Aims and objectives To investigate final‐year nursing students' use of situation awareness when making clinical decisions about patients' progress postsurgery. Background Making clinical decisions about patient care is a generic nursing competence, developed in preregistration nursing programmes and critical to providing safe patient care. Situation awareness is an important precursor to making decisions and is linked to improved clinical outcomes. However, there is evidence to suggest that nursing students feel inadequately prepared to make clinical decisions. Design Endsley's (Situation awareness analysis and measurement. Hillsdale, NJ: Lawrence Erlbaum Associates, 2000) 3‐level situation awareness framework was used to guide the study. Level 1 situation awareness is perception of information required to make a decision. Level 2 relates to comprehending the information. Level 3 situation awareness is projecting how this information will inform the future. Twelve final‐year nursing students were recruited to participate. Think‐aloud research method was used to capture students' decision‐making, followed by semi‐structured interviews. Data were analysed using an adapted protocol analysis and were encoded inductively. The COREQ checklist has been used in reporting the study. Results Students demonstrated level 1, 2 and 3 situation awareness when making clinical decisions. However, it was not demonstrated consistently and at times subsequent decision‐making was inappropriate. Three themes emerged: “systems approach to assessment of postoperative patients”; “policy drives practice”; and “deferring decisions to registered nurses”. Within the themes, students demonstrated differing levels of situation awareness. Conclusion Making safe clinical decisions is a paramount skill for nurses; however, student nurses are ill‐equipped to undertake this skill. Situation awareness is important in informing safe decision‐making, but students' use of situation awareness is variable. Cognitive apprenticeship, applied to supporting development of situation awareness, affords the opportunity to develop students' decision‐making. Relevance to clinical practice Clinical decision‐making is a generic competence for all registered nurses and imperative for safe practice. However, student nurses are unprepared to undertake this skill once registered.
Background Insufficient physical activity (PA) is a leading risk factor for premature death worldwide. Ireland’s public healthcare system, the Health Service Executive (HSE), has supported the development of the National Exercise Referral Framework (NERF) to tackle low levels of PA amongst those with non-communicable diseases (NCDs). ‘NERF centres’ are medically supervised PA programmes across Ireland that have established referral pathways with local hospitals and general practitioners. ULMedX is one such NERF centre offering exercise-based cardiac rehabilitation (EBCR) with the aim of intervention development to reduce early drop-out and maximise adherence for optimal health benefits. Aim The purpose of this research was to identify the major factors influencing participants’ adherence and early drop-out at ULMedX. Exploring areas for future development were also prioritised. Design & setting Qualitative interviews were conducted with long-term attenders and people who have dropped out (PWDO) from ULMedX. Methods Guided by the Theory of Planned Behaviour the 1–1 semi-structured interviews were performed, transcribed, and evaluated through thematic analysis. Results Analysis was performed on 14 participants (50% female; mean age 67.3 years), comprising long-term attenders (n = 7; 13-month duration, 64% of classes) and PWDO (n = 7; 2.8-month duration, 22% of classes). Three major factors affecting adherence and drop-out were identified: social support, perceived outcomes from participation and practical barriers to attendance. Areas for future development included the provision of evening and advanced classes, psychological support, more exercise variety, more educational seminars and new members start as their own group. Conclusion The findings suggest participants at ULMedX are more likely to have had a better experience and commit to the programme if they believed involvement would benefit their physical and mental health, increase their exercise motivation by engendering a positive attitude to exercise, and that the ability to attend was within their control. Future interventions at ULMedX should have their structures centred around these motives for engagement. ULMedX should also test the participant recommendations to overcome the common barriers to adherence.
BackgroundUniversities have been working to adopt more flexible approaches to teaching and learning. New approaches have been accelerated by the coronavirus pandemic whereby university nursing programs have moved more learning into online environments to continue delivering education and supporting nursing students to progress in their study. However, there is significant evidence to suggest that many students remain comfortable with traditional methods of learning. Nursing students in particular prefer to learn by experience and reflection. An important attribute for online learning is related to students' self-regulated learning (SRL) skills. The aim of the study was to explore nursing students' SRL readiness for online learning environments. MethodsA convenience sample of one hundred and fifty undergraduate nursing students who were enrolled in the first year of nursing program participated in an online survey. The survey instrument was a Self-Directed Learning Instrument which had previously been used to measure the students' readiness for self-regulated learning.ResultsResults indicated that students were motivated to improve in their learning and enjoyed finding answers to questions. They also agreed that they continued learning even when they faced difficulties. In contrast, they often did not know what they had to learn; they struggled to manage their learning time, find learning resources, monitor their progress, and self-evaluate their learning outcomes. ConclusionsProviding opportunities to develop nursing students' metacognition is important. Activities such as goal setting and planning, developing time management and assessment strategies, and making explicit support channels for online learning, as well as providing opportunities for self-reflection and self-evaluation strategies to enhance SRL can support this.
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