ZITTEL B., EZZEDDINE S.H., MAKATJANE M., GRAHAM I., LUANGAMORNLERT S. & PEMO T. (2011) Divergence and convergence in nursing and health care among six countries participating in ICN's 2010 Global Nursing Leadership Institute. International Nursing Review59, 48–54 In 2009 the International Council of Nursing (ICN) launched, with support from Pfizer External Medical Affairs, a Global Nursing Leadership Institute (GNLI) which was again repeated in the fall of 2010. The programme, provided in English, at a location near ICN headquarters in Geneva, Switzerland, provided the opportunity for senior and executive level nursing leaders throughout the world to acquire new knowledge and skills about national and global leadership within a supportive and stimulating learning environment. Once selected for participation, GNLI members are requested to complete a country profile – a two to three page précis providing information regarding health and nursing specific to their respective country encompassing the following: the country's health system and how it is funded; identification of current or proposed changes in the health system; national demographic data such as population, gross national income, average life expectancy, number of nurses and physicians, and the top three causes of deaths; and key issues facing the health system and nursing in the country. On arrival at the Institute, participants were divided into leadership development teams, small groups of six persons each, which met throughout the week to discuss the ways in which health challenges and nursing in their respective countries both converged and diverged. Shared insights learned are presented from one such 2010 GNLI team representing nursing leaders from the countries of Australia, Bhutan, Lebanon, Lesotho, Thailand and the USA. A comparative analysis of the health profiles of their respective countries is also provided.

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Transitioning to practice is challenging for baccalaureate nursing students. In baccalaureate nursing programs, the process typically begins in the junior year. A Successful transition depends on how well students apply their developing knowledge during clinical placements. A cross-sectional, multisite, qualitative study was conducted at four universities in Greater Beirut, Lebanon. In total, 35 junior baccalaureate students participated in audio-recorded focus group discussions. Thematic analysis was used to analyze the data. Three themes were sufficient to summarize the students experiences: “being unprepared,” “learning unexpected lessons,” and “taking responsibility.” Three subthemes, revising expectations, discovering divergence, and self-monitoring, were used to clarify the unexpected lessons students learned during clinical placements and how students responded. “Loving nursing and protecting yourself,” making the most of every day, and doubting future readiness were subthemes within the “taking responsibility” theme. Students troubled by nursing practices that diverged from their expectations monitored themselves to avoid falling into poor practices and kept track of the nursing procedures they performed. Only by taking responsibility for their learning, could students develop the competencies they will need as registered nurses. Faculty, clinical instructors, hospital administrators, nurse managers, and registered nurses need to do more to support students to take control of their learning.

Aims: Recovery of the antecedents and assumptions of Goffman's frame analysis to illustrate learning contexts in baccalaureate nursing programs. Design: A discussion paper on the secondary analysis of focus group data. Data Sources: Focus group data collected in a multi-site study conducted in 2017 to understand the challenges of transitioning to practice in Lebanon. The discussion is illustrated with empirical data, but the article is a conceptual paper not a research report. Implications for Nursing: Transition to practice research requires studies of interaction in university schools of nursing to examine the meanings embedded in classroom instruction. Methods: Clarification and use of Goffman's concepts of primary frame, mainframe (storyline), keying, and re-keying to describe how differences in learning contexts make the transition to practice difficult. Conclusion: Baccalaureate nursing education consists in re-keying the knowledge students bring with them to university into an idealized conception of nursing practice. This storyline dominates classroom learning and is re-keyed into the pragmatic approach to nursing practice that dominates learning contexts in clinical units. Students respond to discrepancies between the meanings embedded in classroom and clinical unit learning contexts by striving to apply the classroom storyline or delaying their commitment to a nursing career. Impact: The discussion explains how secondary analysis can overcome some of the limitations of inducive thematic analysis. It promotes frame analysis as an intuitive, conceptually sound method for identifying dominant meanings in baccalaureate nursing education. Qualitative researchers who have used inductive thematic analysis can use frame analysis to complement their previous analyses with a structural sociological perspective. We suggest dimensions to help investigators interpret learning contexts. Frame analysis of classroom interaction will bring new insights to transition to practice research. | 3205 CLINTON eT aL.

We investigated the challenges final-year nursing students (FYNSs) and first-year registered nurses (FYRNs) face as they transition to nursing practice in Lebanon. Our purpose was to understand the challenges of transition from the perspective of FYNS and FYRNs. We conducted focus group discussions with FYNSs and FYRNs recruited from four leading universities. Thematic analysis identified an unexpected paradox that has implications for quality of nursing care and retention of graduates. While humanoids are marketed to communicate empathically with patients, FYNSs in Lebanon struggle to resist becoming robots.