Perspectives of clinical nurse educators on competency-based nursing teaching in blended learning environments during nursing internship: A descriptive qualitative study.

To investigate the perspectives of clinical nurse educators regarding the challenges and essential elements of teaching competence in blended learning environments during nursing internships to inform the development of a competency-based teaching model. Competency-based teaching and blended learning play important roles in enhancing the learning experience of nursing internship trainees. Internship trainees refer to nursing students undergoing supervised practical training in ‎clinical settings.‎ However, clinical nurse educators frequently encounter challenges in acquiring the necessary competence for successful implementation of blended learning strategies. A descriptive‎ qualitative study. This study used semi-structured interviews with 11 certified nurse educators (CNEs) from diverse clinical disciplines in a tertiary hospital in China. Purposive sampling ensured diversity across key characteristics. Ethical approval was obtained and interviews were digitally recorded, transcribed and analyzed thematically. Theoretical saturation guided data collection, with precise measures taken to ensure confidentiality and anonymity. Thematic analysis, employing a constant comparison technique, systematically identified various themes related to blended teaching competence. This approach provided valuable insights into CNEs' perspectives and practices. The analysis involved theoretical sampling, line-by-line coding and comparative evaluation with supporting text materials. The in-depth analysis of teaching competence among clinical nurse educators in blended learning settings during nurse internships revealed five key themes: professionalism, teaching literacy, subject expertise, information literacy and interpersonal communication. These themes recognized clinical nurse educators' perspectives towards establishing a competency-based nursing teaching model for a blended learning environment for nurse internships. Moreover, these perspectives are also crucial in enhancing teaching literacy through effective instructional methods, engagement strategies and the promotion of critical thinking skills. Identifying these themes contributes to efforts to improve teaching effectiveness and enhance learning outcomes for internship trainees in a blended learning context.

Zhou N ，Yang L ，Pan J ，Lv K ... -  《-》

Student and educator experiences of maternal-child simulation-based learning: a systematic review of qualitative evidence protocol.

MacKinnon K ，Marcellus L ，Rivers J ，Gordon C ，Ryan M ，Butcher D ... -  《-》

Perceived challenges of nurse educators while teaching undergraduate nursing students in Pakistan: An exploratory mixed-methods study.

Nurse educators are required to equip students with adequate theoretical and practical knowledge to provide effective nursing care. Limited studies have explored educators' challenges while teaching students. Existing studies are limited because of small sample, overreliance on qualitative approaches, and unreliable instruments that have not been tested. To explore nurse educators' perspectives about their clinical and academic teaching, to develop a questionnaire to determine educators' challenges, and to develop a comprehensive understanding of educators' challenges. A sequential exploratory mixed-methods study. Twelve nursing institutions in five cities of Pakistan. A purposive sample of 12 educators for interviews and 112 for the survey. Semi-structured interviews and survey for data collection and expert consultations for questionnaire development. Thematic analysis for qualitative analysis, descriptive analysis for quantitative, and joint display tables for mixed methods. Educators experience workload and time constraints and struggle to effectively teach students due to inadequate student-educator ratio; underdeveloped curriculum; inadequate resources; inadequate clinical teaching settings for skills, simulation labs; inadequate professional development opportunities; lack of autonomous decision making; lack of educational, management, and research support from the regulatory bodies; and lack of educational research. Nurse educators' issues and challenges are persistent and require support from regulatory bodies and educational authorities. There is a need to develop policies to improve teaching and learning conditions for educators, provide them with the opportunities to enhance their own learning, and opportunities to collaborate with other educators in order to better prepare student nurses.

Younas A ，Zeb H ，Aziz SB ，Sana S ，Albert JS ，Khan IU ，Inayat S ，Khan FH ，Rasheed SP ... -  《-》

Effect of holistic reflective learning program on development of nursing students' professional competency in geriatric clinical practice: a quasi-experimental study.

Reflection is a core competency in geriatric nursing, and reflective learning is an effective approach in nursing education and pracice. An internship program is a transition course that enhances the knowledge, skills, and attitudes of aspiring nursing students in real clinical work. In geriatric clinical setting, nursing internship students require a broad understanding of professional competency that integrates reflective learning with clinical practice to deal with geriatric patient problems and equip them with the knowledge, attitudes, and skills needed to provide quality of care. However, there is a lack of studies examining the effect of holistic reflective learning on professional competency development among nursing internship students in geriatric settings. This study aimed to investigate the effect of professional holistic reflective learning on professional competency development among nursing internship students caring for hospitalized older adults in medical-surgica wards. This study employed a quasi-experimental pretest-posttest design, where 160 participants were grouped into control and intervention groups. This study was conducted at two nursing schools under the Mashhad University of Medical Sciences in Iran in 2020. Baseline information was collected from both groups, followed by a pretest and follow-up assessment. The intervention group received a Blended Professional Holistic Reflective learning program, while the control group received conventional learning(undertaking professional clinical practice as a usual treatment and submitted reflective logbooks),, which included standard lectures and group discussions. Participants were selected based on specific inclusion and exclusion criteria. The selection process was non-randomized and unblinded. The participants were equally divided, with 80 in the control group and 80 in the intervention group. Baseline data, including demographic characteristics, were collected. Pretest data were collected for both groups using the Geriatric Nursing-Specific Mini-CEX (GN-Specific Mini-Clinical Evaluation Exercise), an instrument designed to assess nursing students' professional competency in geriatric nursing practice. The intervention was delivered through a combination of in-person and online sessions over four mounts. Posttest data and follow-up, were collected similarly to the pretest. Data were analyzed using SPSS version 22, and potential confounding variables were controlled for in the analysis. The study included a total of 160 nursing internship students, with no exclusions. At baseline, no significant differences were observed between the intervention and control groups in terms of professional competency (PC) and its dimensions, except for age, which was adjusted as a covariate in the analyses. The intervention group showed a significant improvement in PC and its various domains (communication skills, physical examination, clinical judgment, health education, professionalism, and organizational efficacy) over time. The Generalized Estimating Equation (GEE) analysis confirmed significant interaction effects between time and group for all PC dimensions (p < 0.05). Post-test comparisons revealed that the intervention group scored 2.4 points higher than the control group in overall PC (p < 0.001), with sustained improvements in the follow-up phase. Significant within-group improvements were also found across all PC dimensions for both groups from pre-test to follow-up (p < 0.05). The study found that the professional holistic reflective learning program was effective in developing professional competency among nursing internship students. The blended teaching-learning approach (face-to-face and online) during workshops and geriatric clinical practice is a practical, cost-effective, and time-efficient learning program during students' clinical practice in geriatric settings. Nurse educators are recommended to implement holistic reflective learning during clinical education.

Mohajer S ，Bagheri N ，Chan CM ，Danaee M ，Mazlum SR ，Yoong TL ，Lopez V ，Namazinia M ... -  《BMC Medical Education》

Challenges nurse educators experience with development of student nurses' clinical reasoning skills.

Traditional teacher-centred teaching strategies do not always facilitate the development of desired clinical reasoning skills required for nursing practice. A multiphase study was conducted to facilitate a process of change towards improving educational practices in order to promote the development of undergraduate student nurses' clinical reasoning skills. The study was conducted at a military nursing education institution. This paper reflects on Phase 1, where a descriptive, qualitative study was conducted to explore the challenges nurse educators experienced in utilizing teaching and learning strategies that could promote the development of clinical reasoning skills in undergraduate student nurses. Unstructured interviews were conducted with 16 nurse educators who were selected purposively. Interviews were recorded, transcribed and data were analysed for content. The findings indicate that the clinical learning environment, the military environment, and various role players in the environment are instrumental in nurse educators not utilizing educational practices that promote the development of clinical reasoning skills in undergraduate student nurses. Addressing nurse educator challenges and empowering them with the means, opportunity and skills to utilize student-centred teaching and learning strategies may contribute to the development of undergraduate student nurses' clinical reasoning skills. Raising awareness of challenges nurse educators experience in implementing student-centred facilitation of learning can assist in developing strategies to ensure nurse educators become more student-centred in their teaching.

van Wyngaarden A ，Leech R ，Coetzee I 《-》