Final year nursing students' preparedness for medication administration during COVID-19: A multi-site survey study.

AIM: To examine final-year undergraduate nursing students' characteristics and their perceived preparedness for medication administration across three universities during COVID-19. BACKGROUND: Medication administration is a complex process and medication errors can cause harm to the patient. Nurses are at the frontline of medication administration; therefore, nursing students must be well-prepared to administer medicines safely before graduation. Little is known about final-year undergraduate nursing students' perceived medication administration preparedness during COVID-19. DESIGN: A multi-site study using a cross-sectional survey of student demographics, the 'Preparedness for Medication Administration' (Revised) tool and an open-ended question. METHODS: The questionnaire was distributed to nursing students in their final semester of the program in 2022 across two universities in Australia and one in New Zealand. Completed surveys n=214. Descriptive statistics were used to analyse the demographic data. Differences in demographic data and preparedness scores between the three universities were analysed using ranked means, correlation coefficient, Chi-Square, Mann- Whitney U and Kruskal- Wallace H. Directed content analysis was used to analyse the data from the open-ended question. RESULTS: Overall, students reported high preparedness scores for medication. International students reported significantly higher preparedness scores (Md =119, n=29) compared with domestic students (Md=112.00, n=164), U=1759.50, z=-2.231, p=02, r=.16. Mean ranked scores for each item were above average across the three universities. The impact of COVID-19 on curriculum and students' opportunity to practice may be one explanation for the difference in preparedness scores between universities. International participants reported significantly higher scores on the Preparedness for Medication Administration (Revised) tool than domestic participants. Older students were more confident in applying principles of pharmacology to practice. Students' comments generated three major categories and five subcategories indicating preparedness gaps. CONCLUSION: This study provides insights into students' medication management preparedness during restrictions and before transitioning to the role of Registered Nurse. It highlights the need to provide integrated and comprehensive medication education and assessments throughout the curriculum and the need for additional support for newly graduated nurses in medication management due to the restrictions.

Block learning: Evaluation of a new teaching approach for nursing and midwifery education.

AIM: The aim is to present outcome and engagement data from the initial years of the implementation of a new teaching approach in entry to practice nursing and midwifery education. BACKGROUND: The Block Model (TBM) is a teaching approach that involves studying one unit of study at a time over a four-week period, as opposed to the traditional semester model. This paper presents data revealing the impact of TBM on student engagement and overall experience in entry to practice Bachelor of Nursing and Midwifery programs. DESIGN: The evaluation retrospectively compared key indicators pre- Block Model implementation with outcomes for nursing and midwifery students using TBM approach using standard data sets and external comparators such as the Student Experience Survey and National Employability Survey. METHODS: The study presents a comparative analysis of key indicators and graduate outcomes for students. We use reportable data and two external comparators, the Student Experience Survey and the National Employability Survey, to gauge student learning and graduate employability. The evaluation was conducted in a tertiary institution in Australia with for nursing and midwifery students who completed their studies using TBM approach at the university. RESULTS: The implementation of TBM in nursing and midwifery programs resulted in improvements in learner engagement, retention rates and pass rates. Improvements were also noted graduate outcomes, with an increase in full-time graduate employment. CONCLUSIONS: The results suggest the Block Model is a promising new teaching approach in nursing and midwifery education, with potential benefits for learner engagement, retention and pass rates.

An Exploratory Study of Undergraduate Nursing Students' Experiences of Group Work in Block Model Teaching.

ABSTRACT: The study's aim was to examine students' perceptions of group work taught in a block model in the first unit of an undergraduate nursing program. The study used a qualitative descriptive design with open-ended questions. Data from 27 students were analyzed using thematic analysis. Three main themes emerged from the data: 1) unmet expectations, 2) cognitive and metacognitive strategies (subtheme, reflection), and 3) engagement. The benefits and challenges associated with group work using the block model are highlighted, along with implications for education, practice, and further research.

The impact of motivational interviewing on behavioural change and health outcomes in cancer patients and survivors. A systematic review and meta-analysis.

BACKGROUND: Cancer patients and survivors commonly have poorer health behaviours and subsequent outcomes, often as a result of negative impacts of diagnosis and treatment. Motivational interviewing is reported to be an effective psychological tool to produce a shift in one's behaviour resulting in improved outcomes. However, there is a lack of analyses investigating this tool's impact on healthy behaviours and health outcomes in cancer populations. OBJECTIVE: To investigate the effect of motivational interviewing on behaviours and health outcomes in cancer populations. METHODS: The studies were identified from four databases using variations of the terms "cancer" and "motivational interviewing". Randomised trials, non-randomised trials and quasi-experimental studies which contained control (or usual care) comparators were included. Risk of bias was assessed using the Cochrane Risk of Bias Version 5.1.0 and the Risk of Bias In Non-Randomised Studies of Interventions tools. The quality of evidence was assessed using the GRADE framework. Means difference and standardised mean differences and 95 % confidence intervals were used to report the pooled effects using a random effects model. RESULTS: Twenty-one studies were included in the review and 17 studies were included in the meta-analysis. A total of 1752 cancer patients and survivors received MI as an intervention (or part thereof). Quality of life, anxiety, depression, functional tasks (6-minute walk test), body mass index and body weight (BMI/BW), physical activity (PA), self-efficacy and fatigue were outcomes measured in the selected studies. Effects were seen in functional tasks, physical activity, BMI/BW, depression and self-efficacy. All of these outcomes were from studies that were classed as very low-quality evidence except for BMI/BW and PA, which were from moderate-quality evidence. CONCLUSION: Motivational interviewing had positive effects on functional tasks, PA, BMI/BW, depression and self-efficacy in people diagnosed with cancer. However, more higher-quality studies need to be conducted to further ascertain the effect of this intervention.

The role of digital technologies in supporting quality improvement in Australian early childhood education and care settings.

This national study explored the role of digital technologies in early childhood education and care settings and whether they could contribute to quality improvement as reported by educators and assessors of quality in Australia. In this paper, data from Stage 2 of the Quality Improvement Research Project were used, which comprised 60 Quality Improvement Plans from educators linked with 60 Assessment and Rating reports from the assessors who visited early childhood centres as part of the administration of the National Quality Standards by each of Australia's State and Territory jurisdictions. Bronfenbrenner's ecological systems theory ( Bronfenbrenner, U. (1995). Developmental ecology through space and time: A future perspective. In P. Moen, G. H. Elder, Jr., & K. Lüscher (Eds.), Examining lives in context: Perspectives on the ecology of human development (pp. 619-647). American Psychological Association. 10.1037/10176-018; Bronfenbrenner & Ceci, Bronfenbrenner and Ceci, Psychological Review 101:568-586, 1994) was adopted to facilitate a systemic and dynamic view on the use of digital technologies in these 60 ECEC settings. References (e.g. comments/ suggestions/ examples) made by the educators about the implementation of digital technologies were counted and thematically analysed. Results revealed the strong role new technologies (e.g. documentation and management platforms, tablets, apps, etc.) play in the majority of ECEC settings and especially in relation to three of the seven Quality Areas: Educational programme and practice (Quality Area 1); Collaborative partnerships with families and communities (Quality Area 6) and Governance and leadership (Quality Area 7). Future directions for research are suggested and implications for embracing a more holistic, integrated and broad view on the use of digital technologies are discussed.

Structures and systems influencing quality improvement in Australian early childhood education and care centres.

This study assessed the impact of structural characteristics on quality rating and improvement systems (QRIS) outcomes in an Australian national study. Data from the Australian Children's Education and Care Quality Authority (ACECQA) repository of National Quality Standard (NQS) ratings were used to identify long day care services that had improved from Working Towards NQS to Meeting or Exceeding NQS or had no change over two assessments. QRIS outcomes were examined for state/territory jurisdiction, urban-rural location, community socio-economic status, type and size of provider organisation, centre size and stability of centre owner/provider using multinomial logistic regression analyses. Controlling for jurisdiction, results showed that improvement to Meeting NQS was more likely for not-for-profit versus for-profit providers and for large multi-site provider organisations versus small, stand-alone providers. Improvement to Exceeding NQS was also associated with not-for-profit and larger provider organisations, as well as larger versus smaller centres, and centres that had stable ownership.

A PSYCHOMETRIC APPRAISAL OF THE MOTIVATED STRATEGIES FOR LEARNING QUESTIONNAIRE IN FINAL YEAR UNDERGRADUATE NURSING STUDENTS.

Background: The purpose of this study was to evaluate the psychometric properties of the Motivated Strategies for Learning Questionnaire (MSLQ) in undergraduate nursing students. Method: An exploratory factor analysis was conducted to assess the reliability and construct validity of the MSLQ, using principal axis factoring (PAF) and varimax rotation on the 81-items. Results: 300 Students completed the MSLQ. The MSLQ with 81-items produced an 8-factor solution, eigenvalues greater than 1.0, with only three of the original MSLQ factors retained. Cronbach alpha ranged from .69 to .89; parallel analysis results ranged from 2.22 to 1.80 across the factors. Conclusion: The difference in the empiric fit between the data and the theoretical model suggests the need for instrument revisions, at least for this learner population.

The self-regulated learner, entry characteristics and academic performance of undergraduate nursing students transitioning to University.

BACKGROUND: Although the importance of fostering students self-regulated learning is well known, little is known about the relationship between student entry characteristics, particularly students from disadvantaged backgrounds, self-regulatory strategy use and academic performance. The study aim was to examine undergraduate nursing students' entry characteristics, motivational behaviours and learning strategies, and academic performance after transitioning into the first unit of an undergraduate nursing course. DESIGN: A cross-sectional survey. SETTING: A university in Australia. PARTICIPANTS: First-year undergraduate nursing students. METHODS: The Motivational Strategies for Learning Questionnaire, including demographic information, was distributed to students in the fourth week of commencing University, consent was obtained for the use of student unit grades. RESULTS: For the 448 eligible students, n = 282 (62.9%) completed the survey. Students were categorised by age into three groups: 18 years, 19-22 years, and 23+ years. Entry characteristics, motivation and learning strategies scores and academic performance were related to the age category with the greatest difference between 18 and 23+ student groups. 23 years+ had higher scores for 11 MSLQ scales (mean difference 0.78-0.31, p < 0.05) highest grades (F = 4.694, p = 0.010). Students 23+ years had the highest motivational behaviours and learning strategies. The international students' academic grades in this study were lower than the domestic student's grades (t = -2.212, p = 0.028). CONCLUSION: This study highlights the need to address the tensions that exist between attracting quality students, the requirement to assess their quality efficiently and allowing students from disadvantaged groups the opportunity to enter nursing undergraduate degree courses. This study contributes new knowledge to the impact students' entry characteristics have on motivational behaviours, learning strategy use and academic performance. Knowing this would allow faculty to identify students at risk of failure early in the course and offer instructional support.

Undergraduate nursing student and preceptors' experiences of clinical placement through an innovative clinical school supervision model.

This study explores final year undergraduate nursing and midwifery students and their preceptors' experiences of a newly introduced Clinical School Supervision (CSS) model, which was implemented to reduce a perceived disconnect between theory and practice. A descriptive design was used with qualitative data collected through open-ended survey questions. Respondents included 43 undergraduate nursing and midwifery students involved in the final year and 13 clinical preceptors from a large metropolitan tertiary health service in Victoria, Australia. Qualitative data were analysed using thematic analysis. Students described the CSS as a favoured supervision model with students being able to take advantage of support from both the academic supervisor and nursing staff in the clinical setting, a model which also supported student's sense of belonging. Students experiences indicated the CSS model facilitated consolidation of knowledge, reflective practice and transition to graduate nursing. The preceptors described a commitment to and preparedness for the role, although they found they had little break from teaching and their rosters did not always align with their students'. Preceptors also shared experiences of unfulfilled expectations, lack of recognition and incentives for supervising students. Further studies are needed to identify effective ways to support preceptors in their roles.

Exploration of self-regulatory behaviours of undergraduate nursing students learning to teach: A social cognitive perspective.

Self-regulated learning is a model of learning situated in social cognitive theory that views learners as active participants in their learning. Similarly, peer-learning is a pedagogical approach that assigns greater autonomy to the student and known to enhance student learning. The objective of this study was to determine the self-regulated learning strategies used by final year undergraduate nursing students enrolled in a teaching unit that included a component of peer-teaching. A mixed methods study was conducted across four campuses of one university. Three hundred and five undergraduate nursing students completed The Motivational Strategy for Learning Questionnaire and fourteen students consented to interviews. Key findings included the high level of reported motivational and learning strategies used by students in their approach to learning, and in their roles as near-peer teachers. Learning strategies were associated with higher-order learning and near-peer teaching enhanced shared regulation using dyadic teaching. This study has shown how participating in a formal teaching unit prior to graduating may positively influence self-regulatory behaviours and increase student confidence and is therefore uniquely situated to promoting students' anticipatory control over similar opportunities in the clinical setting once they graduate.

Observed compliance with safe sleeping guidelines in licensed childcare services.

OBJECTIVE: To independently assess compliance with safe sleeping guidelines for infants <12 months in licensed childcare services. DESIGN: Full-day, in-situ observations of childcare practices (including sleep and non-sleep periods) conducted in 2016-2017. SETTING: Australian home-based and centre-based licensed childcare services. All subject to national regulation and legislation to comply with safe sleeping guidelines. PARTICIPANTS: The sample was 18 licensed childcare settings (15 centre-based, 3 home-based) that had infants <12 months (n=49) attending at the time of observation. 31 educators completed self-report surveys. MAIN OUTCOMES AND MEASURES: Standard observations of childcare practices, including a 20-item infant Safe Sleeping Guideline checklist. Educator characteristics, including each individual's knowledge, beliefs and attitudes regarding safe sleeping practices. RESULTS: 83% of childcare services were observed to be non-compliant on at least 1 of 20 target guidelines (median 2.5, max=7); 44% were observed placing infants prone/side and 67% used loose bedding, quilts, doonas/duvets, pillows, sheepskins or soft toys in cots. 71% of the childcare settings had a copy of current safe sleeping guidelines displayed either in or at entry to the infant sleep room. CONCLUSION: Despite 25 years of public health messaging, non-compliance with safe sleeping guidelines was observed to be high in childcare services. Understanding of the reasons underlying non-compliance, particularly in contexts were legislative mandate and access to information regarding safe sleeping is high, is critical to informing ongoing public health messaging and should be the focus of future studies. TRIAL REGISTRATION NUMBER: ANZCTR 12618001056280-pre-results.

Near-peer teaching in undergraduate nurse education: An integrative review.

INTRODUCTION/BACKGROUND: Studies in peer learning and teaching reported in the nursing literature are mainly descriptive, summarising positive aspects using survey and interviews. Application of pedagogical approaches to near-peer teaching in undergraduate nursing, using educational psychology frameworks to explain the outcomes, is relatively unknown. OBJECTIVES: The objective of this integrative review was to ascertain outcomes of near-peer teaching in undergraduate nurse education and theoretical frameworks used to explain outcomes of near-peer teaching. DESIGN: Included qualitative and quantitative studies. METHOD: The review was conducted in accordance with the PRISMA protocol and Joanna Briggs Institute processes and included studies published between the years 1990 and 2017. Quality appraisal involved two independent reviewers analysing the data, and narrative synthesis was used to report results. RESULTS: Two hundred and twenty-one abstracts were assessed independently by two reviewers for relevance to near-peer teaching in undergraduate nurse education, 29 articles selected for further review with 10 meeting the inclusion criteria. Benefits of near-peer teaching were reported as creating a safe supportive learning environment, learners viewing near-peer teachers as effective role models and increased confidence experienced by learner and teacher. Studies focused mainly on cognition in relation to performance with little emphasis on metacognition or affective behaviours, highlighting the need for more studies to provide definitive evidence supporting this pedagogical approach and framing its implementation around theories, particularly from educational psychology. CONCLUSION: Lack of training provided to near-peer teachers highlighted that it is imperative that faculty embed near-peer teaching into the curriculum. To develop this educational intervention, studies in near-peer teaching are required to assess affective behaviours and metacognitive qualities of near-peer teachers to determine how this educational intervention can impact learning and performance of both the learner and near-peer teacher.

'I didn't expect teaching to be such a huge part of nursing': A follow-up qualitative exploration of new graduates' teaching activities.

BACKGROUND: Teaching has long been recognised as an important role for nurses. In addition, much has also been written about new graduates' transitions to professional practice. However, the role of new graduates in teaching is unclear, and at what point they are required to teach others as part of their practice. OBJECTIVES: To explore the teaching activities undertaken by new nursing graduates, and their readiness for this role following a semester-long education subject in their undergraduate degrees. DESIGN: A qualitative descriptive design SETTINGS: All participants were undertaking graduate nurse programs and working in different hospitals across Melbourne, Australia. Five were working in public hospitals, and one in a private hospital. PARTICIPANTS: Six graduate nurses who had completed the education subject at one Australian university and were between four and six months into their graduate year program. METHODS: Semi-structured interviews guided by key questions were conducted by telephone. Transcripts were analysed using thematic analysis. RESULTS: Three themes emerged: expectations and the nature of teaching, nature of learners, and attitudes to teaching role. All participants were engaged in some teaching activity early in their graduate programs. This included students of nursing and other disciplines, and qualified staff, as well as patients and their families. Participants reported feeling more confident and better prepared for their roles having completed the education subject than those of their peers, educated at other universities, who had not covered such content. CONCLUSIONS: New graduates are required to teach others, both formally and informally, early after registration. This requirement of professional practice is assisted by the inclusion of an education subject embedded in the undergraduate nursing degree.

How are we assessing near-peer teaching in undergraduate health professional education? A systematic review.

BACKGROUND: Near Peer teaching (NPT) is reported as an effective pedagogical approach to student learning and performance. Studies in medicine, nursing and health sciences have relied mainly on self-reports to describe its benefits, focusing on psychomotor and cognitive aspects of learning. Despite increasing research reports on peer teaching internationally, little is known about the various domains of learning used in assessment of performance and objective learning outcomes of NPT. OBJECTIVE: To determine the domains of learning and assessment outcomes used in NPT in undergraduate health professional education. METHODS: Quantitative systematic review was conducted in accord with the PRISMA protocol and the Joanna Briggs Institute processes. A wide literature search was conducted for the period 1990-November 2015 of fourteen databases. Grey literature was undertaken from all key research articles. Studies meeting the inclusion criteria were eligible for consideration, including measured learning outcomes of near-peer teaching in undergraduate education in nursing, medicine and health sciences. Set limitations included publications after 1990 (2015 inclusive), English language and objective learning outcomes. A quality appraisal process involving two independent reviewers was used to analyse the data. RESULTS: Of 212 selected articles, 26 were included in the review. Terminology was confusing and found to be a barrier to the review process. Although some studies demonstrated effective learning outcomes resulting from near-peer teaching, others were inconclusive. Studies focused on cognitive and psychomotor abilities of learners with none assessing metacognition, affective behaviours or learning outcomes from quality of understanding. CONCLUSION: The studies reviewed focused on cognitive and psychomotor abilities of learners. Even though evidence clearly indicates that metacognition and affective behaviours have direct influence on learning and performance, indicating more research around this topic is warranted. Methodological quality of the studies and lack of theoretical frameworks underpinned by educational psychology may have contributed to inconsistencies in learning outcomes reported.

Peer-assisted learning: time for nomenclature clarification.

BACKGROUND: Peer-assisted learning (PAL) is used throughout all levels of healthcare education. Lack of formalised agreement on different PAL programmes may confuse the literature. Given the increasing interest in PAL as an education philosophy, the terms need clarification. The aim of this review is to 1) describe different PAL programmes, 2) clarify the terminology surrounding PAL, and 3) propose a simple pragmatic way of defining PAL programmes based on their design. METHODS: A review of current PAL programmes within the healthcare setting was conducted. Each programme was scrutinised based on two aspects: the relationship between student and teacher, and the student to teacher ratio. The studies were then shown to fit exclusively into the novel proposed classification. RESULTS: The 34 programmes found, demonstrate a wide variety in terms used. We established six terms, which exclusively applied to the programmes. The relationship between student and teacher was categorised as peer-to-peer or near-peer. The student to teacher ratio suited three groupings, named intuitively 'Mentoring' (1:1 or 1:2), 'Tutoring' (1:3-10), and 'Didactic' (1:>10). From this, six novel terms - all under the heading of PAL - are suggested: 'Peer Mentoring', 'Peer Tutoring', 'Peer Didactic', 'Near-Peer Mentoring', 'Near-Peer Tutoring', and 'Near-Peer Didactic'. CONCLUSIONS: We suggest herein a simple pragmatic terminology to overcome ambiguous terminology. Academically, clear terms will allow effective and efficient research, ensuring furthering of the educational philosophy.

Bridging the gap: from simulation to clinical practice.

BACKGROUND: There has been a shift from the initial learning of skills on patients in the clinical setting to initial learning in a simulated environment, using part-task models, with the risk of a task focus to the learning. We contend that quality learning in both the simulated and the clinical environment is crucial to enhance the transferability of skills to the clinical setting. CONTEXT: We describe teaching strategies, with the sequencing of events and increasing complexity, for the simulated training of basic procedural skills. These teaching strategies can be readily implemented into basic skills training to 'bridge' the gap between the simulated environment and the clinical setting. IMPLICATIONS: We suggest that our approach takes basic skills training beyond a task-focused approach to exemplify clinical scenarios encountered in real life. We argue that there is a need to broaden the focus of medical student training in basic procedural skills, and that the use of a preceptor model of supervision in the clinical setting better enables the transferability of the skills. Although our strategies are based on learning theory, well-designed research is required to test the efficacy in improving medical student learning.

Incidence and Distribution of Raspberry bushy dwarf virus in Commercial Red Raspberry (Rubus idaeus) Crops in Scotland.

A survey was done in 1998 to determine whether Raspberry bushy dwarf virus (RBDV) was established in raspberry fruiting plantations in Scotland. Raspberry-producing holdings were selected according to geographical area and size. Samples (201), each comprising 60 shoots per stock, were obtained from 77 holdings and tested by enzyme-linked immunosorbent assay (ELISA). ELISA-positive shoots from each infected stock were grafted onto cultivar Glen Clova, which is resistant to the Scottish-type isolate of RBDV (RBDV-S), to establish whether the virus is a resistance-breaking (RB) isolate. RBDV was detected in 22% of the stocks sampled, with 2 to 80% incidence of infection. No RBDV was in any of the 40 plantations containing cultivars resistant to RBDV-S or in Glen Clova plants, which were grafted successfully with samples from 15 infected plantations, indicating that no RB isolates were detected. The percentage of infected plantations increased with time from the planting date. In order to investigate possible sources of infection, ELISA for RBDV was made in 1999 on samples of stocks of raspberry cultivars entered for the lowest certified grade (Standard Grade) in Scotland and, in 1994 to 1997, on certified stocks planted with material originating from outside Scotland. No RBDV was detected in any of the samples. RBDV was found only rarely in samples of wild raspberry in Angus and Perthshire.