An Apprenticeship Practice Partnership Model: An Innovative, Collaborative Solution.

Background: Scientific evidence regarding the effectiveness of physical activity (PA) in the prevention and treatment of chronic diseases is increasing. Healthcare systems are trying to increase exercise prescription treatments. However, it is not clear if health professionals are sufficiently trained. Aim: to analyze the contents related to PA and exercise in the prevention and treatment of chronic diseases in the syllabus of the Bachelor of Science in Nursing at all Spanish universities. Methods: A systematic environmental scan that included a web page search of curricular guide programs of all Spanish universities offering the Bachelor of Science in Nursing was undertaken for the 2017–2018 academic course. The assessment of the European Credit Transfer System (ECTS) about physical activity and/or exercise health-related benefits in the prevention or treatment of chronic diseases was performed by two experts in a peer-review process. ECTS of Practicum and Bachelor thesis were not included in the analysis. Results: In the mean, the Bachelor of Science in Nursing dedicated 5.82% (5.01% mandatory and 0.82% voluntary) of a total of 240 ECTS (ranging from 0 to 45 ECTS). The majority of contents were related to PA promotion; in contrast, contents related to exercise prescription are neglectable. Five Spanish universities do not offer any academic teaching to physical activity on prescription. Conclusions: A great disparity between universities was identified. In general, acquired knowledge seems scarce for PA promotion and exercise prescription in primary healthcare staff. Nurses would need additional physical activity on prescription training to improve PA promotion and exercise prescription knowledge as a coadjutant non-pharmacological treatment for non-communicable chronic diseases in Primary Healthcare settings.

IntroductionSimulation-based learning is robust, but the COVID pandemic created opportunities for novel modalities, including Artificial Intelligence Virtual Simulated Patient (AI-VSP) scenarios. MethodsBetween 2019 and 2022, the following health professional students experienced AI-VSP at one US university: (a) “Headache” scenario: 24 Family Nurse Practitioner (FNP) and 48 Physician Assistants (PA) students, (b) “Insomnia” scenario: 64 Bachelor of Science in Nursing (BSN) and 47 Accelerated Bachelor of Science in Nursing (ABSN) students. Each individually conducted a brief strongly encouraged encounter and subsequently optionally participated in our study. ResultsWhen asked about the scenario's realism, positive answers were 50% (FNP), 16% (PA), 63% (BSN), and 87% (ABSN). Also, 41% FNP, 52% PA, 65% BSN, and 82% ABSN felt capable of creating diagnoses and treatment plans as thoroughly as they would with human patients. Regarding improving diagnostic abilities, favorable responses were 73% (FNP), 74% (PA), 72% (BSN), and 90% (ABSN). When asked whether they would recommend AI-VSP encounters to others, 91% (FNP), 84% (PA), 93% (BSN), and 90% (ABSN) agreed. ConclusionsAI-VSP scenarios were well accepted by students and demonstrated significant promise as a complementary simulation-based learning modality.

BackgroundTracer studies evaluate the effectiveness of university training by assessing how graduates perform in the job market. This study focused on Bachelor of Science in Nursing (BScN) graduates, aiming to describe their training experiences, application of acquired competencies, and overall stakeholder perceptions to inform BScN curriculum improvement.MethodsA convergent parallel mixed-method design was used to collect quantitative and qualitative data concurrently from 2016–2020 BScN graduates (February-May 2023). Graduates and other stakeholders (including educators, employers, and policymakers) in this study were selected from private, public, and faith-based hospitals and universities, colleges, and the Ministry of Health. Quantitative data were gathered via online structured questionnaires adapted and modified from the American International Health Alliance and the Technical Vocational Education and Training tools. Qualitative data were collected through interviews and focus groups with graduates, employers, educators, and policymakers. Quantitative data were analyzed using descriptive statistics, while qualitative data underwent thematic analysis. Integration occurred during interpretation to provide a comprehensive understanding of graduates’ experiences, competency application, and stakeholder perceptions of the BScN program.ResultsAmong the 61 graduates who completed the online survey, 37 (60.7%) were female. Most (48; 78.7%) worked as nurses, while 6 (9.8%) were tutors and 3 (4.9%) worked as tutorial assistants. Demonstration was rated the most useful teaching and learning method by 52 (85.2%) respondents, and 47 (81%) rated practical exams as a useful assessment method. These were also supported by graduates and stakeholders who shared their perspectives with regard to the benefits and impact of the BScN program and training quality. Additionally, 54 graduates (94.7%) found the program very useful in preparing them for their professional roles, which aligned with their views on the connection between acquired competencies and job performance. Both graduates and educators highlighted challenges encountered during training and in professional practice. Policymakers and graduates also offered recommendations for improving the program.Additionally, 54 graduates (94.7%) found the program very useful in preparing them for their professional roles, which aligned with their views on the connection between acquired competencies and job performance. Both graduates and educators highlighted challenges encountered during training and in professional practice. Policymakers and graduates also offered recommendations for improving the program.ConclusionThe findings demonstrate that the BScN program is widely regarded by graduates and stakeholders as effective in preparing students for professional practice, particularly through practical teaching methods such as demonstrations and practical exams. While the program’s impact on competency development and job performance was strongly affirmed, the study also revealed notable challenges during training and practice. These insights support the ongoing review and enhancement of the BScN curriculum.

Transitioning Associate Degree in Nursing Students to the Bachelor of Science in Nursing and Beyond: A Mandate for Academic Partnerships

We would like to highlight the main conclusion by Polsky et al.1 on the similar qualifications of nurses trained within and outside the United States. The nursing shortage is an important phenomenon not only in the United States but also in Europe.2 Since the fall of socialism in Hungary in 1989, the country has become an important source of well-qualified nurses for Western countries. During Hungary’s economic reforms in the early 1990s, nursing education was elevated from diploma level to degree level to match that of other countries in Western Europe. Until 2005, the development of the bachelor of science in nursing program in Hungarian universities was supported by staff at Case Western Reserve University (Cleveland, Ohio) to make it more compatible with the degrees available in Western countries.3 In 1990 there were no degree-holding nurses in the Hungarian health care system (with the exception of the few nursing director posts); by 2000, 2567 out of 62000 nurses in Hungarian health care institutions (mainly hospitals) held a bachelor of science in nursing. Since the mid-1990s it has been compulsory for each hospital department in Hungary to employ at least 1 nurse with a bachelor’s degree. This requirement has accelerated the acceptance of degree-holding nurses in health care institutions. In 2000 nearly all leading domestic nursing posts were held by degree-holding nurses; in subsequent years, an increase in the migration of nurses (as a result of declining domestic opportunities) was detectable by the number of diploma supplements (a document issued to outline the education received) issued in English.4 Since 2000 the master of science in nursing degree has been available in Hungary in an attempt to make domestic nursing careers more attractive. The focus of this complementary degree is on management, education, and research.5,6 In 2006 the Doctoral School of Health Sciences at the Faculty of Health Sciences, University of Pecs (Pecs, Hungary), was established with the aim of strengthening research in nursing and in health sciences.7 In recent years, the number of new applicants to Hungarian universities who are interested in earning a nursing degree has slightly but steadily declined. If the experienced nursing workforce with bachelor’s or master’s degrees continues to move elsewhere for job opportunities, the Hungarian health care system will be threatened.8 The right of individual nurses to migrate and the ability of nations to keep nurses that are citizens both should be considered in order to find a sustainable balance in migration. Figure 1 Emma Trochez, with Goodwill Industries of South Florida in Miami, trims a US interment flag on March 24, 2003. This South Florida non-profit serves as a major supplier of fatigues for the US military, as well as the licensed maker of the interment flag ...

Dear Editor, Since gaining independence in 1971, Bangladesh has achieved significant developmental goals, such as achieving many of its Millennium Development Goals (Roy & Datta, 2021). Nurses are the key to the healthcare system, but nurses in Bangladesh still grapple with considerable challenges due to outdated educational practices and inadequate attention to nursing education and the profession (Lee et al., 2016). Nurses perform a crucial role in healthcare, but the academic infrastructure that supports them is often inadequate, affecting the preparation of professionals and consequently restricting their ability to provide high-quality care to patients. Outdated educational infrastructure produces significant barriers that impede nurses from realizing their full potential. Furthermore, there is a noticeable absence of literature aimed at assessing the current situation, and more research and funding are required to determine essential changes. The formalization of nursing in Bangladesh began shortly after independence with the introduction of a diploma program in nursing (Hadley & Roques, 2007). By 1977, the country introduced both the post-basic Bachelor of Science in Nursing (for diploma in nursing degree holders) and a four-year Bachelor of Science in Nursing (BScN) (Joarder, 2021). Unfortunately, the opening of the BScN program was met with criticism and was temporarily halted due to protests from diploma-holding nurses and students, who feared that BScN graduates would receive preferential benefits (Joarder, 2021). The program was reintroduced on a small scale in some private universities in 1980 and expanded to government universities in 2008 (Joarder, 2021; Khan Rony, 2021). In Bangladesh, government jobs are categorized into various classes, such as first, second, third, and fourth class, which determine status and pay. Nursing was recognized as a second-class profession in Bangladesh only in 2011, an upgrade from its earlier third-class status. While physicians and dentists are classified as first-class employees, the advancement of nurses to second-class underscored significant progress in acknowledging the importance and stature of nurses in the public sector (Joarder, 2021). A major obstacle in nursing education is the absence of established quality assurance for nursing education programs in Bangladesh (Lee et al., 2016). Most universities in Bangladesh typically offer accreditation to various public and private colleges to run BScN programs, with a BScN program seldom available on their main campuses. Furthermore, the absence of formal mechanisms and adequate research complicates the situation for nurse educators, who frequently face resource constraints, making it difficult to systematically identify and address issues within their programs (Berland, 2014). Consequently, most nurses in Bangladesh cease their education after obtaining a bachelor's degree (Lee et al., 2016). Due to limited opportunities for advanced education, only a small number of nurses go abroad to pursue a master's or more advanced education in nursing. Instead, most nurses opt for more readily available degrees, such as a Master of Public Health (Lee et al., 2016). Only very recently have a few colleges and universities begun to offer the MSc in Nursing in Bangladesh (Daily Sun, 2017). Because there are no PhD programs or research-based master's degrees in nursing locally, the potential of nursing research to enhance nursing education and practice in Bangladesh is limited. In addition to these educational limitations, nurses in Bangladesh are not permitted to prescribe medications, as the country does not recognize Nurse Practitioner degrees, even those obtained from abroad (Berland, 2014). Enabling nurses to become Nurse Practitioners and allowing them to practice independently, particularly in rural settings, could significantly enhance healthcare services. This situation warrants critical questions: Who is accountable for hindering the progress of nurses in Bangladesh? Why there seem to be a push to maintain lower educational standards for nurses in the country? What advantages does this approach offer, and who stands to gain from it? Additionally, how do these benefits impact patient health and well-being? These pressing questions need to be addressed by future research to help achieve the developmental goals of Bangladesh in the health sector. There is an urgent need for stakeholders in the health and education sectors to prioritize reforms in nursing education and practice. By tackling these academic challenges, Bangladesh could better equip its nursing workforce to handle the demands of modern healthcare and enhance the quality of care provided to its population, fulfilling the commitments made to the United Nations. Conceptualization: Shimpi Akter and Masuda Akter. Supervision: Humayun Kabir and Masuda Akter. Original writing: Shimpi Akter and Masuda Akter. Critical revisions for important intellectual content: Shimpi Akter, Masuda Akter, and Humayun Kabir. The author declared no acknowledgments for this work. The author declared no competing interest in this work. The author received no financial support for this work. Ethical approval is not required for this work.

Educating Bachelor of Science in Nursing Students in Leadership Strategies Needed for Care Management and Disease Management for the Heart Failure Patient Population

Self-Directed Learning (SDL) is a process in which the learner takes self-initiation for assessing own learning needs and work accordingly with the help of available resources for achievement of required learning, The objective of this study is to identify the readiness for self-directed learning among the Bachelor of Science in Nursing (BSN) students. A descriptive cross sectional study was conducted among BSN students of Yeti Health Science Academy and Kantipur Academy of Health Science, Kathmandu, Nepal. Complete enumerative sampling technique was used in this study where 107 students were involved. Questionnaire method with SDL scale was used for data collection. Most of the respondents 74(69.2%) had high level of readiness for self-directed learning and 33(30.8%) of respondents had low level of readiness for self-directed learning. The association between academic year with the level of readiness for self-directed learning were statistically significant (p=0.045) whereas the association between other variables (age, ethnicity, religion, marital status, family type and residence) with the level of readiness for self-directed learning were statistically insignificant (p>0.05).It is concluded that depending upon the academic year, seniors are more ready towards self-directed learning than junior nursing students.

In this study, the perceptions and experiences of an interprofessional team responsible for the development and delivery of the Registered Practical Nurse (RPN) to Bachelor of Science in Nursing (BScN) Blended Learning Program at Nipissing University were examined. In this program, RPNs can acquire a BScN through distance-based part-time study, including online courses and clinical practicum. In three years, the program has grown from an initial intake of 60 students to a current enrolment of over 600 students (Fitzgerald, Beattie, Carter, & Caswell, 2014).The success of the program is attributed to three factors: a part-time curriculum that permits students to work as they study; partnerships with hospitals and other clinical facilities to support the nurse-learner’s clinical placements; and the performance of a highfunctioning interprofessional team. This study of teamwork will benefit nursing and adult learning educators as well as e-learning professionals involved in the development and delivery of flexible programs for working nurses.

Presence is widely accepted as a core relational skill within the nursing profession. Nurse educators are challenged to ensure that the humanistic aspects of client care are included in the Bachelor of Science in Nursing (BSN) curriculum. Introducing and teaching presence skills early in the BSN curriculum will ensure the essential value of relational engagement with clients. Nursing literature, however, notes presence is a challenging concept for BSN students. Articulating a mid-range theory of nursing presence will facilitate students' conceptual understanding of presence and guide nurse educators to teach presence skills. To propose a mid-range theory of nursing presence. Within the theoretical model, identify development opportunities to improve student nurse use of presence as a relational skill. An extensive literature review was conducted. Materials were synthesized and the mid-range theory was developed. Kim's nurse-client domain provided the perspective that guided the parameters of the theory. Professional nursing presence is dependent upon the combination of five variables: individual nurse characteristics, individual client characteristics, shared characteristics within the nurse-client dyad, an environment conducive to relational work, and the nurse's intentional decisions within the practice domain. The variables are described and the relationships among variables depicted in the model. Specific nurse-sensitive points during a nurse-client interaction determine or influence the nurse presence intervention and dose. Areas designed to teach or improve relational skills are identified for the BSN educator. A mid-range theory of presence contributes to our understanding of the relational aspects of nursing practice within the contemporary healthcare environment. Identifying strategies to teach BSN students presence skills will facilitate the incorporation of the humanistic aspects of client care in the undergraduate curriculum.

Background: Clinical learning environment is an environment where the nursing student is systematically exposed in simulation laboratories and with real patients to learn and practice on their own for better clinical outcomes leading to quality nursing services. This study aimed to assess the nursing students’ perception towards clinical learning environment. Methods: A descriptive cross-sectional study was conducted among 98 nursing students studying in Generic Bachelor of Science in Nursing (B. Sc. Nursing) and Bachelor in Nursing Sciences (BNS) in School of Nursing, Chitwan Medical College, selected using probability stratified proportionate random sampling technique. Structured self- administered questionnaire; Modified Clinical Learning Environment Inventory was used to collect the data and analyzed using Chi-Square test. Results: The findings of the study revealed that, median age of student was 22 years with the range of 19-29 years. Majority of students (64.3%) were from academic program Bachelor of Science in Nursing and 84.7% studied nursing on their own will. Study showed that majority of students (74.5%) had positive perception towards clinical learning environment and the level of perception was found to have statistically significant association with adequacy of patient flow during posting, availability of articles for clinical procedure and use of different clinical teaching methods such as bed side presentation and simulation (p<0.05). Conclusions: Nearly three fourth of the students have positive perception towards clinical learning environment. Many factors such as availability of adequate number of patients, adequate resources tend to influence clinical learning environment. The study results suggest the need of using clinical teaching methods to improve the clinical learning.

PurposeThe objective of this study was to evaluate nursing students’ perceptions of their educational environment in a private college. Perceptions were compared between genders and 2 bachelor’s programs.MethodsA total of 219 students participated in this study, drawn from the Generic Bachelor of Science in Nursing (GBSN) and the Post-Registered Nurse Bachelor of Science in Nursing (PRBSN) programs of the Shifa College of Nursing, Islamabad, Pakistan. The Dundee Ready Education Environment Measure was utilized for data collection. Descriptive statistics were used to calculate total scores, as well as means and standard deviations, and the t-test was applied for comparisons according to program and gender.ResultsThe overall total mean score (119 of 200) is suggestive of more positive than negative perceptions of the educational environment. The mean score of 13 of 28 on the social self-perception subscale suggests that the social environment was felt to be ‘not a nice place.’ The t-test revealed more positive perceptions among students enrolled in the PRBSN program (P<0.0001) than among those enrolled in the GBSN program and more positive perceptions among female students than among male students (P<0.0001).ConclusionCommonalities and differences were found in the perceptions of the nursing students. Both positive and negative perceptions were reported; the overall sense of a positive environment was present, but the social component requires immediate attention, along with other unsatisfactory components. Establishing a supportive environment conducive to competence-based learning would play an important role in bringing desirable changes to the educational environment.

Undergraduate nursing students’ knowledge of aging, attitudes toward and perceptions of working with older adults in Kathmandu Nepal

Does the Use of Standardized Patients in Maternal-Newborn Simulation Increase Student Confidence Prior to Entering the Clinical Setting?

Objectives: To develop a method of measuring medical decision making in a military field setting that would allow an evaluation of the impact of sleep deprivation, fatigue, and other stressors on critical skills deterioration. Methods: Thirty-seven students who were enrolled in a Doctor of Nursing Practice (DNP) program or a Bachelor of Science in Nursing (BSN) program participated in this study. Over the course of three days, student participants were sent five questions in the morning and five questions in the evening. On the fourth day, students were sent 10 questions in the morning and 10 questions in the evening. DNP students received medication calculation questions and BSN students received Basic Life Support (BLS) questions. All questions were drawn from standardized test bank sources, were multiple choice, and were thoroughly reviewed by the research team for relevant content prior to study testing. Results: Twenty-five (50%) and twenty-eight (56%) of the 50 BLS and medication calculation questions met the selection criteria of average response times between 10 and 50 seconds and accuracy of at least 80%. From these, 16 questions were selected from both sets with smaller standard deviations, minimum response times of at least 5 seconds and maximum response times less than 90 seconds. Implications: In order to test the impact of sleep deprivation, fatigue, or any other stressors on critical decision making skills of military medical personnel during field training operations it was necessary to develop a test battery of questions that are sensitive enough to detect variation due to human factors. Our study accomplished this objective, and the resulting medication calculation and BLS questions can be used to readily assess deterioration in critical decision making skills within a field setting. Key Words: Critical Skills, Disaster Training, Sleep and Fatigue