Background: The aim of this study is to validate a newly developed nurses' self-efficacy sources inventory. We test the validity of a five-dimensional model of sources of self-efficacy, which we contrast with the traditional four-dimensional model based on Bandura's theoretical concepts. Methods: Confirmatory factor analysis was used in the development of the newly developed self-efficacy measure. Model fit was evaluated based upon commonly recommended goodness-of-fit indices, including the χ2 of the model fit, the Root Mean Square Error of approximation (RMSEA), the Tucker-Lewis Index (TLI), the Standardized Root Mean Square Residual (SRMR), and the Bayesian Information Criterion (BIC). Results: All 22 items of the newly developed five-factor sources of self-efficacy have high factor loadings (range .40-.80). Structural equation modeling showed that a five-factor model is favoured over the four-factor model. Conclusions and implications: Results of this study show that differentiation of the vicarious experience source into a peer- and expert based source reflects better how nursing students develop self-efficacy beliefs. This has implications for clinical learning environments: a better and differentiated use of self-efficacy sources can stimulate the professional development of nursing students.
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Community care is becoming increasingly important. In the Netherlands, the percentage of people over the age of 65 is expected to increase to 22% by 2025, leading to more elderly patients, often with long-term and complex health problems (multimorbidity). Because many of these patients continue to live at home until a very old age, nurses are increasingly working outside of institutions. The 17 Dutch Bachelor nursing programmes responded to this development with a new national education profile 'Bachelor Nursing 2020 (BN2020)’ with more elements of community care. However, despite the increase in extramural care, the Dutch labour market has a shortage of community nurses with higher professional education qualifications, partly because most nursing students focus on the general hospital setting as the environment for their future career. Whether this is based on a perception of community care that deters making this choice has never been systematically investigated. It is also unclear whether a more community-oriented curriculum will better equip students for working in community care. In response to these issues, the nursing programme at the Amsterdam University of Applied Sciences (AUAS) redesigned its curriculum to include more elements of community care. Three perspectives were chosen for the redesign: (1) the influence of lecturers as role models, (2) positive placement experiences, and (3) five new ‘community-based’ themes in education. These new themes are as follows: patient self-management, shared decision-making, collaboration with the patients’ social system, healthcare technology, and allocation of care. The redesign also includes a ‘paved way’ into community care in the form of a coherent and attractive programme for interested students.This thesis describes whether and how the curriculum-redesign within higher professional education in nursing can be effective in terms of (1) stimulating a positive perception of community care and (2) realising a form of community care in line with the new themes in BN2020. In other words, that students will base choices in their actions/nursing interventions on these new themes in the education profile.
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This speech discusses how the professorship intends to support practitioners in the nursing domain and contribute to shaping nursing leadership and each person's professional individuality. The title of the speech, “Notes on Nursing 2.0,” is particularly intended to emphasize the need for these changes in the nursing domain. Not by assuming that nothing has changed in care and nursing since Nightingale's time. There has. Being educated in the professional domain is not only a given but a requirement. The knowledge domain of care and nursing has developed far and wide in nursing diagnostics and standards. Nursing science research, which Nightingale once started as the first female statistician in the British Kingdom, has firmly established itself in education and practice. Wanting to be of significance to others out of compassion is still the professional motivation, but there is no longer a subservient servitude (Cingel van der, 2012). At the same time, wholehearted leadership is not yet taken for granted in daily practice and optimal professional practice falters due to an equality principle of differently educated caregivers and nurses that has been held for too long. That is the need for change to which this 2.0 version “Notes on Nursing” and the lectorate want to contribute in the coming years. Chapter 1, through the metaphors in the story “The Cat Who Looked at the King,” describes the vision of emancipatory action research and the change principles that the lectorate will deploy. Chapter 2 contains the reason, mission and lines of research that are interrelated within the lectorate. Chapters 3 and 4 address the themes of identity and leadership, discussing their interrelationship with professional practice and developing a research culture. In addition, specific aspects that influence practice and work culture today are addressed, and how the lectorate contributes specifically to the development of nursing leadership and the formation of professional identity in the relevant domain is described. Chapter 5 contains a summary of the principles on which the research program is based, as well as information on current and future projects. Chapter 6 provides background information on the lector and the members of the knowledge circle.
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Despite increased healthcare extramuralisation, related to increased elderly patients living at home, most nursing students still see the hospital as career favourite. This is problematic, because of the widespread labour-market shortages in community care in many Western countries. At the Amsterdam University of Applied Sciences, the bachelor nursing programme was redesigned to stimulate students’ interest in community-care. The effect of this ‘community-oriented’ curriculum on students’ perceptions and placement preferences was then investigated. To measure both, the Scale on Community Care Perceptions (SCOPE) was used. The intervention group (170 students graduating in 2018), followed the new curriculum and was compared to a historic control group (477 students) that followed the older, more ‘hospital-oriented’ curriculum (three cohorts graduating 2015-2017). Both groups were compared on placement preferences, and multiple regression was used to investigate the effect of the curriculum-redesign on their perceptions of community care.The redesign consisted of an integrative approach based on the influence of lecturers, placement experiences, and the introduction of new educational elements in the curriculum. Goal was to broaden students’ views, showing that nursing is more than hospital care. While the curriculum was scrutinised on how patient cases were presented, more than 60 of the 110 cases were located in the hospital, compared to four in community care. Thus, this aspect of the ‘hidden curriculum’ was adjusted. Five new themes related to community nursing were integrated in the ‘generalist’ programme in years 1 and 2, namely: (1) fostering patient self-management, (2) shared decision-making, (3) collaboration with the patients’ social system, (4) healthcare technology, and (5) care allocation. A community care week was organised in year 2, in which all students visited a community nursing team. In the last two years of study, a ‘paved way’ to community care was created in the form of an interesting minor programme ‘Complex Community care’ in year 3, a well-organised 30-week placement in year 4, and a concluding case study from their own practice [Figure 1].[Figure 1]Figure 1. Curriculum-redesign to stimulate interest in community care.A comparison between the historic control and intervention group on perceptions of communitycare and placement preferences, measured with SCOPE, showed no significant positive results in both outcomes. The model in the regression analysis, predicting students' perceptions from the type of curriculum (historic/intervention), showed no statistically significant result, F(1,635) = .021, p = .884, and a low explained variance R2 = .001. A preference for a placement in community care decreased from 9.2% in the historic control group to 8.2% in the intervention group. However, the regression analysis revealed that two variables, in contrast with the curriculum, had a significant influence, to wit ‘belonging to a church/religious group’ and ‘working/has been working in community care’.Though described in the literature as the only effective way, this study showed that curriculum-redesign was not effective, despite its holistic approach. A combination of factors might explain this result. Other pathways in the curriculum may have strongly competed. Disappointing experiences during placements, leading to ‘bad-mouthing between peers, may also be a reason. Finally, highly publicised workforce problems leading to shortages of higher-educated role models may have played a role.As in this study, the effect of the curriculum as a whole is measured, more research is needed on the effect of separate more powerful curriculum interventions, for example the theme-week in year 2. A well thought-out large-scale strategy that mostly appeals to young people aiming to promote positive perceptions of community care could be a valuable supplement.
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There is a wide range of literature suggesting that implicit learning is more effective than explicit learning when acquiring motor skills. However, the acquisition of nursing skills in educational settings continues to rely heavily on detailed protocols and explicit instructions. This study aimed to examine the necessity for comprehensive protocols in the acquisition of nursing skills. In the context of bandaging techniques, three studies were conducted to investigate whether students who practiced with an instruction card containing minimal instructions (implicit group) performed comparably to the students who practiced with a protocol containing step-by-step instructions (explicit group). Study 1 was designed to determine whether both groups performed equally well in applying a bandage during training. Study 2 and 3 were designed to determine if both groups performed equally well during a retention and transfer (multitasking) test, administered after a series of three training sessions. In comparison with the explicit group, the implicit group demonstrated comparable performance with their practice attempts in Study 1 and performed equally well during the retention and transfer test in Study 2. Furthermore, several results from Study 3 indicated better performance of the implicit group. In conclusion, the use of protocols with explicit step-by-step instructions may not be essential for the acquisition of nursing skills. Instead, instructional methods that facilitate implicit learning may be preferable, as students in the implicit group demonstrated at least comparable performance in all studies and tended towards greater consistency when multitasking.
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BACKGROUND: Today's nursing school applicants are considered “digital natives.” This study investigated students' views of new health care technologies. METHOD: In a cross-sectional survey among first-year nursing students, 23 common nursing activities and five telehealth nursing activities were presented along with three statements: “I consider this a core task of nursing,” “I look forward to becoming trained in this task,” and “I think I will do very well in performing this task.” RESULTS: Internet-generation nursing students (n = 1,113) reported a significantly (p ⩽ .001) less positive view of telehealth activities than of common nursing activities. Median differences were 0.7 (effect size [ES], −0.54), 0.4 (ES, −0.48), and 0.3 (ES, −0.39), measured on a 7-point scale. CONCLUSION: Internet-generation nursing students do not naturally have a positive view of technology-based health care provision. The results emphasize that adequate technology and telehealth education is still needed for nursing students. [J Nurs Educ. 2017;56(12):717–724.]
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Background: Nurses and nursing students experienced an emotional burden while working during the COVID-19 outbreak. During the COVID-19 outbreak three questions for nurses working under these extreme circumstances were formulated: 1. What today’s events do you remember? 2. How do you feel (physically and mentally)? 3. Do you have enough support? The purpose of this study was to obtain insight into whether nurses and nursing students perceive that the use of the three-questions-method contributes to effective coping with the emotional burden during the COVID-19 outbreak. Methods: Focus group interviews were held with hospital nurses (n = 11) and nursing students with internships in mental health care (n = 2), hospital (n = 9), and homecare/nursing home care (n = 3) in September 2020 followed by twenty semi-structured interviews one year later. Results: Almost all nurses and nursing students named factors that contributed to the emotional burden: fear, powerlessness, frustration, lack of knowledge about COVID-19, and pressure to pass the internship. Participants indicated that using the three-questions-method can help to effectively cope with the emotional burden during and after the COVID-19 outbreak. Conclusions: Using the three-questions-method offers added value in coping with emotional burden and can be used in education as well as in practice.
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This project studies whether a redesigned baccalaureate nursing curriculum in a University of Applied Sciences in the Netherlands can stimulate positive interest for the field of community care. In many Western countries, healthcare is changing from institutional care delivery to caring for patients in their own homes. Problematic is that most nursing students orientate on a career in the hospital and they do not see community care as an attractive option, due to a limited and often mistaken view of the field. Their career choices lead to increasing shortages in the labour market, which in many Western countries is a societal problem urgently needing attention. Providing students with a curriculum with more elements of community nursing could help them build a more positive perception of the field, leading to more students choosing this area as a career.The curriculum-redesign was based on quantitative and qualitative research about first-year students’ perceptions, placement preferences and underlying assumptions on the field. First, a cross-sectional multicentre survey study (n = 1058) was conducted using the SCOPE (Scale on COmmunity care PErceptions) questionnaire. The findings confirm the hospital’s popularity, with community care being perceived as a ‘low-status-field’ with many elderly patients and few challenges. Students’ perceptions of community care appear to be at odds with things they consider important for their placement (i.e., opportunities for advancement and enjoyable relationships with patients).To better understand the factors underlying the perceptions, a focus group study with first-year students at the start of their programme (n = 16) was performed.This led to formulation of eight redesign themes, namely:(1) variety and diversity,(2) challenges,(3) improving people's health,(4) collaboration,(5) role models,(6) patient- or environment-based perceptions,(7) self-efficacy, and(8) immediate vicinity.First-year students have clear ideas about what they see as important in a placement, but their perceptions do not always appear to be realistic.To remedy these misperceptions, recommendations for curriculum redesign strategies were formulated. Curriculum designers can more prominently highlight the complexity of community nursing in the theory part of the curriculum. As many students strive for challenges, in-depth knowledge about community nursing can be presented about aspects that students lacking experience in the field are not aware of (e.g., working in an interprofessional network). In the courses, patient cases can be presented that do not fit the stereotypical views of community care commonly held. Also, as role models are influential, it is important that students collaborate with mentors in the field with an appropriate level of education, who can act as a source of inspiration, but who also create a structured and supporting learning environment. Finally, it is useful to organise meetings where political developments and labour market issues in healthcare are discussed. This can potentially increase awareness of these topics and contribute to well-informed career decisions. These strategies can potentially foster a more optimistic and realistic career outlook on the community care field.
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Introduction: Nursing students will come across stressful situations during their internships and will continue to do so in future practice. Because of the impact stress can have on performance, nursing students need to be equipped to work and collaborate in such situations. Careful consideration of the needs and desires of nursing students should be taken in account, in order to create a training environment that fosters students' ability to learn to collaborate under stress. Aim: The aim of this study is to identify viewpoints of undergraduate nursing students towards the learning of collaboration in stressful situations, to understand their needs and desires, and to improve educational designs for training to collaborate in stressful situations. Methods: We conducted a Q-methodology study, a mixed methods approach that studies and charts subjectivity, and uses a by-person factor analytical procedure to create profiles of shared viewpoints. The process of our Q-study is based on the following five steps: Q-set development (54 statements), participant selection (n = 29), Q-sorting procedure, data analysis, and factor interpretation. Results: Q-factor analysis resulted in two prevailing factors that answer our research question. Twenty-five students loaded on these two factors, and factor interpretation resulted in Profile 1 “Practice makes perfect, so let's do it” and Profile 2 “Practice is needed, but it scares me”. Whereas Profile 1 regarded learning to collaborate in stress mainly as a challenge, Profile 2 appeared anxious despite feeling the necessity to learn this. An overarching consensus factor revealed the importance of a learning environment in which mistakes can be made. Discussion: The two described profiles align with the biopsychosocial model of challenge and threat, and could help to recognize and address the individual needs of nursing students when learning to collaborate in stressful situations. Incorporating these profiles in training may guide students towards a more challenge-like appraisal of stressful situations.
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Perceptions of community care and placement preferences in first-year nursing students: A multicentre, cross-sectional studyMargriet VAN IERSEL MSc1, Corine H.M. LATOUR PhD1, Rien DE VOS PhD2, Paul A. KIRSCHNER PhD3,5, Wilma J.M. SCHOLTE OP REIMER PhD1,4.1 ACHIEVE - Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, The Netherlands2 Centre of Evidence Based Education, Academic Medical Centre, Amsterdam, The Netherlands3 Open University of the Netherlands, Heerlen, The Netherlands4 Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands 5 University of Oulu, Oulu, FinlandBackground: Despite increasing shortages of well-educated community nurses, far too few nursing students choose community care for their future profession; a strong societal problem that urgently needs resolution. This study provides a solid understanding of causes for the fields’ low popularity by exploring first-year baccalaureate nursing students' perceptions of community care, and their placement preferences along with their underlying assumptions. Insights from this study can be used by educators to positively influence students’ perceptions with targeted curriculum redesign strategies.Summary of work: A cross-sectional multicentre survey study was performed. First-year nursing students from six universities of applied sciences in the Netherlands (n = 1058) participated in the study from September-December 2014. The students completed the ‘Scale on Community Care Perceptions’ (SCOPE), consisting of demographic data, current placement preferences, and three subscales measuring the affective component of community care perception, perceptions of a placement, and a profession in community care. Descriptive statistics were used. Summary of results: For placement, 71.2% of the students prefer the general hospital, 23.4% another area, and only 5.4% choose community care. Students consider opportunities for advancement and enjoyable relationships with patients as most important for their placement. Community care is perceived as a ‘low-status-field’ with many elderly patients, where students expect to find little care variety and few opportunities for advancement. Discussion and conclusions: This study shows why few students show an interest for a career in community care. Students’ perceptions of the field are at odds with aspects they regard as important for their placement. They also underestimate the complexity of community care, where specific traits are required to ensure appropriate nursing care in patients’ homes. Take-home messages: The results of this study allow for three recommendations. First, students and educators should be aware of misconceptions about career opportunities in the field of community care. Second, educators should provide students with experiences that foster an optimistic and realistic career outlook on community care. Third, growing shortages in the community care sector urgently require representatives from the field and educators to collaborate to make community nursing an attractive career alternative.Keywords: Career choice; Students
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