literature reviews for nursing students

Literature Reviews for Education and Nursing Graduate Students

(13 reviews)

Linda Frederiksen, Washington State University Vancouver

Sue F. Phelps, Washington State University Vancouver

Publisher: Rebus Community

Language: English

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Reviewed by Yolanda Griffiths, Professor of Occupational Therapy, Drake University on 12/15/21

Comprehensiveness rating: 5 see less

The authors were thorough and very organized in stepping readers through the process of conducting and writing a literature review. Each area is appropriately indexed and examples are provided in a variety of ways. The synthesis section is especially useful as students often do not understand what this means. Perhaps some content on plagiarism would benefit this section as well. The flow of the material easily guides users logically through each topic.

Content Accuracy rating: 5

The content is accurate and unbiased. The content is presented in an easy to understand way with videos, and examples.

Relevance/Longevity rating: 5

The relevance of the content is classic and the text should be pertinent for many years. The links included in the text are very useful and should be easy for authors to check periodically. Using a digital media is more relevant to today's students than print textbooks. Each section addresses a reasonable chunk of information.

Clarity rating: 5

The book is user friendly, written in an easy to understand manner, and graphics or links add to the understanding of the content. Definitions are clearly written. Such as clarifying the types of literature reviews will be useful for students. Providing a test yourself section at the end of sections allows the reader to check if any content was confusing or not clear.

Consistency rating: 5

The text is consistently laid out in a logical manner which helps to unpack content which may be new or unfamiliar to the reader/student.

Modularity rating: 5

The amount of content allocated to each chapter is appropriate and will be easy to assign readings. The chapter headings are clear and the embedded videos, charts and test questions enlighten each subunit. The hyperlinking in the table of contents helps to navigate the chapters well.

Organization/Structure/Flow rating: 5

The organization of the content is logical and easy to understand the process of completing a literature review. The book is laid out much like a road map where students can see the big picture as well as the supporting parts to the process. The references by chapter are very useful.

Interface rating: 5

The graphics were clear, and the non-serif font aids in eye fatigue. One recommendation is to lower the brightness of the bold blue text in the table of contents to reduce eye fatigue. There was no problem to play the videos and the audio was clear. All links worked well.

Grammatical Errors rating: 5

There were no grammatical errors. There were a few typos such as 1.3.1.8 needs a space between "A specific", 2.3 in the phrase "Articles by the type of periodical in which an article it is published" perhaps remove the word "it", in the table on page 41. under Nursing , the word clinical is spelled "Cclinical", remove the capital C.

Cultural Relevance rating: 5

No evidence of cultural bias or insensitivity.

I am very excited to use this textbook in my doctoral level occupational therapy class. The inclusion of concise explanations of PICO and SPICE will be very useful. This will be a wonderful resource for graduate students and being mindful of costs for textbooks is compassionate.

Reviewed by Susan Bassett, Instructor, Nursing Graduate Program, Eastern New Mexico University on 11/9/21

Each chapter presented a different aspect of doing a literature review. This was organized and orderly. The index/table of contents was very detailed which allowed the reader to easily use this book as a reference while conducting a literature... read more

The content appeared to be entirely accurate. It did a good job of combining information for both education and nursing students. The authors addressed pertinent points of research study development as well as the specific methodology of approaching a research-focused literature review.

The text was up-to-date in methodology, which should not change frequently. The many links to websites were very helpful and yet were basic enough that they should be relevant for years. If they do need updating, the are clearly presented and should be easily updated. The breakdown to very small "chunks" of information per section will help in easily updating specific parts of information.

The book presented a rather complex topic in an extremely straight-forward, easy to read, clear manner. Each small "chunk" of information was identified per section numbering which correlated with movement through the content. The writing was professional and yet not overwhelmed with discipline-specific terminology. Where potentially new terminology was presented, it was immediately followed with definitions and examples.

The book was well-organized and moved along the structure set out early in the book. Content was gradually unfolded, as divided per chapter. There was a bit of repetition (probably about three examples) where the authors attempted to tie information together. Although this stood out to a reader, it seemed more useful in organizing than detrimental in repetition.

The book was subdivided into chapters and then into many small modules of discrete information. It could easily be assigned in part. It could also readily be used as a reference for students to go back and easily find processes or pieces of information they might need later.

I found the continual clear and succinct organization of information to be a defining highlight of this book. When presenting early steps of the research process and then linking these steps with how to conduct a literature review and subsequenty organize and write a literature review, this book is presenting numerous procews steps that must work in tandem. This book did that in a clear and easily readable fashion.

The one feature that did distract me was within the bullet points of 1.3.1. "Types of Reviews". There was a mix of complete and incomplete sentences that worked to convey information succinctly, but distracted me as a reader.

Grammatical Errors rating: 4

I did find several spelling and grammaticl errors (1.3.1.8, , 1.3.1.9, 2.1.1, 2.3, 2.3.1.1, , 2.3.1.4, 2.3 Table A., p. 41, p. 53, p. 54). Although small errors (a few letters or spacing) they should be corrected.

I did not find any mistakes in cultural appropriateness The content did repeatedly talk about bias reduction in the process of writing a literature review

I thought this book was very well-written and contained great information for my students. The links provided were very appropriate and helpful. The Table "Guide to searching for literature at various stages of the scholarly communication process” was particularly helpful. I will immediately begin using portions of the content in this book to support my research class. Additionally, I will recommend the entire book as a reference for the dedicated student (or one intending to go forward to a doctoral level of education in nursing). Thank you for collating all this information and helpful links into one clear, easily readable and understandable document.

Reviewed by Leah Nillas, Associate Professor, Illinois Wesleyan University on 9/6/21

Comprehensiveness rating: 4 see less

This book addresses the basic steps in the process of writing a literature review research. Chapter 2 (What is a Literature Review?) needs to be retitled. I think Chapter 1 (Introduction) clearly defines and characterizes literature review as a research category. Chapter 2 focuses more on the creation of information, information cycle, and selecting appropriate sources. Chapter 7 (Synthesizing Sources) and Chapter 8 (Writing the Lit Review) can still be improved to incorporate specific strategies in synthesizing research literature and examples of writing styles through analysis of a variety of published examples. Writing a synthesis is a challenging skill for most novice researchers.

Information shared is accurate. I did not notice any content error.

Relevance/Longevity rating: 4

Main content is up-to-date. A few citations maybe dated but they are necessary in illustrating different examples of literature reviews. It will be easy to include additional relevant examples of research work that are published recently.

I like how this text is written. Tone is reader friendly and narrative is accessible to novice researchers.

Clearly consistent throughout the chapters.

Clear and purposeful "chunking" of information per chapter.

Readers can easily follow the organization of topics and content.

No obvious interface issues. Appropriate use of multimedia tools.

No grammatical errors.

Text is culturally sensitive. Additional readings, references, or examples can easily be added to incorporate research conducted by diverse authors or literature reviews which focus on diversity and inclusion issues in education and nursing.

This is a good introductory literature review text even for undergraduate education students. Clear discussion of the nature of the research and the writing process. The use of videos and images is helpful in providing multimodal approach in explaining topics or processes. Writing style and tone make the text accessible to novice researchers.

Reviewed by Rebecca Scheckler, Assistant Professor, Radford University on 7/6/20

Two missing topics were inter-library loan and how to avoid plagiarism in writing up the literature review. This second is such an important topic that it deserves its own chapter. read more

Two missing topics were inter-library loan and how to avoid plagiarism in writing up the literature review. This second is such an important topic that it deserves its own chapter.

It is accurate. I found no inaccuracies.

This book is very relevant. Every advanced undergraduate or graduate students requires such a book

I found the book clear. The videos interspersed within the book added much to the clarity. There are lots of good diagrams that add to the clarity. They are not all original but their sources are all cited. The section on boolean searches, usage of asterisks and quotes in searches is very helpful and appropriate although often left out of discussion of searches.

The book is consistent in terminology and framework.

The chapters were cohesive.

Organization/Structure/Flow rating: 4

I like the links to within the text to the references and other matter. What is needed are back links to the text from the references. I also would have liked links from the exercises to the answers of the exercises.

Interface rating: 4

See navigation links mentioned above. The grey literature link is broken.

I saw no grammatical problems. There are many bulleted lists rather than text which is appropriate to this topic.

There could be more attention to cultural context in the frequent examples.

I wondered why nursing and education were combined. They are similar in nature but not identical. separation them out into two books might be appropriate.

Reviewed by Lisa Shooman, Associate Professor, Worcester State University on 6/29/20

Overall, this book provides a very comprehensive and thorough roadmap for creating a literature review. The videos assist the reader in crystallizing the information presented in the text. There is an effective index and glossary that provide... read more

The content is detailed, clearly explained, error-free, and unbiased. My students would greatly benefit from the lucid information presented in this text to guide them with developing a literature review. I would be eager to adopt this book for my students.

The content is timely and will not be quickly out-of-date. The quiz questions at the end of each chapter are relevant and will aid students with the consolidation of the material. The online format allows for updating, and the version history at the end of the text clearly indicated that the book was updated recently.

The text is clear and not ridden with any excess jargon /technical terminology. Pictures, graphics, and videos further elucidate the text. There are helpful questions that stimulate thought and lists that help to organize information.

The internal consistency in the text is excellent. However, Chapter 1.1 and Chapter 2 have the same title and it would benefit the reader to have different titles that would highlight the differences between these two sections. Chapter 1.1 is an overview and Chapter 2 dives into more depth.

The text is efficiently divided into smaller reading sections that are demarcated by numbers. The subsections in each chapter can be assigned at different points in the course. The text is organized logically and systematically that assists the reader with comprehension and provides a roadmap for creating an effective literature review.

The entire text is presented coherently and concisely. The organization of the text takes the reader through the process of creating an effective literature review. It can be used by multiple health professions, although the length of the text is relatively short it includes a considerable depth of the material. Other disciplines that would benefit from using this test in their courses may include occupational therapy, physical therapy, and speech and language pathology students.

The interface of the text is simple and easy to follow. The cover of the text would benefit from photos, color, and graphic design to appeal to the modern digital reader.

No grammatical or spelling errors are noted.

No cultural biases existed in the text in any way. There are no individuals highlighted in the book, and due to the technical nature of the subject matter, the text is inclusive to a variety of races, ethnicities, and backgrounds. No offensive statements are included in this book.

The authors should consider including other health professionals in the title and provide examples that can relate to other health professionals throughout the text. Other health professionals that can benefit from reading this text include occupational therapy, physical therapy, and speech and language pathology students. Literature reviews are relevant for many health professionals in their master's and doctorate programs and the text could serve a wider audience.

Reviewed by Ellen Rearick, Assistant Professor, Framingham State University on 6/1/20

This text covers all areas and the process of the integrative review appropriately. It is an engaging text for graduate students new to these assignments. read more

This text covers all areas and the process of the integrative review appropriately. It is an engaging text for graduate students new to these assignments.

This text is well done, very accurate

This text is relevant. The updates needed regarding APA format should be relatively easy to implement.

This text is clear and provides users with definitions and examples of the variety of reviews.

Very well written using consistent terminology throughout.

The text's reading sections are easily accessible and users will find them organized. Each chapter and its sections are presented in the sequence of the process of an integrative review.

Very clear and logical order.

The navigation of this text was problem-free.

No grammatical errors noted.

No issues with cultural insensitivity noted.

This was a well-organized text using videos to reinforce content that would benefit any education or nursing graduate student new to the integrative review process.

Reviewed by Ruth Stoltzfus, Professor of Nursing; Dir., Grad Programs in Nursing, Goshen College on 6/1/19

This text provides everything a graduate student needs to write a literature review in a concise manner. If you look at the digital pdf, there are many strategies to help the reader learn the process - videos, diagrams, and also text. read more

I found no evidence of bias and no errors.

This book has long-term relevance. The content will not quickly out-date.

I really liked the way the textbook is structured. The author is concise which makes the textbook easy to read.

I found no inconsistencies in terminology or other aspects related to the content.

I will adopt this text for a research course I use and will likely assign only specific chapters. I plan to recommend the textbook to another faculty who teaches a comprehensive research course with the idea of assigning only specific sections to read..

The textbook begins with an introduction to the subject matter. Subsequent chapters develop specific aspects related to lit reviews. The textbook provides a nice "how to" for each element of a lit review. Chapters are also organized in a smooth, easy to follow format.

I only looked at the digital pdf and print pdf versions. The print pdf indicates that there are videos to watch, but of course since it is a print pdf, there is no linkage. I think this would be obvious to a savvy reader - that a print pdf will be limited in what the reader can access.

I found no grammatical errors in my quick read.

I found no evidence of cultural bias or insensitivity.

This is the first open textbook that I have encountered. I was expecting it to be flat and boring! However, it was neither of those. There were color diagrams, color photos, and even videos embedded in the textbook.

I have adopted this book for the Research Lit Review course that I am teaching soon. I am impressed!

Reviewed by Melissa Wells, Assistant Professor, University of Mary Washington on 5/1/19

This book helps students in education and nursing complete a literature review, which may be the first time these students are tackling such a task. The chapters break down the process into defining the special genre of a literature review; providing tips to get started; suggesting where students can find literature to review; explaining how to evaluate sources; detailing the process of documenting sources; giving advice for synthesizing sources; and finally, putting all of these pieces together into a final literature review. Most significantly, the text provides specific examples of ideas presented in the context of both nursing and education, which makes the content directly relatable to the student's course of study. The conclusion recaps the main points of each chapter in bullet form. The text is lacking both an index and a glossary, which would be additions that could strengthen the text.

Content Accuracy rating: 4

The text explains 11 different types of literature reviews that students may encounter or be asked to create. Also, the text is framed to work with multiple methodologies; for example, steps for writing a research question or a hypothesis to frame the literature review are provided. One inconsistency I noted was in diagram 6.2: the APA citation is incorrectly capitalized for the journal title (which should use sentence, not title, capitalization).

The text also includes external links to sources, such as a videos, which provide students with multiple modalities in which to digest the information. An example of a literature review for both education and nursing is provided at the end of the book; instead of embedding these in the text, the hyperlinks refer the reader to the external site. This will be easy to change to a new example in the future, but checks will need to be done to ensure that all such external sources remain actively accessible.

Each chapter opens with learning objectives to help frame the content with which the reader is about to engage. Throughout the text, the language is approachable and reader-friendly. For example, when the text explains more factual components (i.e., what makes a literature review or what the basics of an effective literature review include), this information is presented in bullet points with hyperlinks to the original sources.

Each chapter follows a similar construction, which makes it accessible to the reader. For example, chapters end with a "Practice" and "Check Yourself" section to apply new learning and self-check responses (an answer key is provided in an appendix). Examples in these exercises are either related to nursing or education, continuing with the stated theme of the text.

When I used this text with my own students, I assigned chapters in isolation, since they had already taken a research methods course and were applying that knowledge to create a research proposal in a specific area of study in my course.

The book is organized in such a way that logically walks the reader through the literature review writing process. Clear headings (which are hyperlinked in the table of contents) also allow the reader to jump to specific parts with which they need additional support.

The interface of this document offered a lot of flexibility. Options allowed users to access the text online, or as a download in multiple file types (EPUB, Digital PDF, MOBI, XHTML, Pressbooks XML, Wordpress XML, and Open Document). These formats provide the reader with an opportunity to pick the interface that works best for them.

I did not see any grammatical errors in the text.

Cultural Relevance rating: 4

No culturally insensitive/offensive content was noted. A variety of examples of research topics were included from both nursing and education. Of the images/video thumbnails embedded in the text that involved people, all depicted White people except for 2 images; therefore, more intentional selection of culturally diverse visuals would be helpful in future versions of this text.

I feel this text was helpful to my students as they wrote their own literature reviews. The only weakness in their papers that I noted was their organization of their literature review based on themes/topic, which was addressed in Chapters 7- 8. I now know to focus more on this part of literature review writing with future students. This text is approachable and field-specific, and I will be using it again!

Reviewed by Bernita (Bernie) Missal, Professor, Bethel University on 12/14/18

This book includes all areas that a graduate student needs to begin a literature review. However metasynthesis could have also been included in types of literature review. read more

This book includes all areas that a graduate student needs to begin a literature review. However metasynthesis could have also been included in types of literature review.

This book is accurate although missing qualitative research.

Although content is up to date, some of the article examples need to be updated. (Example: articles published in 1981 and 1992 need to be updated to more recent articles.)

The book is clear and easy to follow. Bullet points were used throughout the book with short paragraphs which helps the student.

Each chapter follows the same format with narrative followed by practice and test questions.

Clear subheadings are used throughout the book.

This book is presented in a logical way and easy for the student to follow.

Images are clear and appropriate for the content.

No specific grammar issues were seen.

It would be helpful for students to include additional examples of cultural studies throughout the book

This book is an excellent resource for graduate students. It has helpful information for the preparation and process for a literature review. Examples of written literature reviews in chapter 8 or in an appendix would be helpful for students.

Reviewed by Nancyruth Leibold, Associate Professor, Southwest Minnesota State University on 6/19/18

The text is overall comprehensive, yet it breaks the information up into manageable parts. See the table of contents for an overview of the topics. The text is very quantitative driven in that the focus is on reviewing quantitative studies. The book included information about PICO statements, but did not include PICO(T) or the time variable, which is not always used in every case. Population was included in the PICO explanation, but a bit more information on the population or aggregate narrowing could improve the PICO section. These items do not hinder use of the book, but these items would need further inclusion by the faculty member using the text as specific to the discipline.

The content in the book is very accurate.

The content in the book is current and should not be obsolete within a short period of time. Any updates would be easy to add.

The text is clear and easy to understand.

The internal organization and terminology of the book is consistent and logical

The text is set up in small reading sessions. The videos and learning activities are well done and break up some of the content, so there is a variety of presentation. The tutorials, figures, practice and self-test areas are also fantastic in that they are quality and sprinkled throughout the text.

The topics in the book are presented in clear and organized fashion. I particularly like the upbeat and personal writing tone of the book. This tone makes it seem like the authors are speaking to me.

The text is free of any significant interface issues. The book is available in many formats. I used the book online and I did have one navigational problem and that is when clicking on a video, it does not open in a new tab and so the book is lost and have to start over going in the start to the book. One easy solution to this is to right click your mouse and then select open in new tab to watch videos. That way, your place in the book is not lost.

No grammar problems present.

The book is not culturally insensitive or offensive in any way.

Overall, this is a well written textbook and I recommend it!

Reviewed by Marjorie Webb, Professor, Metropolitan State University on 6/19/18

From the Introduction to the Conclusion, the text covers the step-by-step process of conducting a literature review. The text includes topics such as, “Where to find the Literature” and “Synthesizing Sources” that will be useful to graduate... read more

The content in the text, including texts, links, and diagrams, is accurate and unbiased. Again, it will aid the graduate nursing student in the long process of conducting a literature review.

The text is current and this type of material does not become dated quickly. The authors did use internet links in the text which will need to be monitored periodically to ensure they are still available. Updates to the text will be relatively easy and straightforward. If media styles change, there may be some challenges to updating.

The text is clear and easy to read. Technical terminology is defined and/or explained.

The text is internally consistent.

The text is organized in sections which facilitates assigning readings based on the subject matter for the class time. It would be pretty easy to divide up this text into easily readable units based on headings and subheadings.

This text is structured well. The topics flow in an organized manner and really help the student see the process of a literature review. The authors discuss the both theory and purpose of the review and the day-to-day logistics of actually performing the review. The day-today organization is not always included in other texts.

The interface is well-done with no distractions.

There was no indication of cultural bias.

I think this text is appropriate for graduate nursing students. Some students struggle with the difference between writing about a topic (generally undergraduate writing) and synthesizing literature on a given topic (generally graduate writing). Chapters seven and eight focus on preparing the graduate student to make the jump to graduate-level writing and should really benefit new graduate students.

Reviewed by Susanna Thornhill, Associate Professor , George Fox University on 3/27/18

This book is fairly comprehensive and offers step-by-step instructions for conceptualizing/researching a literature review. The Table of Contents is well-organized to reflect the book's progression, from establishing the basics of why to write a literature review and the various types of literature reviews, to getting started with formulating a research idea/question, finding and evaluating sources, synthesizing sources, and guidelines on writing the literature review, itself. I found this text to be a straightforward guide for my graduate students in education, and while I worried at first that the merging of education and nursing topics would prove distracting to my education students, I don't believe this was the case.

One thing that was not comprehensive in this book was discussion of qualitative research and methodologies as a valid means of conceptualizing research aims. I hoped for a more balanced discussion between methodological branches as it applied to literature reviews; this book overly favored quantitative methodologies and studies in terms of its direction to readers about how to conceptualize/choose a topic and design a research question in relation to it. Variables that cannot be measured are not inherently un-researchable, which is the conclusion put forth in this textbook. This might serve nursing students better than education students in terms of their discipline's requirements, but it still represents an element that could be improved.

Finally, while the background on what a literature review is, how to conceptualize research, and how to search for and synthesize research was all valuable, the chapter on actually writing the literature review was a bit thin, simply offering tips for introduction, body, and conclusion and some questions for self-evaluation. Some of the most difficult work for students writing a literature review is achieving proper focus, organization, hierarchy of themes, balance in treatment of related topics, etc. None of these issues were discussed in the chapter pertaining to the writing of a literature review.

I did not have any concerns about the book's accuracy. Content was accurate, albeit biased to quantitative and positivist views of research. I would have liked to see it include additional prompts to support students in conceptualizing and valuing qualitative research; this is an area where I had to supplement course readings with additional texts.

The only significant error I could discern in the text was a lack of an Answer Key corresponding to the questions posed at the end of each chapter.

Content is up-to-date and seems like it will hold meaning well over the next few years. The only things I anticipate might go out-of-date is technological information on things like citation managers, search guidelines, and database information. This is easily updatable with future versions of the text. In my view, ERIC is not the best database for educational research and I have confirmed this with educational librarians who support my students, yet it is the only one identified in this text as the best subject-specific source of educational research; this could be revised for additional relevance.

I noticed no issues with the book's clarity. The authors write in a clear and straightforward style, making the text easy to read. Overall, they did well writing for students across two disciplines by avoiding nursing or education-specific terms that would have been problematic to readers in the other discipline.

The book is internally consistent and did not have issues with terminology or framework.

No issues with the book's modularity. Chapter headings and sub-headings were appropriately paced and spaced. I assigned this textbook to my graduate students as a whole text that I wanted them to read at the beginning of a course, but it has been easy to refer them back to particular topics as the course has continued.

In future iterations of the book, I suggest hyperlinking the Answer Key to the exercises at the end of each chapter and/or listing the Answer Key in the Table of Contents for easy referral.

I found the book's organization to be straightforward and sensible. The Table of Contents offers a helpful snapshot of the scope of the book and the authors write in a direct and clear style, which contributes to an appropriate flow for the text.

I did not note any navigation problems with any links. All charts/images loaded well in my iBook app. The authors did a nice job of pulling relevant content and links in to support their ideas; it provided an easy way to seek more information if I wanted it, without feeling like the text was loaded down with unnecessary information.

I only found a few small typos in the text, with no grammar issues. The book is obviously written by two very detail-oriented librarians. I appreciated the clarity of the text and lack of errors.

The text was not culturally insensitive; a variety of topics across nursing and education were discussed as examples, which yielded a fairly balanced text regarding cultural considerations.

Reviewed by Alicia Rossiter, Assistant Professor, University of South Florida on 3/27/18

I believe the book gives a comprehensive overview on how to complete a literature view at the graduate level. It begins with an overview of the purpose of a literature review and moves through the steps to completing the review process. read more

I believe the book was accurate and unbiased. It was easy to read but comprehensive.

Content within the text is relevant and supports the literature view process. It did discuss the various databases for searches which may need updating to include new sites, search engines but otherwise relevant and useful information.

The text is easy to read, provides appropriate examples, includes a section on putting the process into practice as well as a "test yourself" section to ensure the content is understood.

The text is consistent throughout in regards to terminology, framework, and set up.

The text is easy to read and content is leveled for the reader but not over simplified. Content is chunked into sections making it easy for the reader to digest the content. The chapters are well laid out and flow from chapter to chapter. Each chapter contains learning objectives, content sections, practice section, and test yourself section. Well organized and great visuals.

Topics are presented in a logical, clear fashion that flow from chapter to chapter and build as the reader moves through the process.

The text is free of interface issues. I could not get the videos to play but other visuals were appropriate and useful to support content.

The text contains no grammatical errors.

The text is not culturally offensive. There was no evidence of bias or cultural insensitivity.

I think this would be a great resource for graduate student learning to navigate the literature review process. It is easy to read, straightforward, and guides the individual through the process from start to finish. I will recommend this text to my graduate students in evidence-based practice and research courses as a recommended reference.

Chapter 1: Introduction
Chapter 2: What is a Literature Review?
Chapter 3: How to Get Started
Chapter 4: Where to Find the Literature
Chapter 5: Evaluating Sources
Chapter 6: Documenting Sources
Chapter 7: Synthesizing Sources
Chapter 8: Writing the Literature Review

Ancillary Material

About the book.

Literature Reviews for Education and Nursing Graduate Students is an open textbook designed for students in graduate-level nursing and education programs. Its intent is to recognize the significant role the literature review plays in the research process and to prepare students for the work that goes into writing one. Developed for new graduate students and novice researchers just entering into the work of a chosen discipline, each of the eight chapters covers a component of the literature review process. Students will learn how to form a research question, search existing literature, synthesize results and write the review. The book contains examples, checklists, supplementary materials, and additional resources. Literature Reviews for Education and Nursing Graduate Students is written by two librarians with expertise guiding students through research and writing assignments, and is openly licensed.

About the Contributors

Linda Frederiksen is the Head of Access Services at Washington State University Vancouver. She has a Master of Library Science degree from Emporia State University in Kansas. Linda is active in local, regional and national organizations, projects and initiatives advancing open educational resources and equitable access to information.

Sue F. Phelps is the Health Sciences and Outreach Services Librarian at Washington State University Vancouver. Her research interests include information literacy, accessibility of learning materials for students who use adaptive technology, diversity and equity in higher education, and evidence based practice in the health sciences

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Nursing: How to Write a Literature Review

Traditional or Narrative Literature Review

Getting started

1. start with your research question, 2. search the literature, 3. read & evaluate, 4. finalize results, 5. write & revise, brainfuse online tutoring and writing review.

RESEARCH HELP

The best way to approach your literature review is to break it down into steps. Remember, research is an iterative process, not a linear one. You will revisit steps and revise along the way. Get started with the handout, information, and tips from various university Writing Centers below that provides an excellent overview. Then move on to the specific steps recommended on this page.

UNC- Chapel Hill Writing Center Literature Review Handout, from the University of North Carolina at Chapel Hill.
University of Wisconsin-Madison Writing Center Learn how to write a review of literature, from the University of Wisconsin-Madison.
University of Toronto-- Writing Advice The Literature Review: A few tips on conducting it, from the University of Toronto.
Begin with a topic.
Understand the topic.
Familiarize yourself with the terminology. Note what words are being used and keep track of these for use as database search keywords.
See what research has been done on this topic before you commit to the topic. Review articles can be helpful to understand what research has been done .
Develop your research question. (see handout below)
How comprehensive should it be?
Is it for a course assignment or a dissertation?
How many years should it cover?
Developing a good nursing research question Handout. Reviews PICO method and provides search tips.

Your next step is to construct a search strategy and then locate & retrieve articles.

There are often 2-4 key concepts in a research question.
Search for primary sources (original research articles.)
These are based on the key concepts in your research question.
Remember to consider synonyms and related terms.
Which databases to search?
What limiters should be applied (peer-reviewed, publication date, geographic location, etc.)?

Review articles (secondary sources)

Use to identify literature on your topic, the way you would use a bibliography. Then locate and retrieve the original studies discussed in the review article. Review articles are considered secondary sources.

Once you have some relevant articles, review reference lists to see if there are any useful articles.
Which articles were written later and have cited some of your useful articles? Are these, in turn, articles that will be useful to you?
Keep track of what terms you used and what databases you searched.
Use database tools such as save search history in EBSCO to help.
Keep track of the citations for the articles you will be using in your literature review.
Use RefWorks or another method of tracking this information.
Database Search Strategy Worksheet Handout. How to construct a search.
TUTORIAL: How to do a search based on your research question This is a self-paced, interactive tutorial that reviews how to construct and perform a database search in CINAHL.

The next step is to read, review, and understand the articles.

Start by reviewing abstracts.
Make sure you are selecting primary sources (original research articles).
Note any keywords authors report using when searching for prior studies.
You will need to evaluate and critique them and write a synthesis related to your research question.
Consider using a matrix to organize and compare and contrast the articles .
Which authors are conducting research in this area? Search by author.
Are there certain authors’ whose work is cited in many of your articles? Did they write an early, seminal article that is often cited?
Searching is a cyclical process where you will run searches, review results, modify searches, run again, review again, etc.
Critique articles. Keep or exclude based on whether they are relevant to your research question.
When you have done a thorough search using several databases plus Google Scholar, using appropriate keywords or subject terms, plus author’s names, and you begin to find the same articles over and over.
Remember to consider the scope of your project and the length of your paper. A dissertation will have a more exhaustive literature review than an 8 page paper, for example.
What are common findings among each group or where do they disagree?
Identify common themes. Identify controversial or problematic areas in the research.
Use your matrix to organize this.
Once you have read and re-read your articles and organized your findings, you are ready to begin the process of writing the literature review.

2. Synthesize. (see handout below)

Include a synthesis of the articles you have chosen for your literature review.
A literature review is NOT a list or a summary of what has been written on a particular topic.
It analyzes the articles in terms of how they relate to your research question.
While reading, look for similarities and differences (compare and contrast) among the articles. You will create your synthesis from this.
Synthesis Examples Handout. Sample excerpts that illustrate synthesis.

Regis Online students have access to Brainfuse. Brainfuse is an online tutoring service available through a link in Moodle. Meet with a tutor in a live session or submit your paper for review.

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Implementing evidence into practice requires nurses to identify, critically appraise and synthesise research. This may require a comprehensive literature review: this article aims to outline the approaches and stages required and provides a working example of a published review.

Are there different approaches to undertaking a literature review?

What stages are required to undertake a literature review.

The rationale for the review should be established; consider why the review is important and relevant to patient care/safety or service delivery. For example, Noble et al 's 4 review sought to understand and make recommendations for practice and research in relation to dialysis refusal and withdrawal in patients with end-stage renal disease, an area of care previously poorly described. If appropriate, highlight relevant policies and theoretical perspectives that might guide the review. Once the key issues related to the topic, including the challenges encountered in clinical practice, have been identified formulate a clear question, and/or develop an aim and specific objectives. The type of review undertaken is influenced by the purpose of the review and resources available. However, the stages or methods used to undertake a review are similar across approaches and include:

Formulating clear inclusion and exclusion criteria, for example, patient groups, ages, conditions/treatments, sources of evidence/research designs;

Justifying data bases and years searched, and whether strategies including hand searching of journals, conference proceedings and research not indexed in data bases (grey literature) will be undertaken;

Developing search terms, the PICU (P: patient, problem or population; I: intervention; C: comparison; O: outcome) framework is a useful guide when developing search terms;

Developing search skills (eg, understanding Boolean Operators, in particular the use of AND/OR) and knowledge of how data bases index topics (eg, MeSH headings). Working with a librarian experienced in undertaking health searches is invaluable when developing a search.

Once studies are selected, the quality of the research/evidence requires evaluation. Using a quality appraisal tool, such as the Critical Appraisal Skills Programme (CASP) tools, 5 results in a structured approach to assessing the rigour of studies being reviewed. 3 Approaches to data synthesis for quantitative studies may include a meta-analysis (statistical analysis of data from multiple studies of similar designs that have addressed the same question), or findings can be reported descriptively. 6 Methods applicable for synthesising qualitative studies include meta-ethnography (themes and concepts from different studies are explored and brought together using approaches similar to qualitative data analysis methods), narrative summary, thematic analysis and content analysis. 7 Table 1 outlines the stages undertaken for a published review that summarised research about parents’ experiences of living with a child with a long-term condition. 8

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An example of rapid evidence assessment review

In summary, the type of literature review depends on the review purpose. For the novice reviewer undertaking a review can be a daunting and complex process; by following the stages outlined and being systematic a robust review is achievable. The importance of literature reviews should not be underestimated—they help summarise and make sense of an increasingly vast body of research promoting best evidence-based practice.

↵ Centre for Reviews and Dissemination . Guidance for undertaking reviews in health care . 3rd edn . York : CRD, York University , 2009 .
↵ Canadian Best Practices Portal. http://cbpp-pcpe.phac-aspc.gc.ca/interventions/selected-systematic-review-sites / ( accessed 7.8.2015 ).
Bridges J , et al
↵ Critical Appraisal Skills Programme (CASP). http://www.casp-uk.net / ( accessed 7.8.2015 ).
Dixon-Woods M ,
Shaw R , et al
Agarwal S ,
Jones D , et al
Cheater F ,

Twitter Follow Joanna Smith at @josmith175

Competing interests None declared.

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The different chapters are easy to read and gives the students a structured way to prepare for the literature review. It has a good mix of contemporary and seminal literature and provides the students a good base for preparing to write a literature review.

This text is appropriate for nursing students in their 3rd year of studies when considering how to approach their final dissertation. It has everything needed to promote and plan for project success.

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The Future of Nursing 2020 - 2030
Literature Reviews for Nursing Students

Ways to Organize a Literature Review

CHRONOLOGICAL (by date): This is one of the most common ways, especially for topics that have been talked about for a long time and have changed over their history. Organize it in stages of how the topic has changed: the first definitions of it, then major time periods of change as researchers talked about it, then how it is thought about today.

BROAD-TO-SPECIFIC : Another approach is to start with a section on the general type of issue you're reviewing, then narrow down to increasingly specific issues in the literature until you reach the articles that are most specifically similar to your research question, thesis statement, hypothesis, or proposal. This can be a good way to introduce a lot of background and related facets of your topic when there is not much directly on your topic but you are tying together many related, broader articles.

MAJOR MODELS or MAJOR THEORIES : When there are multiple models or prominent theories, it is a good idea to outline the theories or models that are applied the most in your articles. That way you can group the articles you read by the theoretical framework that each prefers, to get a good overview of the prominent approaches to your concept.

PROMINENT AUTHORS : If a certain researcher started a field, and there are several famous people who developed it more, a good approach can be grouping the famous author/researchers and what each is known to have said about the topic. You can then organize other authors into groups by which famous authors' ideas they are following. With this organisation it can help to look at the citations your articles list in them, to see if there is one author that appears over and over.

CONTRASTING SCHOOLS OF THOUGHT : If you find a dominant argument comes up in your research, with researchers taking two sides and talking about how the other is wrong, you may want to group your literature review by those schools of thought and contrast the differences in their approaches and ideas.

YouTube Video Series on Writing a Literature Review

Ways to Structure a Literature Review

Topical order (by main topics or issues, showing relationship to the main problem or topic)
Chronological order (simplest of all, organize by dates of published literature)
Problem-cause-solution order
General to specific order
Known to unknown order
Comparison and contrast order
Specific to general order
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Succeeding in Literature Reviews and Research Project Plans for Nursing Students

Graham R. Williamson - University of Plymouth, UK
Andrew Whittaker - London South Bank University, UK
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This is a very clear and simple to read book. It addresses the different aspects of preparing and writing a literature review at the end of studies for nursing students.

This text is appropriate for nursing students in their 3rd year of studies when considering how to approach their final dissertation. It has everything needed to promote and plan for project success.

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Book Title: Literature Reviews for Education and Nursing Graduate Students

Authors: Linda Frederiksen, Sue F. Phelps

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Book Description: This open textbook is designed for students in graduate-level nursing and education programs. From developing a research question to locating and evaluating sources to writing a sample literature review using appropriate publication guidelines, readers will be guided through the process. This book has been peer-reviewed by 7 subject experts and is now available for adoption and use in courses or as a library resource. If you’d like to adopt the book, please let us know . You can view the book's Review Statement for more information about reviewers and the review process. The Accessibility Assessment for this is book is also available. If you'd like to adopt or adapt this book, please let us know .

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Student nurse education and preparation for palliative care: A scoping review

Abiola durojaiye.

1 Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland

2 Department of Nursing and Midwifery, Health Research Institute, University of Limerick, Limerick, Ireland

Associated Data

All relevant data are within the paper and its Supporting information files and the DOI's are provided for all materials that informed the results of this paper: https://figshare.com/articles/journal_contribution/Support_file_1_docx/23247950

The World Health Organisation and palliative care stakeholders recommend that healthcare workers are educated in palliative care. Provision of high-quality palliative care is fundamental to nursing practice. However, caring for palliative care patients and meeting family needs is challenging without appropriate knowledge and experience. Palliative care education and clinical skill development for undergraduate student nurses is a priority to ensure graduate nurses are equipped with the knowledge and skill to deliver safe and competent care.

A scoping review guided by Arksey and O’Malley’s framework was used to identify undergraduate student nurses’ palliative care education and preparation. A comprehensive literature search of five electronic databases and grey literature were conducted from January 2002 to December 2021. The aim was to review the empirical evidence and ascertain how undergraduate student nurses’ palliative care education is organised, facilitated, delivered and evaluated. Screening was performed independently by two reviewers against eligibility criteria with meetings to discuss included papers and form a consensus. Data was extracted and related to palliative care undergraduate student nurses’ education, educational model, methodology, key findings, and recommendations. Analysed and summarised data was mapped onto the four key review questions (educational models utilised, methods used to assess effectiveness, facilitators/barriers and gaps in the literature).

34 papers met the criteria for this review. The review highlights that undergraduate nursing palliative care education is more evident in high income countries. Limited and diverse published research existing in low- and middle-income countries. Educational models utilised were theoretical and experiential learning and educational process, early integration and multiple learning methods which were highlighted as facilitating factors. However, crowded curricula, lack of palliative care clinical placement expertise, difficulty providing clinical placement, timing and delivery of palliative care and difficulty responding to simulated environments (manikins) were perceived barriers. Nevertheless, palliative care education can increase knowledge, positive attitude, self-confidence and adequate preparation of undergraduate student nurses.

This review highlights that there is limited research regarding the timing and delivery of palliative care principles and practice in undergraduate student nurse education. Early integration of palliative care education impacts upon students perceived preparedness for practice and positively influences their attitudes to palliative care provision.

Internationally, nurse education has and continues to experience radical change in response to societal demands and professional requirements and standards. The move from medical task-oriented care to individual person and family-centred care at all stages of the lifespan is reflected in the education models that underpin the art and science of the nursing profession [ 1 ]. Focusing on palliative care is an essential part of nursing education and it is important for undergraduate student nurse to gain knowledge on palliative care to improve the overall quality of healthcare [ 2 ]. The need for palliative care education has been well documented by the World Health Organisation [ 3 ] and supported by the International Council of Nurses [ 4 ]. This need highlights that we require undergraduate student nurses to be appropriately educated to have the necessary knowledge, skills and attitudes to be able to provide palliative care across all healthcare settings upon graduation. Palliative care encompasses:

“ the active holistic care of individuals across all ages with serious health-related suffering due to severe illness, and especially of those near the end-of-life. It aims to improve the quality of life of patients, their families and their caregivers” [ 5 ]

The elimination of serious health-related suffering includes the various health conditions or severe illness that are most likely to generate a need for palliative care. Health-related suffering is considered serious when it compromises physical, social, spiritual, and/or emotional functioning, and when it cannot be relieved with professional intervention. The goal of palliative care is to prevent and relieve suffering, and to support the best possible quality of life for patients and their families, regardless of the stage of the disease or the need for other therapies [ 5 ]. The alleviation of suffering is an essential function of nursing [ 6 ] and caring for a patient that requires palliative care and meeting the family’s needs is challenging without appropriate knowledge [ 7 ]. Educational and clinical training requirements for undergraduate student nurses in palliative care is a phenomenon that must be considered globally. A limited but growing number of schools of nursing programmes include palliative care content in their undergraduate nursing curricula [ 8 , 9 ]. In addition, consensus conferences and position statements have been developed to outline and define the attitudes, knowledge and skills involved in palliative care [ 8 , 9 ].

While in 1967 Cicely Saunders [ 10 ] made a seminal contribution to palliative care philosophy and practice there has been a slow gradual growth and development of palliative care education. Before the 1990s, the palliative care educational needs of nurses were often overlooked in traditional nursing education settings [ 6 ]. Post 2002, there has been a great focus and emphasis for the need of palliative care education within undergraduate nursing programs. This focus and development can be linked to the priority and definition given to palliative care by the WHO [ 11 ]. Following the WHO definition in 2002 many palliative care programmes have been integrated in nursing curricula in the Western world. Palliative care educational programs that have been described typically consist of multisession training programs that incorporate attitudinal discussions and provide core knowledge and skills practice. According to the WHO policy on palliative care education, it is expected that palliative care education would be embedded in all nursing programs, but this remains unrealised in some schools of nursing [ 9 ]. Teaching palliative care within undergraduate student nurse education is seen to improve holistic, compassionate, individualised person and family-centred care [ 1 ]. Therefore, there is a need to investigate how palliative care education is embedded in undergraduate nursing curriculum, what is being taught, how it is delivered, and how undergraduate student nurses are prepared for clinical practice. Furthermore, as compassionate, competent and holistic care are at the core of nursing, knowledge of palliative care concepts is a fundamental expectation of graduating nursing students [ 12 ]. The shared theory of palliative care [ 13 ] suggests that to be competent in providing palliative care one requires sufficient knowledge and as competence influences performed interventions this translates to patient outcomes. This relationships between knowledge, competence, and patient outcomes provide a clear rationale to address the aspect of undergraduate nurses’ palliative care education. While reviews have been conducted within undergraduate nurse education, they have focused on educational interventions [ 14 ], effects of simulation [ 15 ], modes of delivery/teaching strategies [ 16 ] and death education [ 17 ]. In addition, this work was pre-1994 [ 17 ] and between 1984–2012 [ 16 ], 2000–2013 [ 14 ] and 2011–2016 [ 15 ]. Thus, there is a need to map the literature to identify undergraduate student nurses’ palliative care education and preparation for their practice as a registered nurse. This paper addressed this need through reviewing the literature from 2002 to 2021 representing the 20 years since the WHO 2002 definition of palliative care.

Due to the broad nature of palliative care and nursing education, a scoping review methodology was employed. This allowed for the presentation of a broad synthesis and mapping of the available evidence which is not limited by study quality or design [ 18 ]. This was an interactive process where each step was returned to and advanced during the process [ 19 ]. Consequently, utilising a scoping review assisted in identifying the current body of knowledge and existing gaps in the literature [ 20 ]. Through the systematic and transparent synthesis of the evidence, a rigorous map of the findings is presented in order to highlight the extent and nature of the literature, identify gaps and make recommendations [ 21 , 22 ]. The Arksey and O’Malley [ 18 ] framework was adopted for this review and the authors incorporated recent scoping review methods updates [ 21 – 23 ].

The framework utilises a five-step process:

identifying the research question,
identifying relevant studies,
study selection,
plotting the data, and
arranging, summarising and communicating the outcomes

The aim of this scoping review is to scope and map the literature to identify undergraduate student nurses’ palliative care education and preparation for practice.

Identification of research question

Step one of Arksey and O’Malley’s [ 18 ] framework and to meet the aim of this review, the focus is on the following questions:

What educational models are utilised within palliative care undergraduate student nurse education?

What methods have been used to assess effectiveness of palliative care undergraduate student nurse education.

What facilitators or barriers have been reported relating to the success/failure of the models of palliative care undergraduate student nurse education?

What gaps in the literature exist on preparation within palliative care undergraduate student nurse education?

Identification of relevant studies.

In step two of Arksey and O’Malley’s [ 18 ] framework to capture the broad scope of palliative care literature, a broad range of keywords and MeSH terms were used within the search [ 18 ]. The search strings were developed and agreed by the review team (AD/RR/OD). A search strategy ( Table 1 ) and inclusion criteria guided the review, and the search was conducted across five databases MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Academic Search Complete, PsycINFO and Cochrane Library. An additional search was conducted for grey literature (International Clinical Trials Registry Platform Search Portal) across nursing and palliative care websites. The search was conducted from the 01-01-2002 to the 10-12-2021. The search words were used in ‘title’ and ‘abstract’ searches utilising Boolean operators ‘OR’ and search strings were finally combined using Boolean operators ‘AND’. All citations were exported to Endnote Library 2021 (Clarivate Analytics, Pennsylvania, USA) for duplicates to be identified and removed (AD/OD) and exported to Rayyan (Qatar Computing Research Institute) for screening and voting to occur (AD/OD).

Study selection

For the third step of Arksey and O’Malley’s [ 18 ] framework papers were screened in Rayyan independently by two reviewers to identify papers that meet the selection criteria ( Table 2 ). Then, the full texts of the remaining studies were retrieved and screened against the selection criteria. Papers that met the selection criteria were included in the review.

Mapping/plotting of data

The fourth step of Arksey and O’Malley’s [ 18 ] framework involved mapped the existing literature in terms of nature, characteristics and source of evidence [ 24 ]. In accordance with Arksey and O’Malley’s [ 18 ] process, this stage involved extracting summaries from each paper in a data extraction table ( Table 3 ). The data extracted from each paper pertained to the author, year, title, country, aim/focus of the paper, educational model, methodology, key findings and recommendations for undergraduate nursing palliative care education and practice. The extracted data supported the mapping of data onto the review questions and to meet the aim of the review.

Abbreviations : AANC–America Association of Nursing Council, ANOVA- Analysis of Variance, BSN- Bachelor of Science in Nursing, CIPP- Content, Input, Process and Product, EAPC- European Association of Palliative Care, ELNEC- End-of-Life Nursing Education Consortium, EOL- End-of-Life. FATCOD- Frommelt Attitude Towards Care of the Dying Scale, IPE- Interprofessional Education, PC- Palliative Care, PEOLC-Palliative and End-of-Life Care, PCQN- Palliative Care Quiz for Nursing, SPSS- Statistical Package for Social Sciences, STATA- Statistical Software UG-Undergraduate, UNDA- University of Notre Dame Australia, UNPCKS- Undergraduate Nursing Palliative Care Knowledge Survey.

Arranging, summarising and communicating the outcomes

The fifth and final stage of Arksey and O’Malley’s [ 18 ] framework involved summarising and communicating the findings. A total of 34 papers was generated representing 10 countries in this scoping review. The papers are summarised and communicated under the study characteristics and the four key objectives identified in step one of the review processes. To support this process the data is mapped and charted within each reported section to present a clear and succinct summary of the data.

The search of the databases and grey literature generated 18,243 results of which 18,235 originated for the five databases and 8 from grey literature searches. 7,696 duplicates were identified and removed and the remaining 10,547 papers went forward for title and abstract screening. Following title and abstract screening 10,498 papers were excluded leaving the remaining 49 papers going forward to the full-text review stage. The full text review process identified 34 papers that met the inclusion criteria and the reasons for the 15 excluded papers are reported in the PRISMA flow diagram [ 58 ] ( Fig 1 ). This review is reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-analysis for Scoping Reviews (PRISMA-ScR) ( S1 Checklist ) [ 59 ].

An external file that holds a picture, illustration, etc.
Object name is pone.0286678.g001.jpg

From: Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. Doi: 10.1136/bmj.n71. For more information, visit: http://www.prisma-statement.org/ .

Characteristics of the studies

The screening process generated thirty-four papers that met the inclusion criteria from ten countries and more than a half 56% (n = 19) were from the USA. Papers in this review comprised of fourteen secondary data papers, thirteen quantitative papers, four qualitative papers, and three mixed-methods papers ( Table 4 ). The quantitative designs varied, using descriptive, observation, exploration and quasi-experimental designs. Three of the thirteen quantitative papers utilised standardised survey tools: Undergraduate Nursing Palliative Care Knowledge Survey (UNPCKS) [ 30 ], Frommelt Attitude Toward Care of the Dying Scale (FATCOD) [ 38 ] and Palliative Care Quiz for Nursing (PCQN) [ 49 ]. The four qualitative papers utilised qualitative descriptive design [ 26 ], ethnography observation [ 39 ], qualitative approach and semi-structured interview [ 45 ] and consensus-based design [ 51 ]. One of the three mixed-method papers utilised a longitudinal quantitative approach and thematic analysis to analyse qualitative data in response to open ended questions [ 36 ]. The second utilised a consultation survey via telephone and email, and a consensus-based comment and national approval process for data analysis [ 40 ]. The third paper used a 12-question survey that utilised mixed-method approach to evaluate students [ 46 ]. In addition, within the discussion/opinion papers one utilised reflective essay and assignment [ 46 , 49 , 55 ]. One utilised 2 to 3 nursing licensure examination interwoven throughout the course and a 10-question quiz with nursing licensure type items [ 33 ]. A third utilised an observer checklist in debriefing sessions [ 14 ] to evaluate learning outcome.

The sample size of the quantitative papers in this review consists of the undergraduate student nurses, nursing schools/faculties, nurse educators/experts, academic leads and deans of nursing schools. Surveys included 15 national nursing faculties [ 29 ], 35 nursing schools/faculties [ 56 ] 88 nurse educators and 135 expert nurses [ 32 ], 13 academic leads and 36 deans of nursing schools [ 37 , 42 ]. However, other papers did not reference the number of respondents [ 30 , 48 , 49 , 53 ]. Student sample sizes within the quantitative papers spanned from 83 third-year diploma nursing students [ 43 ] to 117 third-year nursing students [ 38 ] and 1,200 undergraduate nursing students [ 28 ]. Within qualitative papers sample sizes spanning from 13 participants (7 newly trained nurses and 6 nurse tutors) [ 45 ] to 17 female junior and senior baccalaureate students [ 26 ] and 60 third-year nursing students in eight group sessions [ 39 ]. The mixed-methods papers had sample sizes of 336 year-three student nurses at one university [ 36 ], 37 bachelor of nursing students [ 46 ] and 8 faculties of Canadian schools of nursing [ 40 ]. The samples represented in this review were characterised by a wide range of ages, nursing programs and ethnicities with degree program students as the majority in representation.

Four educational models were identified in this review and the conceptual or theoretical framework underpinning the palliative care education approach was evident in 5 papers and students’ year of study evident in 12 papers ( Table 5 ). Within the papers reviewed, the facilitators delivering the palliative care education were evident in 11 papers and educational delivery strategies in 22 papers ( Table 6 ). While a broad range of educational facilitators are identified it is recommended that palliative care education should be facilitated by experts [ 25 , 32 , 39 , 57 ] and that experts are needed for high-fidelity simulation to enhance knowledge in palliative care and mentor students [ 32 , 44 ].

Only 4 papers in this review highlights the evaluation of learning outcomes. The first paper utilised 2 to 3 nursing licensure examination interwoven throughout the course and a 10-question quiz with nursing licensure type items [ 33 ]. The second paper utilised an observer checklist within debriefing sessions [ 14 ]. The third paper utilised an assignment on student observation experience and case study analysis of a palliative care case study with pre and post-test [ 49 ]. The fourth paper utilised a reflective essay and assignment [ 55 ]. Within this review, palliative care education was deemed effective if it resulted in positive learning outcomes for students and 15 papers highlight effectiveness which was identified through knowledge gained, self-confidence and adequate preparedness ( Table 7 ).

What facilitators/barriers have been reported relating to the success/failures of the models of palliative care undergraduate student nurse education?

Within this review nine of thirty-four papers reported a wide range of facilitators that contributed to the success of the models of palliative care undergraduate student nurse education. The educational process was highlighted as a means of preparing students for care of the terminally ill [ 45 ]. While early integration was highlighted as enhancing and impacting undergraduate student nurses’ comfort and perceived preparedness [ 29 ]. Multiple learning methods have been shown to increase knowledge and positive attitude of undergraduate student nurses towards the provision of palliative care [ 54 ] and clinical exposure to meaningful learning opportunities with patients experiencing serious life-threatening illnesses facilitates learning and enables change of attitudes [ 32 ]. A structured palliative care course [ 38 ] and the use of palliative care documents and guidelines to facilitate the success of palliative care education within the undergraduate student nurses’ program were seen to influence students’ ability to be clinically competent [ 52 , 56 ]. In the last decade, the use of simulation and analysis of scenarios has assisted to prepare students [ 38 ] and a key element within the simulation was debriefing which allowed for analysis of the dynamics occurring during the scenario [ 25 ].

Within this review, several factors acted as barriers to palliative care education were evident specifically the issue of a crowded curricula and the lack of time in the curriculum [ 40 , 53 , 57 ]. This lack of time and crowded curriculum is compounded by the lack of palliative care expertise [ 40 ] and the difficulty in providing clinical placement [ 57 ]. This results in educators and students feeling ill prepared to deliver palliative care education or feel adequately prepared for future practice [ 40 , 54 ]. Furthermore, there is limited research about the timing and teaching of palliative care content in undergraduate course [ 44 ] and students can find simulations using manikins difficult [ 47 ]. These factors limit undergraduate student nurses in developing the cognitive skills required for effective palliative care clinical decision making [ 44 ].

In this review there is evidence of disparity and lack of research in low-middle income countries. Also, there is evidence specific to undergraduate student nurse palliative care education preparedness, barriers and implications for practice in this review. From the educational aspect, there is a lack of integration of palliative care philosophy and conceptual framework [ 44 ], crowded curricula [ 53 ], lack of nurse educators and expertise to teach palliative care within nursing faculties [ 40 , 53 , 57 ] and timing and teaching of palliative care [ 44 ] were evident from the empirical studies in this review. From a clinical practice perspective there are difficulties in providing clinical placement [ 57 ] and responding to manikins presents difficulties [ 47 ] and these barriers warrant further investigation. Hence, there is a need for further and continual research and publications in many areas of palliative care education.

This scoping review draws together the research literature on undergraduate student nurse education and preparation for palliative care. The focus of papers identified in this review were on palliative care education (sixteen papers), end-of-life care education (eleven papers), death and dying education (four papers) and palliative and end-of-life care education (three papers). These are specific terms used for people living with life-limiting conditions that require palliative care depending on the stage of their illness or condition. The papers reviewed highlight that palliative care undergraduate nurse education is evident in both high-income countries (twenty-nine papers 85%) and in low- and middle-income countries (five papers 15%). Notwithstanding, the impact of globalisation and the effect the internet and technology has on influencing and sharing information world-wide, it is evident from this review that there is a lack of published research from low- and middle-income countries or collaborative palliative care education or research between high and low- and middle-income countries. This is important as the highest proportion of adults in need of palliative care are from low- and middle-income countries and where palliative care still developing and is primarily limited to urban areas [ 60 ].

In discussing the review question (a) What educational models are utilised within palliative care undergraduate student nurse education? This review highlights that theoretical and experiential learning go hand-in-hand in palliative care education and training [ 38 ]. This review identified five conceptual frameworks for palliative care education see Table 5 . Utilising frameworks in education provides a fundamental structure to explain human behaviour towards learning [ 61 ]. Educational models are the philosophical foundation of any overall approaches and beliefs about learning, instruction and content through providing meaning and direction [ 62 ]. However, there was no evidence of integration of palliative care philosophy with the conceptual frameworks identified in this review. The use of a conceptual framework to deliver palliative care is a valuable tool for nurse educators to structure education and serves as a standard for practice because many educators/teachers continue to find values and benefits in using learning styles concept that are applicable in different situations. There is likely to be a conceptual framework which is appropriate in one situation and not in another. Therefore, there is a need to be clear which palliative care educational models and the methods are beneficial and appropriate to use. Following which it is important to investigate the conceptual frameworks appropriates and fit with palliative care philosophy to facilitate, deliver and evaluate palliative care education for undergraduate student nurses.

Discussing the review question (b) What methods have been used to assess effectiveness of palliative care undergraduate nurse education? This review highlights that palliative care educational programs facilitated by an expert multi-disciplinary team through a series of course contents that are both theoretical (classroom) and practical (skills practice in a simulated setting with anatomic models) is most effective and promote better preparation of undergraduate student nurses. For palliative care education to be effective it must result in positive learning outcomes for students [ 63 ]. Within this review effectiveness was identified through knowledge gained, self-confidence and adequate preparedness and is in line with other research [ 41 , 64 ]. Key within palliative care education is assessment of learning as it determines whether the learning goals are met. Well-designed assessment methods provide valuable information about student learning and identifies what was learned, how well and where they struggled [ 52 ]. The assessment methods identified in this review seem limited when compared to palliative care philosophy and educational contents. Hence, there is a need for further investigation of assessment methods that identify learning, preparedness, competence and outcomes in practice. In some incidents funding is required to determine the effectiveness of palliative care learning outcomes especially in low- and middle-income countries.

Discussing review question © What facilitators/barriers have been reported relating to the success/failure of the models of palliative care undergraduate student nurse education? It is evident that palliative care education is facilitated by a multidisciplinary team that includes nurse tutors, palliative experts, expert guest lecturers and other professional experts. Both theoretical and experiential components develop students’ knowledge, skills, and attitudes. Additionally, palliative care education is being delivered using single or multiple strategies in the classroom, online and in a simulated environment/skills development laboratory, where students continue to practice key skills and demonstrate attitudes in a supervised clinical setting.

The use of blended learning that works together to develop students’ knowledge, skills, and attitudes is evident in this review. Educational processes which organise and systematise patient care [ 45 , 52 ] and early integration [ 29 , 46 ] enhance and impact undergraduate student nurses’ comfort and perceived preparedness. Multiple learning methods have shown to increase knowledge and positive attitude of undergraduate student nurses towards the provision of palliative care [ 54 , 65 ] and clinical exposure to meaningful learning opportunities facilitates learning [ 32 , 66 ]. Structured palliative care course influence students’ ability to be clinically competent [ 38 ] and the use of palliative care documents and guidelines facilitates the success of palliative care education within the undergraduate student nurses’ program [ 6 , 7 ]. In addition, within the last decade the use of simulation and analysis of scenarios has assisted to prepare students [ 38 , 63 ] and a key element within simulation is debriefing which allows for analysis of the dynamics occurring during the scenario [ 25 , 67 ].

What is evident from this review and the wider literature is that palliative care education requires careful planning, selection of appropriate teaching methods and learning materials, developing a course schedule and planning for student assessment [ 27 , 68 ]. In addition, palliative care educational programs typically require a period of study, allowing time and opportunities for students to develop essential competencies that encompass essential knowledge, skills, values, and positive attitudes [ 69 ]. Therefore, palliative care undergraduate student nurse education should start early in the program and it is crucial for nurse educators to carefully define the core knowledge that students must achieve at each level of their academic program [ 7 , 29 , 46 ].

However, to achieve the delivery of palliative care education within undergraduate nursing programs a balance has to be achieved to offset the barriers of a crowded curricula and the lack of time in the curriculum [ 29 , 40 , 53 ]. This lack of time and crowded curriculum is compounded by the lack of palliative care expertise [ 40 ]. and the difficulty in providing clinical placement [ 57 ]. These result in educators feeling ill prepared to deliver palliative care education and students feeling inadequately prepared for future practice [ 70 ]. Furthermore, this review highlights that there is limited research and agreement about the timing and teaching of palliative care content in undergraduate course [ 44 , 71 ] and simulation presents difficulties for students [ 47 , 72 ].

While a broad range of facilitators are identified within this review [ 25 , 29 , 39 , 57 ] it is recommend that palliative care education be facilitated by experts to enhance knowledge in palliative care and mentor students particularly for high fidelity simulation [ 73 ]. The absence of expert facilitation may limit undergraduate student nurses development of the cognitive skills required for effective palliative care clinical decision making [ 44 , 74 ]. Therefore, there is a need for guidance and support for both educators and students in simulation laboratory [ 75 ]. To support nurse educators responsible for designing undergraduate student nurse course contents expertise and training should be both theoretically and practically to adequately prepare students for practice.

Discussing review question (d) What gaps in the literature exist on preparation within palliative care undergraduate student nurse education? The evidence from this review highlights the disparity and lack of research in low- and -middle income countries. Research efforts build the science of nursing education through the discovery and translation of innovative evidence-based strategies. Therefore, there is a need for nurse educators, researchers and experts in the field of palliative care in low- and -middle income countries to be involved in rigorous research in the teaching-learning process and outcomes at all levels of nursing education. From the educational perspective, this review highlighted the integration of palliative care philosophy and conceptual framework, crowded curricula, the lack of nurse educators with expertise and delivery timing of palliative care education as areas for further consideration and investigation.

Given that palliative care education improves students’ knowledge and increases their preparedness, further research is warranted into the correlation of palliative care philosophy and the conceptual framework to underpin undergraduate student nurse education. From a practice perspective the difficulty in providing clinical placement needs consideration and investigation. To address placement issues there is a need to consider and improve on the limited clinical placement on specialist unit, large number of students scheduled for placement at the same time and short length of placement that may negatively impact the opportunities for clinical experiences in real patients care situations. In addition, family/client involvement in palliative care education and placement provision needs to be addressed in the context of future service provision and the rights of people with life-limiting illness concerning choices that affect their lives. This needs to be considered in terms of how undergraduate student nurses will meet the professional training and educational standards requirements upon graduation. The consideration of a hub and spoke model could be one way to of bridging this issue and utilising family placement as a learning environment for students for preparing them for their future role as a registered nurse [ 76 , 77 ].

Limitations

While this review used precise, transparent methods based on study and reporting guidelines by Arksey and O’Malley [ 18 ] no quality appraisal was conducted as the focus of this review was to update and map the evidence. Thus, this paper only offers a descriptive account of available information and there was no patient and public involvement and there are opportunities for engagement, potentially following published guidance on stakeholder involvement in systematic reviews [ 78 ]. In addition, papers in this review were limited to only five databases which may have affected the inclusion of low- and -middle income countries and the inclusion of secondary data can be seen as both a strength and limitation.

Conclusions

This scoping review illustrates the evidence on palliative care education in preparing undergraduate student nurses for practice. The evidence identifies a wide, varied and expanding range of educational models, facilitation and delivery strategies currently in use. It is evident from this review that undergraduate student nurses require palliative care education in order to produce nurses with the graduate capabilities to deliver high-quality palliative care and to better meet the needs of an ageing population and rising consumer expectations. However, it is suggested that the integration of palliative care education contents requires focused curriculum planning to ensure clarity and cohesion in the content delivery method that is interactive and flexible involving application of different teaching strategies to minimise gaps and overlaps. While effectiveness of palliative education is important as it increases students’ knowledge, improves their attitudes and prepares them to provide palliative care, future research needs to measure application to practice. Furthermore, future research needs to detail the content delivery method, assessment and evaluation method clearly.

Supporting information

S1 checklist, funding statement.

The authors received no specific funding for this work.

Data Availability

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Types of Nursing Literature

Systematic reviews.

Also known as "meta-analysis", a systematic review identifies an intervention for a specific disease or other problem in health care, and determines whether or not this intervention works. To do this authors locate, appraise and synthesize evidence from as many relevant scientific studies as possible. They summarize conclusions about effectiveness, and provide a unique collation of the known evidence on a given topic, so that others can easily review the primary studies for any intervention

Empirical research articles

Usually published in peer-reviewed journals. Although a research article will include a bibliography of other literature reviewed, and may lead you to similar articles, its primary purpose is to present original findings. Look for the following elements

Introduction
Research design (participants)
Discussion of data & methods

Evidence-Based Care Sheets and Evidence-Based Articles

Both evidence-based care sheets and evidence-based articles are similar to review articles (described below). These types of articles focus on summarzing research relating to specific ailments and the efficacy of their treatments, and serve as general overviews.

Review articles

Summarizes and synthesizes the results of many different original studies. Its purpose is to define the state of the literature on a particular topic, and discuss different methodologies for conducting research. Review articles are excellent sources for locating research articles, and contain helpful bibliographies.

Clinical articles

Written for practitioners. Clinical articles might present a particular case study or define a new technique.

(source: Clemens, Rachel, "Library Research Guide for Nursing," Dept. of Nursing, Cal State University)

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The use of ultrasonography in education for undergraduate nursing students: A literature review

Affiliations.

1 School of Nursing, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
2 Department of Nursing, University of Miyazaki Hospital, Miyazaki, Japan.
3 Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
PMID: 38527918
DOI: 10.1111/jjns.12596

Aim: The incorporation of ultrasonography into nursing practice is becoming more common, but how ultrasonography is used or applied in nursing student education is still unclear. This study aimed to review and synthesize relevant literature on the use of ultrasonography in education for undergraduate nursing students.

Methods: An electronic literature search was conducted in June 2022 (updated in June 2023) using MEDLINE, CINAHL, Scopus, and Ichushi-Web databases. Two researchers independently screened/assessed the eligibility of the studies, synthesized extracted data using a narrative synthesis (due to anticipated heterogeneity across studies), and evaluated the methodological quality of quantitative studies using the Medical Education Research Study Quality Instrument.

Results: Thirteen peer-reviewed articles were included in the review. All of the studies were conducted in high-income countries, and the majority of them employed an uncontrolled single-group design. Ultrasonography was used mainly for visualizing the vascular system to improve students' puncture skills, but it was also used with various other applications. The included studies were predominantly of moderate quality and heterogeneous, but all of them reported at least some benefits in nursing student education, such as enhancing knowledge and understanding of subcutaneous anatomical structures, and improving confidence in and/or skills of venipuncture and other visualization/assessment methods.

Conclusions: This review provides a broad perspective and highlights the potential use of ultrasonography in education for undergraduate nursing students. Further research is needed to develop standardized teaching methods/curriculum and competency assessments in order to ensure minimum competency standards for students and to improve clinical outcomes for patients.

Keywords: literature review; nursing education; nursing students; ultrasonography; undergraduate nursing students.

Publication types

Open access
Published: 29 March 2024

Competency scale of quality and safety for greenhand nurses: instrument development and psychometric test

Run Nan Zhai 1 ,
Ying Liu 1 &
Jia Xin Wen 1

BMC Nursing volume 23 , Article number: 219 ( 2024 ) Cite this article

76 Accesses

Metrics details

Guaranteeing nursing service safety and quality is a prioritized issue in the healthcare setting worldwide. However, there still lacks a valid scale to measure the quality and safety competencies of newly graduated nurses globally.

This scale was developed in two phases. In Phase One, a literature review and three-round e-Delphi were conducted to generate the initial item pool; while in Phase Two, five experts tested the content validity of the scale. The construct validity was evaluated using confirmatory factor analysis (CFA), and the data were collected among 1,221 newly graduated nursing students between May, 2017 and August, 2017. Finally, the internal consistency reliability and test-retest reliability were tested.

The final version’s Competency Scale of Quality and Safety (CSQS) was confirmed by the CFA involving 64 items in six dimensions, including patient-center care, safety, evidence-based practice, collaboration and teamwork, continuous quality improvement, and informatics. The results of data showed that the data supported the modified model of CSQS (Standardized Root Mean Square Residual = 0.03, p = 0.053, Adjusted Goodness of Normed Fit Index = 1.00, Root Mean Square Error of Approximation = 0.007, Fit Index = 0.95, Goodness of Fit Index = 0.97, χ 2 /df = 1.06), and the standardized factor loadings of items were from 0.59 to 0.74 ( p < 0.05). The internal consistency reliability of the total scale was 0.98, and the test-retest reliability was 0.89.

Conclusions

CSQS was a valid and reliable instrument to measure the safety and quality abilities of greenhand nurses, and could be fully utilized by nursing students, greenhand nurses, nursing educators, as well as hospital nursing managers.

Peer Review reports

At the beginning of the 21st-century, deficiencies of healthcare safety and quality were highlighted by the Institute of Medicine [ 1 ]. One of the primary aims of healthcare organizations is to furnish patients with high-quality and safe care [ 2 ]. This imperative stems from reports indicating that millions of patients worldwide suffer disability or death each year due to unsafe medical practices. Moreover, caregiver infractions against patient safety can impose significant financial burdens on patients [ 3 ]. Upholding the purpose to protect medical care deficiencies, a fresh competency framework for all health careers to provide patient-centered care and improve the safety and quality of patients’ care was put forward by the IOM in the early 2003 [ 4 ]. Nurses are pivotal in the healthcare service system, constituting the foremost group in accomplishing the goal of providing quality and safe care to patients [ 2 ].However, the nursing errors or deficiency remain high among newly graduated nurses. For instance, 86 nursing errors were reported from 42 new nurses by Zhang [ 5 ]. A study by Treiber and Jones also revealed that approximately 55% of newly admitted nurses committed nursing errors within the initial five years of their clinical careers [ 6 ]. Thus, the competency based quality and safety education for nurses has been correspondingly developed, which is consistent with the mission of IOM [ 7 ]. In the early 2005, the initiative was launched to establish the national competency framework for Quality and Safety Education for Nurses (QSEN) by the reputed organization of American Association of Colleges of Nursing (AACN) [ 1 ].The QSEN framework was respond to quality and safety concerns by providing the foundational knowledge, skills and attitudes to ensure that nurses provide quality and safe care in their daily practice [ 8 ]. Furthermore, over the past decade or so, this competency-based framework has been integrated into the curricula of nursing programs in numerous countries [ 9 ].

McClelland, an American psychologist, initially referred competency to the knowledge, attitudes, skills and traits that affected the job performance of an individual [ 10 ]. The globally renowned Knowledge, Skills, and Attitudes (KSA) model, proposed by Benjamin Bloom [ 11 ], has found widespread application in the human resource management industry for assessing employees’ competency [ 11 , 12 ]. In the field of nursing, the competencies of QSEN involve a complete set of knowledge, skills, and attitudes as the chief tactics that effectively apply competencies including patient-center care, safety, evidence-based practice, collaboration and teamwork, continuous quality improvement, and informatics [ 7 ], which is based on KSA model [ 9 ]. The QSEN competency framework was initially developed for prelicensed nursing students with the purpose of establishing minimum standards for secure clinical settings safety and high-quality practice [ 7 ]. However, the development of the comprehensive QSEN competency assessment scale to assess graduated bachelor nursing students (BNS) experienced a long history upon the completion of this study.

At the beginning, Cronenwett, et al. [ 7 ] recruited 16 universities among the USA to clarify the definitions associated with the six dimensions of QSEN ability components and the guidelines of overall teaching courses for prelicensure nursing students at graduation. Soon after, Barton, et al. [ 13 ] performed a Delphi among the USA for consensus regarding varied QSEN abilities to be included in teaching courses. At last, a total of 162 QSEN abilities were obtained from 18 nursing experts among 16 states. Simultaneously, Sullivan, et al. [ 14 ] conducted a survey in 17 universities among 565 students to develop a nursing students assessment tool regarding the preparation and importance of these QSEN abilities. This tool was named as QSEN of student evaluation survey (QSEN-SES), which included 19 items of learned contents in the knowledge dimension; while in the skill dimension, it was composed of 22 items of skill preparedness; and in the attitude dimension, it was comprised of 22 items. Additionally, the results confirmed that QSEN competencies were important for the further work of most of the nursing students. However, this scale did not test the psychometric property.

Later, Pauly-O’Neill, et al. [ 15 ] conducted a study to assess the QSEN competencies of BNS using the observational checklist tool, but there was also no psychometric property reported for this tool. At the same time, Piscotty, et al. [ 16 ] developed BSN Quality and Safety Self-Inventory (QSSI) with two dimensions and 18 items. Although QSSI featured acceptable validity and reliability, it failed to reflect the QSEN framework through six components.

The utilization of the QSEN framework was not only implemented in the USA, but also in the South Korean. Lee, et al. [ 17 ] assessed the evaluation methods and contents of the QSEN competencies of nursing students. They translated and modified the QSEN-SES of Sullivan, et al. [ 14 ] into a Korean version. However, the Korean version of QSEN-SES only reported the content validity, and there was no other psychometrics report.

Additionally, Nygårdh, et al. [ 18 ] applied the QSEN framework to create the competency tool of QSEN in Sweden. According to previously reported results, three main dimensions were chosen to present the QSEN competencies by Nygårdh, et al. [ 18 ]. The reliability of the Swedish version of the QSEN instrument was compared with the reliability of the instrument of Cronenwett et al. [ 7 ], but its validity and internal consistency reliability were not evaluated.

More recently, based on the QSEN framework, Liu, et al. [ 19 ] conducted an e-Delphi study in China to develop indicators for evaluating the QSEN competencies of BNSs at their graduation. Through three rounds of e-Delphi with 22 experts, consensus was achieved regarding 88 indicators in six dimensions among these experts that a comprehensive indicator could be used to formulate the curriculum and teaching content, while it could not be used as the assessment tool to measure newly graduated nurses’ quality and safety competencies (QSC). Therefore, further efforts were required to develop the assessment tool.

Through the history of QSEN competency development, it can be noticed that various countries have recognized the importance of formulating the QSEN competencies of nursing students to provide safety and quality nursing care to patients in their future work. However, there is an obvious deficiency between the requirement of an assessment tool and QSEN [ 20 ]. Besides, in the nursing discipline, the students achieving baccalaureate are regarded as the leading workforce in the clinical practice [ 21 ], but no Competency Scale of Quality and Safety (CSQS) has been found to measure their QSC when they are graduated, making it necessarily important to develop an assessment tool to evaluate the QSC of the pre-licensed BNSs using the QSEN framework. To this end, the present study was carried out to develop the evaluation scale and measure the QSC of BNSs upon their graduation.

Research design and procedures

The cross-sectional survey design was conducted to develop and test the scale psychometrical properties in two phases. Literature review and three-round e-Delphi were conducted for the pool development of the CSQS items in the first phase, while in the second phase, the psychometrics of CSQS were assessed through Step 2 to Step 5 in Fig. 1 .

The development and psychometrical testing process regarding the competency scale of quality and safety

First Phase: CSQS items development

Step 1: Based on the QSEN framework, the item pool was generated through literature review and three-round e-Delphi among 22 nursing experts [ 19 ]. The initial round of e-Delphi sought to elucidate the concept and components of QSC-BNS by soliciting insights from experts through two semi-structured open-ended questions. These questions were “How do you define the QSC-BNS?” and “How do you define each dimension of the QSC-BNS?“. Following content analysis from experts’ opinions and the integration of literature review items, a total of 89 items across six dimensions were identified, including patient-centered care, safety, evidence-based practice, collaboration and teamwork, continuous quality improvement, and informatics, were identified. Subsequently, these items were presented to the same panel of experts for the second round of e-Delphi, where they were asked to evaluate the importance of each item using a 5-point Likert scale. Items meeting the criteria of an interquartile range (IR) of ≤ 1.5, a median of ≥ 3.5, and a consensus level of agreement (CLA) of ≥ 70% were identified to have reached the consensus level and were retained, following the approach suggested by Keeney et al. [ 22 ]. One item failed to achieve a CLA of more than 70% and was consequently removed. The remaining 88 items were then resubmitted to the same group of experts to obtain their consensus opinion. At the end of the third round e-Delphi, consensus was achieved among 88 items with a median ranging from 4.00 to 5.00; the IR ranged from 0.00 to 1.50, and the CLA ranged from 76 to 100%. Thus, the initial item pool of CSQS was composed of 88 items in six dimensions, including patient-centered care (13 items), safety (17 items), evidence-based practice (15 items), collaboration and teamwork (15 items), continuous quality improvement (13 items), and informatics (15 items).

The CSQS was a five-point Likert scale with an evaluation score of 1 = completely incompetent to 5 = completely competent, with a lower score indicating a lower QSC, and a higher score suggesting a higher QSC.

Second phase: CSQS psychometrical testing

Testing content validity.

Step 2: The content validity index was defined as the ratio of scale items scored as quite or very relevant to constructs by all of raters [ 23 ]. The CSQS content validity with 88 items were tested among five experts. The experts inclusion criteria included: (1) those who at least obtained a master degree or taught master students; (2) those who taught nursing management courses or had experience of working in management positions; and (3) those who would like to assess items. Four-point Likert Scale (from 1 = not relevant to 4 = very relevant) was utilized by experts to assess items relevant to defining the constructs [ 23 ]. Based on the suggestions proposed by Polit, et al. [ 24 ], the Content Validity Index (I-CVI) and CVI of scale average (S-CVI/Ave) of the items equal or greater than 0.8 and 0.9 were acceptable when there were five experts.

Pre-testing CSQS

Step 3: The pre-testing of CSQS was conducted among 31 BNSs to identify the clarity, difficulties, and comprehensiveness of the scale. These students met the inclusion criteria: (1) those who had entranced a bachelor nursing program; and (2) those who had completed the national nursing license examination at their graduation. The exclusion criteria was nursing students who failed to finish the coursework or take the nursing license examination.

Testing factor structure and reliability of CSQS

Step 4: Based on the instrument development progress by Crocker and Algina [ 25 ] and DeVellis [ 26 ], direct confirmatory factor analysis (CFA) without exploratory factor analysis (EFA) can be feasibly conducted when the theory can support the instrument development. It has become popular to directly conduct CFA without EFA in contemporary instrument development progress, such as the development of Medication Adherence Scale [ 27 ] and Readiness for Practice Instrument for Senior Undergraduate Nursing Students [ 28 ]. Herein, the development of CSQS was strongly based on the conceptual framework of QSEN from the beginning to the end. Additionally, QSEN specifically included six dimensions of QSC [ 7 ], so that the structure testing of CSQS used the CFA directly and excluded the EFA method. This is attributed to the fact that EFA can only group items [ 26 ], failing to clarify the structures of CSQS based on the QSEN framework. However, determined by the theory [ 26 ], CFA can clarify the structures of instruments. In this case, the CSQS was hereby evaluated using the CFA method, and the internal consistency reliability (ICR) of CSQS was reported by Cronbach’s alpha.

Step 5: The final version of CSQS stability was evaluated by test-retest reliability [ 23 ]. Twenty BNSs were included in this process with 2 weeks of interval [ 25 ]. The inclusion and exclusion criteria for the BNSs were the same as described in Step 3.

Participants and settings

According to Kline [ 29 ] in the progress of constructing validity testing, one item involving 10 to 20 participants was recommended. Herein, one item involving 15 participants were used to determine the sample size. Considering the attrition of participants, 10% of the sample size was added. Thus, a total of 1,452 participants were required. The inclusion and exclusion criteria for selecting the participants were the same as described in Step 3, who enrolled in a bachelor nursing program, fulfilled the required courses, and successfully passed the national nursing license examination upon graduation were included in the study. Initially, the purposive sampling method was employed to identify universities offering bachelor nursing programs. Subsequently, nine universities across seven cities in China, with which the researcher could establish connections, were selected for inclusion. Following this, a convenient sampling strategy was utilized to select bachelor of nursing students who met the predetermined inclusion and exclusion criteria from these universities.

Data collection and ethical consideration

The ethical application of this study was approved by Ethical Committee of researcher Organization (No. NYHL1701), and permissions for the data collection were received from each university. The data collection process was composed of the following steps: (1) the researcher assistants in each university were informed of the study purpose, as well as the exclusion and inclusion standards for the participants; (2) the researcher assistants and researcher sent the information sheet, consent form, and package of questionnaires to BNSs by survey host of “So Jump” survey host or Mail; and (3) the researcher checked the completeness of the answered questionnaires. The data were collected from May 2017 to August 2017.

Statistical analysis

The frequencies, percentages, standard deviations (SD), median and means of the participants were described using IBM SPSS 22.0 program. SPSS software was also utilized to analyze the skewness, kurtosis and item-to-total correlation (ITC) of the items before performing CFA. The Cronbach’s alpha greater than 0.8 was taken to define the acceptable ICR of final version of CSQS.

The researcher conducted the CFA using the LISREL 8.72 program to test the CSQS factor structures. Before operating the CFA, the normality, multicollinearity and linearity were tried out using the SPSS software. The consistency between the measurement model and the research data was assessed by standards adopted from Hair., et al. [ 30 ], including Root Mean Square Error of Approximation (RMSEA) < 0.08, p ≥ 0.05, Goodness of Fit Index (GFI) > 0.90, Standardized Root Mean Square Residual (SRMSR) < 0.07, Adjusted Goodness of Fit Index (AGFI) > 0.90, Normed Fit Index (NFI) > 0.90, and χ 2 / df < 2.00. In the case of a sample size greater than 500, the cut-off factor loading of the item above 0.3 was considered suitable [ 30 ]. Herein, the significant α was set as 0.05.

Characteristics of the participants

A total of 1,452 questionnaires were distributed, and 1,232 completed questionnaires were gathered successfully. After excluding univariate outlier with absolute z-score more than 3 [ 29 ], 1,221 questionnaires were adopted, with a response rate of 84.09%. The participants were selected from 9 schools, involving 76 boys (6.2%) and 1,145 girls (93.8%) aged from 20 to 25, with a mean score of 22.70 (SD: 0.95).

Psychological testing of CSQS

Content validity.

Herein, the CSQS S-CVI/Ave was 0.98, and the I-CVI ranged from 0.8 to 1 among five experts. Both met the standards recommended by Polit, et al. [ 24 ]. Therefore, the CSQS content validity was contented. In addition, the wording of some items was revised following the opinions from the experts.

Pre-test CSQS

In Step 3, 31 BNSs did not have any problems regarding the description of the items. The Cronbach’s alpha of each dimension ranged from 0.89 to 0.94, while that of the overall scale was 0.98.

Construct validity and internal consistency reliability

The items were hereby analyzed before running CFA among 1221 BNSs. According to the descriptive statistical results, the kurtosis value of 88 items ranged from − 0.54 to 0.40, while the skewness value was between − 0.46 and − 0.11. Since the acceptable skewness values was between − 1 and + 1 [ 31 ], and kurtosis absolute values was under 2 [ 32 ], all the items met the selection criteria for further analysis. Additionally, the score of ITC was between 0.54 and 0.74 in this study. Ferketich [ 33 ] stated that an ITC smaller than 0.30 did not contribute much to the measurement concept, while an ITC larger than 0.70 might be redundant [ 25 ]. Thus, the researcher removed items with an ITC less than 0.30 or greater than 0.70. After analysis, the scores of 24 items were above 0.70, and were deleted. The ICR values of the total scale were 0.98. Additionally, the ICR values of the six CSQS dimensions ranged from 0.87 to 0.93, all above 0.8 [ 23 ] (Table 1 ), justifying the reasonability of conducting the CFA.

Three assumptions were tested before performing CAF, and these assumptions were found acceptable. The maximum likelihood estimation method was adopted for implementing CFA. Six dimensions with 64 items were included in the modified CSQS, and the outcome is shown in Fig. 2 . The GFI indicators of the modified CSQS were satisfied: SRMSR = 0.03, p = 0.053, AGFI = 0.95, RMSEA = 0.007, GFI = 0.97, NFI = 1.00, and χ 2 /df = 1.06. Besides, the standardized factor loadings of items were from 0.59 to 0.74 ( p < 0.05). The detailed information of each item is presented in Additional file 1. The mean scores for each dimension are delineated in Table 2 .

The measurement model regarding the final competency scale of quality and safety. Note CQI = Continuous quality improvement, CAT = Collaboration and Teamwork,PCC = Patient-centered care, SAF = Safety, EBP = Evidence-based practice, INF = Informatics, RMSEA = root-mean-square error of approximation

Test-retest reliability

In Step 5, the researchers tested the stability of the final version of the CSQS. The CSQS questionnaires were sent to 20 BNSs, and the time interval between the first and the second to answer the questionnaires were 14 days. The results showed the test-retest Pearson’s product moment r of each dimension was between 0.72 and 0.89 and the total scale was 0.89. Since the reliability coefficient of the total scale was higher than 0.80 as recommended by Polit and Beck [ 23 ], the CSQS stability was considered favorable.

In the current clinical environment, it is of great value to keep the quality and safety of healthcare services. Based on the QSEN competency framework and the common view of Chinese experts, six dimensions of QSC were hereby formed, which were congruent with previous academic claims [ 7 , 18 ]. Additionally, it was also known as the first valid and reliable scale developed globally to measure the QSC of newly graduated nurses with bachelor degree.

The development of CSQS items ensued from meticulous scrutiny, integrating insights derived from an extensive literature review and three iterative rounds of e-Delphi. During the initial e-Delphi round, definitions pertaining to QSC and its six dimensions were distilled from semi-structured questionnaires, drawing upon the expertise of Chinese professionals and aligning with the QSEN competency framework [ 7 , 8 ]. Subsequent rigorous evaluations across the second and third e-Delphi rounds yielded a refined set of 88 items, meeting stringent criteria (IR ≤ 1.5, median ≥ 3.5, and CLA ≥ 70%) [ 22 ]. This meticulous process secured agreement from Chinese experts, affirming the suitability of these items for evaluating the quality and safety competencies of BNSs.

In the second phase, the psychometric properties of CSQS were tested through four steps including CVI testing, pre-testing CSQS, CFA testing, and test-retest reliability. The purpose of conducting CVI testing was to assess the ability of the instrument’s items to effectively capture the specific constructs of interest [ 25 ]. With both S-CVI/Ave and I-CVI meeting the criteria outlined by Polit et al. [ 24 ], it is evident that the constructs of CSQS adequately reflect the QSC of BNSs. In order to ensure the readability of CSQS for participants, a pretesting phase was implemented. Results indicated that the items within CSQS were easily comprehensible, exhibiting an initial high level of intrinsic consistency (ICR value > 0.8) [ 24 ]. Prior to performing CFA, item analysis was conducted. This analysis identified 24 items with excessively high ITC scores (over 0.7), suggesting redundancy and the potential for participant fatigue [ 25 , 33 ]. Consequently, these items were removed. Subsequently, the CFA conducted on the remaining 64 CSQS items supported the final modified model with empirical data and all items’ factor loadings exceeding 0.3 [ 30 ]. Thus, the six dimensions of the final 64-item CSQS demonstrated satisfactory construct validity. Furthermore, the ICR value of the final CSQS was notably high, with both the total scale and each dimension’s score surpassing 0.8 [ 23 ], indicating a homogeneous reflection of the overarching construct of QSC. Moreover, the stability of the final CSQS was confirmed, with the total scale’s score exceeding 0.8 [ 23 ]. Based on the average scores of the six dimensions ranked in descending order, they were discussed in an orderly manner as follows.

Safety competency is defined as the knowledge, skills, and attitudes of BNSs in the future clinical work to grasp nursing technology and knowledge, abide by hospital regulations and rules, standardize nursing operations, protect patients and themselves from injury, or minimize the risk of injury during their practice or clinical work. Nygårdh, et al. [ 18 ] also proposed that nursing students should avoid risk factors while implementing patient care, which was consistent with the present findings. Furthermore, the World Health Organization’s (WHO) World Alliance for Patient Safety endeavors to incorporate patient safety courses into curricula worldwide, with the goal of instructing medical and nursing students in risk management [ 34 ]. Hence, the enhancement of patient safety can commence with the education of students [ 35 ].

In addition, from patient admission to discharge, nurses spend the most time to communicate and contact with patients and play a key role in protecting their rights and security, which makes nurses one of the high-risk groups of occupational exposure. Thus, efforts should be made not only to ensure the safety of patients, but also the occupational safety of nurses. In this developed measurement tool, the content related to the occupational safety of nurses was included, which was consistent with the results of Qaraman, et al. [ 36 ], who also stressed the necessity of providing training concerning occupational health and safety for nursing students by setting up appropriate courses.

Additionally, in this study, safety competency garnered the highest average score among the six dimensions. This outcome could be attributed to nursing schools placing greater emphasis on patient safety education for nursing students, addressing perspectives from both patients and nurses. Educational institutions typically aim to instill safety competencies in nursing students by providing training in both patient and occupational safety [ 37 ]. Furthermore, teaching hospitals often enhance nursing students’ safety competency through the implementation of patient safety education programs [ 38 ] and occupational health training [ 39 ]. However, it’s noteworthy that the item pertaining to “Handling specialist resuscitation procedures and being capable of performing resuscitation work” received the lowest score within this dimension. Hence, there’s a pressing need to enhance students’ proficiency in resuscitation workflows and complex problem-solving skills [ 40 ].

The competency of collaboration and teamwork refers to the knowledge, skills, and attitudes of BNSs in further clinical work to collaborate with multidisciplinary team members and play their duty role in the group, such as coordinating with team members, improving team member communication, and making the decision with patients together. In addition to doctors, nurses and patients, the chief nurses, other nursing staff, patients’ families, nutritionists and cleaners should also be included as team members. This dimension was previously brought up [ 41 ]. Taking the operating room team as an example, it is crucial to improve the team cooperation ability of all members for the successful achievement of the goal. In their study, Burke et al. [ 42 ] highlighted coordination, cooperation, and collaboration as fundamental focal points essential for shaping and executing integrated care models. In China, Li and Wang [ 43 ] also highlighted the importance of helping nursing students master cooperation and teamwork skills, and learn how to communicate with both their peers and patients. This dimension’s high average score could be attributed to the widespread adoption of the “problem-oriented” teaching method in China. This approach encourages students to collaborate in groups to analyze and resolve issues, thereby fostering the development of communication, collaboration, and teamwork competencies [ 44 ].

The definition of “Patient-centered Care” is referred to as the knowledge, skills, and attitudes of BNSs mastered to provide humanistic care and effective communication with patients, satisfy patient needs, and guide or care patients or their families to involve self-care activities in their future clinical work. Charette, et al. [ 45 ] also mentioned this domain in their study. The significance of patient-centered care has grown substantially, as it correlates with enhanced quality of care [ 46 ]. Studies have demonstrated that patient satisfaction rises when students exhibit a positive outlook towards patient-centered care [ 47 ]. In nursing specialty courses, educators typically underscore the importance of prioritizing patient-centered care. Consequently, this dimension received a relatively high average score. However, the item pertaining to “correctly assessing the physical, spiritual, psychological, cultural, and social needs of patients” scored the lowest. This could be attributed to nursing students’ deficiency in evaluating patients as holistic individuals [ 48 ]. Thus, nursing students should be encouraged to carry out holistic and patient-centered nursing care and adapt to the varieties from person to person. Schools or hospital managers should also set up courses or provide an environment to help students develop their comprehensive humanistic and cultural nursing care abilities in their future work.

Informatics competency refers to the knowledge, skills, and attitudes of BNSs in the future clinical work to obtain and utilize information to implement management, provide nursing care, conduct scientific research, and improve the progress of nursing care. The hereby obtained results were in line with those proposed by Nygårdh, et al. [ 18 ]. Given the pervasive integration of information technologies into the healthcare system [ 49 ], nurses, comprising the majority of the workforce in the health sector, require proficient nursing informatics skills [ 50 ]. Chinese nursing educators have developed the information literacy of students by setting up the section of information management in the Nursing Management textbook [ 37 ]. The item concerning “making correct decisions about relatively complex care issues based on the retrieval of relevant information” received the lowest score. This could be attributed to nursing students’ insufficient mastery of information retrieval skills and their ineffective utilization of health information [ 51 , 52 ]. Consequently, integrating nursing informatics, particularly for the retrieval of relevant nursing care information, into undergraduate nursing education can enhance nurses’ capability to leverage technology in addressing patients’ complex issues. This, in turn, empowers them to deliver high-quality nursing care.

Evidence-based practice (EBP) competency is defined as the knowledge, skills, and attitudes of BNSs in the future clinical work, which can effectively integrate the clinical opinions of the experts as well as the most effective empirical evidence in clinical nursing care. These findings were consistent with those of the study by Nygårdh, et al. [ 18 ], who proposed that it was vital to provide best care on the basis of evidence-based nursing practice. The ability of evidence-based nursing practice can help nursing students solve complicated clinical problems by using evidence instead of subjective judgment in their practice or future work [ 53 , 54 ]. However, the item regarding “describing the meaning of evidence-based nursing care” obtained the lowest score within this dimension. This could be attributed to EBP being a core course primarily for master’s degree nursing students, with less emphasis on undergraduate education [ 55 ]. The findings underscored by Adamakidou et al. [ 56 ] highlight the imperative of enhancing nurses’ competence in EBP through education, suggesting that introducing EBP education at the undergraduate level to raise awareness among nursing students is a foundational step. Therefore, nursing educators should impart sufficient knowledge of EBP to bachelor of nursing students and train them to apply EBP principles in resolving patients’ clinical issues.

The definition of continuous quality improvement competency is the knowledge, skills, and attitudes of BNSs in the future clinical work, who are required to be clear about the evaluation criteria and methods of nursing quality, use them to monitor the nursing process, and be able to perform improvement methods to continuously enhance the nursing care quality and safety. Cronenwett, et al. [ 7 ] and Nygårdh, et al. [ 18 ] also stated the same conclusion. This dimension exhibited the lowest average score among the six dimensions. Notably, the item addressing “describing continuous quality improvement methods such as Deming Circle, Root Cause Analysis, and Quality Control Circle” received the lowest rating within this dimension. This could be attributed to BNSs’ limited clinical experience [ 57 ]. Furthermore, the abstract nature of the content related to quality improvement methods might pose challenges for these students in comprehension and application [ 57 ]. Additionally, researches have consistently indicated that both students and newly graduated registered nurses tend to score lower on quality improvement compared to other QSEN competencies since the inception of QSEN in 2005 [ 14 , 58 ]. However, it is crucial to underscore that the advancement of patient safety hinges on the knowledge of quality improvement among clinical frontline staff [ 59 ]. Thus, it is necessary for nursing students to master the relevant concepts and measures of quality improvement, such as some nursing quality management methods designed in Chinese nursing management courses, including the plan-do-check-act (PDCA) cycle, root cause analysis (RCA), and clinical pathway (CP) [ 37 ]. Besides, cultivating the competency of continuous quality improvement enables nursing students to be aware of the importance of continuous quality improvement as part of their daily work, which may encourage them to get continuously involved in quality improving activities.

However, the present study is still exposed to some limitations. Firstly, this scale was only used to measure the competency of quality and safety regarding greenhand nurses with bachelor degree, and might be limited to assess other levels of greenhand nurses. Therefore, in the subsequent study, greenhand nurses with different educational levels, such as college, can be selected, and the scale can be revised according to their needs. Secondly, given that the participants in this study were not randomly selected, the generalization of this study might be affected.

CSQS is an effective and valid tool involving 64 items in 6 dimensions to measure the safety and quality competencies of greenhand nurses through CFA testing. Its internal consistency reliability is 0.98 and retest reliability is 0.89, indicating its applicability for the self-evaluation of graduated nursing students or greenhand nurses to find out their deficiencies. In light of the lower-scored items, nursing students can take proactive measures to enhance their safety and quality competencies. Additionally, nursing educators can utilize CSQS to evaluate BNSs, identifying areas of weakness. Subsequently, educators can refine teaching materials, methodologies, or even course curricula to bolster students’ quality and safety competencies. Moreover, hospital nursing managers can employ this tool to thoroughly assess the deficiencies of new nurses and ascertain their precise requirements for safety and quality knowledge. Subsequently, managers can leverage the assessment results as evidence to design targeted clinical safety and quality training programs.

Data availability

The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request.

Abbreviations

Confirmatory Factor Analysis

Exploratory Factor Analysis

United States of America

Competency Scale of Quality and Safety

Quality and Safety Education for Nurses

Quality and Safety Education for Nurses of student evaluation survey

International Nursing Council

Bachelor Nursing Students

Quality and Safety Self-Inventory

Quality and Safety Competencies

Consensus Level of Agreement

Item Content Validity Index

Content Validity Index of scale average

Item-to-Total Correlation

Internal Consistency Reliability

Standard Deviations

Root Mean Square Error of Approximation

Goodness of Fit Index

Adjusted Goodness of Fit Index

Standardized Root Mean Square Residual

Normed Fit Index

Patient-centered care

Collaboration and Teamwork

Evidence-based practice

Continuous quality improvement

Informatics

Plan-Do-Check-Act

Root Cause Analysis

Clinical Pathway

World Health Organization

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Zhai, R.N., Liu, Y. & Wen, J.X. Competency scale of quality and safety for greenhand nurses: instrument development and psychometric test. BMC Nurs 23 , 219 (2024). https://doi.org/10.1186/s12912-024-01873-5

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Literature Reviews for Nursing Students; Ways to Organize a Literature Review. CHRONOLOGICAL (by date): This is one of the most common ways, especially for topics that have been talked about for a long time and have changed over their history. Organize it in stages of how the topic has changed: the first definitions of it, then major time ...
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Literature Review. • Describes the existing body of knowledge by integrating and synthesizing the literature to create something new. o Topic: Blood Donation. Paragraph 1: Information/research findings on red blood cells pulled from multiple sources. Paragraph 2: Information/research findings on platelets pulled from multiple sources.
PDF Undertaking a literature review: A step-by-step approach
step-by-step approach to undertaking a review of the literature in order to facilitate student nurses' and novice reviewers' understanding. What is a Literature Review? A literature review is an objective and thorough summary and critical analysis of the relevant, available research and non-research literature on the topic being studied ...
Succeeding in Literature Reviews and Research Project Plans for Nursing
Now in it's fourth edition and thoroughly updated to ensure all content is mapped to the new 2018 NMC standards, this book is a practical and readable guide to undertaking a research project plan or a literature review for final year assessment. The book guides readers from start to finish, beginning with choosing a nursing topic and developing questions about it, then accessing and critically ...
PDF Literature Reviews for Education and Nursing Graduate Students
Literature Reviews for Education and Nursing Graduate Students is written for new graduate students and novice researchers just entering the work of their chosen discipline. It is meant to assist "students who can complete course assignments to scholars who can make a contribution to their respective fields." (Switzer & Perdue, 2011, p. 12).
Nursing Literature Reviews
Nursing Literature Reviews. The nursing literature reviews below were written by students to help you with your own studies. If you are looking for help with your nursing literature review then we offer a comprehensive writing service provided by fully qualified academics in your field of study. Literature Review Service.
Preface
Literature Reviews for Education and Nursing Graduate Students is written for new graduate students and novice researchers just entering the work of their chosen discipline. It is meant to assist "students who can complete course assignments to scholars who can make a contribution to their respective fields." (Switzer & Perdue, 2011, p. 12 ...
Succeeding in Literature Reviews and Research Project Plans for Nursing
This is a very clear and simple to read book. It addresses the different aspects of preparing and writing a literature review at the end of studies for nursing students. The different chapters are easy to read and gives the students a structured way to prepare for the literature review.
About
Literature Reviews for Education and Nursing Graduate Students is an open textbook designed for students in graduate-level nursing and education programs. Its intent is to recognize the significant role the literature review plays in the research process and to prepare students for the work that goes into writing one. Developed for new graduate ...
Literature Reviews for Education and Nursing Graduate Students
Book Description. Literature Reviews for Education and Nursing Graduate Students is an open textbook designed for students in graduate-level nursing and education programs. Its intent is to recognize the significant role the literature review plays in the research process and to prepare students for the work that goes into writing one ...
Literature review of the research on nursing students' professional
Influencing factors and mechanism. The development of self-concept is a dynamic process subject to the constraints of age and cognitive development. Nursing students' professional self-concept was dynamic. It undergoes constant change with an in-depth study of courses and the impact of the internship [ 61 ].
Improving clinical experiences for nursing students in nursing homes
The purpose of this integrative review of literature has been to describe strategies associated with effective clinical learning experiences for nursing students in RACF-SNs, including nursing homes. The review revealed that students are often reluctant to undertake clinical placements at these sites.
PDF Sample Literature Review For Nursing Students
Sample Literature Review For Nursing Students Short, R. (2008). Assessing pain. Nursing Older People, 20(4), 16-18. Retrieved from Academic Search Premier database. Purpose: The article urges nurses to make the national guideline, The Assessment of Pain in Older People, part of their personal practice and carry with them the simple tools to
Student nurse education and preparation for palliative care: A scoping
Literature review. 2000 to 2017 14 papers Themes generated. Multiple methods of education delivery have shown to increase nursing students' knowledge about EOL care, and a positive attitude can affect the care delivered at EOL. ... Nursing students benefit from receiving end-of-life care education in their prelicensure curriculum.
A.C. Buehler Library: DNP Nursing Resources: Welcome
Includes a link to information about your student email account. Blackboard Help. Types of Nursing Literature. Systematic Reviews. Also known as "meta-analysis", a systematic review identifies an intervention for a specific disease or other problem in health care, and determines whether or not this intervention works. ...
Full article: Literature review of the research on nursing students
Nursing students' professional self-concept was dynamic. It undergoes constant change with an in-depth study of courses and the impact of the internship [ 61 ]. It is also a longitudinal process of continuous understanding, adaptation, and internalisation. The development and change deserve attention.
The use of ultrasonography in education for undergraduate nursing
This study aimed to review and synthesize relevant literature on the use of ultrasonography in education for undergraduate nursing students. Methods. An electronic literature search was conducted in June 2022 (updated in June 2023) using MEDLINE, CINAHL, Scopus, and Ichushi-Web databases.
Experiences for Geriatric Care from Nursing Students ...
(1) Background: Studies have shown that clinical experience has an impact on how students perceive geriatric care. The vulnerability of older people particularly allows students to reflect on and evaluate their learning. In this context, communication between tutors and students is important to guiding a contextualized view of the complexity of clinical situations. The principal objective was ...
The use of ultrasonography in education for undergraduate nursing
This study aimed to review and synthesize relevant literature on the use of ultrasonography in education for undergraduate nursing students. Methods: An electronic literature search was conducted in June 2022 (updated in June 2023) using MEDLINE, CINAHL, Scopus, and Ichushi-Web databases. Two researchers independently screened/assessed the ...
Competency scale of quality and safety for greenhand nurses: instrument
Guaranteeing nursing service safety and quality is a prioritized issue in the healthcare setting worldwide. However, there still lacks a valid scale to measure the quality and safety competencies of newly graduated nurses globally. This scale was developed in two phases. In Phase One, a literature review and three-round e-Delphi were conducted to generate the initial item pool; while in Phase ...

Literature Reviews for Education and Nursing Graduate Students

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Book Title: Literature Reviews for Education and Nursing Graduate Students

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Student nurse education and preparation for palliative care: A scoping review

Associated Data

Identification of research question

What educational models are utilised within palliative care undergraduate student nurse education?

What gaps in the literature exist on preparation within palliative care undergraduate student nurse education?

Study selection

Mapping/plotting of data

Arranging, summarising and communicating the outcomes

Characteristics of the studies

What facilitators/barriers have been reported relating to the success/failures of the models of palliative care undergraduate student nurse education?

Limitations

Conclusions

Supporting information

Data Availability

DNP Nursing Resources: Welcome

Welcome to the DNP Nursing Resources Guide

Technology Assistance

Types of Nursing Literature

Empirical research articles

Evidence-Based Care Sheets and Evidence-Based Articles

Review articles

Clinical articles

The use of ultrasonography in education for undergraduate nursing students: A literature review

Publication types

Competency scale of quality and safety for greenhand nurses: instrument development and psychometric test

Conclusions

Research design and procedures

First Phase: CSQS items development

Second phase: CSQS psychometrical testing

Pre-testing CSQS

Testing factor structure and reliability of CSQS

Participants and settings

Data collection and ethical consideration

Statistical analysis

Characteristics of the participants

Psychological testing of CSQS

Pre-test CSQS

Construct validity and internal consistency reliability

Test-retest reliability

Data availability

Abbreviations

Acknowledgements

Author information

Contributions

Corresponding author

Ethics declarations

Consent for publication

Conflict of interest

Additional information

Electronic supplementary material

Supplementary Material 1

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