Caroline Browne

Aim
The aim of this study was to explore how final semester undergraduate nursing students engage with reflective practice, by comparing their preferences towards digital storytelling or written reflections.

Background
Reflective practice is an essential component of professional nursing practice. Reflection is embedded as both a learning and an assessment tool in undergraduate nursing curriculum, however it may not come easily to some students. Digital storytelling was integrated into the final semester of a Bachelor of Nursing program, as an innovative way to engage students in reflective practice.

Design
A descriptive survey design was used in this study.

Methods
An online survey was used to explore nursing student experiences using both digital storytelling and written forms of reflection. Descriptive statistics were used to analyse student preferences, and content analysis was used to analyse open ended responses.

Results
A total of 147 responses were received across two cohorts (response rate of 24 %). Preferences were mixed between the two methods. Digital Storytelling provided an opportunity for students to share their stories with their peers leading to reflective learning, whilst written reflection provided an avenue to enhance clinical confidence and identify areas for development. Both methods had challenges including the timing of reflective activities within their units, expressing and sharing emotion, and working with technology and assessment restrictions to complete reflections.

Conclusion
Students need to be introduced to different methods of reflection throughout their undergraduate studies, so they can engage in reflective practices that work for them. Nursing educators need to recognise the importance of students sharing their stories to derive meaning from their experiences and transform their learning.

Developing reflective practice in undergraduate nursing students is an important outcome of any Bachelor of Nursing (BN) program. Integrating reflection helps students: understand their values and expectations; link theory to practice; improve professional competence; and manage the stress and anxiety of transitioning to practice. Undergraduate students often engage with reflective practice at a descriptive level, and for reflection to be effective it must be purposeful and linked to practice. A Digital Storytelling Workshop was integrated into a final semester nursing unit to provide students with a creative way to reflect on their experiences and motivations across the degree.

Final Semester BN students completed an online survey (n = 117) evaluating their experience with reflection, including a depth of reflection questionnaire. Additionally, three students participated in interviews exploring their experiences with reflection across the curriculum. Findings suggest that students used reflection, and even critical reflection, to help them understand their practice. Offering alternate methods to develop reflective practice early in the BN curriculum may allow more students to engage with the reflective process and achieve a deeper level of reflection. The timing of the reflective activities in their final semester provided an opportunity for enhancing confidence prior to transition into professional practice.

Background
The nursing workforce faces significant stressors every day that can lead to exhaustion and burnout. The unprecedented challenges that were faced during the Covid-19 pandemic, placed an added burden on nurses who were already under pressure. Nurses were at the frontline of care provision, and nursing leaders had to rapidly implement strategies to support and maintain staff safety, short and long-term well-being.

Objective
A scoping review of strategies nurse leaders and organisations initiated to enhance the well-being of their colleagues during the Covid-19 pandemic was undertaken. Experiences from around the globe have been collated to provide an insight into well-being initiatives that can inform future practice to sustain and retain the nursing workforce.

Design
A scoping review of strategies nurse leaders and organisations initiated to enhance the well-being of their colleagues during the Covid-19 pandemic was undertaken.

Method
A search of key electronic databases identified articles published between January 2020 and February 2023. 21 pieces of original research that met the inclusion criteria were reviewed.

Results
Well-being interventions evaluated in the literature included: dedicated well-being spaces, peer debriefing, psychological support, online resources and education, introduction of well-being strategies and resources, and meditations. There were six broad themes identified that enhanced the success of well-being strategies including: Education and Communication, Tailored or Adaptable Strategies, Support from Leadership, Sharing Experiences and Peer Support, and Feeling appreciated and heard. There were also barriers to accessing well-being interventions that have been identified.

Conclusion
The Covid 19 pandemic highlighted how imperative strong nursing leadership is for supporting nurses at every level. Practical strategies provided psychological support essential for maintaining the health and well-being of the nursing workforce. The strategies identified demonstrate the creativity and adaptability of nursing leadership to look after colleagues to maintain and sustain our nursing workforce.

Tweetable
Strategies implemented during the COVID-19 pandemic can be used to guide ongoing initiatives to enhance wellbeing for the nursing workforce.

Background: Educational methods continue to evolve to meet the challenge of teaching undergraduate nursing students. Innovative teaching pedagogies require nursing students to be actively involved in their own learning compared with traditional didactical styles. Method: Students were exposed to three distinct teaching pedagogies: inquiry-based, online, and educator-led during their second year of study. Students' learning preferences were explored using a mixed-methods approach. Quantitative data were collected using an online questionnaire, followed by a focus group interview. Results: The quantitative data revealed students preferred being taught directly from educators rather than through self-directed and online study. Manifest content analysis of qualitative data revealed four categories that supported student learning and five categories that hindered student learning. Conclusion: Students struggled when required to be self-directed in their learning. Students reported feeling uncertain and overwhelmed initially, which highlighted the importance of strong social and academic support to facilitate effective learning.

Problem A lack of understanding of the challenges that Enrolled Nurses experience as they transition to Registered Nurse may prevent the development of resources and strategies necessary to ensure their success in the program. Question What are the experiences of nursing students who are enrolled in a Bachelor of Nursing program as they transition from Enrolled Nurse to Registered Nurse? Methods A qualitative interpretive approach, influenced by phenomenology and underpinned by Schlossberg’s Transition theory, was used in this study. Data was collected from Enrolled Nurses (n = 7) using individual interviews and enriched with additional context from a focus group of nursing academics (n = 4). Findings Five themes were identified: ‘Standing out from the crowd’, ‘struggling with the academic demands’, ‘seeking personal and professional balance’, ‘moving beyond the constraints of being an EN’ and ‘growing within the program’. Discussion The challenges experienced by the Enrolled Nurses, such as adapting to the requirements of the tertiary program and balancing study with their other life responsibilities, were identified as being exacerbated by the 12 months of advanced standing that they receive. Strategies to overcome these challenges included accessing academic and personal resources. Success within the program was discussed by these students as empowering their personal and professional lives. Conclusion The challenges the Enrolled Nurses encountered and strategies they employed to succeed in the program are identified in this study. Recommendations to improve the transition of Enrolled Nurses through a Bachelor of Nursing program are proposed.

Developing a professional identity is an essential transition for nursing students as they move through their undergraduate degree. Professional identity is described as a person's perception of themselves within a profession or the collective identity of the profession. The formation of a professional identity is an evolving process, shaped by the media, educational experiences and role modelling. The aim of this study was to develop a greater understanding of the perceptions that students, about to embark on their undergraduate nursing degree, had of the nursing profession. A drawing and mind mapping exercise was conducted with a convenience sample of commencing nursing students to explore how they viewed their future profession. The data underwent thematic analysis and then grouped into sub-themes and themes. Four key themes were identified, ‘To be a nurse, I have to look the part’, ‘To be a nurse, I have to perform in a variety of roles’, ‘To be a nurse, I have to connect with others’, and ‘To be a nurse, I have to care for myself.’ The formation of a strong pre-professional identity is important for nursing students due to the link between future job satisfaction and the development of a robust nursing workforce.

Background Substantial numbers of Enrolled Nurses (ENs) enrol in higher education programs to undergo the transition to Registered Nurse (RN) with the experience described as containing numerous challenges. Objectives This paper reports on a synthesis of the literature that explores the experiences of ENs undertaking a program of study to convert to RN. Consequently, a model is developed to identify educational interventions and resources to enable a successful transition for these students. Design A narrative review was completed with thematic synthesis of the literature guided by Schlossberg's Transition Theory, and Thomas and Harden's framework for systematic analysis of qualitative studies. Data sources CINAHL, Scopus, ProQuest Central and Health Collection were searched. Review methods The databases were searched for English language journal articles, theses and grey literature published from 1987 to 2016 from Australia, New Zealand, the United Kingdom, Canada and the USA. The key search words included truncations of: “enrolled nurse”, ‘licensed practical nurse’, “transition”, “conversion” and “experience”. This resulted in the identification of 33 related articles for review. Results Themes and sub-themes developed from the literature synthesis were integrated into an ‘EN to RN Transition model.’ The four stages of the model reflect the experiences of the ENs as they overcame the various challenges they encountered during their transition to RN. The model was used to develop recommendations that may improve their transition experience and decrease attrition. Conclusion This paper reports on a synthesis of the literature, and presents a four stage model, that reflects the experiences of ENs in their transition to RN. Recognising the elements within each stage can assist educators develop strategies and provide educational resources to enhance the EN journey.

Curriculum re-design in entry to practice nursing degrees requires a rigorous and multifaceted approach to align the needs of students, professional and industry stakeholders, community needs, the faculty’s vision and university and regulator requirements. This paper relates the initial steps in the process taken to achieve this re-design in one Australian university’s Bachelor of Nursing program, and describes our experiences in two parts. The first part outlines the context in which the need for curriculum renewal was triggered and the ensuing processes undertaken in the development of our new course aim, course outcomes and graduate attributes. The second part discusses how undertaking these activities then came to influence the adoption of Complexity Thinking in the design of our conceptual model, which then guided our program structure and overarching learning and teaching approaches. We share these experiences to illustrate the steps we undertook on this journey, to outline and example the program we created, and to continue the scholarly discussions around the design of baccalaureate nursing program structures, especially those that implement pedagogies inspired by the concepts related to Complexity Theory. The choice of complexity thinking as a guiding theory was key in providing the lens through which we were inspired to graduate nurses with the skills to provide care in complex situations and value the learning that comes through uncertainty, reflection, adaptation and emergence.

Background International clinical placements provide undergraduate students with a unique and complex clinical learning environment, to explore cultural awareness, experience different health care settings and achieve clinical competencies. Higher education institutions need to consider how to structure these placements to ensure appropriate and achievable aims and learning outcomes. Objectives In this study we described the structure, aims and learning outcomes associated with international clinical placement opportunities currently undertaken by Australian undergraduate nursing students in the Asia region. Participants Forty eight percent (n = 18) of the institutions invited responded. Eight institutions met the inclusion criteria, one of which offered three placements in the region, resulting in 10 international placements for which data were provided. Methods An online survey tool was used to collect data during August and September 2015 on international clinical placements conducted by the participating universities. Descriptive data on type and numbers of placements is presented, along with results from the content analysis conducted to explore data from open ended questions on learning aims and outcomes. Results One hundred students undertook 10 International Clinical Placements offered in the Asian region by eight universities. Variations across placements were found in the length of placement, the number of students participating, facilitator to student ratios and assessment techniques used. Five categories related to the aims of the programs were identified: ‘becoming culturally aware through immersion’, ‘working with the community to promote health’, ‘understanding the role of nursing within the health care setting’, ‘translating theory into professional clinical practice’, and ‘developing relationships in international learning environments’. Four categories related to learning outcomes were identified: ‘understanding healthcare and determinants of health’, ‘managing challenges’, ‘understanding the role of culture within healthcare’ and ‘demonstrating professional knowledge, skills and behaviour’. Conclusions International clinical placements in the Asia region appear to vary greatly from one education institution to the next with no clear consensus from either this study's findings or the literature on which structure, support and assessments lead to greater student learning.