Marianne R. Jeffreys

Predicting nontraditional student retention and academic achievement.

Early identification of factors that restrict or support academic achievement and retention is a priority concern for nurse educators. Guided by the Bean and Metzner model of nontraditional undergraduate student attrition, the author examines the influence of self-efficacy and select academic and environmental variables on academic achievement and retention among nontraditional nursing students.

Evaluating the influence of cultural competence education on students' transcultural self-efficacy perceptions.

Guided by the cultural competence and confidence (CCC) model, the Transcultural Self-Efficacy Tool (TSET) was used to evaluate the influence of cultural competence education on the transcultural self-efficacy (TSE) perceptions of undergraduate nursing students following an integrated approach to cultural competence education. Results continue to support that TSE is influenced by formalized education and other learning experiences. As hypothesized, compared with novice students, advanced students’ scores were higher for all subscales in both cross-sectional (n = 147) and longitudinal (n = 36) study designs. Results from analysis of variance and covariance demonstrated that none of the demographic variables predicted change; semester was the sole predictor, lending additional support that (a) the educational interventions throughout the four semesters influenced TSE changes and (b) all students regardless of background benefit (and require) formalized cultural competence education. Implications for nurse educators conclude the article.

Development and Psychometric Evaluation of the Transcultural Self-Efficacy Tool: A Synthesis of Findings

The initial and ongoing assessment of students’self-efficacy perceptions (confidence) concerning culture care of diverse individuals is a valuable component in transcultural nursing education. The Transcultural Self-Efficacy Tool (TSET) was designed as a diagnostic tool to measure and evaluate students’ transcultural self-efficacy perceptions for performing general transcultural nursing skills among diverse client populations. This article summarizes the steps in the TSET’s development and evaluation, synthesizes reliability and validity findings from a series of psychometric investigations, and discusses future research and educational applications in transcultural nursing using the TSET.

Evaluating enrichment program study groups: academic outcomes, psychological outcomes, and variables influencing retention.

The purpose of this study was to describe and evaluate select aspects of an enrichment program (EP) for students who participated in peer mentor/tutor (PMT) led study groups throughout the semester. The evaluation addressed three areas related to the underlying conceptual framework: (1) academic outcomes; (2) psychological outcomes (satisfaction); and (3) variables influencing retention. Overall, study group participants achieved higher pass rates, lower withdrawal rates, and positive psychological outcomes (satisfaction). Students perceived that environmental variables were more influential than academic variables in influencing retention. Social integration variables were perceived as greatly supportive. Implications for nurse educators are discussed.

Construct validation of the Transcultural Self-Efficacy Tool.

The study was designed to further validate the Transcultural Self-Efficacy Tool (TSET) by identifying: (a) the presence and growth in transcultural self-efficacy (TSE) perceptions over time, and (b) select demographic variables influencing differences in TSE percepts among student groups. The TSET was administered to 566 culturally diverse students enrolled as first-semester (novice) students or fourth-semester (advanced) students in undergraduate nursing programs. The results supported the conclusion that TSE is a dynamic construct that changes over time and is influenced by previous health care experience and education. This was evidenced in the different ratings of self-perceptions between novice and advanced students on the three TSET subscales: cognitive, practical, and affective. Gender, age, ethnicity, and income were not significant predictors on any of the subscales. The results supported a change in the expected direction on several scores, thus providing an estimate of construct validity. Implications for further research and applications are discussed.

Factor analysis of the transcultural self-efficacy tool (TSET).

The factor structure of the Transcultural Self-Efficacy Tool (TSET) was analyzed using data from 272 culturally diverse undergraduate nursing students. The TSET is a questionnaire designed to measure students’ confidence for performing general transcultural nursing skills among diverse client populations. Using the most recent imputation techniques for missing data, researchers demonstrate how common exploratory factor analysis (CEFA)—(as opposed to principal components analysis)—can (and should be) used in examining the factorial composition of the tool. Standard errors for factor loadings were computed and utilized in deciding whether a given item loaded significantly on a factor and whether the difference between the factor loadings of two or more items on the same factor were statistically significant. The CEFA, comprised of 69 of the 83 items, yielded four factors—“Knowledge and Understanding,” “Interview,” “Awareness, Acceptance, and Appreciation,” and “Recognition”—with internal consistency ranging from .94 to .98. Reliability of the total instrument was .99. It was concluded that the present CEFA study continues to support that the TSET assesses the multidimensional nature of transcultural self-efficacy while also differentiating between three types of learning: cognitive, practical, and affective. The benefits of this support allow the researcher/educator to move beyond mere assessment to the design, implementation, and evaluation of diagnostic-prescriptive teaching strategies for cultural competence education.

Jeffreys's Nursing Universal Retention and Success model: Overview and action ideas for optimizing outcomes A–Z

BACKGROUND Nursing student persistence, retention, and success are universally desired outcomes yet remain elusive and challenging worldwide. OBJECTIVES The aim of this study is to provide nurse educators with an organizing framework and action ideas for optimizing student outcomes. CONCEPTUAL MODEL Jeffreyss Nursing Universal Retention and Success (NURS) model presents a globally-applicable framework for examining the multidimensional factors that affect undergraduate and graduate nursing student retention and success in order to make a positive difference. DISCUSSION This article presents a brief overview of the empirically-based NURS model and indicates that retention decisions, persistence, and optimal outcomes will be based on the interaction of student profile characteristics, student affective factors, academic factors, environmental factors, academic outcomes, psychological outcomes, outside surrounding factors, and professional integration factors. CONCLUSION An A-Z list of action ideas provides nurse educators with a springboard for further developing ideas tailored to individual program and student needs. Recommendations for global collaborative partnerships and networks are presented.

Chapter 3: Theoretical Basis for Transcultural Care

Margaret Andrews, PhD, RN, CTN, FAAN1 Jeffrey R. Backstrand, PhD2 Joyceen S. Boyle, PhD, RN, CTN, FAAN3 Josepha Campinha-Bacote, PhD, MAR, PMHCNS-BC, CTN-A, FAAN4 Ruth E. Davidhizar, DNSc, RN, APRN, BC, FAAN (deceased)5 Dawn Doutrich, PhD, RN, CNS6 Mercedes Echevarria, DNP, APN7 Joyce Newman Giger, EdD, APRN, BC, FAAN8 Jody Glittenberg, PhD, RN, FAAN, TNS9 Carol Holtz, PhD, RN10 Marianne R. Jeffreys, EdD, RN11 Janet R. Katz, PhD, RN12 Marilyn R. McFarland, PhD, RN, FNP-BC, CTN-A13 Gloria J. McNeal, PhD, MSN, ACNS-BC, FAAN14 Dula F. Pacquiao, EdD, RN, CTN15 Irena Papadopoulos, PhD, MA, RN, RM, FHEA16 Larry Purnell, PhD, RN, FAAN17 Marilyn A. Ray, PhD, MA, RN, CTN-A18 Mary C. Sobralske, PhD, RN, CTN19 Rachel Spector, PhD, RN, CTN-A, FAAN20 Marian K. Yoder, EdD, RN21 Rick Zoucha, PhD, PMHCNS-BC, CTN22

Evaluating cultural competence in the clinical practicum.

Aim. The main purpose is to introduce a tool for evaluating the extent of culturally specific care provided for a diverse clientele, the frequency of cultural assessments, and the development of culturally sensitive and professionally appropriate attitudes, values, and beliefs. Background. Legal, ethical, and accreditation mandates demand theoretically based, valid, comprehensive tools to assess aspects of culturally specific care; yet no relevant ones existed. Method. The Cultural Competence Clinical Evaluation Tool (CCCET) was administered at the end of a second semester medical‐surgical nursing course (n = 161). Results. The Content Validity Index (CVI) was 0.91. The reliability coefficients provided evidence for internal consistency. Conclusion. Student and teacher ratings were relatively close, suggesting that respondents took the task of CCCET completion seriously and honestly, that cultural competence was a visible theme throughout the course, and that students and instructors worked closely together in the clinical practicum setting to achieve learning objectives (including cultural competence).

Cultural Discovery: An Innovative Philosophy for Creative Learning Activities

The purpose of this article is to describe a philosophical approach for integrating general transcultural nursing concepts and skills within a first semester associate degree nursing course. The authors wished to design a learning activity that would provide meaningful experiences and stimulate critical thinking among nontraditional, culturally diverse students who must learn to care for many clients of diverse cultural backgrounds. With a focus on culture, aging, and health, this creative learner-centered approach, called Cultural Discovery, emphasizes learning outcomes in both the cognitive and affective domains. Cultural Discovery includes several components in conjunction with the Leininger Acculturation Health Care Assessment Enabler for Cultural patterns in Traditional and Nontraditional Lifeways, specifically: background reading assignments, classroom activity component, collaborative library introductory program, videotape program, interview, literature review, reflection, and written paper assignment Implemented over an eight week period, Cultural Discovery assisted beginning nursing students to systematically conduct a basic general cultural assessment, identify some similarities and differences among individuals within cultural groups, distinguish between varying dimensions of acculturation, and discover the importance of culturally congruent nursing care.