Quality Advancement in Nursing Education - Avancées en formation infirmière
Quality Advancement in Nursing Education - Avancées en formation infirmière (QANE-AFI), a bilingual double-anonymized peer-reviewed journal, aims to address questions and issues related specifically to quality advancement in nursing education. Many themes are addressed, including the assessment, indicators, and standards of quality nursing education, the evaluation, program modality outcomes, and the nature and key elements of educational quality. With the collaboration of several highly respected scholars in the nursing field, Quality Advancement in Nursing Education - Avancées en formation infirmière, published three times per year, promotes excellence in nursing pedagogy through the publication of research, theoretical, and policy papers from Canadian and international perspectives. Currently accepting submissions. Articles are accepted and published in either English or French. Next edition: June 30, 2026
Canadian Association of Schools of Nursing
Professional Education in the Current Context of Public Health and Immunization Programs: An Interview With Canada Research Chair Holder Dr. Shannon MacDonald
Copyright (c) 2026 Susan M. Duncan, Jacinthe Pepin (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Revisiting Frameworks for Nursing Education Knowledge Development
Copyright (c) 2026 Jacinthe Pepin, Susan M. Duncan (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Interview With Patrick Lavoie, Holder of the Canada Research Chair in Decision-Making and Nursing Education
Copyright (c) 2025 Jacinthe Pepin, Susan M. Duncan (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
An Essential Critical Mind in the Nursing Education Publication Process
Copyright (c) 2025 Susan M. Duncan, Jacinthe Pepin (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Clinical Reasoning Conceptualization Among Clinical Placement Supervisors and Strategies to Support Its Development in Nursing Students in Clinical Placements
Introduction: Clinical reasoning (CR) is a fundamental competency that the next generation of nurses must develop to ensure the delivery of safe, high‑quality care. However, clinical placement supervisors report feeling insufficiently equipped to support the development of CR, to recognize difficulties associated with exercising this competency, and to address them effectively. This study aimed to explore the conceptions of CR held by undergraduate nursing clinical placement supervisors, as well as the pedagogical strategies they implement to support the development of this competency among students in clinical placements. Method: A descriptive qualitative approach was used. An open‑ended questionnaire and semi‑structured interviews were employed to collect data from clinical placement supervisors. A content analysis, conducted according to L’Écuyer’s (1990) model, was used to identify supervisors’ conceptions of clinical reasoning, the pedagogical strategies they implemented, the clinical reasoning difficulties encountered by students in clinical placements, and the remediation measures used. Results: A total of 13 clinical placement supervisors participated in the study. The analysis revealed a relatively vague understanding of clinical reasoning, which was generally perceived as a hypothetico‑deductive process. Only one participant mentioned the intuitive component of clinical reasoning. The main strategies used by participants to support the development of this competency among students were: 1) adapting to students’ levels; 2) asking them to conduct research; 3) questioning; and 4) discussing situations encountered in practice. Establishing connections emerged as the primary difficulty related to clinical reasoning. Remediation approaches essentially mirrored the same strategies used to provide support. Discussion: The results highlight the need for education to clarify conceptions of clinical reasoning, to implement recognized pedagogical strategies, to identify students’ difficulties, and to put in place more systematic measures to address them. Enhancing support for clinical placement supervisors in guiding the development of students’ clinical reasoning—along with better integration of pedagogical strategies based on a clinical reasoning model, using a structured approach—will help optimize the quality of clinical training.
Copyright (c) 2026 Kathleen Lechasseur, Sandrine Hegg, Isabelle Ledoux, Patrick Lavoie, Marie-France Deschênes (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Translation and Adaptation of the Stages of Transition Theory for Newly Graduated Nurses: A French-Language Resource for Integrating the Next Generation
The transition from studies to professional practice is a complex process that is unique to each newly graduated nurse (NGN). When confronted with the realities of clinical practice, NGNs frequently experience negative emotions that contribute to transition shock, such as doubt, confusion, loss of confidence, and disorientation. Although this phenomenon varies in intensity and duration from one NGN to another, it is nonetheless possible to anticipate the sequence of the transition in order to prevent or mitigate the effects of this shock. The stages of transition theory thus appears to be an essential resource for guiding research on the attraction, integration, and retention of the next generation of nurses within health care organizations. This article presents the French translation and adaptation of Duchscher’s (2008) stages of transition theory to the Quebec francophone context. A four-step process was undertaken, inspired by the recommendations of Sousa and Rojjanasrirat (2011) and by the translation and adaptation work of Lavoie et al. (2021). Seven experts in nursing education and the original author contributed to the translation and adaptation. The theory conceptualizes transition as a transformation process that is nonlinear and not strictly progressive during which the NGN evolves both personally and professionally as they move through three stages: doing, being, and knowing/becoming. The article concludes with a discussion of four elements: the methodological considerations that guided the translation and adaptation process; the limits of the theory’s scope; the evolution of integration practices and their implications for the theory; and the application of the theory in practice.
Copyright (c) 2026 William Tessier, Martin Charette, Patrick Lavoie, Judy Boychuk Duchscher (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Designing for Success: Evaluating Immersive Virtual Reality Learning in Nursing Education From a Remote Context
Purpose: This study aimed to explore how undergraduate nursing students in rural programs experience immersive virtual reality (IVR) as a strategy to support clinical learning and professional development. Situated learning theory (Lave & Wenger, 1991) provided the theoretical framework for this study. Method: This qualitative study used focus groups and interviews with nursing students from two rural campuses of a Canadian undergraduate nursing program. Data were analyzed thematically, informed by situated learning theory. Results: Participants identified four key influences on their learning with IVR: orientation and readiness to engage, physical and technological context, faculty facilitation, and realism of the simulation. IVR offered opportunities to engage in complex clinical decision-making and promoted confidence and active participation. Conclusion: IVR, when integrated into nursing curricula using principles of situated learning theory, may support learner engagement and confidence among students in rural programs. Findings suggest the importance of thoughtful design, facilitation, and contextual relevance in virtual simulation experiences.
Copyright (c) 2026 Nicole Harder, Kellie Graveline, Sufia Turner, Temilolu Mudashiru, Kim Workum (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Student Voices to Integrate Planetary Health Into Nursing Curriculum
Embedding planetary health into nursing curricula is a priority as climate change, biodiversity loss, and pollution are accelerating globally and across Canada (Government of Canada, 2024). Evidence-informed frameworks such as the Planetary Health Education Framework (Faerron Guzmán et al., 2025) and the National Nursing Education Framework (Canadian Association of Schools of Nursing, 2022) provide guidance. To adopt the best way forward, it is vital to also seek nursing students’ views on the positioning of planetary health within their nursing education as they are the future custodians of the planet and nursing leaders. Taking an appreciative inquiry approach, this study conducted focus groups with undergraduate students to seek their understanding of the positioning of planetary health within our current curriculum and ask their opinions on how to embed planetary health concepts and processes. The resulting recommendations, along with existing research and guiding frameworks, strengthen support and offer a clear road map on how to integrate planetary health into our nursing curriculum.
Copyright (c) 2026 Andrea Chircop, Brittany Barber, Lisa Doucet, Fenggang Zhou, Karen Curry, Shauna Houk, Alexander Fulford, Chelsa States (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Strategies to Support Clinical Nursing Students Requiring Accommodations for Physical and/or Sensory Disability: A Scoping Review Protocol
Introduction: Post-secondary institutions are seeing increasing numbers of students requiring accommodation. In the clinical education of nursing students with physical and/or sensory disabilities, it is unclear what strategies are available to promote students’ success. Objective: The objective of this scoping review protocol is to identify the available evidence on strategies that have been implemented to support the clinical education of nursing students who require accommodation for a physical and/or sensory disability in the learning environment. Inclusion Criteria: This scoping review will consider studies that include nursing students with physical and/or sensory disabilities in any regulated nursing designation programs that use clinical placements as a component of nursing education. Peer-reviewed quantitative, qualitative, and mixed-methods studies; systematic reviews; unpublished dissertations; policy reports from schools of nursing; and text and opinion papers that focus on clinical education of nursing students will be included without limitations on language. Methods: Databases to be searched include Ovid MEDLINE, CINAHL (EBSCO), ERIC (EBSCO), APA PsycInfo (EBSCO), Web of Science, and Scopus. Unpublished studies and gray literature searches will be undertaken in ProQuest Dissertations & Theses and a limited number of relevant nursing websites. No limit on date or region will be applied. Records will be screened and extracted by two independent reviewers. Results will be presented as tables with an accompanying narrative summary. Discussion: As the number of students with physical and/or sensory disabilities in nursing education increases, nursing programs and educators must be aware of how to support these students to complete their education. The clinical learning environment poses unique challenges that need to be explored further. Findings will have implications for policy and programming in nursing education.
Copyright (c) 2025 Roya Haghiri-Vijeh, Joyce Tsui, Janet Montague, Dima Milly, Jessica Mussell, Bernadette Zakher, Dzifa Dordunoo, Jennifer Webber (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Identifying Priorities for Pre-licensure Nursing Curriculum to Care for People With Intellectual and Developmental Disabilities: A Delphi Study
Background: People with intellectual and developmental disabilities (IDD) experience inequitable health care and outcomes. Pre-licensure nursing programs do not adequately prepare student nurses to care for this population. Purpose: To identify priorities for pre-licensure nursing curriculum content about nursing care for people with IDD. Methods: A three-round, mixed-methods Delphi study, inclusively designed, was administered to nurses and people with IDD. Data were analyzed using descriptive statistics and content analysis. Findings: A total of 16 nurses and 16 people with IDD participated in this study. At the end of the third survey round, consensus had been reached for 77% (10/13) of items under the category of person-centred care, 100% (6/6) of items about communication, 100% (5/5) of items about advocacy, 85.7% (6/7) of items about health and diagnoses, 100% (4/4) of items about collaboration, and 100% (3/3) of items about decision-making. Conclusion: These findings provide nursing faculty with direction for action in IDD-inclusive nursing curriculum. Future studies are needed to explore teaching and learning methods for further implementation.
intellectual and developmental disabilities
Copyright (c) 2025 Anna Don, Sushma Chowdhury, Selam Gessese, Jarrod Mclean, Kimberley Zappavigna, Daniel Kennedy, Amber Rathwell (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Two-Stage Exams in Undergraduate Nursing Education: A Descriptive Study on the Reduction of Barriers and Grade Inflation
Purpose: Collaborative assessment, including two-stage exams, has been widely implemented in undergraduate education as both an assessment method and a learning strategy. In a two-stage exam, students complete an individual exam, then immediately complete the same exam in small groups. Although the benefits of two-stage exams are well supported in the literature, weighting practices can vary. This descriptive study examined systemic and individual barriers to assessment among undergraduate nursing students and explored the potential for grade inflation associated with two-stage exams. Method: A total of 130 first- and second-year students enrolled in a collaborative undergraduate nursing program in British Columbia were recruited for the study. A pre-exam survey captured descriptive data on perceived barriers and their impact on exam performance, while a post-exam survey assessed satisfaction with two-stage exams, perceived effects on knowledge retention, and reduction of barriers. Grade inflation, a cited concern in the literature, was quantified by analyzing stage-one and stage-two exam scores across six undergraduate nursing courses using theoretical weighting scenarios. Results: Some participants (69%) identified with at least one barrier to assessment, with the most common being test anxiety (59.2%); anxiety, stress, or mental health concerns (46.1%); and attention-deficit/hyperactivity disorder, attention deficit disorder, or Autism spectrum disorder (26.9%). Most participants (86.1%) indicated that two-stage exams helped to reduce barriers to assessment, primarily by allowing them to revisit the question (67.6%), providing them with a second chance (65.7%), and improving their understanding of the question (64.8%). Additionally, 90% (n = 97) stated that they felt better prepared to apply this knowledge in future courses or clinical settings. Perceptions of increased knowledge mastery was rated as 4.47 on a five-point scale, participant satisfaction was 4.4, and participation was 4.65. Grade inflation ranged from 0.33% for an A+ grade weighted at 90/10 to 9.63% for a D grade weighted at 75/25. Conclusion: Findings highlight the prevalence of assessment-related barriers among nursing students and suggest that two-stage exams may help mitigate these challenges. Quantifying grade inflation across weighting scenarios provides faculty with evidence to guide decisions regarding the implementation of two-stage exams.
Copyright (c) 2026 Amy N. Rodall (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Responses to the Missing and Murdered Indigenous Women and Girls Report Within the Canadian Higher Education Sector: A Scoping Review
Background: In 2019, the Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls (MMIWG2S+) was released by the Government of Canada, along with 231 Calls for Justice aimed at putting an end to the horrific violence against Indigenous women, girls, and 2S LGBTQQIA+ people. Purpose: The purpose of this scoping review was to examine scholarly articles that have been published in response to the MMIWG2S+ report/Calls for Justice and responses that are presented on higher education websites in Canada. Method: We searched key databases and online sites for relevant sources and screened texts to confirm eligibility. We included 63 scholarly articles and 94 online sources. We conducted content analysis and an analytical synthesis on the data from the academic articles. The online sources were analyzed with content analysis. The responses to the MMIWG2S+ report were categorized into six themes: illuminating report findings for readers; we must act and this is how; discourses about genocide; seeing the bigger picture; a guiding framework for research and practice; and critique of the report and challenges. Results: Reactions to the calls within the higher education sector have been slow and incomplete. Responses are still in their infancy and need to move from discussion to action. Our findings are timely as they hold academics and educators to account through shedding light on the current discussions and (in)actions surrounding the MMIWG2S+ report within higher education. Conclusion: We advocate for Canadian higher education institutions to prioritize the MMIWG2S+ crisis and involve Indigenous organizations and people in their efforts to respond to the report.
Copyright (c) 2026 Abeer A. Alraja (primary author), Kendra L. Rieger (primary author), Mona Lisa Bourque Bearskin, Sheryl Reimer-Kirkham, Barbara Astle, Kathleen Lounsbury, Francine Morin, Patricia Victor, Colleen Seymour, Shelly Johnson, Monica Friesen, Janice Linton, Elizabeth Kreiter, Jessica Wilson, Una Chang (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Processes, Experiences, and Outcomes Associated With Accommodation and Nursing Students With Disabilities: A Scoping Review
Background: More accessible nursing programs for a broader segment of society, including students with disabilities, will enhance diversity of thought in program curricula and representation among nurse graduates. Key to realizing these benefits is the ways in which nurse educators can best promote accessible and inclusive learning environments for nursing students with disabilities. Purpose: We completed a scoping review of published research reports, non-research publications, and dissertations related to accommodation and baccalaureate nursing students with disabilities. The review explored what is known from existing literature about the processes, experiences, and outcomes associated with classroom and clinical accommodation for nursing students with disabilities from the perspectives of learners and educators. Method: Online databases were used to identify literature that was written in English, published from 1990 to 2024, and focused on accommodation for nursing students with any visible or invisible disability within a nursing program leading to registered nurse status. Arksey and O’Malley’s (2005) methodological framework guided the selection of 84 publications, charting of the data, and summarizing results. Results: Accommodation processes are linked to disclosure, require collaboration, need to account for context, and must comply with legislation. The experience of accommodation for nursing students ranges from worrisome to supportive, while faculty experiences are similarly varied: feelings range from skepticism and internal struggle to acceptance and willingness. No standardized process and no universally accepted target outcome exist for the accommodation process. Tensions and uncertainties about how to best support nursing students with disabilities are ongoing. Conclusions: Intersectoral collaborative scholarly work is needed to advance practices for managing the complexities associated with the accommodation process in nursing education. Evidence is needed to ensure the process promotes equitable and inclusive experiences for nursing students with disabilities and supports nurse educators in managing their primary role through ample resources and professional development opportunities.
Copyright (c) 2026 Nadine Janes, Mary Ann Fegan, Zoraida Beekhoo, Mikaela Gray (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Accommodations for Students With Disabilities and Associated Barriers in Nursing and Psychiatric Nursing Education: Mixed-Methods Research
Background: The experience of disability is often overlooked within equity, diversity, and inclusion initiatives in nursing education. Nursing students who self-identify as having a disability or disabilities have reported issues regarding accessibility and accommodations. Nurse educators have reported general uncertainty regarding ways to support students, especially within clinical practice settings. Purpose: The purpose of the study was to investigate the perceptions of nursing and psychiatric nursing students and faculty, with a focus on accommodations and associated barriers. Methods: Mixed-methods research was conducted to answer the following question: What accommodation practices promote or limit the inclusion of nursing and psychiatric nursing students with disabilities in theory and clinical practice settings? Data were collected through an anonymous online survey. A total of 95 responses were included in the analysis. Participants included students in undergraduate degree programs in nursing (n = 21) and psychiatric nursing (n = 22), academic nursing/psychiatric nursing faculty (n = 49), and accessibility professionals (n = 3) in Western Canada. Results: Two main themes were derived from the parallel analysis of the qualitative and quantitative data. The first theme focused on the provision of reasonable accommodations and the second focused on attitudes towards nursing and psychiatric nursing students with disabilities. Students who received accommodations reported that accommodations contributed to their success in the classroom environment (94%), skills lab (86%), and clinical setting (86%). The attitudes of participants towards accommodations were largely favourable. However, barriers to accessing accommodations were noted, mainly within clinical settings. The faculty participants identified lack of knowledge on accommodation processes and a lack of time to implement individual accommodations as a barrier. While the majority (74%) of participants agreed that students with disabilities could meet the theory requirements of professional programs, only half of the participants thought that these students could meet the clinical program requirements. Significant differences in responses were evident between participants who self-identified as having a disability or disabilities and those who did not. Conclusion: The findings highlight the need for effective accommodation processes for nursing students with disabilities, particularly within clinical environments. There is also a need for increased education, support, and resources for faculty to improve their levels of preparedness.
Copyright (c) 2025 Andrea E. Thomson, Catherine Baxter, Sherri Dyck, Michelle Magnusson, Michelle Cleland (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Introduction of a Pedagogical Activity Designed to Prepare the Next Generation of Nurses for Ongoing Climate Change
Introduction: Climate change is considered one of the top threats of the 21st century to population health. The consequences are many, touching physical environments as well as all natural and human systems. Nurses play a key role in the evaluation and care of persons affected by climate change. Numerous professional associations, including the Ordre des infirmières et infirmiers du Québec (OIIQ), recommend enhancing the competencies of nurses to prepare them to deal with climate change. Despite these recommendations, university curricula are still not adequately preparing the next generation of nurses in this regard. Pedagogical Innovation and Context: A Quebec university school of nursing introduced a pedagogical innovation to empower future nurses to intervene with the population within a context of climate change. This innovation, based on theoretical foundations critical to the nursing discipline and developed with an interdisciplinary lens, includes two elements: an independent theoretical module and an interprofessional simulation designed for a broad audience. The theoretical module seeks to develop a greater understanding of the principles of public health emergencies, various relevant services (prevention, preparation, recovery, etc.), and interdisciplinary collaboration. The simulation, in turn, constitutes an opportunity to participate in a public health emergency intervention alongside students enrolled in the pre-med program. Results: After having completed the theoretical module, 23 students from two programs (baccalaureate in nursing and pre-med) took part in the interdisciplinary simulation. They deemed the pedagogical activity highly relevant and stated that they were satisfied that the targeted learning objectives were achieved. Discussion: The activity’s success was due to several elements, including its foundation in community practice and the inclusion of interprofessional program collaboration. The implementation, however, was challenging in a few areas, primarily regarding the recruitment of students. Participation was notably voluntary, as the activity was not included in the curriculum. These obstacles should be considered when holding such an activity. Conclusion: Climate change is an imminent menace. Nurses are called upon to play a key role, given that their practice already entails intervening with the populations affected by climate change. This pedagogical innovation shows that it is possible to improve university curricula by adding activities that will adequately prepare the next generation of nurses to meet the growing and changing needs of the population.
Copyright (c) 2025 Sabrina Blais, Frances Gallagher, Sarah Lafontaine, Marie-Andrée Houle, Isabelle Ledoux (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Exploring Icebreakers in Nursing Education Through a Mixed-Methods Design: Helpful or Harmful?
Background: Icebreakers share the common goal of promoting interaction. Despite the overwhelming positive regard for icebreakers in nursing education, they may have unintended consequences, such as highlighting inequities or perpetuating microaggressions. This research project incorporated the concept of microaggressions to explore how undergraduate nursing students experienced icebreakers within the classroom setting. Methods: This mixed-methods exploratory sequential design study used a quantitative survey followed by a semi-structured focus group using interpretive description thematic analysis. Results: A total of 43 students completed the quantitative survey, and three students participated in the follow-up focus group. The findings demonstrate that although well intentioned, icebreakers can also cause harm. Three themes were generated: revealing inequities, unveiling multiple tensions, and identifying conflict between purpose and outcome. Conclusion: Through our small study, we found that icebreakers can detract from content delivery, reveal inequities, and be divisive rather than contribute to a greater sense of belonging for students.
Copyright (c) 2025 Laura Vogelsang, Shannon Vandenberg, Morgan C. Magnuson, Samantha Walstra (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Pillars of an Excellence Model in Practice Education for Nurse Practitioner Students in Primary Care
Since primary care nurse practitioners were first introduced in 2007, the Government of Quebec has sought to increase their numbers in the health care system. One of the principal challenges in this regard consisted of ensuring the availability of high-quality clinical placements for nurse practitioner students specializing in the field of primary care. To address this issue, a CIUSSS (integrated university health and social services centre) joined forces with a university school of nursing in a major urban centre to participate in EXTRA, Healthcare Excellence Canada’s leadership development program. This project, consisting of two phases, sought to increase the number of quality placements for preparing primary care nurse practitioner students. This article discusses the first phase, which focused on developing an excellence model for these placements. A data collection framework was created and included a literature review as well as individual and group interviews with various parties involved in the clinical placement process. The thematic analysis allowed for determining the following five key elements, which constitute the pillars of the excellence model: 1) the partnership (between the CIUSSS and the university); 2) the diversity of the clinical exposure; 3) the support and development of supervisors; 4) the participation of patients in the clinical education of primary care nurse practitioner students; and 5) a learning culture based on strengths- and evidence-based data. The model emphasizes the importance of the ongoing processional development of supervisors, particularly regarding the preparation of student placements. As for the placement experience per se, it attests to the significance of students benefiting from a varied clinical exposure and an effective process for entering and integrating health care settings. Lastly, the model showcases the need to ensure clear and efficient communication between the university and the health care setting and to set time aside for clinical supervision.
Copyright (c) 2026 Irene Sarasua, Jérôme Ouellet, Michèle Desmarais, Mylène Lévesque, Beverley-Tracey John (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Addressing Workplace Bullying Among Undergraduate Nursing Students Using an Online Educational Tool
Background: Workplace bullying among nurses is a prevalent and serious problem in health care with detrimental physical, psychological, and organizational consequences. Nursing students and novice nurses are more likely to encounter incidents of workplace bullying in their clinical settings. Although workplace bullying is one of the largest challenges that the nursing profession faces today, there is a scarcity of intervention research aimed at educating nursing students on effective responses to bullying. Purpose: To evaluate the effectiveness of an online educational tool in improving self-efficacy and intent to intervene related to bullying. Methods: The design was quasi-experimental, using a one-group pre-test/post-test approach. A convenience sampling technique was used. A total of 41 undergraduate nursing students from two baccalaureate nursing programs located in Western Canada completed a demographic questionnaire and the self-efficacy to respond to disruptive behaviours scale with an additional item about intent to intervene. A paired sample t-test was used for normally distributed data, and the Wilcoxon signed-rank test was used for data with non-normal distribution. Results: Both outcome measures (self-efficacy and intent to intervene) had significant pre- and post-intervention differences except for one measure of self-efficacy. Conclusion: This study adds to current nursing knowledge by developing and evaluating an evidence-based online educational tool to prepare nursing students in identifying and managing bullying in health care settings.
Copyright (c) 2025 Abeer A. Alraja, Donna E. Martin, Lorna Guse, Lukas Neville (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Validation of an Educational Program Developed to Help Charge Nurses Exercise the Function Inherent to Their Role: A Delphi Approach
Background: A charge nurse holds a clinical-administrative management position in health care institutions. To perform this position effectively, they must demonstrate specific competencies, including leadership, interpersonal communication, clinical-administrative caring, problem-solving, and knowledge and understanding of the work environment. Due in part to the shortcomings of existing training targeting this position, charge nurses receive limited support in terms of the appropriation of their position and the strengthening of their competencies. In response to this situation, a training was developed that takes into consideration the five required competencies, includes principles that promote the transfer of training, and would be systematically provided to new charge nurses exercising their position in health care institutions. This training was then subjected to an empirical validation process in order to be scientifically recognized. Objective: To empirically validate the training developed to support charge nurses in fulfilling their position, by assessing content validity and reliability. Method: This study is based on the conceptual model entitled “Modèle de formation pour l’assistante infirmière-chef” as well as the methodological framework Conducting and REporting DElphi Studies (CREDES) and reporting guidelines established by Spranger et al. (2022). A Delphi approach was used to validate the training by through a self-administered online questionnaire completed by experts. The questionnaire was divided into different sections, each containing specific validation questions. Content validity and reliability were assessed. A content validity index (CVI) ≥ 0.80 was targeted for each section and for each individual questions within those sections. A content analysis of the qualitative data obtained from the expert comments was conducted; this was followed by a non-parametric Mann–Whitney test for each section to assess the training's reliability. Findings: Two consultation rounds proved necessary. A total of 33 experts participated in the first round, and 21 in the second. Regarding content validity, after the second round of consultations, 11 of 12 sections and 104 of 113 questions had a CVI ≥ 0.80. The qualitative data analysis led to modifications in the training content for sections and questions that did not achieve the target validity index, in addition to generating seven recommendations to be considered when developing a training. Lastly, reliability was present with a p > 0.05 for nine out of 12 sections. Conclusion: This study validated the training developed to support charge nurses in fulfilling their position by strengthening their competencies. Supporting charge nurses in this manner will have positive impacts, particularly on the quality of care, the safety of users, and the retention rate of nursing staff.
Copyright (c) 2025 Maripier Jubinville, Eric Tchouaket Nguemeleu, Caroline Longpré (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Education About Digital Health and Artificial Intelligence and Learning Needs: Perspectives of Undergraduate Nursing Students
Background: Nurses have long used different types of technologies in clinical practice and nursing education. Technology is rapidly evolving, and nurses must keep pace. Purpose: This study aimed to explore nursing students’ perspectives on their preparedness for digital health. Methods: A mixed-methods design was used. Senior-level undergraduate nursing students from two schools of nursing in Eastern and Western Canada participated in focus group interviews and completed a 45-item cross-sectional researcher-developed survey consisting of four parts. We applied in the survey a five-point rating ranging from very low to very high or strongly agree to strongly disagree. Curricular documents were also reviewed to identify how digital health concepts are being incorporated and used to aid in the interpretation of the findings. We analyzed qualitative data using thematic analysis and quantitative data using descriptive statistical analysis. Results: A total of 18 participants took part in focus groups, and 74 completed surveys were included in the analysis. Themes included experiences influencing students’ learning about digital health and suggestions for improving learning about digital health. Survey results were as follows: Self-rated knowledge about digital health and confidence (five items: mean = 17.50/25; SD = 3.30); perceived digital health preparedness and current nursing education opportunities (12 items: mean = 43.65/60; SD = 6.90); perceived benefits and concerns and relevance of digital health to nursing and future practice (22 items: mean = 82.92/110; SD = 6.18); digital health education needs (six items: mean = 23.31/30; SD = 4.59). Findings from both sources corroborate gaps identified in curricular materials. Conclusion: Nursing students have strong digital capabilities and access to some educational opportunities in their schools and in the clinical setting. However, there is a need for more systematic education and improved learning experiences about digital health (existing and emerging technologies such as artificial intelligence) so that the next generation of nurses is better prepared for this era of digital revolution.
Copyright (c) 2025 Manal Kleib, Antonia Arnaert, Lynn M. Nagle, Rebecca Sugars (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
“Gaining Perspective”: A Photovoice Study of a Circumpolar Experience for Northern Canadian Nursing Students in Northern Norway
Purpose: The benefits of study-abroad experiences for nursing students have been well documented. Since 2010, an undergraduate nursing program in Northern Canada has had an exchange partnership with nursing schools in Northern Norway. Given the mostly anecdotally reported successes of the exchanges, this study aimed to formally investigate the educational experiences of Northern Canadian nursing students who completed a clinical practicum and cultural experience in Northern Norway. Methods: This qualitative study employed photovoice methodology. As photovoice is participatory action research (PAR), students learned about the methodology prior to embarking on their international exchange. While abroad, they engaged in photographic documentation that later served as a catalyst for data collection (interviews and focus group) and data analysis. Aligned with PAR, students participated with the researchers in data analysis. Moreover, the photos and stories later served as a tool to bring about action; specifically, the students endorsed future exchanges. Results: Four nursing students (n = 3 in third year; n = 1 in fourth year) who completed a 7-week course in Northern Norway during 2023 participated in this study. Thematic analysis revealed “gaining perspective” as the overarching theme. Three subthemes highlighted other ways of knowing, being, and doing for nursing practice and life. Conclusion: Similar to other evidence supporting study-abroad experiences for nursing students, this opportunity for Northern Canadian nursing students in another circumpolar country offered professional and personal learning.
Copyright (c) 2025 Gloria Bott, Pertice Moffitt (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
From the Practice of Innovation to Conceptual Clarity and Sustainability of Innovations in Nursing Education
Exploring the Acceptability, Feasibility, and Perceived Effects of Immersive Virtual Reality in Comparison to Standardized Patient Simulations in Nursing Education: A Mixed-Methods Pilot Study
Purpose: Simulation using immersive virtual reality (IVR) is gaining in popularity in nursing pedagogy. Considering its innovative character, it is essential to tailor the integration of IVR simulation based on the acceptability and feasibility reported by nursing students. Moreover, little is known about its effects compared to other simulation types, such as standardized patient simulation (SPS). This study aimed to compare the acceptability, feasibility, and perceived effects of IVR and SPS activities among undergraduate nursing students. Method: A pilot mixed-methods randomized crossover-controlled trial over two campuses in the province of Quebec was completed. The sample included undergraduate nursing students (n = 14). Participants were randomly assigned to begin with IVR or SPS, followed by the other modality. Data collection included post-assessments regarding acceptability, cognitive load, engagement, situational motivation, and satisfaction after each simulation type. We performed Wilcoxon tests using SPSS. We conducted individual or dyad interviews using a semi-structured interview guide addressing acceptability and feasibility. Three team members analyzed verbatim transcripts. Inductive coding was used to explore emerging ideas, followed by deductive coding to categorize initial codes within the predefined dimensions of acceptability and feasibility from Sidani and Braden’s (2021) framework. Summary tables were produced to condense data. Results: Acceptability was conceptualized in five dimensions: appropriateness, convenience, effectiveness, adherence, and risks. Feasibility was separated into five subthemes: quality of trainers, preparation of participants, material resources, context, and fidelity of the scenario. Participants appreciated the various possibilities and immersive aspects of IVR, such as practising in a safe environment and the innovative, fun experience. A qualitative improvement in patient assessment structure, fluidity, priority establishment, clinical reasoning, and autonomy was also reported. The fidelity of the scenario was deemed higher for IVR than for SPS, according to participants who discussed the use of IVR for evaluation. However, some nuances in implementing IVR, such as targeted competencies, technical problems, equipment comfort, familiarization, and risks of cybersickness should be considered before IVR implementation in nursing education. Furthermore, quantitative results indicated comparable results between IVR and SPS simulations across all variables. No statistically significant difference was found between the two modalities. Conclusion: The implementation of IVR appears acceptable and feasible for undergraduate nursing students, with particular attention to certain factors to ensure optimal outcomes. Quantitative results suggest comparable outcomes, highlighting points of convergence of the two simulation approaches in nursing education. These findings underline the importance of seeking the opinions of primary users when introducing innovative pedagogical interventions. Despite the study’s limitations, this pilot research provides insights into using IVR and SPS activities with nursing students. Future research should focus on testing IVR for evaluation purposes in nursing curricula.
Copyright (c) 2025 Émilie Gosselin, Josiane Provost, Hugo Carignan, Sylvie Charette, Émilie Gosselin, Patrick Lavoie, Marie-Hélène Lemée, Daniel Milhomme, Nadia Turgeon, Isabelle Ledoux (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Key Elements to Include in a Training for Charge Nurses: A Scoping Review
Background: The position of the charge nurse involves clinico-administrative responsibilities and requires five essential competencies: leadership, interpersonal communication, clinical-administrative caring, problem-solving, and knowledge and understanding of the work environment. However, these competencies are rarely addressed in ongoing training for charge nurses in health care institutions, and the existing trainings identified either do not cover all five required competencies or provide only limited content related to them. As a result, without appropriate training, charge nurses may be unable to fully meet the complex demands of their position and there will be a gap between the complex requirements of this position and the ability to meet them. There is a clear need for a scientifically grounded training that addresses these gaps. Objective: To identify the key elements for operationalizing and strengthening the competencies required for the position of charge nurse, with a view to incorporating them into a training to be developed for this purpose. Method: A scoping review was conducted using the Joanna Briggs Institute (JBI) methodology. Using a strategy developed by the research team, the CINAHL, MEDLINE, Cairn, and ScienceDirect databases as well as grey literature sources were queried. To be included, publications had to meet the following criteria: address the charge nurse position and include at least one key element for implementing or strengthening at least one of the five core competencies; be published between 2000 and 2021; and be written in either French or English. Findings: Out of 2,672 records identified, 23 articles met the inclusion criteria for this scoping review. Analysis of these publications revealed key elements that could be associated with conceptual content, practical application or knowledge integration. Conclusion: This scoping review helped identify the content to be incorporated into charge nurse training currently under development, thus supporting the development and reinforcement of charge nurses’ competencies, thereby enabling them to effectively fulfill their position.
Copyright (c) 2025 Maripier Jubinville, Caroline Longpré, Eric Tchouaket Nguemeleu, Stephanie Robins, Fatima El-Mousawi, Emilie Bélanger, Katya Kruglova, Drissa Sia, Idrissa Beogo (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Pedagogical Approaches and Teaching Strategies Used in Nursing Education to Teach Academic Writing: A Scoping Review
Academic writing is considered an essential skill in post-secondary education in general and in nursing specifically (Mitchell et al., 2020). The importance of writing for future nurses is reflected in the Canadian Association of Schools of Nursing (CASN) National Nursing Education Framework’s standards. This national consensus-based framework outlines the expectations of undergraduate nursing programs and graduates according to the six domains of knowledge, research skills and critical inquiry, nursing practice, communication and collaboration, professionalism, and leadership (CASN, 2022). Academic writing is embedded in each of these domains, as it provides students with a venue to share factual knowledge, demonstrate critical thinking, and make important connections between theory and practice (Naber & Wyatt, 2014). A scoping review of research on the pedagogical approaches and teaching strategies used to teach academic writing in nursing education yielded 12 studies. Findings show a range of approaches with varying degrees of success. Further research is needed on how best to guide and assess students’ writing.
Copyright (c) 2025 Rose McCloskey, Patricia Morris, Lisa Keeping-Burke, Ali McGill, Alex Goudreau, Holly Knight, Sarah Buckley, Dave Mazerolle, Courtney Jones (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
An Investigation of Nursing Students’ Experience With an Evidence-Based Practice Serious Game: A Transversal Study
Background: Integrating evidence-based practice (EBP) into nursing education is a complex challenge, as traditional teaching methods often lack experiential learning opportunities. Serious games have emerged as promising tools to enhance engagement, critical thinking, and skill acquisition in health care student education. EviGame, a serious game designed to introduce nursing students to EBP, fosters decision-making, autonomy, and structured feedback within an interactive learning environment. Understanding how students engage with such games and the factors that influence their experiences is essential for exploring their learning dynamics. Purpose: This exploratory cross-sectional study aims to a) investigate nursing students’ learning experiences with EviGame using the Game Experience Questionnaire – Core Module (GEQ–CM) (IJsselsteijn et al., 2013) and b) explore the relationships between overall GEQ–CM scores and individual factors such as age, gender, prior gaming experience, fatigue, and stress levels. Methods: The study was conducted in October 2022 with second-year undergraduate nursing students at a Swiss university. Participants played EviGame and subsequently completed the GEQ–CM, assessing seven dimensions of game experience: competence, immersion, flow, positive affect, negative affect, tension/annoyance, and challenge. Additional demographic and psychometric data were collected. Data analysis included descriptive statistics, Spearman’s rank correlation, and Mann–Whitney U tests. Results: Among the 146 students enrolled in the course, 43 participated in the study, with 37 completing the questionnaire. Students reported high levels of competence (M = 3.28) and positive affect (M = 3.18), suggesting confidence and enjoyment in the game. The low challenge score (M = 2.39) indicates that the game lacked sufficient difficulty for some learners. Significant positive correlations were observed between the overall GEQ–CM score and both age (rs = 0.4881; p = 0.0022) and stress level (rs = 0.6316; p < 0.001). Women demonstrated higher overall engagement than men (z = 2.961; p = 0.0031). Prior gaming experience did not yield significant effects on results. Conclusion: The study indicates that EviGame is generally well received by nursing students, particularly regarding competence and positive affect. However, the low challenge score underscores the need for adaptive scenarios and dynamic difficulty adjustments to sustain engagement and cognitive involvement. The study also highlights the influence of age and stress on students’ experiences, with women reporting higher engagement levels. These insights provide valuable guidance for refining serious games in nursing education. Further research should assess the long-term effects on clinical reasoning and the integration of serious games in nursing curricula.
Copyright (c) 2025 Azmira Bajra, Sylvain Boloré (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Registered Nurse Prescribing in Ontario: Learners’ Perspective
Background: In response to evolving health care demands and the increasing need for accessible patient care, eight Canadian provinces have expanded the scope of practice for registered nurses (RNs) to prescribe medications. Ontario is the latest province to approve RN prescribing. RNs with prescribing authority in Ontario can prescribe specific medications approved by the Ministry of Health and Long-Term Care and authorized by the College of Nurses of Ontario (CNO). RNs must complete one of the four available CNO Council–approved RN prescribing education programs to become an authorized prescriber in Ontario. As RN prescribing is new to Ontario, it is essential to assess the effectiveness of the educational programs preparing nurses for this new role. Purpose: A quality improvement project (QIP) was conducted to gain learners’ perspectives on one of Ontario’s CNO-approved RN Prescribing programs. Methods: This QIP focused on learners enrolled through the University Consortium RN Prescribing Program. Pre- and post-course surveys were administered via Qualtrics XM. Data collected included demographic information, motivation for enrolling in the program, employment plans related to the expanded scope of practice, familiarity with the new CNO Practice Standards, and confidence in prescribing safely. Pre- and post-course survey composite scores were computed to reflect participants’ overall familiarity with the RN prescribers’ scope of practice and their confidence in their ability to prescribe safely within the scope of practice. We conducted Mann-Whitney U non-parametric tests were conducted to determine any statistical difference between the median of the pre- and post-course composite scores (familiarity scores and confidence level). Results: A total of 194 pre-course and 136 post-course anonymous survey questionnaires were completed through Qualtrics XM. The baseline demographic characteristics were similar in pre- and post-course groups. Top motivators for taking the course were career advancement and personal goals. The median familiarity score for pre-course (2.50) and post-course (3.0) surveys was statistically significant (U = 4141.5, z = –10.93, p < 0.001). The median confidence score for pre-course (80.5) and post-course (85.0) surveys was not statistically significant (U = 11629, z = –‍1.843, p = –0.065). Conclusion: Upon completion of the course, learners in the University Consortium’s inaugural RN prescribing program reported increased familiarity with the scope of practice and confidence in their ability to prescribe safely. Introducing safe registered RN prescribing in Ontario can significantly advance health care by optimizing resource use, improving access to care, and enhancing patient-centred care.
Copyright (c) 2025 Sherry Morrell, Gina Pittman, Erin Ziegler, Jane Simanovski, Amy Horton, Debbie Sheppard-LeMoine, Hala Abu Rashid, Ava Mammarella, Ibrahim Abdulmoula, Mustafa Al-Hamdani (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Nursing Students’ Perceptions of Using ChatGPT in a Written Assignment
Introduction: The availability and use of artificial intelligence (AI) tools is accelerating significantly. As these technologies proliferate, many post-secondary institutions have responded by banning students from using AI tools such as ChatGPT and framing the conversation as breaches of academic integrity. Background: Despite these institutional responses, many students adopt these tools as part of their learning journey. In health care settings, the adoption of such tools in the context of patient care provision is a reality. Consequently, there is a relevant pedagogical opportunity to examine how such tools inform the experiential learning of nursing students and their future practice. Methods: To address the dearth of information regarding nursing students’ perceptions of using AI tools, a Canadian university teaching team incorporated ChatGPT into an undergraduate nursing course assignment. A pilot quasi-experimental pre-post-test survey design was employed to examine student perceptions of using ChatGPT. After obtaining institutional ethics approval, a neutral third party collected the anonymous data. Findings: Pilot study results highlighted significant student concerns regarding the ethics of using AI tools. Additionally, students described such tools as meaningful avenues to support learning access and equity. Finally, students identified a high probability of use of AI tools in their future practice, suggesting that exposure and support during learning can positively influence responses to these tools in practice settings. Conclusion: The students surveyed are now practising nurses; thus, findings may provide insight into perceptions of new nurses regarding the integration of AI to support competencies required by the nurses of tomorrow.
Copyright (c) 2025 Lorelei Newton, Angela Wignall, Claire Fullerton (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Inaugural Innovate 2025 Conference: Conference Abstracts and an Interview With Dr. Shannon Scott
An Interview With Community Health Nurse Educator and Researcher Tanya Sanders
Copyright (c) 2025 Susan M. Duncan, Jacinthe Pepin (Author) http://creativecommons.org/licenses/by-nc-nd/4.0/