Undergraduate nursing students' perceptions of their clinical learning environment

The clinical learning environment (CLE) is an interactive network of forces influencing student learning outcomes in the clinical setting. This study used mixed methods to identify factors characterizing students' perceptions of the CLE. The sample consisted of 229 undergraduate students in the second or third year of their biophysical nursing strand. The five subscales of the Clinical Learning Environment Scale, 'staff-student relationships', 'nurse manager commitment', 'patient relationships', 'student satisfaction' and 'hierarchy and ritual', were supported by qualitative data obtained from student interviews. Interpersonal relationships between the participants in the CLE were crucial to the development of a positive learning environment. Student satisfaction with the CLE was both a result of, and influential in creating, a positive learning environment. Nurse educators, clinical venues, and all others participating in the undergraduate nursing students' clinical education, must collaborate in order to create a CLE which promotes the development of well-educated registered nurses capable of providing safe, cost-effective patient care.     

Does a new learning environment come up to students' expectations? A longitudinal study.

School transitions and educational innovations confront students with changes in their learning environment. Though expectations are known to influence perceptions and motivation, which, in turn, influence the effectiveness of any situation, students' expectations for a new learning environment have received little attention. This longitudinal survey, conducted with 1,335 high school students (average age, 15 years), studied students' expectations and subsequent perceptions of 5 characteristics of a new environment (fascinating content, productive learning, student autonomy, interaction, and clarity of goals) and the students' (prospective) dissatisfaction. Results showed that expectations were positively related to later perceptions. Also, high prospective dissatisfaction was related to higher actual dissatisfaction with the environment later on. Investigating expectations and prospective dissatisfaction in relation to student characteristics (i.e., motivational orientations; conceptions of learning; strategies for regulation, information processing, and affective processing) show that motivational problems and fear of failure were risk factors for educational innovations. Furthermore, students' disappointment with the new environment was related to undesirable changes in student characteristics, such as increased fear of failure. The findings stress the importance of preparing students for curricular changes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The structure of attitudes toward persons with a disability, when specific disability and context are considered.

Examined the structure of the Disability Social Relationship (DSR) scale developed by S. A. Grand et al (1982) with data from 259 university students in 5 health care areas: occupational therapy, physical therapy, medicine, nursing, and clinical psychology. Data support the multidimensionality of attitudes toward persons who have a physical disability and the interaction influence of specific target disability and social situation on these attitudes. Attitudinal components, as measured by the DSR scale, reflected the importance of perceived limitations of particular disabilities, apprehensions concerning social stigmatization, situational constraints, and Ss' perceptions of functional limitations as interfering with relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identification, accommodation, and success of students with learning disabilities in nursing education programs

Few studies have addressed the issue of nursing students with learning disabilities, although students with both identified and undiagnosed learning disabilities are pursuing nursing education. Legal mandates concerning these students impact nursing programs and faculty. To reduce the risk of discrimination litigation, nursing education programs need to establish educational strategies to promote these students' success. The purpose of this research was to discover the extent to which Bachelor of Science in Nursing and Associate Degree of Nursing programs in one southeastern state admit, identify, and graduate nursing students with learning disabilities, and to identify accommodations provided by these programs to promote success among this student population. Of the 54 programs surveyed, 45 responded. Almost 50% indicated that their program had admitted nursing students with learning disabilities and one-third reported graduating students with learning disabilities. Enrolled students with undiagnosed learning disabilities were identified during their course of studies by both faculty members and by students themselves. The most frequently reported accommodations for students were counselors, tutors, tape-recorded lectures, and computer access. As the number of students with learning disabilities seeking post-secondary education increases, nursing programs and nurse educators will be involved with greater numbers of students needing educational accommodations.     

Identification of a new P450 subfamily, CYP4F1, expressed in rat hepatic tumors

This study focused on the belief of some nurse educators that caring cannot be taught directly and is learned by students from faculty role-modeling and faculty student interactions in clinical, classroom, and other situations. The purpose was to further explore these beliefs to determine if nursing students perceived that they learn caring behaviors through observing role-modeling by faculty, as well as to explore students' perceptions of other means by which they learn about caring. Since opportunities for faculty to model nurse caring behaviors in the clinical setting are varied and serendipitous, a videotaped scenario simulating a patient care situation, using professional actors, was created and shown to nursing students. The videotape was seen by 137 BSN and ADN students who then recorded their perceptions on a two-page open-ended questionnaire developed by the researchers. Results from this study indicated that students do learn about caring from faculty role-modeling, as well as from health care staff they encounter, often in a very paradoxical way. Many interesting and unintended results also occurred through the use of this research approach.     

Bridge to the future: nontraditional clinical settings, concepts and issues

Healthcare restructuring in the wake of healthcare reform places greater emphasis on primary healthcare. Clinical education in acute care settings and existing community health agencies are not compatible with teaching basic concepts, principles and skills fundamental to nursing. Problems of clients in acute care settings are too complex and clients in the community are often too dispersed for necessary faculty support and supervision of beginning nursing students. Nontraditional learning settings offer the baccalaureate student the opportunity to practice fundamental skills of care and address professional skills of negotiation, assertiveness, organization, collaboration and leadership. An overview of faculty designed clinical learning experiences in nontraditional sites such as McDonald's restaurants, inner city churches, YWCA's, the campus community and homes are presented. The legal, ethical and academic issues associated with nontraditional learning settings are discussed in relation to individual empowerment, decision making and evaluation. Implications for the future address the role of the students and faculty as they interact with the community in which they live and practice.     

Regulation of rat neuronal voltage-dependent calcium channels by endogenous p21-ras

Clinical teaching behaviour is a critical determinant for quality clinical learning experiences of student nurses. It is believed that a better understanding of the perceptions of clinical teaching behaviours between student nurses and nurse educators will enhance clinical teaching. This study examined the perceptions of effective clinical teaching behaviours of nurse educators by student nurses (n = 81) and nurse educators (n = 10) in a hospital-based 3-year general nurse training programme in Hong Kong. Knox & Mogan's Nursing Clinical Teacher Effectiveness Inventory (NCTEI) (1985) was adopted. The respondents were asked to rate the importance of each discrete behaviour on a seven-point scale. It was found that there was greater agreement in the 10 most important behaviours than the 10 least important behaviours among the four groups: students, junior students, senior students and nurse educators. No statistically significant difference could be identified in the perceptions between the nurse educators and students as well as between the junior and senior students regarding the five behavioural categories. The nature and the student status of the nursing programme was accountable for most of the discrepancies between the findings of this study and those of past studies.     

Learning needs of congestive heart failure patients

Congestive heart failure (CHF) affects approximately one-half million Canadians and five million Americans. Patient education is a vital component of nursing care of this population, with the goals of improving the CHF patient's quality of life, minimizing symptoms and hospital admissions, and reducing length of hospital stay. A review of the literature related to the educational needs of CHF patients reveals minimal research. The purpose of this study was to compare the perceived learning needs of CHF patients by patients and nurses, and to identify existing gaps between their perceptions. Fifty (50) CHF patients and 47 cardiac nurses were surveyed using a modified version of the CHF Patient Learning Needs Inventory developed by Hagenhoff et al. This instrument measured the importance of specific learning topics within the categories of anatomy and physiology, medications, diet, risk factors, activity, psychological factors, and other pertinent information. The results indicated that both groups found most information "moderately" to "very" important to learn. The patients generally rated all information items higher than nurses did. The most significant finding was that the nurses rated the diet category as second in importance, while the patients rated it last. The results from the study will be incorporated into a needs-based educational program for CHF patients.     

Differential importance faculty and students' place on counseling and psychological services.

179 university faculty were surveyed about how they would judge the importance of various counseling and psychological services, and 1,078 undergraduate students were surveyed to determine the differential importance faculty and students place on such services. Faculty interest in personal counseling, psychotherapy, drug counseling, and marital counseling was congruent with the traditional expertise and interests of psychologists practicing on college campuses. Students placed more emphasis on information-giving activities, such as educational counseling and academic advising, activities psychologists usually do not see as being in their domain. (5 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Out on campus: sexual orientation and academic climate in a university context

Although lesbian, gay, and bisexual (LGB) students often "come out" in university settings, empirical studies have demonstrated that these environments are often hostile toward them. The current paper posits that such hostile contexts adversely affect their educational experiences. Results from a survey of a stratified random sample of 1,927 undergraduate and graduate students on a scale measuring perceptions of academic climate (General Campus Climate) supported this claim: LGB students had more negative perceptions of a variety of campus factors. In addition, a scale measuring perceptions of Lesbian, Gay, and Bisexual Campus Climate found that LGB students were more likely than heterosexuals to perceive the campus as inhospitable to LGB people. Women and racial and ethnic minorities were also more likely to rate the LGB climate as hostile. Finally, data from two scales measuring attitudes believed to influence these perceptions yielded gender, racial/ethnic, religious, and sexual orientation differences in theoretically meaningful directions. Results indicate that LGB students often experience the university in more negative ways than heterosexual students, and that certain campus communities--particularly women and racial/ethnic minorities--are more aware of this negativity and contribute to it less because of their relatively more progay attitudes. Implications for how to improve LGB students' experiences are discussed.     

Perceptions of psychotherapy and psychotherapists: Implications from a study of undergraduates.

The nature of popular perceptions of psychotherapy and psychotherapists as well as predictors of various perceptions were explored. Participants were 265 undergraduate students. Responses to rating scale items indicated that the participants were fairly knowledgeable and had generally favorable perceptions of the field. Analyses of responses to open-ended items suggested, however, that a disconcerting proportion of the participants viewed therapists as prone to act on countertransference. Attempts to determine predictors of perceptions demonstrated the importance of direct (personal therapy ) experience and provided a modicum of support for the role of exposure to media portrayals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Professional self-concept of nurses: a comparative study of four strata of nursing students in a Canadian university

This study represents an effort to refine our understanding of measurement of professional self-concept by testing a tool across various strata of nursing students. The Professional Self Concept of Nurses Instrument, developed in studies of Australian nursing students, was applied to samples of basic undergraduate, post-basic and graduate students in a Canadian university nursing programme. The findings suggest that the tool is sensitive to the predictable development of professional self-concept as students advance through professional education, especially in the dimensions of professional practice and satisfaction. The authors propose that the instrument may have specific applications in evaluating the effects of traditional and innovative educational strategies upon the evolution of professional self-concept in nurses.     

Update--noise induced hearing loss and the military environment

Quality clinical experiences are a critical component of advanced practice nursing (APN) curricula. Historically, nursing instructors coordinated both the didactic and clinical components of a course. Increasingly, course coordinators organize the didactic component, and external preceptors working in the clinical setting function as practicum teachers. Both scenarios involve labor-intensive processes, and neither facilitate the scheduling of clinical experiences that build on progressive learning across the student's curriculum. A centralized, computerized, relational data base for efficient management of APN preceptors and students across the curriculum was designed. One master's-prepared clinical coordinator maintains the data base and performs all related functions. This system offers numerous benefits to students, preceptors, ] faculty, and nursing school, including balanced and progressively complex clinical learning experiences for students from competent preceptors: consistent interface with students and preceptors; faculty relief from time-consuming tasks; rapid generation of a variety of tables, rosters, and reports; consistent tracking of preceptor evaluations; timely acknowledgment of preceptor assistance; and efficient communication among students, preceptors, faculty, and school administration.     

An ethical analysis of student-faculty interactions

Senior nursing students described their interactions with faculty in a journal writing assignment. These interactions were categorized by the ethical perspectives of justice, autonomy, beneficence, and caring. An ethical analysis of faculty-student interactions is a strategy that may help nursing faculty and students understand differing perceptions about their relationships.     

Resident and faculty perceptions of effective clinical teaching in family practice

Increasing interest in clinical teaching has led to the realization that the unique subset of skills which characterizes effective clinical teaching needs to be identified. Such identification will lead to development of these skills and improvement in the quality of clinical teaching. Family practice faculty are vitally concerned with improving their clinical teaching skills, since clinical teaching is the core of education in family medicine and since many family physicians who become preceptors have had no formal training as teachers. In this investigation of effective clinical teaching behaviors, faculty and residents generally agree in their perceptions of the helpfulness of 58 clinical teaching behaviors. Neither group felt that emphasis on references and research is as important a factor in effective clinical teaching as are residents' active participation in the learning situation and positive preceptor attitudes toward teaching and residents. It was perceived that the ineffective clinical teacher has a negative attitude toward residents, is inaccessible, and lacks skills in providing feedback, while the effective clinical teacher has skills in two-way communication, creates an educational environment that facilitates learning, and provides constructive feedback to residents.     

Predictors of Psychological Help Seeking in Clinical and Counseling Psychology Graduate Students.

Psychologists are often called upon to provide supervision, mentorship, and training to graduate student therapists-in-training. In these roles, psychologists may influence whether graduate students enter personal therapy during their training. This study investigated variables (including perceived faculty attitudes about students in personal therapy) that predict psychotherapy help seeking in clinical and counseling psychology graduate students (N = 262). The findings indicated that confidentiality issues, general attitudes about therapy, and perceptions of the importance of personal therapy for professional development were important predictors of graduate student help seeking. The implications for faculty, supervisors, and mentors of therapists-in-training are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-efficacy as a predictor of academic performance in science

Nursing students have traditionally experienced difficulties with the science subjects in nursing curricula, and irrespective of the institution conducting a nursing programme, this trend appears to be continuing. A satisfactory means of predicting academic performance in these subjects will facilitate the development of educational strategies designed to assist students overcome their difficulties. In this study, an instrument called the Self-Efficacy for Science (SEFS) was developed and tested. The SEFS was designed to predict academic performance in the science areas of a first-year undergraduate nursing course. A cohort of first-year students enrolled in a bachelor of nursing course were surveyed by questionnaire. Students' academic scores for two first-year science subjects were obtained and used as the criterion measure for the study. Principal component factor analysis revealed the SEFS contained six instead of the hypothesized four factors. These six factors could explain 70% of students' self-efficacy for science. Cronbach alpha of the SEFS was 0.9. The SEFS could predict 24% of the cohort's academic performance in a physical science subject and 18.5% for a bioscience subject. Studying science in the final year at high school was not statistically significantly related to the SEFS. Implications for students and future research are discussed.     

Facilitators and barriers for minority students in master's nursing programs

The purpose of this exploratory qualitative study was to identify facilitators and barriers to admission to and successful completion of a master's of science in nursing program as perceived by minority students in that program. Students currently registered in the master's of science in nursing program of a large midwestern private university who were classified as minority according to federal classification were interviewed using an interview guide of 10 open-ended questions. Data analysis identified emergent themes in the transcribed interviews. Major areas drawn from the data included personal factors, undergraduate education, support systems/family and friends, support systems/employment, graduate program/university, and graduate faculty. In each area, respondents identified both facilitators and barriers to their success in graduate education. In addition, respondents suggested several specific strategies for recruitment and retention of minority students in graduate nursing programs.     

Development of a scale to assess student nurses' views of the professional nursing role.

A sample of 488 nursing students and 94 instructors rated the importance of each of 112 behaviors common to practicing nurses. A final scale was developed consisting of 60 items on which students shifted toward faculty views as class rank increased. Reliability computed for a cross-validation group was r = .89. Significant gains in student scores occurred as class rank increased, indicating that students adopt faculty professional views in direct relation to length of training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)