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: February 27, 2026
Canadian Association of Schools of Nursing
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
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 Peer-reviewed quantitative, qualitative, and mixed-methods studies; systematic reviews; unpublished dissertations; policy reports from schools of nursing; and text and opinion papers that focus on clinical education of nursing students will be included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
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
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/
An Evolutionary Concept Analysis of Bullying Towards Nursing Students in the Clinical Practice Environment
Concept analysis is a technique used to determine defining attributes, with the purpose of developing a concept to expand nursing knowledge. The interrogation of attributes, antecedents, and consequences aids in clarifying ambiguity with a view to developing an operational definition. Establishing a clear definition of a concept lays the groundwork for future research and practice. Nursing students embark on a sequenced set of clinical learning experiences as a primary component of their undergraduate program. Being bullied is common in clinical practicum experiences for nursing students and is often seen as unavoidable, resulting in negative impacts on student learning, health care team functioning deterioration, decreased quality of care for patients, and negative impacts on retention and satisfaction with the nursing profession. Numerous studies have investigated the concept of bullying in the profession, yet the range of how bullying manifests creates a challenge for analysis and agreement of the concept. Rodgers’s (2000) evolutionary method was used for this literature-based concept analysis to lead to a meaningful understanding of the concept over time by identifying attributes, antecedents, and consequences. Attributes specific to bullying of nursing students in the clinical environment included intentionality, temporality, negative interactions, denied opportunities, and workload challenges. Several surrogate terms were identified in this analysis. Antecedents identified for bullying included power imbalances, working conditions, entrenched behaviour, and organizational dysfunction. Consequences associated with bullying affect students, the nursing profession, and the workplace. The most prevalent finding from this concept analysis is that bullying is used to describe many different types of behaviour. This analysis contributes to the foundation of evidence supporting the discussion around the need for continued clarity and further research on the phenomenon of bullying in the clinical environment. Further analysis is needed to clarify the concept of bullying to expand knowledge in the nursing discipline by addressing the antecedents to influence change in nursing education. Clarity on how bullying is defined is necessary to facilitate recognizing and reporting bullying and developing effective interventions.
Copyright (c) 2025 Geraldine Irlbacher, Lenora Marcellus (Author) http://creativecommons.org/licenses/by-nc-nd/4.0/
Exploring the Influence of Clinical Externships on Newly Graduated Nurses’ Transition to Practice
Purpose: In 2021, the Ontario government began funding clinical externships to help hospitals faced with significant human health resource issues during the COVID-19 pandemic. Clinical externships provide students an opportunity to work alongside nurses as unregulated health care workers in hospitals. Limited research is available related to clinical externship programs in Ontario, with most research focusing on programs in the United States, measuring retention, and studying how students felt during or immediately after the completion of the programs. The aim of this study was to explore how newly graduated nurses (NGNs) felt their participation in a clinical externship program influenced their transition from student to nurse. Methods: This study used interpretive description as its research methodology. Exploring associations, relationships, and patterns within a phenomenon while borrowing elements from the more traditional qualitative techniques, interpretive description was chosen to generate an understanding of participant experiences that would be relevant and useful to clinical practice. Using social media and purposive sampling, nurses in their first year of practice who worked as a clinical extern while in nursing school were recruited to participate. Eight NGNs completed interviews. Interviews were transcribed verbatim, and data analysis used a constant comparative approach. Results: Three main themes emerged: developing self-efficacy, developing a professional identity, and being on the inside. Clinical externships gave participants exposure to the clinical setting over and above those offered by clinical placements and consolidations in the nursing program. This exposure provided participants the opportunity to develop self-efficacy in skills, assessments, and communication; start to develop a sense of themselves as nursing professionals; and gain an insider glimpse into the realities of nursing. Conclusion: This study contributes to the knowledge of how clinical externships may influence the transition to practice of NGNs in Ontario and has several implications for various relevant groups. Nursing educators must advocate for adequate clinical exposure and hands-on experiences, integrating more experiential learning opportunities into nursing curriculum. Researchers, policy makers, and practice leaders must also collaborate to evaluate externship programs to help inform continued programs and opportunities for improvement.
Copyright (c) 2025 Jessi Hembrey, Amy Hallaran, Kirsten Woodend (Author) http://creativecommons.org/licenses/by-nc-nd/4.0/
Development of a Nurse Practitioner Fellowship Program in Cardiometabolic Health
In a landscape marked by the increasing prevalence of cardiovascular-kidney-metabolic (CKM) syndrome, there is a pressing need for novel health care models that offer optimal care to affected individuals. The current care system, marked by fragmentation and a lack of holistic approaches, falls short in addressing the multi-faceted needs of patients living with CKM syndrome, highlighting the necessity for a tailored and comprehensive care model. Nurse practitioners (NPs) are uniquely positioned to pioneer these innovative models, leveraging their nursing skills and incorporating medical activities into their practice. However, specialized education is essential, emphasizing a deep understanding of the complex, chronic, and progressively worsening nature of CKM syndrome. Fellowship programs are pivotal in equipping NPs with the expertise required to enact this advanced cardiometabolic health care paradigm. This article presents the process of development of a new NP fellowship program in cardiometabolic health developed by the faculty of nursing at a francophone university. This narrative outlines the context surrounding the development process of this program, stemming from the escalating incidence of cardiometabolic conditions compounded by the inadequacies of existing health care models. Addressing this gap, the proposed fellowship program aimed to refine NPs’ capabilities in managing cardiometabolic health intricacies through an immersive, multidisciplinary educational experience. This initiative represents the first of its kind in North America to be conducted in French and is designed to elevate the standard of care for individuals living with CKM syndrome. This paper encompasses a literature review and the adoption of conceptual frameworks like Calkin’s (1984) model for advanced nursing practice. The program’s structure, pedagogical strategies, and expected outcomes are thoroughly examined, showcasing the comprehensive approach taken to equip NPs with the skills and knowledge necessary for this specialized domain. The article argues for the critical role of specialized preparation in advancing NPs’ competencies, ultimately contributing to improved patient outcomes in cardiometabolic health. By fostering a deeper understanding and more effective management strategies, the fellowship program is poised to set a new standard in health care delivery for this growing patient population.
Copyright (c) 2025 Maria Cecilia Gallani, Alexandre Zarié, Julie-Anne Boutin, Bruno Pilote (Author) http://creativecommons.org/licenses/by-nc-nd/4.0/
Resilience Among Indigenous Graduate Nursing Students: A Scoping Review
Aim: The aim of this scoping review was to systematically assemble, examine, and map the extant literature pertaining to the resilience among Indigenous nursing students in graduate programs. Background: Although graduate preparation for health care professionals positively influences the health outcomes of recipients of care through participation in decision-making, advanced practice roles, education, policy development, and research, colonial frameworks present in the form of institutional or program-related barriers limit the number of Indigenous students to access graduate nursing programs. Moreover, entrenched Euro-Western epistemology and ontology that privilege certain knowledges and ways of knowing reinforce the understanding of resilience as being outcomes-based. Resilience among Indigenous Peoples, however, embraces ideas of transformation and adaptation that incorporate complex social dynamics and interpersonal processes that foster movement towards well-being, healing, and growth. Design: A scoping review was conducted using the Arksey and O’Malley (2005) and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews) framework (Moher et al., 2009) guided the reporting. Method: Six databases were searched for relevant articles by a health sciences librarian. This was supplemented by hand searches and internet searches for grey literature. A total of 708 results published between 2000 and 2023 were retrieved from the six database searches. Following title and abstract screening, a total of 88 full-text articles were independently reviewed, resulting in two items for inclusion in the study. Results: Two themes were identified from the review that may tangentially influence resilience among Indigenous graduate nursing students: identity and biculturalism. Gaps in the literature included limited global literature on resilience; no exploration of the explicit experience of resilience; study samples and populations frequently merging Indigenous students with marginalized students and Black and other racialized students, making it difficult to link findings with specific groups of participants; and reporting of support program development and evaluation of these programs. Conclusion: This review highlighted that research on Indigenous graduate nursing students’ experience of resilience is lacking. Moreover, concepts such as biculturalism perpetuate a dichotomous and colonial understanding of Indigenous graduate nursing students’ experience of resilience. Relevance to Universities and Nursing Education Programs: While strategies such as transition programs and talking circles are valuable as initial steps, governance approaches that produce program- and university-wide policies must be reconceptualized. While inclusion policies benefit student completion and retention rates, these policies do little to transform the academy. We suggest an Indigenous board of governors comprising Elders, local Indigenous scholars and educators, and Indigenous students whose mandate is to develop, implement, and oversee policies and practices that directly affect Indigenous students and allow them to become part of universities’ governance models.
Copyright (c) 2025 Monique Sedgwick, Chloe Crosschild, Noelle Rohatinsky, David R. Scott (Author) http://creativecommons.org/licenses/by-nc-nd/4.0/
Group Dynamics as a Component of the Clinical Learning Environment: A Mixed Sequential Exploratory Study
Context and Problem Statement: In the clinical learning environment (CLE), various components influence the experiential learning of nursing students, including group dynamics in a group practicum modality. To date, the scientific literature does not fully explore the impact of this component in clinical education, hindering the establishment of optimal conditions for student learning. The purpose of this study was to explore group dynamics among nursing students as a component of the CLE within the group practicum modality. Objectives: 1) To describe group dynamics in relation to learning based on existing literature and from the perspective of nursing students, clinical supervisors, and nursing staff, 2) to adapt the Évaluation de l’environnement d’apprentissage clinique (EEAC) instrument to include the concept of group dynamics, 3) to explore the components of CLE, including group dynamics, among baccalaureate nursing students at a francophone university in New Brunswick, and 4) to explore the links between group dynamics and other components in the CLE recognized in the literature. Methodology: We used a mixed sequential exploratory design. Phase 1: Scoping review followed by a descriptive interpretive approach. Phase 2: Adaptation of the EEAC instrument. Phase 3: Cross-sectional descriptive study. Results: Several student characteristics and stress-related factors influence group dynamics and the learning experience. Peer support enhances interpersonal relationships among group members and contributes to the learning experience. Support from nursing staff positively impacts group dynamics and student learning experiences. Additionally, supervision by clinical instructors significantly explains group dynamics. Conclusion: Recognizing the crucial role of group dynamics as an influential component in the CLE, parties involved in nursing student education now have conclusive results. This information enables them to make significant contributions to creating an optimal learning environment for students.
Copyright (c) 2025 Marjolaine Dionne Merlin, Frances Gallagher, Stéphan Lavoie (Author) http://creativecommons.org/licenses/by-nc-nd/4.0/
Being Paid to Be a Student: Risks and Rewards – An Exploratory Mixed-Methods Study
Background: Baccalaureate nursing students conclude their education with a preceptorship experience to integrate and consolidate knowledge, skills, and attributes in a clinical setting. Within the Canadian context, there is a lack of understanding about the experience of student compensation during the preceptor experience. Objective: To understand the perceptions of fourth-year nursing students and their instructors regarding the benefits and challenges of students participating in a compensated preceptorship initiative. Methods: This study used an exploratory mixed-methods design. Participants were fourth-year students in a bachelor of science in nursing preceptorship course and their assigned instructors at a university in Western Canada. This study used a survey design to collect student perceptions about the benefits and challenges of having their preceptorship experience in either a compensated or a traditional model. Survey design also gathered faculty perceptions of the benefits and challenges of teaching in these two models. Results: A total of 25 student participants completed the survey, 23 of whom were satisfied with their choice to participate or not participate in the compensated model. The benefits of choosing to participate were being compensated, being part of the system, and having a job after completing their studies. Challenges include missing the student role, poor communication, and pushbacks from staff and other students. The benefits of choosing not to participate were the opportunity to stay in a chosen placement and being under less pressure, while challenges included financial strain and not having a job lined up after completing their studies. Five of seven faculty indicated that the compensated preceptorship experience provided less opportunity for consultation on program concepts and learning opportunities. Conclusion: Student participants were overall satisfied with their choice to participate or not participate. Faculty members were cognizant of the financial strain on students but worried about the impact on learning in compensated environments. Given the mixed perceptions noted by faculty and students, there is a need for better understanding of how best to implement these initiatives.
Copyright (c) 2025 Kathleen Miller, Tanya Paananen, Safina McIntyre, Yvonne Shelast (Author) http://creativecommons.org/licenses/by-nc-nd/4.0/
Nursing Education for the Coordination of Care and Services: A Scoping Review
Purpose: A crucial part of the health care field is the coordination of care and services, which requires suitable education for the nurses who are responsible for it. However, there is great diversity in the educational programs provided to those nurses, with significant differences in terms of content and pedagogical methods. The objective of this scoping review is to identify and assess educational programs to determine preferred content and content warranting further study as well as to highlight existing pedagogical innovations. Methodology: We systematically researched the MEDLINE, CINAHL, Web of Science, Global Health, JBI, ProQuest Dissertations & Theses Global and EBM Reviews – Cochrane databases for sources published between January 2008 and December 2023. We also covered grey literature. We did not apply any limits to the type of research design. We used a thematic approach to data analysis, both deductive (guided by the theoretical framework Modèle des activités de coordination des soins et des services pour les personnes ayant des besoins complexes) and inductive, and submitted the findings to a review by experts. Findings: Nineteen courses or programs were selected from among scientific sources (n = 15) and grey literature (n = 4). Of those, the coordination activities category “intervening with intra- and inter-disciplinary teams” appears less well covered than the other three categories of the model. Specifically, activities touching on the clarification of roles and responsibilities (n = 5) and leadership (n = 5) are rarely addressed. As well, in the category “intervening with the person and those close to them,” the activity related to planning end of life care is barely addressed (n = 2). Several pedagogical innovations were identified, including the involvement of the person and someone close to them in simulation activities, using conceptual maps to develop an individualized care and services plan, and use of evolutive case studies. Discussion and Conclusion: The findings highlight the importance of revising and enhancing existing educational programs to better prepare nurses to meet the growing challenges of coordinating care. Continuous reflection on how to adapt courses, whether initial or continuing, is needed to guarantee more efficient and sustainable coordination of care.
Copyright (c) 2025 Marlène Karam, Pegah Torabi, Asma Boubaker, Isabelle Brault (Author) http://creativecommons.org/licenses/by-nc-nd/4.0/
A Pilot Feasibility Study of an Undergraduate Nursing Student Harm Reduction Community Health Placement
Background: Nursing students may struggle with community placements, preferring hospital placements because of the emphasis on acute care. There are limited numbers of community health nurses available for students, so settings outside of health services can be used as venues for community health placements. Purpose: We aimed to evaluate a pilot placement outside of health services setting in the context of a research study focused on harm reduction for people who use substances, to assess whether the placement was effective in engaging students with the full scope of community health nursing (CHN). Methods: We evaluated students’ experiences in this clinical placement using a thematic analysis approach to semi-structured qualitative interviews. We recruited students after their placements were completed and their final grades were submitted. Results: Three students participated in this evaluation and reported an increased understanding of CHN principles, such as social justice and equity, to address how social determinants of health affect clients. They also gained insight into the value of evidence-based practice and the full scope of CHN, particularly how it intersects with harm reduction. The nursing instructor role was critical to the success of the placement. Students wanted to have a higher level of interaction with people facing structural barriers to health during the placement. Conclusion: Our placement outside of health services settings was effective in expanding nursing students’ understanding of the full scope of CHN practice, including social determinants of health. Future studies can expand on this pilot to assess the value of diverse community placements for students.
Copyright (c) 2025 Miriam Woo, Carla Ferreira, Twyla Ens Ms., Carla S Ginn, Jennifer Jackson (Author) http://creativecommons.org/licenses/by-nc-nd/4.0/
Opportunities for Nursing Education Advancement in Primary Health Care
The Triple Planetary Health Crisis: Nursing Leadership in Championing the Integration of Planetary Health in Canadian Nursing Education
During the past decade, planetary health has emerged as a scientific field of practice and global movement in response to the major disruptions to our world, such as catastrophic floods, droughts, wildfires, heat domes, and extreme heat, affecting the health and well-being of humans and the planet. The concept of planetary health has been increasingly acknowledged by Canadian nurse educators, and globally, about the importance for integration in baccalaureate and graduate nursing curricula. In 2022, the Canadian Association of Schools of Nursing updated its National Nursing Education Framework to include planetary health. There is, however, a gap in the Canadian literature of the process for integrating planetary health content in an already-full nursing curriculum. This paper highlights the pivotal historical timeline of the planetary health movement alongside the emergence educational initiatives, such the Call to Action in 2019 in the Canadian context and the global movement to address the planetary health crisis. The author describes how a nurse educator champions and leads the integration of planetary health content in a Canadian baccalaureate nursing program, while addressing the barriers to and facilitators of curricular change. It is important that nurse educators receive further professional development in equipping them with an understanding of planetary health and how to integrate and actualize this content in the nursing curricula. Planetary health knowledge is essential in preparing the next generation of nursing students so they can better address and mitigate the catastrophic impact of the planetary health crisis so all can flourish.
Copyright (c) 2024 Barbara Astle (Author) http://creativecommons.org/licenses/by-nc-nd/4.0/