participants were female (83.3%) and over 50 years old (51.2%). The majority of the participants had less than 5 years of sessional experience (58.3%). Only 26.2% (n = 22) of the participants intended to become permanent academics. Participants generally reported favourable working experiences. 'Job satisfaction' was found to be positively correlated with several subscales including 'social support from supervisor' (r = 0.64, p < 0.001), 'social support from colleagues' (r = 0.54, p < 0.001) and 'sense of community' (r = 0.64, p < 0.001). CONCLUSION: This study provides new insights into the sessional nursing workforce, including their demographics and work experiences. It identified factors related to positive work experience, such as opportunities for professional development, sense of community, quality leadership and support. Strengthening these factors may improve the work experience of sessional staff, contribute to reduced attrition and support workforce sustainability.
Revista brasileira de enfermagemAlbert Lengruber de Azevedo, Sílvia Teresa Carvalho de Araujo, Paulo Sergio da Silva, Francisco Gleidson de Azevedo Gonçalves
OBJECTIVES: to understand nursing students' perceptions of nonverbal communication using chronemics in surgical settings. METHODS: a qualitative, descriptive-exploratory study, based on Edward T. Hall's theory of nonverbal communication. Thirty nursing students from a public institution in northern Brazil participated. Data were collected in May and June 2025 through semi-structured interviews and analyzed using thematic content analysis. RESULTS: chronemics was perceived as a central element in surgical settings. The accelerated pace generated strangeness, anxiety, and insecurity, hindering learning. The waiting period revealed the team's priorities, indicating who receives attention in the care flow. The nursing staff's time management highlighted the conflict between task efficiency and availability for teaching, establishing itself as a training model. FINAL CONSIDERATIONS: chronemics constitute an essential dimension and a crucial element of communication in nursing education and in healthcare teams.
JMIR research protocolsTshepo Kabelo Mohale, Wilma Ten Ham-Baloyi, Olivia Baorapetsi Baloyi, Emelda Zandile Gumede
BACKGROUND: Virtual reality (VR) is increasingly used in health care training and nursing education to address clinical skills gaps and provide immersive learning experiences. While multiple systematic reviews have synthesized primary research on VR effectiveness, no umbrella review has comprehensively evaluated and integrated findings from existing systematic reviews specifically focused on nursing and midwifery education. OBJECTIVE: This umbrella review aims to systematically identify, critically appraise, and synthesize findings from published systematic reviews and meta-analyses examining the use of VR in nursing and midwifery education, with particular emphasis on clinical skills training. METHODS: This protocol will follow the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) 2015 statement and is registered with PROSPERO (CRD420261303572). Nine databases will be searched, including PubMed, CINAHL, Scopus, Web of Science, ERIC, PsycInfo, Cochrane Library, African Journals Online, and SciELO. Two independent reviewers will conduct screening, data extraction, and methodological appraisal using AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews, version 2). The overlap of primary studies across reviews will be calculated using the corrected covered area (CCA) method, and decision rules for managing overlap will be applied. Narrative synthesis will follow Synthesis Without Meta-Analysis guidance. Certainty of evidence will be assessed using an adapted GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach with a prespecified framework for downgrading based on AMSTAR 2 ratings, overlap, heterogeneity, imprecision, and indirectness. RESULTS: The review search and screening commenced in July 2026 and are ongoing as of August 2026. Full-text screening and data extraction are scheduled for September to October 2026, followed by methodological appraisal, overlap assessment, and evidence synthesis from October to December 2026. Manuscript preparation is planned for November to December 2026, with the review findings expected to be submitted for publication in early 2027. CONCLUSIONS: This umbrella review will provide the first comprehensive, high-level synthesis of evidence on the use of VR in nursing and midwifery clinical training. By systematically appraising and grading the certainty of existing systematic reviews, it will identify the most robust findings while exposing critical evidence gaps. The resulting evidence gap map and summary of findings will offer clinicians, policymakers, and researchers a clear roadmap for evidence-based decision-making and prioritization of future primary research.
Perspectives on medical educationÁlvaro Carmona Pestaña, Jenifer Santos García, Patricia Ferrero Sereno
BACKGROUND & NEED FOR INNOVATION: Health professions education needs learning experiences that help students practise careful observation, evidence-based description, interpretive reasoning and attention to the human dimensions of illness. Undergraduate nursing education still needs clearly described, theory-informed and transferable museum-based models that move beyond cultural enrichment. GOAL OF INNOVATION: We designed a curriculum-embedded museum-based innovation for first-year nursing students. Its central contribution is a transferable sequence for slow, deliberate and dialogic observation: preparation, slow looking, evidence-based description, facilitated interpretation, humanistic reflection and clinical transfer. STEPS TAKEN FOR DEVELOPMENT AND IMPLEMENTATION OF INNOVATION: The activity was delivered at the Museo Nacional del Prado across two academic years and was informed by visual thinking approaches, experiential learning and reflective practice. Students engaged with selected artworks as complex visual and human situations rather than diagnostic riddles. EVALUATION OF INNOVATION: We used anonymous pre- and post-activity questionnaires across two cohorts, supported by open-ended responses, faculty field notes and voluntary student reflections. A total of 874 valid questionnaires were analysed as unmatched group-level responses. Students reported higher post-activity scores in perceived knowledge, observational skills and educational value, with smaller differences in empathy. Descriptive qualitative content analysis suggested that students valued close looking, art-medicine integration and clinical relevance. CRITICAL REFLECTION ON YOUR PROCESS: The evaluation supports feasibility, acceptability and implementation stability, not objective improvement in clinical performance. Key lessons concern how to design and facilitate museum-based learning: preserve the slow observation sequence, avoid reducing artworks to diagnoses, and pair humanistic reflection with transfer to nursing practice.
The American journal of nursingBevin Cohen, Charleen Jacobs-McFarlane, Catherine Finlayson, Aliza Ben-Zacharia, Keiko Iwama, Nancy Roecklein, Toby Bressler, Kimberly Souffront, Mount Sinai H…
PhD-prepared nurses are increasingly employed in health care delivery settings, although their roles and contributions are not well publicized. Spotlighting opportunities for PhD-prepared nurses in health systems may encourage more nurses to pursue research doctorates. The goals of this article are to demonstrate the versatility of research doctoral training by highlighting a growing community of PhD-prepared nurses working in a New York City health system and exploring their educational journeys, career pathways, and professional roles; and to describe the process of finding and sustaining a community of shared professional identity. Whether their roles explicitly included research or not, PhD-prepared nurses sought opportunities to drive organizational change, shape policy, bridge the gap between evidence generation and application, and advance the profession to improve health care delivery.
The National Organization of Nurse Practitioner Faculties has identified communication, psychomotor skills, and cognitive decision-making as core competencies for all nurse practitioners. Faculty leaders of the Family Nurse Practitioner (FNP) Program at the University of Texas at El Paso were tasked with developing innovative assignments to help FNP students meet core competencies. This article discusses the challenges and successes of creating and implementing best-practice simulation events for FNP students to help students practice these core competencies, utilizing standardized patients, and maintaining the psychological safety of all participants. Findings from each event are utilized to help improve or refine future events.
Issues in mental health nursingLakshika Lagoshan, Ahinsa Brandigampola, Thilini Jayasinghe, Stephica Jeganathan Jubert Stanley
Bullying-related victimization in clinical learning environments is an important psychosocial stressor in nursing education, with potential implications for students' coping processes and professional development. Although bullying and related interpersonal mistreatment have been widely documented, research has largely focused on prevalence and descriptive experiences, with limited attention to factors influencing students' coping responses. This study examined associations between bullying-related victimization, self-esteem, and coping strategies among undergraduate nursing students in Sri Lanka and tested whether self-esteem moderated the association between bullying-related victimization and coping responses. An analytical cross-sectional study was conducted among 214 undergraduate nursing students with clinical placement experience. Data were collected using self-report measures of bullying-related victimization and perpetration, self-esteem, and coping strategies. Descriptive statistics, Spearman's rank-order correlations, and moderation analyses using Hayes' PROCESS macro were performed. The bullying-related victimization score was positively correlated with problem-focused coping (rs = 0.22, p = 0.001), emotion-focused coping (rs = 0.34, p < 0.001), and avoidant coping (rs = 0.35, p < 0.001). Bullying-related perpetration was positively associated with emotion-focused and avoidant coping. Self-esteem was negatively correlated with problem-focused (rs = -0.32, p < 0.001) and emotion-focused coping (rs = -0.15, p = 0.031). Self-esteem significantly moderated the relationship between victimization severity and problem-focused coping (B = 0.049, SE = 0.020, p = 0.017), but not emotion-focused or avoidant coping. These findings suggest that bullying-related victimization is associated with multiple coping responses, while the moderating role of self-esteem appears limited to problem-focused coping.
British journal of nursing (Mark Allen Publishing)Mark Kenwright, Chris Bye, Donna Doherty, Daniela Leese
The commitment to give equal priority to mental and physical health (parity of esteem) guides the Nursing and Midwifery Council's Future Nurse Standards of Proficiency - a generic set of standards for nurse education. However, a recent national survey revealed that nursing students reported that the specific communication skills needed to address mental health problems are missing from practice assessments. This article reviews the current use of practice assessment documentation in which communication and relationship management skills are interpreted as 'professional values' rather than explicit mandatory skills. The proposal is to use appropriate sections of the University College London Competence Frameworks for the Delivery of Effective Psychological Interventions to enhance the teaching and assessment of communication skills across the fields of nursing. These validated, evidence-based competencies could help to contextualise specific communication skills and techniques, making them more explicit and tangible for both students and assessors.
British journal of nursing (Mark Allen Publishing)Maria Tomy
This commentary explores the growing prevalence of impostor syndrome among nurse lecturers in university settings. Even though impostor syndrome has an impact on personality, wellbeing, and productivity, it frequently goes unnoticed due to the professionalism and resilience associated with the role. Impostor syndrome, or the impostor phenomenon, is characterised by persistent self-doubt despite evident achievement and is particularly recognised among early-career academics adjusting to unfamiliar systems and expectations. The discussion critically analyses impostor syndrome as a contemporary issue in academic practice, drawing on Professional Standards Framework (PSF) dimensions, Staff and Educational Development Association (SEDA) values, educational theories, pedagogical literature, institutional policies, and wider academic culture. It highlights how it is shaped by organisational structures and professional identity tensions, particularly during the transition from clinical practice to academia. The experience has implications beyond the individual, influencing teaching confidence, student learning, and the preparedness of the future nursing workforce. Addressing impostor syndrome requires supportive mentorship, inclusive academic environments, and a wider recognition of the systemic factors contributing to the experience.
Global health actionFilipa Ventura, Pedro Parreira, Gisela Mosca Teixeira, Pedro Lucas, Paulo Lino Kidayi, Harilalaina Willy Franck Randriamarotia, Rivo Solotiana Rakotomalala, Ey…
BACKGROUND: Adherence to healthcare-associated infection prevention and control best practices is essential to reducing morbidity and mortality in sub-Saharan Africa, where structural and educational challenges may affect adherence. Strengthening nursing education requires contextually appropriate frameworks and valid tools to evaluate them. OBJECTIVE: To evaluate the psychometric properties of the culturally adapted InovSafeCare Questionnaire and examine the structural relationships proposed by the InovSafeCare Model among undergraduate nursing students in sub-Saharan Africa. METHODS: A multiple-method approach was employed, involving the translation, cultural adaptation, and psychometric evaluation of the InovSafeCare Questionnaire. Data were collected from 486 undergraduate nursing students across four higher education institutions in two sub-Saharan African countries. Principal component analysis and reliability testing examined the questionnaire structure, followed by path analysis to evaluate the relationships among the model constructs. RESULTS: Psychometric analysis yielded a 10-factor solution explaining 52.1% of the variance, with Cronbach's alpha value ranging from 0.64 to 0.88. The structural model demonstrated acceptable-to-moderate fit (χ2/df = 5.59; CFI = 0.88; GFI = 0.95; RMSEA = 0.097). No direct relationships were found between educational constructs and self-reported adherence. Instead, these associations operated through psychological and contextual mediators, including motivation, expectations, skepticism, environmental complexity, and overload and fatigue. The model explained 18.9% of the variance in adherence. CONCLUSIONS: The culturally adapted InovSafeCare Questionnaire demonstrated acceptable psychometric properties, and structural analysis provided preliminary support for the model's applicability in the sub-Saharan African sample. Further research should replicate the measurement and structural model across settings before considering its use to inform contextually adapted educational interventions.
JMIR research protocolsLucille Kelsall-Knight, Jennifer M Goldberg, Kelvin McMillan, Elizabeth K Darling, Charlene Downing
BACKGROUND: Sexual and gender diverse populations experience inequities in health and health care access, as well as gaps in health professional education. Preregistration nursing and midwifery education represents a critical formative stage for developing inclusive and affirming practice; however, the integration of sexual and gender diversity within curricula remains variable and inconsistently described. Mapping how inclusive pedagogical practices address sexual and gender diversity in preregistration nursing and midwifery education will clarify current approaches and identify gaps in the literature. OBJECTIVE: This study aims to map how sexual and gender diversity is addressed through inclusive pedagogical practices in preregistration nursing and midwifery education globally. METHODS: This protocol follows the Joanna Briggs Institute (JBI) guidance for scoping reviews and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) reporting checklist and will be reported in accordance with PRISMA-ScR guidance. We will search the CINAHL, MEDLINE, PubMed, Scopus, and Web of Science databases, as well as targeted gray literature. Two reviewers will independently screen titles and abstracts, followed by full-text screening, and extract data using a piloted form through Covidence. Prior to formal screening, reviewers will pilot-test the inclusion criteria on a sample of titles and abstracts to ensure consistency. Agreement will be discussed, and the eligibility criteria will be refined as required. Data extraction will include pedagogical practices addressing sexual and gender diversity (teaching strategies, curriculum content, simulation, and assessment), theoretical or conceptual frameworks; outcomes and indicators (knowledge, attitudes, skills, confidence, and learning environment), and any identified equity considerations (attention to gender identity and sexual orientation and intersectionality). Synthesis and presentation of findings will be completed using the Patterns, Advances, Gaps, Evidence for Practice, and Research Recommendations (PAGER) framework. RESULTS: The scoping review was initiated in May 2026 following protocol registration with the Open Science Framework. Preliminary searches conducted in November 2025 informed the final search strategy. The final searches were conducted in May 2026 across 5 databases. At the time of manuscript submission, screening and data extraction were in progress. Data charting and synthesis are expected to be completed by October 2026, with findings anticipated for dissemination in December 2026. CONCLUSIONS: This review is expected to identify diverse but inconsistently applied inclusive pedagogical practices, which show a predominance of short-term outcome evaluations and limited theoretical underpinning. It will also highlight key gaps, particularly in the inclusion of gender diverse populations, midwifery-specific evidence, and rigorously evaluated interventions. This review will provide a comprehensive map of inclusive pedagogical practices addressing sexual and gender diversity in preregistration nursing and midwifery education, identify gaps in the evidence base, and inform curriculum development and educator training. TRIAL REGISTRATION: Open Science Framework 10.17605/OSF.IO/8GHVD; https://osf.io/8ghvd. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/93408.
Revista da Escola de Enfermagem da U S PBruna Pedroso Canever, Saionara Nunes de Oliveira, Caroline Cechinel Peiter, Samara Eliane Rabelo Suplici, Diana Coelho Gomes, Maria Lígia Dos Reis Bellaguarda…
OBJECTIVE: To understand nursing students' perceptions of the use of clinical simulation in biosafety education. METHOD: A qualitative, exploratory, and descriptive study conducted in 2023 based on the implementation of clinical simulation for biosafety learning. Participants were 26 students enrolled in the "Fundamentals of Nursing" course of an undergraduate nursing program at a federal university in southern Brazil. Data were analyzed using IRAMUTEQ® software. RESULTS: Three categories emerged: (1) Emotional regulation for interaction and communication with patients and families, highlighting feelings of anxiety and the need for emotional regulation during the application of standard precautions; (2) Contributions of simulation to learning biosafety practices, emphasizing a better understanding of the use of personal protective equipment, risk perception, and the integration of theory and practice; and (3) Strengths and weaknesses perceived by students regarding their performance, including self-assessment, recognition of technical limitations, and strengthened teamwork. CONCLUSION: Clinical simulation was perceived as a strategy that promotes learning of biosafety practices by integrating technical, emotional, and communication-related aspects, thereby contributing to safer and more reflective professional education.
Applied nursing research : ANRMengxia Shi, Xuan Hu, Xuehua Zhu
BACKGROUND: Artificial intelligence technology is rapidly penetrating the field of nursing education, and students are widely using AI tools in their learning process. As a result, the ethical issues thus raised are drawing increasing attention. OBJECTIVE: This study aims to explore nursing undergraduates' ethical experiences in AI-assisted learning, such as academic integrity, privacy protection, and learning fairness. METHODS: This descriptive qualitative study was conducted at a university in Eastern China. Purposive sampling was used to recruit 21 undergraduate nursing students across all four academic years. Data were collected through semi-structured interviews from December 2025 to February 2026. Thematic analysis was performed following Braun & Clarke's six-step framework. RESULTS: 4 themes and 13 sub-themes were identified. Students' trust in AI varied along a spectrum from complete reliance to deep skepticism. While some students proactively protected privacy and verified AI-generated information through systematic cross-checking, others showed indifference or a lack of verification due to limited motivation or access. Perceptions of fairness were diverse, ranging from viewing AI as an equal-opportunity tool to concerns about resource disparities between free and paid platforms. Despite AI's efficiency, a recurring theme among participants was the irreplaceable value of face-to-face interpersonal communication with teachers and peers. CONCLUSION: This single-center qualitative study offers contextual insights into nursing students' ethical experiences with AI-assisted learning. These insights may inform the development of AI ethics curricula and institutional guidance, while further research is needed to explore transferability across diverse settings and to evaluate the effectiveness of educational interventions.
Frontiers in neurologyShuang Liang, Na Zhang, Yimin Jiang, Jingyu Li, Zhiying Shang, Cuiling Ji, Lu Chen
OBJECTIVE: To explore the characteristics and influencing factors of training transfer among neurosurgical specialty nurses, and to provide empirical evidence for nursing educators, clinical managers, and training designers to develop optimization strategies. METHODS: Purposive sampling recruited 32 participants (15 specialty nurses, 11 instructors, and 6 training managers) from 16 Chinese institutions. Semi-structured interviews were conducted, and data were analyzed using framework analysis. This study followed the Consolidated Criteria for Reporting Qualitative Research. RESULTS: Two overarching themes and eight subthemes were identified. Theme 1 described the practical manifestations of training transfer among neurosurgical specialty nurses, including effective transfer of basic perioperative care competencies, adaptive application of advanced competencies, and extension of training outcomes from individual care to specialty development. Theme 2 identified facilitators and barriers influencing training transfer, including individual motivation and professional identity, contextualized teaching, organizational empowerment, resource mismatch, and sustainability challenges after training. CONCLUSION: Training transfer among neurosurgical specialty nurses represents an adaptive reconstruction process shaped by individual readiness, educational design, organizational support, and specialty-specific clinical contexts. Effective transfer requires not only high-quality training but also appropriate role positioning, resource alignment, and sustained post-training support.
International journal of nursing education scholarshipAmelia S Lanz, Rebecca G Davis
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.
Revista da Escola de Enfermagem da U S PNadiye Barış Eren, Bahar Çiftçi
OBJECTIVE: To examine the effect of puzzle-based reinforcement on nursing students' academic achievement and motivation toward instructional materials. METHOD: To conduct a cluster-randomized controlled trial with 70 first-year nursing students allocated to intervention and control groups. Both groups received a 2-hour interactive lecture on Roper, Logan, and Tierney's Life Model. The intervention group completed a one-week puzzle-based reinforcement program, while the control group received no additional intervention. Data were collected using achievement tests and the Instructional Material Motivation Scale and analyzed using paired-samples t-tests, independent-samples t-tests, and regression analysis. RESULTS: Knowledge scores increased in the intervention group, whereas knowledge scores decreased in the control group. Between-group comparisons and regression analysis showed that puzzle-based reinforcement was associated with higher post-test knowledge scores and relatively higher motivation subscale scores compared with the control group (p < 0.01). CONCLUSION: The findings suggest that puzzle-based reinforcement may be a valuable instructional approach, associated with positive learning outcomes and relatively higher motivation toward instructional materials in nursing education. TRIAL REGISTRATION: ClinicalTrials.gov: NCT07090850.
Revista da Escola de Enfermagem da U S PNaomi Tamima Estevam Cipriano, Jacks Soratto, Cristiane Damiani Tomasi
OBJECTIVE: To develop and evaluate a participatory and dialogic health education program with nursing students at a community college in Criciúma, SC, on the Human Immunodeficiency Virus and its care pathway. METHOD: Action research, grounded in Critical Pedagogy, conducted with 19 nursing students in their 8th through 10th semesters of the program. The training took place in four stages: exploratory, planning, action, and evaluation, with questionnaires administered before and after the intervention. RESULTS: Before the training, self-assessments of knowledge regarding Pre-Exposure Prophylaxis, Post-Exposure Prophylaxis, and Antiretroviral Therapy were predominantly rated as fair or poor/very poor. After the intervention, all participants rated their knowledge as very good or good. There was also an increase in the perceived readiness to welcome and counsel people regarding the Human Immunodeficiency Virus care pathway within the Unified Health System, from 52.6% to 94.7%. CONCLUSION: The participatory and dialogic health education program developed with nursing students proved effective in expanding knowledge about HIV and its care pathway, as well as in strengthening participants' confidence in approaching people living with HIV.
Frontiers in public healthDongmei Liu, Wanpeng Zhen, Meiyuan Yang, Yongchao Jin, Ye Lin, Huifeng Bo, Rui Yang
BACKGROUND: As higher education increasingly shifts toward online models, nursing education has also widely adopted digital learning formats, one of the key theoretical foundations of which is the self-regulated learning model. Existing research has confirmed that academic self-efficacy is significantly and positively associated with the development of students' self-regulated learning abilities. However, its mediating mechanism between online real-time teaching interaction and self-regulated learning ability in nursing students has not yet been systematically explored. METHODS: This study adopted a cross-sectional survey design. From September 30th, 2025 (with a data collection period of one week), a questionnaire survey was conducted among nursing students from four nursing undergraduate programs in Jilin Province. Using the convenience sampling method, a total of 813 valid questionnaires were collected. Data were collected through questionnaires, utilizing the following instruments: the online real-time teaching interaction (ORTTI), the academic self-Efficacy (ASE), and the self-regulated learning (SRL) scales. All data were processed using the SPSS AU statistical analysis platform. Analytical methods encompassed descriptive statistics, correlation analysis between variables, path analysis with Bootstrap mediation testing, and mediation effect testing for academic self-efficacy. RESULTS: The results indicate that, the online real-time teaching interaction was significantly and positively related to self-regulated learning ability in nursing students (r = 0.809, p < 0.01). Academic self-efficacy appears to partially mediate the relationship between online real-time teaching interaction and self-regulated learning ability. Its mediating effect value is 0.478, accounting for 56.7% of the total effect. CONCLUSION: These findings suggest that online real-time teaching interaction is directly and positively associated with the self-regulated learning ability of nursing students, and may also be indirectly associated with it through higher academic self-efficacy. The results highlight the importance of intentionally designing interactive components in online nursing education that support academic self-efficacy. These findings may inform the design of interactive online courses that support nursing wstudents' academic self-efficacy and self-regulated learning.
OBJECTIVE: To evaluate the effectiveness of a simulation-based educational programme designed to support evidence-based pressure ulcer/injury (PU/I) prevention and management among undergraduate nursing students (P.J. Šafárik University in Košice, Slovakia) and to examine the relationship between perceived educational effectiveness and objectively demonstrated clinical competence. METHOD: A single-group post-intervention observational study was conducted among second-year undergraduate nursing students. The educational programme was developed according to international PU/I clinical practice guidelines and the Healthcare Simulation Standards of Best Practice. Students' perceived educational effectiveness was assessed using the simulation effectiveness tool-modified (SET-M), while clinical competence was evaluated using an objective structured clinical examination (OSCE). Associations and group differences were examined using non-parametric tests. RESULTS: The experimental cohort comprised 61 second-year undergraduate nursing students. Students demonstrated high levels of psychomotor competence, with >90% correct performance across all assessed OSCE competencies. The SET-M total score was 46.13±6.54, indicating highly positive perceptions of the simulation experience. No significant association was found between the SET-M total score and OSCE performance (ρ=-0.129, p=0.321), nor between individual SET-M domains and objectively assessed competence. Previous simulation experience and previous secondary education were not associated with either educational outcome. CONCLUSION: The simulation-based educational programme was associated with high levels of objectively demonstrated psychomotor competence and highly positive learner perceptions. However, perceived educational effectiveness was not associated with objectively assessed clinical competence, highlighting the importance of combining learner-reported and performance-based outcome measures when evaluating simulation-based education. These findings support simulation as a strategy for teaching evidence-based PU/I management in undergraduate nursing education.
Journal of Christian nursing : a quarterly publication of Nurses Christian FellowshipTeresa Sienkiewicz, Edward Williams
Failure to progress in nursing school has negative consequences for students, institutions, and the nursing profession. Poor student engagement, cognitive overload, and perceptions that institutions do not care contribute to student attrition. A retrospective analysis of student outcomes in an accelerated baccalaureate nursing course supports implementation of a textbook-based note-taking guide as a cost-effective learning strategy for Health Education Systems, Inc. (HESI) examination preparation and improved scores. Students relayed that the guides showed the instructor was engaged and thoughtful of students' time.
BMC medical educationTanja Lehnen, Frederike Lueth, Lisa Wolter, Jutta Busch, Laura Püschel, Miriam Leimer, Anne C Rahn, Katrin Balzer, Wolfgang von Gahlen-Hoops
AIM: Interprofessional education is considered an important strategy for improving interprofessional collaboration in healthcare practice. The aim of the interEdu project was to develop a longitudinal core curriculum to strengthen interprofessional competencies in undergraduate nursing education. METHODS: The study was conducted using a mixed methods design with qualitative and standardized interviews and evidence syntheses. The results were triangulated via joint displays and were discussed in an expert workshop. The curriculum was designed by the interprofessional project team based on these results. RESULTS: The interEdu curriculum comprises nine chapters. The central element is a framework of interprofessional competencies, which forms the basis of competence descriptions that are formulated over three years of nursing education. It has a spiral structure and offers modules and learning units based on the situational principle. In order to facilitate a transfer between the different learning venues, appropriate learning methods are recommended. These are learner-centered to support collaborative learning and self-directed learning. CONCLUSIONS: The interEdu curriculum will be used to longitudinally integrate interprofessional education into educational programs for nursing and other healthcare professions. In particular, the spiral structure and the interprofessional competencies formulated longitudinally over the whole undergraduate education cycle should contribute to the continuous development of competencies.