Faculty of Nursing

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A critical examination of high-fidelity human patient simulation within the context of nursing pedagogy
(2009) Parker, Brian; Myrick, Florence
The use of high-fidelity human patient simulators (HPS) have been embraced by nursing education programs in the development of immersive clinical simulations despite the lack of research into a pedagogy or educational philosophy appropriate to guide this technology-based learning tool. In this article, we explore this approach to clinical teaching through a critical examination of the application of behaviorist and constructivist pedagogy to high-fidelity scenario-based simulation sessions. Practical guidelines for developing simulation-based learning sessions that reflect both philosophical paradigms are provided. Consideration is also given to societal trends such as the digital revolution and the incoming millennial generation who represent the aptitude of the modern nursing student to utilize high-fidelity realistic and immersive simulation. Depending on the desired goal of simulator utilization, the nurse educator may want to draw on constructivism or behaviorism or a blend of both educational philosophies to best meet the needs of the adult learner.
A shared reality: implementation of a redesigned clinical course during the Covid-19 Crisis
(2020) Maykut, Colleen; Dressler, Melissa; Harrison, Nicole; Newell-Killeen, Holly; Posteraro, Allana; Weatherwall-Waldner, Kylie
Many institutions of higher education were caught unprepared for the consequences of covid-19 on program delivery and completion; notably schools of nursing with clinical practicums. The purpose of senior clinical practicums is to foster nursing students’ readiness for practice. A practicum offers the students the opportunity to engage in advocacy and leadership, respond effectively and efficiently to changes in client status, navigate and mitigate ambiguity in the healthcare system and partner with interdisciplinary team members to ensure a holistic approach. The disruption of face-to-face programming required schools of nursing to quickly redesign courses to ensure learning outcomes were met and students would successfully graduate prepared to enter their practice. The intent of this article is to share the lived realities of nursing students and faculty members during the implementation of a redesigned course during the pandemic crisis.
A virtual, simulated code white for undergraduate nursing students
(2022) Stephen, Tracey; King, Keith; Taylor, Mischa; Jackson, Margot; Hilario, Carla
Background Nurses and nursing students are increasingly vulnerable to workplace violence, both verbal and physical, as health care settings and clients cope with unprecedented challenges including the COVID-19 pandemic. Concurrently, clinical learning opportunities for nursing students have been curtailed by public health restrictions and limited capacity. While virtual simulations have been promoted as an alternative to clinical hours, their effectiveness as an educational intervention on workplace violence has yet to be assessed. Purpose The authors sought to evaluate a virtual, simulated code white—a set of organized responses to a client, visitor, or staff member exhibiting the potential for violence—involving 4th year undergraduate nursing students, randomly sorted into an intervention group and a control group. Methods Pre and post test measures of knowledge and attitudes about mental health, workplace violence and virtual simulation were collected, as well as qualitative data from focus groups. Findings While the sample size (n = 24) was insufficient to detect meaningful differences between the intervention and control groups, descriptive statistics and focus group data revealed significant gaps in participants’ knowledge around managing workplace violence. Participants rated the virtual simulation highly for its realism and the opportunity to experience working in a virtual environment, while they felt the preamble and debrief were too short. Conclusions The findings illustrate a virtual code white simulation has clear educational benefits, and that multiple iterations, both virtual and in person, would most likely increase the benefits of the intervention.
A visual narrative inquiry into the experiences of youth who are homeless and seek mental health care
(2013) Jackson, Margot; Richter, Solina; Caine, Vera
Our study, a narrative inquiry into the experiences of at risk youth who experience precarious housing situations and mental health needs, is a collaborative conceptualization among representatives of iHuman staff, youths and researchers. Key findings relate to: the number of distinct and disconnected services youth have had contact with in their lives; the life situations and events that at risk youth have experienced over time; their feelings and emotions on what it is like to be homeless; as well as the youths’ suggestions and recommendations for services they deem important for themselves and future generations. [Taken from report]
Academic performance of nursing students in anatomy and physiology before, during and after a stability period of COVID-19
(2022) Narnaware, Yuwaraj; Cuschieri, Sarah
The COVID-19 has drastically disrupted nursing education globally. The present study demonstrated that the mean class average of anatomy and physiology midterms and final examinations during synchronous online teaching was significantly higher (P<0.001) compared with face-to-face teaching. However, the class average and GPA were not different between faceto-face and hybrid/flex teaching. Virtual teaching of these subjects also significantly (P<0.001) increased the students’ GPA in both courses during Covid-19 compared to before and after a stability period of Covid-19. The present study demonstrates that due to a strict lockdown and self-isolation, students either spent more time studying these subjects or took advantage of the lack of online supervision of their exams which may have increased their class average and GPA.
Access 2022: setting new goals for digital health in Canada
(2019) Neumeier, Melanie
Canada Health Infoway has been a champion for digital health access for all Canadians since its inception in 2001. As a government funded not-for-profit organization, Infoway works with Canadians, academics and a variety of health care organizations across the country to transform the delivery of health care in Canada. While huge strides have been made towards a digitally integrated system, Canada remains behind peer countries in access to care and digitally-enabled services (Infoway, 2019). In the 2017 Commonwealth Fund ranking of health care system performance, Canada ranked ninth out of eleven countries overall and was last in terms of access to care like same-day physician appointments and emergency department wait times (Green, 2018). This shows that while technology is advancing its application in health care is not keeping up.
Access to mental health for Black youths in Alberta
(2021) Salami, Bukola; Denga, Benjamin; Taylor, Robyn; Ajayi, Nife; Jackson, Margot; Asefaw, Msgana; Salma, Jordana
Introduction: The objective of this study was to examine the barriers that influence access to and use of mental health services by Black youths in Alberta. Methods: We used a youth-led participatory action research (PAR) methodology within a youth empowerment model situated within intersectionality theory to understand access to health care for both Canadian-born and immigrant Black youth in Alberta. The research project was co-led by an advisory committee consisting of 10 youths who provided advice and tangible support to the research. Seven members of the advisory committee also collected data, co-facilitated conversation cafés, analyzed data and helped in the dissemination activities. We conducted in-depth individual interviews and held four conversation café-style focus groups with a total of 129 youth. During the conversation cafés, the youths took the lead in identifying issues of concern and in explaining the impact of these issues on their lives. Through rigorous data coding and thematic analysis as well as reflexivity and member checking we ensured our empirical findings were trustworthy. Results: Our findings highlight key barriers that can limit access to and utilization of mental health services by Black youth, including a lack of cultural inclusion and safety, a lack of knowledge/information on mental health services, the cost of mental health services, geographical barriers, stigma and judgmentalism, and limits of resilience. Conclusion: Findings confirm diverse/intersecting barriers that collectively perpetuate disproportional access to and uptake of mental health services by Black youths. The results of this study suggest health policy and practice stakeholders should consider the following recommendations to break down barriers: diversify the mental health service workforce; increase the availability and quality of mental health services in Black dominated neighbourhoods; and embed anti-racist practices and intercultural competencies in mental health service delivery.
Adverse events: consequences of error: Oh no…it happened to me
(2015) Pollard, Cheryl
Learner objectives: Explain the importance of understanding how healthcare professionals are effected when involved in patient safety incidents, adverse events or near miss situations. Discuss common reactions to being involved in a patient safety incident, an adverse event or a near miss situation. Identify how organizations could potentially better support health care professionals. Describe the next steps in investigating the “Consequences of Error.” Describe how students have been involved in undergraduate student research.
An effective teaching strategies to improve student’s academic performance
(2022) Narnaware, Yuwaraj
Biosciences (Anatomy, Physiology, Microbiology & Immunology) and life sciences (Botany, Zoology & Biochemistry) are considered a cornerstone of any health-and life sciences-related professions. However, these subjects serve as a pre-requisite for future health care and life sciences courses. A strong knowledge base of these subjects is crucial for health care and life sciences students to become successful practitioners after graduation. Traditionally, these courses are taught in a didactic, content-driven way. The author’s research and scholarship program focus on ways to change this way of thinking and move teaching in these courses toward a concept-based and student-centered approach that fosters student engagement and knowledge retention and improves their academic performance. Moreover, teaching and learning of the biosciences and life sciences worldwide are impacted by reduced face-to-face instructional hours, increased student enrollment, student demographics, fewer dedicated faculty members, minimal or no use of human and animal dissection, and requirements to move classes and labs on-line due to pandemics such as COVID-19. In this interactive presentation, first, the author will discuss factors impacting the teaching and learning of biosciences and life sciences. Secondly, he will employ and evaluate the impact of various teaching strategies that are designed to enhance engagement and knowledge retention in order to equip students with the skills they need to successfully apply their biosciences and life sciences knowledge in their professional practice. These initiatives include but are not limited to: the use of the most advanced and cutting-edge educational teaching technology, inclusion of anatomical images in their examinations, various on-line and in-class activities and content reinforcement (repeated knowledge testing) aimed to improve knowledge of their subjects, academic performance, reduce exam anxiety and stress, and reduce cognitive load while improving their interactive and communication skills, critical thinking and prepare them as active learners.
An impact of images on anatomy scores in nursing students
(2018) Narnaware, Yuwaraj; Burleson, Kathryn M.
Anatomy has been a foundational class in the curricula of medical and other health related disciplines. There are many tools for teaching anatomy which approach learning through both verbal and visual means including textbooks, online modeling and computer software, dissection of cadavers or other preserved specimens and anatomical models (Drake RL, 2014). Practical examinations in anatomy assess visual knowledge through slides, labeled tissues, and body images, but the impact of using images in written examinations is less understood. Research shows that visualization can increase confidence in learning and retention of long term knowledge (Bartholome and Bromme 2009) while potentially altering learner’s cognitive load, memory, and examination anxiety and stress (Mayer RE, 2005). Most of the studies on the effects of including images on anatomy examinations are focused in medical, pre-nursing, or pre-health science students but have not yet been assessed in nursing students.
An integrative literature review on selecting patient assignments for undergraduate nursing students in the clinical setting
(2021) Mella, Adam
One of the key functions of a clinical nursing faculty is selecting patient assignments for undergraduate nursing students in the clinical setting. However, there is limited existence of evidence or strong scholarship that informs clinical nursing faculty on this specific process. In particular, they are left wondering regarding the factors, variables and methods that can be considered in this process. Hence, an integrative literature review was conducted that addressed the following questions: What is the current state of evidence and what are the best practices in selecting patient assignments for undergraduate nursing students in the clinical setting? What factors and variables do clinical nursing faculty consider in this process? A total of nine documents and two chapters from clinical nursing education books met the inclusion criteria for this literature review. The factors identified from the literature review considered in the patient selection process were: (a) needs of the patients and their families, (b) nursing students’ learning needs and characteristics, (c) course objectives, (d) knowledge of the clinical faculty in clinical teaching, and (e) the learning environment. With respect to the methods of patient selection, three methods were also identified from the literature review: (a) faculty-led, (b) student-directed and (c) shared approach. The findings of this review indicate that further research is needed to better understand other factors and variables that may influence the patient selection process in the clinical learning environment. More qualitative studies are recommended to provide a more in-depth understanding about the processes, relationships, methods, assumptions, biases and behaviours involved regarding this topic in clinical nursing education.
Anatomical knowledge loss in fourth year nursing students
(2022) Narnaware, Yuwaraj
There is growing concern over the loss of anatomical and physiological knowledge in medical, allied-health & nursing students over time (Narnaware & Neumeier, 2020a, Narnaware, Y. 2021). Numerous studies have demonstrated the difficulty of the students in these disciplines to retain and apply anatomical knowledge as they progress through their programs of study (Narnaware and Neumeier, 2020a). However, physiological knowledge retention has not been studied as extensively as anatomical knowledge retention in health care disciplines, with very few studies focusing on nursing students (Aari et al., 2004). Of those studies, most are carried out after graduation (Aari et al., 2004) or are focused on a single or a limited number of organ systems (Pourshanazari et al., 2013). We have previously shown that physiology students retained approximately 86.6% of their first-year physiological knowledge over four months (Narnaware et al., 2020b). To improve the acquisition and retention of physiological knowledge, the present study aims to develop an interventional strategy that includes the repeated assessment of cardiovascular physiology and defenses knowledge over eight weeks. Nursing students were quizzed on two components of cardiovascular physiology (vascular system and blood) and defenses using the online quizzing system Kahoot. Each Kahoot quiz included 9-11 knowledge and comprehension level multiple-choice questions, and new sets of questions were used for each week’s Kahoot quiz. Data were statistically analyzed using SPSS II, and means were compared using 2-sample t-tests. The scores are described as the mean and standard deviation (SD) and are presented in figure 1 and table 1. Statistical significance was set at P < 0.05 for all tests. Compared to week 1, repeating knowledge of the vascular physiology and defenses yielded a significantly higher (P<0.05) knowledge retention at week 2 (8.4% & 11.7%). However, this retention was highest at weeks 3 (18.7% & 16.9%) and weeks 4 (21.6% & 14.3%), P<0.001) in both organ systems, with less significant improvement (P<0.05) at week 6 (13.3%) and no significant difference in defenses (4.6%). No significant differences in knowledge retention were found between vascular and defenses at week 8. However, compared to vascular and defenses, content reinforcement of blood was highly significant at all weeks. Compared to week 1, knowledge retention of blood was highest at week 4 (69.5%), week 6 (55.2%), and week 8 (54.7%), P<0.0001), with less significant retention at week 2 (27.8%) and week 3 (31.2%), P<0.001). Although organ system-specific improvements in knowledge retention were found, the study results show that repeated knowledge assessment can significantly improve knowledge retention of cardiovascular physiology and defenses in nursing students and agrees with previously reported studies in medical students (Pourshanazari et al., 2013). Therefore, content reinforcement should be used as one of the interventional strategies to improve knowledge retention in nursing students, and further research should be conducted to explore effective ways to maintain increased retention over more extended periods.
Anatomical knowledge retention & interventional strategies in nursing education
(2019) Neumeier, Melanie; Narnaware, Yuwaraj
Creating experiential learning opportunities to improve knowledge acquisition and retention is a common goal in post-secondary education, but it may not be clear how to start. In this presentation, we discuss how to develop and use a knowledge retention study to identify gaps in learning and implement targeted learning strategies.
Anatomical knowledge retention in second‐year Bachelor of Science & Psychiatric Nursing students
(2020) Narnaware, Yuwaraj; Neumeier, Melanie
There is growing concern that nursing, medical and allied health students do not retain enough anatomical knowledge to confidently and successfully apply it in future classroom and clinical settings ( Doomernik et al., 2017). Evidence now shows that knowledge retention is impacted by many factors including admission criteria, teaching hours (Narnaware and Neumeier, 2019), age, sex, ethnicity, prior knowledge of science/biology, a gap between high school and university, and health care discipline (McVicar et al., 2015; Vogl , 2017). In Canada, the discipline of nursing can be subdivided into three professional designations, each with different educational requirements; Registered Nurses, Licensed Practical Nurses, and Registered Psychiatric Nurses (Canadian Nurses Association, 2019).
Anatomical knowledge retention in third-year nursing students
(2021) Narnaware, Yuwaraj; Neumeier, Melanie
Human anatomy and physiology are considered a cornerstone of any health related profession and serve as a pre requisite for future nursing courses and clinicals (McVicar et al., 2015). However, numerous studies suggest that students experience great difficulty in transferring the fundamental anatomical knowledge that they gain in the first year of their programs to future theory/clinical practice ( Gunay & Kilinc, 2018). Most of the knowledge transfer, loss and/or retention studies have been carried out in medical, allied health disciplines, and this has been assessed only in second year nursing students recently (Narnaware & Neumeier, 2020). This study seeks to determine the percent of anatomical knowledge retained by third year nursing students and determine the levels of knowledge retention in the body’s organ systems.
Are clinical instructors preventing or provoking adverse events involving students: A contemporary issue
(2018) Christensen, Lorna
Errors are inevitable. Unfortunately, when errors happen in health care, leading to adverse events, human lives are put at risk. There has been an abundance of international research into adverse events since the landmark report To Err is Human was published by the Institute of Medicine (IOM) in 2000, and much has changed in healthcare culture since the recognition that system failures—rather than individual negligence—contribute to most adverse events (Reason, 2000, p. 768). However, studies have focused largely on registered professionals—and even when healthcare students were included, the focus remained on the students themselves, often excluding their instructors. So, what can clinical instructors do to prevent adverse events involving their students, and what might they be doing inadvertently to provoke these events? Certainly, no instructor would like to believe that they contributed to a student’s mistake; yet, so many students and nurses have a story of a “terrible teacher”—one that made them feel unintelligent, incompetent, or downright scared. What is the ultimate role of the clinical instructor in patient safety? This article proposes a framework to begin to understand nursing student error prevention, with the aim to assist clinical instructors, nursing faculty, and nursing leaders in addressing an unrecognized aspect of adverse events.
Are nursing/IT collaborations the key to maximizing health care apps?
(2018) Neumeier, Melanie
Nurses working with IT professionals to develop better mobile apps for health care is discussed. From the Trends and Issues in Nursing Informatics Column.
Beyond deficits: shifting perspectives in child and youth mental health
(2019) Jackson, Margot
The social significance of the dominant narrative in mental health is one of particular concern to the author and one that has emerged during the course of this narrative inquiry. This chapter shares personal stories of the author's experiences as a nurse and researcher working within the realm of child and youth mental health and provide an intimate look at the life of one young woman whom she met at CAY. The young woman had a tremendous impact on the author's understanding of mental health, of developing personal strength, and of overcoming adversity; her life story is a guide and inspiration for other youth who have shared a similar narrative, as well as those touched by mental health. The narrative approach places personal experience as the focal point to facilitate understanding, insight, and change; it allows individual voices to be heard and places value on all that is shared. Thus, this chapter provides the reader with an understanding of child and youth mental health through a narrative inquiry lens and encourages alternative ways of learning and knowing. To provide care and support for youth they need to be viewed in a different light, focusing on their strengths and potentials and as always becoming.
Bioscience student’s perspectives & academic performance before, during & after a stability period of COVID-19
(2022) Narnaware, Yuwaraj; Cuschieri, Sarah
Findings suggest that nursing students may have counter-balanced the missing active learning strategies of face-to-face learning and adopted self-directed learning during the COVID-19 period through synchronized learning. Virtual, synchronized learning by using a ‘blended, multi-modal & pedagogical’ approach may serve as a “new normal” of teaching and learning of biosciences if pandemics like Covid-19 re-emerge in the future.
Brain regulation of feeding behavior and food intake in fish
(2000) Lin, Xinwei; Volkoff, Hélène; Narnaware, Yuwaraj; Bernier, Nicholas; Peyon, Pierre; Peter, Richard
In mammals, the orexigenic and anorexigenic neuronal systems are morphologically and functionally connected, forming an interconnected network in the hypothalamus to govern food intake and body weight. However, there are relatively few studies on the brain control of feeding behavior in fish. Recent studies using mammalian neuropeptides or fish homologs of mammalian neuropeptides indicate that brain orexigenic signal molecules include neuropeptide Y, orexins, galanin and β-endorphin, whereas brain anorexigenic signal molecules include cholecystokinin, bombesin, corticotropin-releasing factor, cocaine- and amphetamine-regulated transcript, and serotonin. Tachykinins may also have an anorectic action in fish. The brain hypothalamic area is associated with regulation of food intake, while sites outside the hypothalamus are also involved in this function. There is correlation between short-term changes in serum growth hormone levels and feeding behavior, although possible mechanisms integrating these functions remain to be defined.

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