Caring for nursing students is caring for patients: A multicentre cross-sectional study on the relationship between nursing students' caring and the perception of instructors' caring.

BACKGROUND: Caring in nursing is a fundamental aspect, yet teaching and fostering caring behaviours in nursing students remain challenging. Clinical instructors play a crucial role in this process. OBJECTIVES: The aims of this study were a) to describe nursing students' caring behaviours and perceptions of instructor caring, b) to assess sex-related and year of course differences in students' caring behaviours and perceptions of nursing caring, and c) to investigate the association between nursing students' caring and their perception of instructors' caring. DESIGN: A multi-centre, cross-sectional observational study was conducted. SETTING: The study involved undergraduate nursing students from four teaching hospitals of a university in Northern Italy. PARTICIPANTS: A total of 316 nursing undergraduate students participated in the study (83.9 % female, 16.1 % male, 23.1 % 1st year, 48.1 % 2nd year, 28.8 % 3rd year). METHODS: Participants completed online self-reported surveys assessing caring behaviours, empathy, burnout, and perceptions of instructor caring. Caring behaviours, expressive and instrumental caring, were measured using the Caring Behaviour Inventory (CBI), and perceptions of instructor caring were assessed using the Nursing Students' Perceptions of Instructor Caring (NSPIC) questionnaire. RESULTS: Students' caring behaviours were positively associated with their perceptions of instructor caring, particularly in relation to a supportive learning climate and instructor flexibility. Female students displayed higher scores in expressive caring, while students in their second and third years demonstrated increased instrumental caring behaviours. Responding to Individual Needs was significantly lower in third-years students, compared to first- and second-year ones. CONCLUSIONS: This study emphasizes the crucial role of clinical instructors in shaping nursing students' caring attributes. However, the influence of sex on caring behaviours remains unclear, necessitating further investigation. These findings underscore the significance of nurturing caring behaviours in nursing education and offer insights for selecting, training, and supporting clinical instructors, to foster more compassionate and competent nurses.

Construcción y atributos del profesionalismo en una escuela de enfermería en chile

Objetivo: Construir una definición consensuada de profesionalismo que contenga los atributos esenciales del ser profesional en una Escuela de Enfermería. Material y Método: Diseño descriptivo cualitativo, que utilizó el análisis de contenido en tres fases secuenciales: 1) Revisión integrativa entre los años 2009 y 2019 en las bases de datos Pubmed, CINAHL, Nursing (Proquest), en referencias de los estudios seleccionados y en páginas de sociedades científicas internacionales, sin límites de idioma. De los 33 textos completos seleccionados, se identificaron definiciones de profesionalismo y sus atributos por medio de las cinco etapas propuestas por Whittemore y Knafl; 2) Exploración con enfoque cualitativo, cuya muestra intencionada fue con informantes claves de la carrera de Enfermería: estudiantes de último año, académicos, egresados y empleadores; 3) Integración de la información recolectada a través de una construcción grupal, generando registros de definiciones y atributos comunes que se relacionaron bajo un sistema de categorías hasta lograr la saturación. Finalmente, se planteó una propuesta de la definición conceptual y los atributos del profesionalismo, validados por un participante de cada categoría. Resultados: Los atributos identificados fueron: la entrega de un cuidado humanizado, basado en sólidos conocimientos científicos, con liderazgo, responsabilidad y respeto a personas, familias y comunidades. Conclusiones: Se definió profesionalismo con cinco atributos del ser profesional que coinciden con la literatura internacional. Es relevante que académicos, tutores clínicos y preceptores hagan propios estos atributos, porque a través del modelaje de estos, contribuyen a formar a los futuros profesionales.

Objective: To construct a consensual definition of professionalism that includes the essential attributes of being a professional in a school of nursing. Materials and Methods: Qualitative descriptive design using content analysis in three consecutive phases: 1) Integrative review between 2009 and 2019 in the databases Pubmed, CINAHL, Nursing (Proquest), in the references of the selected studies and in the pages of international scientific societies, without language limitations. From the 33 full texts selected, definitions of professionalism and its attributes were identified through the five stages proposed by Whittemore and Knafl; 2) Exploration with a qualitative approach, whose intentional sample included key informants from the nursing study program, such as final year students, instructors, graduates and employers; 3) Integration of the information collected through a group construction, generating records of definitions and common attributes, which were related under a system of categories until saturation was reached. Finally, a proposal was made for a conceptual definition and attributes of professionalism, validated by a participant in each category. Results: The attributes identified were the provision of humanized care based on sound scientific knowledge, with leadership, responsibility and respect for individuals, families and communities. Conclusions: Professionalism was defined using five attributes that are consistent with the international literature. It is relevant that instructors, clinical tutors and preceptors embrace these attributes, because they ultimately contribute to the training of future professionals.

Objetivo: Construir uma definição consensual de profissionalismo que contenha os atributos essenciais para um profissional em uma escola de enfermagem. Material e Método: Estudo descritivo qualitativo que utilizou a análise de conteúdo em três fases sequenciais: 1) Revisão integrativa entre 2009 e 2019 nos bancos de dados Pubmed, CINAHL, Nursing (Proquest), nas referências dos estudos selecionados e nas páginas de sociedades científicas internacionais, sem limitações de idioma. A partir dos 33 textos completos selecionados, foram identificadas as definições de profissionalismo e seus atributos por meio das cinco etapas propostas por Whittemore e Knafl; 2) Exploração de abordagem qualitativa com amostra intencional que incluiu informantes-chave do programa de estudos de enfermagem, como alunos do último ano, docentes, graduados e empregadores; 3) Integração das informações coletadas por meio de uma construção em grupo, gerando registros de definições e atributos comuns que foram relacionados sob um sistema de categorias até atingir a saturação. Finalmente, foi feita uma proposta de definição conceitual e de atributos de profissionalismo, validada por um participante de cada categoria. Resultados: Os atributos identificados foram a prestação de cuidados humanizados, com base em conhecimento científico sólido, com liderança, responsabilidade e respeito pelos indivíduos, famílias e comunidades. Conclusão: O profissionalismo foi definido por meio de cinco atributos que são consistentes com a literatura internacional. É importante que os docentes, tutores clínicos e preceptores adotem esses atributos, já que eles contribuem para a formação dos futuros profissionais.

Factores facilitadores y obstaculizadores del aprendizaje a través de la simulación

Objetivo: Identificar los factores que facilitan y dificultan el aprendizaje a través de la simulación y el ECOE, desde la perspectiva de los estudiantes y los docentes en la carrera Técnico en Enfermería de Nivel Superior. Material y Método: Estudio cualitativo con diseño fenomenológico, donde se aplicó encuesta en línea y se desarrollaron entrevistas semiestructuradas y grupos focales. El muestreo fue no probabilístico por conveniencia y participaron diez estudiantes y diez profesores pertenecientes a la carrera en una universidad privada en la ciudad de Santiago (Chile). Para llevar a cabo el proceso de análisis, codificación y clasificación de los datos, se utilizó el software de análisis NVivo. Se consideraron los principios y responsabilidades de la Declaración de Singapur sobre Integridad en la Investigación. Resultados: Los elementos favorecedores para las habilidades procedimentales son la metodología; la práctica y repetición; los profesores; los insumos y materiales y la motivación. Los elementos obstaculizadores fueron el nerviosismo, la falta de insumos y el tiempo escaso. Las limitaciones se dieron por el contexto sanitario, que implicó recoger información a distancia. Conclusiones: Se identificaron aspectos favorecedores y obstaculizadores para el logro de las habilidades procedimentales en la formación de técnicos en enfermería. Estos resultados pueden ser considerados insumos para realizar propuestas de diseño curricular que aborden aspectos didácticos, metodológicos y humanos.

Objective: To identify the factors that facilitate and hinder learning through simulation and OSCE, from the perspective of students and instructors in the field of licensed practical nurses (known as TENS in Chile). Materials and Methods: Qualitative study with a phenomenological design, in which an online survey was administered, and semi-structured interviews and focus groups were carried out. Non-probabilistic convenience sampling was used and ten students and ten instructors belonging to a TENS training program of a private university in Santiago de Chile participated. NVivo analysis software was used to carry out the data analysis, coding, and classification process. The principles and responsibilities of The Singapore Statement on Research Integrity were considered. Results: Facilitating elements for procedural skills were methodology, practice and repetition, instructors, supplies and materials, as well as motivation. Hindering elements were nervousness, lack of supplies and time scarcity. Limitations were caused by the healthcare setting, which involved having to collect information remotely. Conclusions: Facilitating and hindering aspects for the achievement of procedural skills in the training of TENS nurses were identified. These results may contribute to outline curriculum design proposals that address didactic, methodological, and person-related aspects.

Objetivo: Identificar os fatores que facilitam e dificultam a aprendizagem através da simulação e do ECOE, da perspectiva dos estudantes e professores no âmbito dos técnicos de enfermagem (conhecidos como TENS no Chile). Materiais e Método: Estudo qualitativo com desenho fenomenológico, onde foi aplicado uma pesquisa on-line e foram realizadas entrevistas semiestruturadas e grupos focais. Foi utilizada uma amostragem não- probabilística por conveniência e participaram 10 estudantes e 10 professores pertencentes à um programa de formação de TENS de uma universidade privada em Santiago do Chile. Para realizar o processo de análise, codificação e classificação dos dados, foi utilizado o software de análise NVivo. Foram considerados os princípios e responsabilidades da Declaração de Singapura a Integridade em Pesquisa. Resultados: Os elementos facilitadores das competências processuais foram a metodologia, a prática e repetição, os professores, os materiais e a motivação. Os elementos que dificultam são o nervosismo, a falta de materiais e o tempo escasso. As limitações foram causadas pelo contexto da saúde, o que implicou a recolha de informação à distância. Conclusões: Foram identificados os aspectos favoráveis e obstáculos à obtenção de competências processuais na formação de técnicos de enfermagem. Estes resultados podem ser considerados como contributos para propostas de concepção curricular que abordem aspectos didáticos, metodológicos e humanos.

From clinical expert nurse to part-time clinical nursing instructor: design and evaluation of a competency-based curriculum with structured mentoring: a mixed methods study.

BACKGROUND: Transition from a clinical expert nurse to a  part time clinical nursing instructor (PTCNI) poses several challenges. Designing a professional development curriculum to facilitate the transition from a clinical expert nurse to a  PTCNI is critical to effective education. A comprehensive competency-based curriculum was developed and implemented with structured mentoring to prepare clinical expert nurses as PTCNIs. METHODS: A mixed-methods study with a sequential-exploratory approach was conducted in Iran in 2019. In the qualitative phase, Saylor et al.'s (1981) seven-step model was used, consisting of (1) collecting evidence from a systematic review, (2) conducting interviews with learners, (3) setting goals and objectives, (4) design, (5) implementation, (6) evaluation, and (7) feedback. In the quantitative phase, curriculum domains were evaluated. Additionally, the effective professional communication skills module was implemented using a quasi-experimental study with a pre-test post-test single-group design for 5 PTCNIs in a pilot study. RESULTS: After integrating the findings of the literature review and field interviews in the analysis stage, a curriculum was developed with a total of 150 h, six modules, and 24 topics. Results of the pilot study showed a significant improvement in the confidence of PTCNIs as a result of the implementation of the effective communication skills module using the mentoring method (t = - 16.554, p = 0.0005). CONCLUSIONS: This competency-based curriculum was based on the evidence and needs of PTCNIs and provides a complete coverage of their clinical education competencies. It is suggested that managers of educational institutes that offer nursing programs use this curriculum to prepare them in continuing education programs. Further studies are needed to thoroughly evaluate the learning outcomes for students.

Clinical nursing instructors' perceived challenges in clinical teaching.

AIM: The purpose of this qualitative study was to explore the challenges in clinical teaching that are encountered by clinical instructors and to foster the relevant training. METHODS: Focus group methodology was used. The participants were 54 clinical nursing instructors who were recruited from middle Taiwan and participated in one of five focus groups of 2-3 h each. The data transcripts were analyzed by using qualitative content analysis. RESULTS: Five challenges emerged: (i) teaching outside one's area of expertise; (ii) building cooperative relationships with the clinical staff; (iii) the unit's use of students as nursing staff; (iv) inappropriate clinical practices by the clinical staff; and (v) clinical staff members' negative comments toward the students. These challenges revealed clinical nursing instructors' difficulties in balancing clinical teaching quality and their relationships with the clinical staff members. CONCLUSION: The identified challenges reflect the need to support clinical instructors and assist them to prepare for their role through training programs or policy changes.

Nursing instructors' perception of students' uncivil behaviors: A qualitative study.

BACKGROUND: Uncivil behavior is a serious issue in nursing education around the world, and is frequently faced by instructors and students. There is no study in relation to explain the concept and dimensions of uncivil behavior in nursing education of Iran. AIM: The aim of this study was to determine the perception of nursing educators about student incivility behavior. METHODS: This was a qualitative study. Data from 11 semi-structured interviews were analyzed using conventional content analysis. Participants and research context: In all, 11 nursing educators of 5 various nursing schools in Tehran, capital of Iran, participated. Ethical considerations: Organizational approval by the Universities, and informed consent were ensured before conducting the research. The principles of voluntariness, confidentiality, and anonymity were respected during the research process. RESULTS: Three themes were found: disruptive behavior affecting communication climate, disruptive behavior affecting ethical climate, and disruptive behavior affecting learning climate. Discussion and final considerations: The results of this study demonstrated that uncivil behavior affects every ethical, communicational, and learning climate and threaten peace of the instructors, students, and the academic community. With the consideration of mutuality in incivility behaviors, the authors propose to examine students' perceptions and identify dimensions of uncivil behavior of instructors for formulating strategies to minimize such behaviors in nursing educational society.

Impact of Instructors' Caring on Students' Perceptions of Their Own Caring Behaviors.

PURPOSE: The aim of this study was to identify the correlation between instructors' and students' caring behaviors and to explore the impact of instructors' caring on students' perceptions of their own caring behaviors. DESIGN: A descriptive, nonexperimental design was used in this study. METHODS: A total of 586 student nurses from four countries (Greece, the Philippines, India, and Nigeria) were recruited to participate in this study during the months of September 2013 to January 2014. Data collection was based on interviews using two standardized questionnaires: the Nursing Students' Perception of Instructor Caring (NSPIC) and the Caring Behavior Inventory (CBI). Inferential statistics such as the Pearson r correlation and regression analysis were used to determine correlations between relevant variables. FINDINGS: Student nurses perceived "instills confidence through caring" (mean = 4.275, SD = 0.755) as the most frequently demonstrated subscale, while "control vs. flexibility" (mean = 3.469, SD = 0.701) was the least demonstrated subscale. The highest self-reported subscale in the CBI was "assurance" (mean = 4.796, SD = 0.949), while "connectedness" (mean = 4.541, SD = 0.985) was the lowest self-rated subscale. The NSPIC correlated significantly with the CBI (r = .587, p < .001). Four of the five subscales in the NSPIC correlated significantly with the CBI when considered individually; the exception was the "Supportive learning climate" subscale (r = .009, p < .40). Among the NSPIC subscales, "instills confidence through caring" explained 32% in the CBI and "appreciation of life's meaning" explained 3% in the CBI. CONCLUSIONS: Instructors' caring behaviors influenced nursing students' caring behaviors positively. Through positive faculty modeling and role modeling, nursing students can be professionally trained to develop the competence of caring. CLINICAL RELEVANCE: The knowledge generated from this study provides direction in developing useful and effective caring strategies and curricular programs for nursing students. Understanding this concept in a cross-cultural context is necessary in order to develop an international perspective about caring, which is necessary in developing and formulating effective teaching and clinical strategies.

Qualitative study of humanization-based nursing education focused on role modeling by instructors.

This study explored the perspectives and experiences of Iranian nursing students and nursing instructors about role modeling. Using a purposeful sampling strategy, 22 nursing students and seven nursing instructors were recruited from five nursing schools in Tehran. Three focus-group discussions and two individual semi-structured interviews with nursing students, and seven semi-structured interviews with nursing instructors, were conducted to gather data. A qualitative content analysis approach was utilized and three main themes emerged during data analysis: "attempt to promote emotional development,""attempt to promote spiritual development," and "attempt to promote intellectual development." It was concluded that understanding the factors influencing role modeling will be helpful for developing strategies to integrate role modeling into nursing education so as to promote the quality of nursing education in Iran.