Hsiu-Min Tsai

The effects of Team-Based Learning on learning behaviors in the maternal-child nursing course.

BACKGROUNDnThe Team-Based Learning (TBL) method has been used as a teaching strategy in many disciplines. It is instructor-led, learner-centered learning with functions similar to those of problem-based learning, but it is more cost-effective. However, little is known about the application of TBL to nursing education.nnnOBJECTIVESnThe objectives of the study are to employ the TBL approach in a Maternal-Child Nursing course and to evaluate its effects on learning outcomes.nnnDESIGNnWe present one-group pretest-posttest research design with the intervention of the TBL teaching strategy.nnnSETTINGSnThe study was conducted in one of the nursing universities in Taiwan.nnnPARTICIPANTSnOne-hundred-four students in 2011 and 103 students in 2012 in an RN-to-BSN program who enrolled in the Maternal-Child Nursing course participated in this study. These students had graduated from a five-year nursing diploma program before enrolling in the RN-BSN program.nnnMETHODSnData were collected before and after the implementation of the TBL, which included active learning, in-class activities, and application exercises. The Class Engagement Survey (CES), Value of Teams (VTs), Self-Directed Learning Instrument (SDLI), and exam scores were used to measure students learning outcomes.nnnRESULTSnTBL significantly influenced the students learning outcomes. Students who expressed that TBL increased their learning interests had a higher score on VT; and students who had high achievement from the current TBL course had higher scores on the CES, VT, and SDLI. The means of the group test scores and the final examination score were significantly higher than the individual scores from the in-class tests in both 2011, 2012, and the combination of 2011 and 2012.nnnCONCLUSIONnThe TBL design requires out-of-class preparation before all classes, which requires active and self-directed learning. TBL provides opportunities to foster learner-to-learner interactions, which lead to more active engagement and teamwork among learners. It also promotes the students class engagement and teamwork values, and it increases academic performance. The TBL is suggested to have a greater effect on academically weaker students.

Job stress and job satisfaction among new graduate nurses during the first year of employment in Taiwan

Nurse graduates are leaving their first employment at an alarming rate. The purpose of this study was to explore the relationships between job stress, job satisfaction and related factors over time among these nurses. This study applied a longitudinal design with three follow-ups after nurse graduates first employment began. Using convenience sampling, participants were 206 new graduates from a university. The Work Environment Nursing Satisfaction Survey and the Clinical Stress Scale were used in this study. Results indicated that job stress remained moderate across three time points. Participants working 12u2009h shifts exhibited less job stress. Job satisfaction significantly increased in the twelfth month. Participants working 12u2009h shifts had a higher degree of job satisfaction. Job stress was negatively correlated with job satisfaction. The 12u2009h work shifts were related to job stress and job satisfaction. These results implied that health-care administrators need to provide longer orientation periods and flexible shift schedules for new graduate nurses to adapt to their work environment.

The effects of a deliberate practice program on nursing students' perception of clinical competence

BACKGROUNDnNew nursing graduates readiness for practice often does not meet the requirements needed in the real situation of clinical sites. Therefore, nurse education has placed more emphasis on developing students technical skills to cultivate proficiencies needed for clinical sites.nnnOBJECTIVESnTo develop a program including deliberate skill practices and technical skill testing, each conducted before students clinical practicum, and to examine the programs effects on nursing students clinical competence.nnnDESIGNnThe study was a repeated measure correlational design.nnnSETTINGSnOne nursing university.nnnPARTICIPANTSnTwo-hundred-fifty-six and 266 nursing students in a RN-to-BSN night school program in Taiwan completed pretest and posttest surveys, respectively in 2009 and 2010. Their mean age was 22.61 years and had worked 12.75 months as a nurse.nnnMETHODSnStudents were asked to participate in the deliberate nursing practice program, which includes skill practice and tests, before their last clinical practicum. The Clinical Competence Questionnaire was used to measure the outcome of deliberate practice.nnnRESULTSnFindings indicated that participants who had nursing work experience, a higher grade point average, practiced their skills by watching videos, and higher pretest competence scores exhibited significantly higher posttest competence scores. Participants who worked in the operating room/outpatient department, scored higher on self-confidence in clinical performance, and had a higher level of future job stress exhibited significantly lower posttest competence scores.nnnCONCLUSIONSnAlthough work experience increased clinical competence, working in the operating room/outpatient department where many nursing skills were not performed did not have the effects. In contrast, skill reviews and better performance before practice promoted competence. Attaining motor skill competency is a slow process requiring practices. Thus, providing deliberate skill-practice program is suggested to help students increase their competence.

New graduate nurses' clinical competence, clinical stress, and intention to leave: a longitudinal study in Taiwan.

This longitudinal research study aimed to develop a pregraduation clinical training program for nursing students before graduation and evaluate its effect on students self-perceived clinical competence, clinical stress, and intention to leave current job. A sample of 198 students returned the questionnaires before and after the program. They were followed up at 3, 6, and 12 months after graduation. Results showed that posttest clinical competence was significantly higher than pretest competence, positively related to clinical competence at 3 and 12 months, and negatively related to clinical stress at 3 months. The clinical competence at 3 months was positively related to clinical competence at 6 and 12 months, and clinical competence at 6 months was related to intention to leave at 12 months. Intention to leave at 6 months was positively related to intention to leave at 3 and 12 months. Clinical stress at 3 months was positively related to clinical stress at 6 and 12 months, but not related to intention to leave at any time points. The training program improved students clinical competence. The stressful time that was correlated with new graduate nurses intention to leave their job was between the sixth and twelfth months after employment.

Acculturation, collectivist orientation and organisational commitment among Asian nurses working in the US healthcare system

AIMnTo examine the relationships between acculturation, collectivist orientation and organisational commitment among Asian nurses in US hospitals.nnnBACKGROUNDnFew studies have explored these three variables together in the same study and examined their statuses and mutual relationship among Asian nurses in Western hospitals.nnnMETHODnThe study was a cross-sectional design using snowball sampling. A total of 195 Asian nurses participated. The collectivist orientation scale, organisational commitment questionnaire and acculturation factors were used to collect data. Pearson correlation, anova and regression were used to analyse the data.nnnRESULTSnMost participants were female Filipinos with a mean age of 39.92 and a bachelors degree and stayed in the USA for 13.35 years. They used and preferred to use both their mother language and English, identified themselves as Oriental or Asian and culturally, viewed themselves as very or mostly Asian. Participants scored high on collectivism and commitment. Collectivism was significantly correlated with commitment but did not mediate acculturation factors and commitment.nnnCONCLUSIONnTo increase Asian nurses commitment, it is important that administrators understand their cultural values and provide them with a cultural competent and sensitive environment.nnnIMPLICATIONS FOR NURSING MANAGEMENTnHealthcare administrators can increase Asian nurses commitment through understanding their needs and attitudes toward their job and organisation.

Innovative strategies for teaching nursing research in Taiwan.

Background:Evidence-based practice is imperative in clinical settings because it bridges the gap between research findings and clinical practice. Promoting nursing student interest and enthusiasm for research is therefore crucial when teaching nursing research. Objective:The aim of thus study was to develop innovative teaching strategies that increase nursing students’ interests and engagement in research. Methods:This study employed a descriptive, pretest–posttest, quasiexperimental design with 103 participants in the experimental group and 106 in the control group. The Attitudes toward Research Questionnaire, Classroom Engagement Scale, Self-Directed Learning Instrument, Nursing Eight Core Competencies Scale, Value of Teams survey, and a research knowledge test were applied to evaluate the outcomes of the innovative teaching strategies. Results:Scores for the research knowledge test were significantly higher in the experimental group than in the control group in posttest 1 and posttest 2. After the intervention, participants in the experimental group exhibited higher scores on attitudes toward research, eight core competencies in nursing,value of teams, classroom engagement, and self-directed learning than participants in the control group. Students in the experimental group perceived a lower degree of pressure and higher degrees of interest, enjoyment, and acceptance of the research course than students in the control group. Conclusions:This study confirmed that using innovative teaching strategies in nursing research courses enhances student interest and enthusiasm about evidence-based practice.

Preparing the future nurses for nursing research: A creative teaching strategy for RN-to-BSN students

Developing effective teaching strategies to stimulate students interest and enthusiasm are urgently needed in current research courses. The purposes of the study were to implement the Cookie Experiments teaching strategy in research course and examine the effects of the strategy on students attitudes towards nursing research. The study was a pretest-post-test design with 95 students at a Registered Nurses to Bachelor of Science in Nursing (RN-to-BSN) program enrolled in the nursing research course. Results indicated that there was a significant effect of the Cookie Experiments teaching strategy on students attitudes towards research. Although students perceived a median high score of pressure from the research course, they regarded that the pressure is conducive to their learning of research. Students highly suggested to continuously applying this teaching strategy in the future nursing research courses. Developing and using various teaching strategies with attractive and hands-on methods to motivate nurse students, learning research is strongly recommended.

The relationship of individual characteristics, perceived worksite support and perceived creativity to clinical nurses' innovative outcome

AIMS AND OBJECTIVESnTo understand the relationship of individual characteristics, perceived worksite support and perceived personal creativity to clinical nurses innovative outcome (receiving the Nursing Innovation Award).nnnBACKGROUNDnSince the idea of applying creativity and innovation to clinical nursing practice and management was first advocated in the Nursing Administration Quarterly in 1982, the topic of nursing innovation has gained worldwide attention. To increase the prevalence of nursing innovation, it is important to identify and understand the related factors that influence nurses innovative outcome.nnnDESIGNnThis study used a cross-sectional descriptive survey design.nnnMETHODSnA self-administered questionnaire was completed by 32 award winners and 506 nonawarded clinical nurses in Taiwan.nnnRESULTSnThe level of creativity perceived by all participants was moderate-to-high. Individual characteristics (rxa0=xa00·61) and worksite support (rxa0=xa00·27) were both correlated with perceived creativity. Individual characteristics and worksite support showed some correlation as well (rxa0=xa00·21). Individual characteristics and worksite support could predict perceived creativity after controlling for demographic variables, but only individual characteristics had an effect on innovative outcome. Perceived creativity did not have mediation effects either between individual characteristics and innovative outcome or between worksite support and innovative outcome.nnnCONCLUSIONSnClinical nurses individual characteristics had a direct relationship to innovative outcome, whereas neither worksite support nor creativity was correlated with innovative outcome. Although worksite support did not show effects on innovative outcome, it was related to both perceived creativity and individual characteristics. As suggested by other scholars, there might be other related factors between creativity and innovative outcome.nnnRELEVANCE TO CLINICAL PRACTICEnAlthough worksite support did not have effect on clinical nurses innovative outcome, it was related to individual characteristics. Hospital administrators or nursing directors can foster a supportive environment where creative nurses would be more likely to work and engage in innovative activities.

The development and psychometric testing of a theory-based instrument to evaluate nurses' perception of clinical reasoning competence.

AIMnThe purpose of the study was to develop and psychometrically test the Nurses Clinical Reasoning Scale.nnnBACKGROUNDnClinical reasoning is an essential skill for providing safe and quality patient care. Identifying pre-graduates and nurses needs and designing training courses to improve their clinical reasoning competence becomes a critical task. However, there is no instrument focusing on clinical reasoning in the nursing profession.nnnDESIGNnCross-sectional design was used. This study included the development of the scale, a pilot study that preliminary tested the readability and reliability of the developed scale and a main study that implemented and tested the psychometric properties of the developed scale.nnnMETHODnThe Nurses Clinical Reasoning Scale was developed based on the Clinical Reasoning Model. The scale includes 15 items using a Likert five-point scale. Data were collected from 2013-2014. Two hundred and fifty-one participants comprising clinical nurses and nursing pre-graduates completed and returned the questionnaires in the main study. The instrument was tested for internal consistency and test-retest reliability. Its validity was tested with content, construct and known-groups validity.nnnRESULTSnOne factor emerged from the factor analysis. The known-groups validity was confirmed. The Cronbachs alpha for the entire instrument was 0·9.nnnCONCLUSIONnThe reliability and validity of the Nurses Clinical Reasoning Scale were supported. The scale is a useful tool and can be easily administered for the self-assessment of clinical reasoning competence of clinical nurses and future baccalaureate nursing graduates. Study limitations and further recommendations are discussed.