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  1. Chuan OL, Barnett T
    Nurse Educ Pract, 2012 Jul;12(4):192-7.
    PMID: 22277167 DOI: 10.1016/j.nepr.2012.01.003
    The aim of this exploratory study was to describe and compare student nurses (n=142), staff nurses (n=54) and nurse tutors (n=8) perceptions of the clinical learning environment (CLE), and to identify factors that enhanced or inhibited student learning. The setting was a private hospital in Penang, Malaysia. Data were collected using a structured, self-administered questionnaire that consisted of six a priori subscales. Principal component analysis supported a six factor solution and a reduction in the number of items from 44 to 34. Participants' overall perception of the CLE was positive, though there were significant differences in 5 of the 6 subscales between the three groups. For students and their tutors, the most positive component of the CLE was 'supervision by clinical instructors'. Staff nurses reported more favourably on the learner friendliness of the CLE than did students or tutors. Factors that enhanced student learning included students' and staff nurses' attitude towards student learning, variety of clinical opportunities, sufficient equipment, and adequate time to perform procedures. Factors that hindered student learning were: overload of students in the clinical unit, busy wards, and students being treated as workers.
  2. Janes G
    Nurse Educ Pract, 2006 Mar;6(2):87-97.
    PMID: 19040861 DOI: 10.1016/j.nepr.2005.09.003
    This paper analyses the experience of one individual in the development and delivery of an innovative, undergraduate leadership development module. The module is accessed by practising health care professionals in Malaysia as part of a top-up Honours Degree and is delivered solely using a virtual learning environment (VLE), in this case Blackboard. The aim of this analysis is to contribute to the current body of knowledge regarding the use of VLE technology to facilitate learning at a distance. Of particular relevance is the paper's focus on: the drivers for e-learning; widening participation and increasing access; the experience of designing and delivering learning of relevance for this contemporary student population and evaluating the VLE experience/module. The development and delivery of this module is one result of a rapidly growing area of education. As a novice teacher in her first year in the higher education sector, this experience was a significant and stimulating challenge for a number of reasons and these are explored in greater depth. This is achieved by means of personal reflection using the phases of module development and delivery as a focus.
  3. Achike FI, Nain N
    Nurse Educ Pract, 2005 Sep;5(5):302-11.
    PMID: 19040837 DOI: 10.1016/j.nepr.2005.04.002
    Since the introduction of problem-based learning (PBL) into medical education in the late 1960s, several new and old medical schools have adopted this approach the main attraction of which includes the promotion of student-centered and life-long learning, team spirit, communication skills and enquiry. With an ever-increasing information base and changing attitudes in the health sciences, these are highly desirable characteristics of the health worker of the future, who will be required to grapple with these phenomenal changes. From medical education, the PBL approach has inevitably spread to other disciplines, especially the health-related disciplines. In the Asia-pacific region (Malaysia in particular), PBL was introduced into medical education in the early 1970s, but the growth has been slow; the reasons are discussed. Only recently (in the 1990s) have more medical and non-medical schools started to adopt PBL. The management of the Pantai Institute of Health Science and Nursing decided to adopt PBL for the Nursing curriculum. A one-day introductory workshop was, therefore, organized to expedite the process. Post-workshop feedback obtained through a five-point Likert scale questionnaire indicated a successful outcome. The workshop process is, therefore, documented as reference especially for Nursing colleges in places where PBL expertise is in short supply.
  4. Chan KG, Pawi S, Ong MF, Kowitlawakul Y, Goy SC
    Nurse Educ Pract, 2020 Oct;48:102864.
    PMID: 32920369 DOI: 10.1016/j.nepr.2020.102864
    The aim of this study was to investigate factors influencing nursing students' intention to use a simulated web-application 'Integrated Nursing Education System' for practicing electronic health documentation. The cross-sectional study was conducted at a Malaysian University that provides undergraduate nursing degree program. A total of 133 undergraduate nursing students in their year 2 to year 4 of the program were recruited. They had accessed the simulated web-application as part of the teaching-learning activities during the academic year 2016/2017. Technology Acceptance Model was used to guide the study. Validated questionnaires were used to measure the students' perceived ease of use, perceived usefulness, attitudes and intention to use the application. Data collection was done at the end of the semester. Data analysis was done using SPSS (19.0) and AMOS (23.0). Perceived usefulness was the most influential factor of the students' intention to use the simulated web-application. Perceived ease of use influenced their perceived usefulness significantly. Nurse educators should explain the usefulness of the simulated web-application before assigning students to access it to practice electronic health documentation. The availability of a stable internet access and IT support is important to influence students' perceived ease of use and intention to use the application.
  5. Eskandari F, Abdullah KL, Zainal NZ, Wong LP
    Nurse Educ Pract, 2018 Sep;32:52-57.
    PMID: 30029085 DOI: 10.1016/j.nepr.2018.07.007
    The use of physical restraint exposes patients and staff to negative effects, including death. Therefore, teaching nursing staff to develop the improve knowledge, skills, and attitudes regarding physical restraint has become necessary. A quasi-experimental pre-post design was used to evaluate the effect of educational intervention on nurses' knowledge, attitude, intention, practice and incidence rate of physical restraint in 12 wards of a hospital using a self-reported questionnaire and a restraint order form in Malaysia. The educational intervention, which included a one-day session on minimising physical restraint use in hospital, was presented to 245 nurses. The results showed a significant increase in the mean knowledge, attitude sand practice score and a significant decrease in the mean intention score of nurses to use physical restraint after intervention. There was a statistically significant decrease in the incidence rate of physical restraint use in the wards of the hospital except geriatric-rehabilitation wards after intervention.
  6. Nelwati, Abdullah KL, Chong MC
    Nurse Educ Pract, 2019 Nov;41:102648.
    PMID: 31707147 DOI: 10.1016/j.nepr.2019.102648
    BACKGROUND: Undergraduate nursing students are required to acquire professional values during professional nurse education to provide safe and high quality patient care. However, there was no documentation in professional values among Indonesian undergraduate nursing students and the factors influencing its development.

    PURPOSE: The purpose of this study was to determine professional values among Indonesian undergraduate nursing students and examine the relationship between students' demographic factors and professional values.

    DESIGN: A cross-sectional study using convenience sampling was applied to recruit 391 Indonesian undergraduate nursing students. The 26 items of Nurses Professional Values Scale Revision (NPVS-R) with five dimensions was employed to collect data. Descriptive and inferential statistics, independent samples t-test were applied to analyse and interpret data.

    RESULTS: The result showed that the total score of nurse professional values was high (95.80 ± 12.93). The most important professional value dimension was caring, while activism was the least important values. The NPVS-R total score had a significant association with length of professional clinical practice of the students (p 

  7. Li A, Zain NM, Yusuf A, Deng H, He Q
    Nurse Educ Pract, 2024 Jul;78:103988.
    PMID: 38843688 DOI: 10.1016/j.nepr.2024.103988
    OBJECTIVE: The purpose of this meta-analysis was to assess the effects of online education for practical skills among nursing students.

    METHODS: This research was done by searching PubMed, Embase, CINAHL, and Web of Science electronic databases from inception to August 18, 2023, to identify English-language articles. Data extraction, quality assessment, and literature screening were carried out independently by two researchers. The Cochrane risk of bias tool and the Methodological Items for Nonrandomized Studies (MINORS) tool were used to assess the risk of bias of the included studies. Meta-analysis was carried out using Review Manager (RevMan) version 5.3 software.

    RESULTS: Eighteen studies involving 2274 nursing students met the inclusion criteria. Nursing students' skills (SMD = 0.43, 95 % CI [0.33, 0.54], P<0.00001), knowledge (SMD = 0.16, 95 % CI (0.02, 0.30], P = 0.02), satisfaction (SMD = 0.29, 95 % CI (0.10, 0.47], P < 0.01), and confidence (SMD = 0.56, 95 % CI [0.29, 0.83], P < 0.0001) were all significantly improved by the online teaching intervention compared with traditional face-to-face instruction. Self-efficacy (SMD = 0.1, 95 % CI [-0.13, 0.33], P = 0.41) was also improved, but the difference was not statistically significant.

    CONCLUSION: Online learning is a novel and efficient approach to teaching practical skills to nursing students. Online education can enhance students' knowledge, skills, confidence, and learning satisfaction, and it is superior to traditional classroom instruction. The findings of this study can serve as a basis for the development of standardized online teaching techniques and assessment metrics.

  8. Yan X, Jia X, Feng L, Ge W, Kong B, Xia M, et al.
    Nurse Educ Pract, 2024 Aug 02;79:104087.
    PMID: 39142120 DOI: 10.1016/j.nepr.2024.104087
    OBJECTIVES: To address the nursing crisis, it is imperative to comprehend the factors that influence nursing competencies, which are crucial for the delivery of quality patient care.

    BACKGROUND: Facing demographic shifts and increasingly complex healthcare demands, China's nursing sector struggles with workforce shortages and the need to enhance core competencies. This research explores the interplay of social support, psychological resilience, mindfulness and nursing competencies in various hospital environments in China.

    METHODS: Through a cross-sectional survey, 941 nurses across tertiary, secondary and private healthcare settings completed self-assessment questionnaires. The analysis included multiple linear regression and comparative methods to assess how psychological resilience, mindfulness and social support have an impact on nursing competencies.

    RESULTS: Findings revealed a strong relationship between psychological resilience and nursing competencies, with resilience being a key predictor. Mindfulness and social support also significantly contributed to competency levels. Nurses in tertiary hospitals showed greater competencies than those in secondary or private facilities.

    CONCLUSION: Enhancing nursing competencies requires targeted interventions focusing on professional development and supportive workplace cultures. Incorporating psychological resilience, social support and mindfulness into nurse training is crucial for improving practice and policy.

  9. Qin Q, Cheng L, Wang JJ, Mohd Shariff N
    Nurse Educ Pract, 2024 Dec 13;82:104233.
    PMID: 39693945 DOI: 10.1016/j.nepr.2024.104233
    AIM: This study aims to synthesize and analyze a trauma-informed care (TIC) framework and its applications in nursing practice and education.

    DESIGN: This study employed a hybrid systematic narrative review.

    METHODS: Eligible studies were reviewed following the hybrid systematic narrative review guidelines. Peer-reviewed articles published in English between January 2015 and June 2024 were included. These articles were retrieved from CINAHL, PubMed, Web of Science and Scopus databases. Quantitative, qualitative and mixed-methods studies were also included. All the included studies underwent data synthesis, analysis and quality assessment.

    RESULTS: Sixteen studies were included: twelve studies examined trauma-informed care (TIC) in nursing practice and four focused on nursing education. Four primary frameworks were identified, with the Substance Abuse and Mental Health Services Administration (SAMHSA) framework being the most referenced. Most nurses held positive attitudes toward TIC, although their knowledge levels were generally moderate. Educational interventions significantly improved the TIC skills of nursing students. Although TIC offers substantial benefits, its implementation remains challenging. These challenges include time constraints, limited resources and concerns regarding potential re-traumatization.

    CONCLUSION: Nurses generally showed positive attitudes toward TIC; however, significant knowledge gaps and implementation barriers remained. Addressing these challenges by incorporating TIC into nursing education could enhance nursing competencies. Standardized TIC education is essential for improving clinical practice and optimizing patient outcomes. Future research should evaluate the effectiveness of TIC in diverse healthcare settings and develop strategies to support nurses in high-pressure environments. Expanding and deepening TIC curricula holds significant potential for enhancing care quality and fostering a trauma-informed healthcare system.

  10. Zhou B, Mui LG, Li J, Yang Y, Hu J
    Nurse Educ Pract, 2024 Feb;75:103874.
    PMID: 38244336 DOI: 10.1016/j.nepr.2024.103874
    AIM: To delineate the prevalence of smartphone addiction among nursing students. Further, to identify associated harms and underlying risk factors based on established theoretical models.

    BACKGROUND: Smartphones have become indispensable tools for students. However, excessive use can lead to smartphone addiction, causing physiological, psychological and social harm. Nursing students represent a unique population whose smartphone use may differ from other disciplines due to clinical training demands.

    METHODS: A scoping review was conducted following the Arksey and O'Malley framework. Seven databases were systematically searched from inception to August 2023. Inclusion criteria encompassed original research on smartphone addiction, harms and risks among nursing students. Data were extracted and thematically synthesized.

    RESULTS: Studies (n=39) met inclusion criteria, representing 15 countries. Rates of smartphone addiction among nursing students ranged from 19% to 72%, averaging 40-50%. Incorporated into Engel's biopsychosocial models, the harm is emphasized across individual inclinations, emotional aspects, cognitive processes and executive functions. Physiological harms include sleep disruption, vision concerns,other physiological concerns. psychologically, addiction correlated with increased anxiety and depression,decline in self-esteem, learning and attention and other psychological concerns. socially, it encompasses harms such as interpersonal relationships challenges, career development and decline in social abilities. The I-PACE model identifies various risk factors for smartphone addiction among nursing students, including personal factors such as interpersonal relationship anxiety and perceived academic pressure, affective factors like high stress and learning burnout, cognitive factors such as the need for online social interaction and low perception of social support, as well as executive factors like extended usage duration, poor self-control and usage before sleep.

    CONCLUSION: Smartphone addiction among nursing students presents tangible harms. A proposed theoretical model integrating established frameworks provides avenues to better comprehend addiction genesis and potential intervention strategies. Given addiction's multi-factorial nature, future research investigating harm mitigation through optimizing predisposing, precipitating and perpetuating factors is warranted.

  11. Junli A, Isa SNI, Ibrahim FS
    Nurse Educ Pract, 2023 May;69:103617.
    PMID: 36996552 DOI: 10.1016/j.nepr.2023.103617
    BACKGROUND: The retention of cardiopulmonary resuscitation skills among healthcare providers is critical to ensure the delivery of effective treatment to patients who experience cardiac arrest. However, the factors influencing cardiopulmonary resuscitation skills retention among healthcare providers have yet to be well studied.

    OBJECTIVE: This scoping review aimed to map the factors influencing cardiopulmonary resuscitation skills retention among healthcare providers.

    METHODS: A literature search was conducted using the Web of Sciences, Scopus, Cochrane, Google Scholar and PubMed electronic databases. The inclusion criteria were original publications published during the last five years (2018 - 2022), availability of full texts in English and evidence of the retention of pertinent cardiopulmonary resuscitation in terms of knowledge and abilities.

    RESULTS: Three cross-sectional studies, two prospective studies, one each of prospective descriptive-analytical study, randomised controlled trial, intervention and prospective interventional study, prospective pre-post study, retrospective study, cluster randomised control trial and randomised education trial study comprise the 14 publications including in this study. The thematic analysis identified four major themes that influence the retention of cardiopulmonary resuscitation skills: experience, training type, training frequency and other factors. The final theme identified infrastructure access, evidence-based practice review meetings and healthcare providers' educational background.

    CONCLUSION: To retain skills in cardiopulmonary resuscitation, healthcare providers must be regularly updated and trained on the latest cardiopulmonary resuscitation guidelines.

  12. Wang M, Liu Y, Guo W, Kang T, Jiang Q
    Nurse Educ Pract, 2025 Feb;83:104288.
    PMID: 39947057 DOI: 10.1016/j.nepr.2025.104288
    AIM: This study aims to compare the effects of narrative pedagogy with traditional teaching methods on nursing education outcomes.

    BACKGROUND: Narrative pedagogy has been developed for over a decade, and while studies confirm that it can stimulate student interest, foster empathy, and enhance the integration of theoretical knowledge with practical skills in nursing care, there is still insufficient evidence to recommend its widespread adoption.

    METHODS: In November 2024, a comprehensive search was conducted across databases including PubMed, Embase, The Cochrane Library, Web of Science, OVID, Scopus, PsychInfo, CNKI, Wanfang Data, Chinese Science and Technology Periodical Database (VIP) and China Biology Medicine disc (CBM) to identify studies that met the inclusion and exclusion criteria. Relevant data were extracted, and the quality of studies was assessed prior to conducting a meta-analysis. The review protocol was prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO)(CRD42024606820).

    RESULTS: Out of an initial pool of 11748 articles, 41 studies were selected for meta-analysis after a rigorous screening process. The results indicate that narrative pedagogy significantly improves nursing students' final examination scores, practical skills, empathy, and professional identity compared with traditional teaching methods.

    CONCLUSION: Narrative pedagogy effectively enhances nursing students' final examination performance, practical skills, empathy, and professional identity. However, given the limited number and quality of the included studies, these findings should be confirmed by further high-quality research.

    TWEETABLE ABSTRACT: Narrative education has been used in nursing teaching for more than 15 years, but there is no evidence to show the effectiveness of narrative education in nursing students. Therefore, this study aims to conduct the first systematic review and meta-analysis of the learning effects of narrative education on nursing students. From the establishment of the database until November 2024, a systematic evaluation search was conducted on 11 databases. After careful screening process, 41 studies on narrative education of urination nursing students in China were selected for meta-analysis. The results show that narrative education is significantly better than traditional teaching methods in improving final exam scores, practical skills, humanistic care ability, empathy and professional identity. Given the limited number and quality of included studies, these findings should be confirmed by further high-quality studies.

  13. Wang R, Raman A
    Nurse Educ Pract, 2024 Dec 16;82:104238.
    PMID: 39700839 DOI: 10.1016/j.nepr.2024.104238
    AIM: The study aimed to comprehensively analyze and evaluate the effects of blended learning in nursing education.

    BACKGROUND: Blended learning addresses significant challenges in nursing education by offering flexible and adaptive learning environments that support the development of both theoretical knowledge and practical skills. Its importance grew post-COVID-19. Although some reviews have synthesized its effects in nursing education, they often focused on a limited scope and studies, leaving gaps in understanding its broader impact.

    DESIGN: Systematic literature review.

    METHODS: We employed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to search for literature published in PubMed, CINAHL, Web of Science, EMBASE, ERIC, Scopus and Cochrane Library from 2000 to June 26, 2024. Two researchers independently screened each article for eligibility and extracted the data.

    RESULTS: This review included 54 studies and found that blended learning positively influenced nursing students in five key areas: academic performance and skill development, learning engagement and motivation, self-management in learning, psychological and emotional well-being, learning experience and satisfaction. These were captured in a visual model showing the comprehensive impact of blended learning. Critical research gaps were identified, including a lack of randomized controlled trials and limited studies on mental health and clinical thinking abilities.

    CONCLUSIONS: The results of the study showed that the effects of blended learning in nursing education were positive and multi-dimensional. Despite some inconsistencies in findings, blended learning was shown to offer significant advantages over traditional learning, though further research is required to address areas of uncertainty.

  14. Li A, Zain NM, Abu Wardeh Y, Yusuf A, Deng H
    Nurse Educ Pract, 2025 Mar 01;84:104320.
    PMID: 40058330 DOI: 10.1016/j.nepr.2025.104320
    BACKGROUND: Although online and offline blended teaching has emerged as a new teaching method, little research has been conducted on teaching clinical nursing skills and even less on the online teaching of this aspect of nursing apprenticeships.

    AIM: This study aimed to evaluate a blended online and offline teaching module for surgical nursing apprenticeship using the Learning Pass mobile application.

    DESIGN: A clustered randomised control trial was conducted among 166 nursing students at a university.

    METHODS: The intervention group received online and offline blended teaching methods using the Learning Pass mobile application (n = 83), while the control group used traditional face-to-face teaching methods (n = 83). Participants were assessed on self-directed learning ability before and after the experiment. Skill performance and learning attitude were measured post-experiment.

    RESULTS: A significant increase in self-directed learning ability was observed in the intervention group compared with the control group (t = 2.379, p = 0.019). The skill scores also showed a significant increase in the intervention group compared with the control group (t = 3.623, p 

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