BackgroundNursing education necessitates vigilance for clinical safety, a daunting challenge given the complex interchanges between students, patients and educators. As active learners, students offer a subjective understanding concerning safety in the practice milieu that merits further study. This study describes the viewpoints of senior undergraduate nursing students about compromised safety in the clinical learning environment.MethodsQ methodology was used to systematically elicit multiple viewpoints about unsafe clinical learning from the perspective of senior students enrolled in a baccalaureate nursing program offered at multiple sites in Ontario, Canada. Across two program sites, 59 fourth year students sorted 43 theoretical statement cards, descriptive of unsafe clinical practice. Q-analysis identified similarities and differences among participant viewpoints yielding discrete and consensus perspectives.ResultsA total of six discrete viewpoints and two consensus perspectives were identified. The discrete viewpoints at one site were Endorsement of Uncritical Knowledge Transfer, Non-student Centered Program and Overt Patterns of Unsatisfactory Clinical Performance. In addition, a consensus perspective, labelled Contravening Practices was identified as responsible for compromised clinical safety at this site. At the other site, the discrete viewpoints were Premature and Inappropriate Clinical Progression, Non-patient Centered Practice and Negating Purposeful Interactions for Experiential Learning. There was consensus that Eroding Conventions compromised clinical safety from the perspective of students at this second site.ConclusionsSenior nursing students perceive that deficits in knowledge, patient-centered practice, professional morality and authenticity threaten safety in the clinical learning environment. In an effort to eradicate compromised safety associated with learning in the clinical milieu, students and educators must embody the ontological, epistemological and praxis fundamentals of nursing.

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Cardiovascular diseases, which include coronary heart diseases (CHD), remain the leading cause of death in Canada and other industrialized countries. This qualitative study used photo-elicitation, focus groups and in-depth interviews to understand health behaviour change from the perspectives of 38 people who were aware of their high risk for CHD and had received information about cardiovascular risk modification while participating in a larger intervention study. Participants were drawn from two selected regions: Sudbury and District (northern Ontario) and the Greater Toronto Area (southern Ontario). Analysis drew on concepts of place and space to capture the complex interplay between geographic location, sociodemographic position, and people’s efforts to understand and modify their risk for CHD. Three major sites of difference and ambiguity emerged: 1) place and access to health resources; 2) time and food culture; and 3) itineraries or travels through multiple locations. All participants reported difficulties in learning and adhering to new lifestyle patterns, but access to supportive health resources was different in the two regions. Even within regions, subgroups experienced different patterns of constraint and advantage. In each region, “fast” food and traditional foods were entrenched within different temporal and social meanings. Finally, different and shifting strategies for risk modification were required at various points during daily and seasonal travels through neighbourhoods, to workplaces, or on vacation. Thus health education for CHD risk modification should be place-specific and tailored to the needs and resources of specific communities.

Q-methodology is an alternate way of measuring the subjective views of individuals in a variety of settings such as clinical practice, research and educational institutions. Q-sorts may be used for research and/or classroom activities because the activity can promote discussion related to the content of a class. If using an activity like this one, educators and researchers need to be mindful of potential barriers to sorting in order to minimise them and maximise the potential of the activity.

Background: Evidence suggests that gamification increases student engagement in course activities. However, student feedback about gamification in nursing contexts is needed. Purpose: The aim of this study was to describe nursing student perceptions of how gamification impacts student motivation and engagement. Methods: A convergent mixed-methods study was conducted. Surveys were completed by 58 first-year nursing students. Survey comments and data extracted from the learning management system were also collected. Results: Students generally found gamification valuable, interesting, and enjoyable. Gamification took effort and was perceived as important. Students felt that they had some choice in participation in the gamified activities. Conclusions: Gamification is a viable strategy for promoting motivation and engagement among first year nursing students. More qualitative research is needed to enable game design refinement through investigation of contextualized student experiences. Refined game design may impact the development of learner skills through a moderating effect on engagement in course activities.