Unpacking the Paradox: Understanding the Gap Between Perceived and Actual Competence in LGBTQ+ Health Care.

BACKGROUND: Awareness about existing health disparities affecting sexual minorities remains insufficient, and nursing professionals often lack self-awareness about their biases and assumptions concerning lesbian, gay, bisexual, transgender, or queer/questioning (LGBTQ) individuals. PURPOSE: To explore how exposure to the LGBTQ community, during both classroom and clinical experiences, relates to nursing students' confidence in providing culturally congruent care to this group. METHODS: This nonexperimental correlational study occurred at a Midwest 4-year public university, involving final-semester baccalaureate nursing students who completed demographic and educational preparation surveys regarding their confidence in providing health care to the LGBTQ population. RESULTS: Results indicate that participants with no direct care experience were more confident in their communication skills and culturally congruent patient care for sexual minorities compared to those exposed to sexual minorities in clinical settings. CONCLUSIONS: Nursing students' perceptions and experiences in delivering culturally congruent health care to sexual minorities provide an interesting perspective for examining the Dunning-Kruger effect.

Improving suicide risk screening in the emergency department.

Suicide is a significant and increasing public health concern. Research has shown that screening for suicide risk is inconsistent in acute care settings and that a variety of different tools are used for that purpose. The Columbia-Suicide Severity Risk Scale (C-SSRS) has emerged as a validated and recognised suicide risk screening tool. This article describes a quality improvement project designed to improve the screening of patients for suicide risk in a large hospital system in the Midwestern US. As part of the project, 97% of nurses working in the organisation's emergency departments self-completed a 30-minute interactive learning module on the background, relevance and application of the C-SSRS. The C-SSRS enables nurses to classify the severity of suicide risk, which helps to provide interventions commensurate with patients' level of risk. Following completion of the module, there was a significant increase in the percentage of patients screened for suicide risk.

Experiences of Undergraduate Male Students in Nursing: On the Outside Looking in.

BACKGROUND: Measures to improve gender diversity of the profession have yielded only a modicum of progress. PURPOSE: To investigate the relationship between marginalization and gender minorities in baccalaureate nursing programs in the United States. METHODS: A descriptive cross-sectional study compared self-reported marginalization in male and female baccalaureate nursing students. The sample was drawn from the American Association of Colleges of Nursing database of US baccalaureate nursing programs, and the Englund Marginality Index (EMI) was used to measure marginalization, along with a demographic survey. RESULTS: In the study, 6480 full-time baccalaureate students from a traditional face-to-face nursing program in the United States participated. The results show that male participants had higher EMI scores (mean = 40.0, SD = 9.1) compared with female nursing students (mean = 35.1, SD = 9.0); t(6478) = 14.9, P < .001. CONCLUSIONS: Marginalizing behaviors must not be tolerated or promulgated. More needs to be done to better support and integrate men into nursing programs as they bring forth a unique perspective and skill set to the profession.

Minority Stress and Health Disparities in Lesbian, Gay, Bisexual, Transgender, and Queer or Questioning Adults.

In recent decades, much attention has been placed on reducing health disparities that have plagued the lesbian, gay, bisexual, transgender, and queer or questioning community. Significant health disparities continue to exist compared with the heterosexual population. Sexual minorities tend to experience higher rates of acute and chronic conditions than the general population. Sexual minorities are more likely to delay seeking medical care and are less likely to lack a consistent source for health care. A provider's failure to recognize and a person's lack of disclosure prevent vital discussions about human immunodeficiency virus risk, hormone therapy, cancer risk, hepatitis, and sexual health.

A Critical Minority: The Marginalization of Male Faculty in Nursing Academia.

AIM: The purpose of this study was to investigate the relationship between gender and marginalization in nursing academia. BACKGROUND: Men continue to be significantly underrepresented in nursing academia because they experience numerous barriers to their integration and success in the profession. METHOD: A descriptive cross-sectional design was implemented in this pilot study to investigate differences in perceived marginalization between male versus female faculty teaching in Commission on Collegiate Nursing Education-accredited colleges. Marginality was measured using the Englund Marginality Index (EMI). RESULTS: Male nursing faculty participants reported higher scores on the EMI ( M = 43.6, SD = 9.9) than female faculty ( M = 37.2, SD = 9.6), t (1428) = 6.0, p < .001. CONCLUSION: As the nursing faculty shortage continues to increase, it is imperative that leaders in nursing education steer their efforts toward attracting a more robust and diverse faculty population.

Self-Compassion and Resilience in a National Sample of Nursing Students Amid the COVID-19 Pandemic.

ABSTRACT: Nationwide, nursing students experienced multiple interruptions in learning because of the pandemic. Little is known about the impact of COVID-19 on resilience and self-compassion. A descriptive cross-sectional design was used to examine pandemic-related factors, resilience, and self-compassion using the Brief Resilience and Self-Compassion scales. The majority of participants (n = 259, 73.4 percent) described declining mental health. There was a moderate relationship between resilience, self-compassion, and age (r = .30, n = 353, p = .00/r = .290, n = 353, p < .01). Resilience and self-compassion are integral to student success. Strategies to support students' mental and physical health are discussed.

Differences in Marginality Between Nursing Students With and Without Disabilities.

BACKGROUND: Barriers exist in nursing education for students with disabilities. Students with disabilities often experience associated stigma and a perceived lack of support by nursing faculty and academic leaders. METHOD: A nonexperimental descriptive design was used to examine differences in perceived marginality between nursing students with and without disabilities (n = 7,399) in the United States. RESULTS: Participants who identified as having a disability described more marginalization (M = 45.9, SD = 10.5) than participants who did not identify as having a disability (M = 38.3, SD = 9.2), t(927) = 19.4, p < .001. CONCLUSION: Findings suggest marginalization exists for students with disabilities. Academic leaders and faculty should address systems, structures, and polices that potentially pose barriers to self-reporting, matriculation, and progression of students with disabilities. [J Nurs Educ. 2022;61(8):429-438.].

Perceived marginality in veteran and nonveteran nursing students in baccalaureate programs.

BACKGROUND: Veteran nursing students often have difficulty transitioning to campus life. Barriers include issues with admissions, financial support, as well as classroom environments. These barriers often push veterans and their unique needs to the periphery. METHOD: The purpose of this descriptive cross-sectional study was to examine mean differences in perceived marginality between veteran and nonveteran nursing students enrolled in baccalaureate programs using the Englund Marginality Index. RESULTS: Results indicate that veteran nursing students report higher perceived marginality (M = 40.18, SD = 10.68) than nonveteran nursing students (M = 38.82, SD = 9.51); t (1154) =2.09, p = 0.036. CONCLUSION: Veteran nursing students in this study demonstrate higher levels of perceived marginalization. Strategies aimed at decreasing attrition and marginalization should be implemented, thus improving the diversity of the nursing workforce.

Differences in perceived marginalization in doctorally prepared nursing faculty.

BACKGROUND: Debate regarding the role of Doctor of Nursing Practice-prepared faculty in academic settings continues. Perceived barriers to successful integration include a lack of respect, inadequate infrastructure, and insufficient resources. PURPOSE: The purpose of this study was to compare differences in self-reported marginalization in doctorally prepared (Doctor of Philosophy/Doctor of Nursing Practice) nursing faculty working in academic settings. METHOD: A descriptive cross-sectional design was implemented to compare differences in self-reported marginalization between doctorally prepared faculty teaching in Commission on Collegiate Nursing Education accredited colleges. Marginality was measured using the Englund Marginality Index. FINDINGS: Results of an independent-samples t-test indicate that Doctor of Nursing Practice -prepared faculty self-reported higher levels of marginalization (M = 41.7, SD = 9.6) than Doctor of Philosophy -prepared faculty (M = 39.1, SD = 10.5); t(583) = 2.8, p = .006. DISCUSSION: Strategies to decrease marginalization include improving systemic issues surrounding shared governance and outdated tenure systems as well as enhancing infrastructures that improve collaboration among doctorally prepared faculty.

Bridging the Gap: Use of Educational Gaming to Teach Acid-Base Imbalance Interpretation in Nursing Students.

BACKGROUND: The purpose of this study was to investigate the relationship between an acid-base imbalance educational gaming activity and subsequent performance on a course examination on the subject. METHOD: A nonexperimental descriptive design was employed using retrospective data obtained from both College of Nursing internal records and the learning management system used by the nursing program. A total of 435 students in the intervention group and 409 in the control group were included in the study. RESULTS: Differences in mean (SD) scores between the 2 groups for the acid-base content questions on the course examination were statistically significant (intervention group, 16.64 [1.92]; control group, 16.03 [1.62]; t842 = 2.34, P = .019). CONCLUSION: The results suggest that using educational gaming may improve retention and application of nursing knowledge.

Improving Patient Discharge Education Through Daily Educational Bursts: A Pilot Study.

The purpose of this study was to investigate the impact that daily discharge education "bursts" using the teach-back method had on participants' confidence levels in their self-care management abilities. Daily educational bursts positively impacted participants' self-confidence in their postdischarge self-care management abilities. Nursing professional development practitioners could use the results of this study to address the inconsistency of providing effective, daily discharge education for patients.

Using unfolding case studies to develop critical thinking skills in baccalaureate nursing students: A pilot study.

BACKGROUND: Research has consistently demonstrated that new graduate nurses do not possess sufficient critical thinking skills when they transition to clinical practice. Unfolding case studies encourage students to participate in a number of critical thinking skills including information-seeking, logical reasoning, and analyzing of clinical data. OBJECTIVE: The aim of this study was to determine how the use of unfolding case studies as a learning modality affected baccalaureate students' critical thinking skills in their Adult Health Theory course. The researcher compared course examination scores earned by nursing students who were taught using traditional case studies to scores obtained by nursing students who completed unfolding case studies. SETTING: The pilot study took place at a moderate-sized comprehensive university in Wisconsin. DESIGN: A non-experimental correlational design using course examination scores data was employed to examine how the use of unfolding case studies as a learning modality affected baccalaureate students' critical thinking skills in their Adult Health Theory course. PARTICIPANTS: A total of 160 students comprised the intervention group while an additional 142 students represented the control group in the study. METHODS: An independent-samples t-test was performed to explore differences in mean scores between the intervention and control groups. RESULTS: Results of the t-test indicate that mean examination scores were significantly higher for the intervention group (M = 234.9, SD = 13.1) than for the control group (M = 228.2, SD = 13.3); t(299) =, p < .001. CONCLUSIONS: Results of this study suggest that unfolding case studies more effectively develop students' critical thinking skills than do a more traditional, static case study.

Development and Validation of a Marginality Index for Nursing Students.

AIM: The purpose of this study was to develop a marginality tool that speaks specifically to the domain of nursing education. BACKGROUND: Minority nursing students in the United States have consistently reported feelings associated with the process of marginalization. Given the dearth of instruments that measure marginality directly, the concept has not been sufficiently investigated in nursing students METHOD: The Englund Marginality Index (EMI) was administered to 323 nursing students currently enrolled in a baccalaureate nursing program in Wisconsin. A psychometric evaluation of the index was performed. RESULTS: The EMI consists of 19 items and explained 70 percent of the variance. Cronbach's α coefficient for the instrument was .90. Test-retest correlation was strong at r = .92, a strong support for the temporal stability of the instrument. CONCLUSION: The findings from this study demonstrate that the EMI is a valid and reliable measure of marginality.

Life at the Margins: Marginality and Race in Undergraduate Students and Faculty.

The United States has become increasingly diverse, but this same rise in diversity is not reflected in the nursing profession. The purpose of this study was to investigate the relationship between marginality and minority status for nursing students in two states with very different racial/ethnic minority profiles. Marginality was measured using the Koci Marginality Index. When comparing students by geographical region, there were statistically significant differences between the two groups with regard to the marginality subconcepts of intermediacy, differentiation, power, secrecy, voice, liminality, and reflectiveness. Data were also collected from nurse faculty at each of the universities in Texas and Wisconsin. Findings suggest that there are significant differences between the two faculty samples with regard to advising, tutoring, and mentoring activities, as well as referral of minority students to campus resources. Marginalization is a complicated, deeply entrenched issue that continues to significantly impact minority nursing students across the nation.

More than a cultural experience: Assessing the impact of a medical-surgical international clinical on nursing students' academic performance.

A review of the extant literature suggests that there remains a dearth of evidence regarding the evaluation of well-defined outcomes related to international nursing clinical experiences. The purpose of this study was to explore the relationship between students' clinical experience (traditional versus international) and a number of academic outcomes including final medical-surgical course grades, performance on relevant Assessment Technologies Institute (ATI) proctored exams, and National Council Licensure Examination (NCLEX) pass rates. A non-experimental design was implemented using retrospective data obtained from a small university in the Midwest. Students complete a medical-surgical clinical in India during the interim of their third semester in the nursing program. Results of the t-tests show a statistically significant difference in final grades for Adult Health II theory when comparing students who completed a traditional clinical (M = 83.1, SD = 3.8) with those who completed an international clinical (M = 81.6, SD = 5.2); t(100) = 2.0, p = .043. The difference in mean scores for traditional clinical students (M = 70.3, SD = 6.6) versus international clinical students (M = 66.2, SD = 7.2) for the Adult Medical-Surgical proctored exam reached statistical significance, t(119) = 4.5, p ≤ .001. In contrast, there was no significant difference in means scores between the two groups with regard to scores on the Comprehensive Predictor proctored exam (traditional clinical, M = 76.1, SD = 5.9; international clinical, M = 75.2, SD = 6.4); t(121) = 1.0, p = .316. Finally, a chi square test of independence found that the relationship between clinical status and performance on NCLEX was not statistically significant, χ2 (1, N = 197) = 0.132, p = .716. Further research is needed to examine the impact of international clinicals on a broader range of outcomes including academic, cultural competency, and clinical performance measures.

Nontraditional Students' Perceptions of Marginalization in Baccalaureate Nursing Education: Pushed to the Periphery.

BACKGROUND: Despite the continued efforts to diversify the population of nursing students in the United States, marginalization and attrition remain significant issues for nontraditional students. PURPOSE: The purpose of this study was to investigate the relationship between marginality and nontraditional student status in nursing students enrolled in a baccalaureate nursing program in Texas. METHOD: A nonexperimental, descriptive, correlational design was used for data collection. Participants (n = 192) completed a demographic survey, and marginality was measured using the Koci Marginality Index-70. RESULTS: There was a statistically significant difference in mean scores for a number of variables including gender, age, race/ethnicity, marital status, total household income, completion of a previous college degree, being a parent, and a student for whom English is a nonnative language. CONCLUSION: The findings from this research study suggest that marginalization remains a significant issue for nontraditional, prelicensure nursing students.