Shauna Haynes PhD, RN, Michelle Van Der Wege DNP, APRN, FNP-C
{"title":"Exam retakes in nursing education: Challenges, opportunities, and implications for student success","authors":"Shauna Haynes PhD, RN, Michelle Van Der Wege DNP, APRN, FNP-C","doi":"10.1016/j.teln.2026.06.026","DOIUrl":"10.1016/j.teln.2026.06.026","url":null,"abstract":"<div><h3>Background</h3><div>Exam retakes are a debated strategy in nursing education, where assessment practices must support student learning while maintaining rigor to ensure patient safety. This research article discusses students’ perceptions of permitting retakes in nursing courses and student outcomes in a medical-surgical nursing class.</div></div><div><h3>Methods</h3><div>Students were allowed to retake one module exam for the medical-surgical nursing course. At the end of the semester, students were given an anonymous five-question survey regarding their perceptions of this opportunity. Qualitative data was analyzed to determine common themes. Additionally, faculty retrospectively reviewed course grades to determine the impact of this policy on final grades.</div></div><div><h3>Results</h3><div>The majority of students chose to retake the exam, citing a desire for increased knowledge or improved grades as their primary motivation. Most students showed improved scores on the remediation exam. Students further report decreased anxiety related to testing and improved study methods.</div></div><div><h3>Conclusions</h3><div>Potential advantages include improved knowledge retention, enhanced confidence, reduced test anxiety, and increased persistence for students at risk of attrition. Potential disadvantages include grade inflation and increased faculty workload.</div></div>","PeriodicalId":46287,"journal":{"name":"Teaching and Learning in Nursing","volume":"21 4","pages":"Pages e1660-e1665"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Usability of augmented reality for clinical decision-making: A qualitative study in a nursing baccalaureate program","authors":"Bettina Flaiz RN, Sabine Münzenmay RN, MA, Margrit Ebinger MPH","doi":"10.1016/j.teln.2026.07.002","DOIUrl":"10.1016/j.teln.2026.07.002","url":null,"abstract":"<div><h3>Background</h3><div>Augmented reality (AR) provides immersive learning experiences in nursing education, yet evidence on its effectiveness for advanced students’ clinical skill development is limited.</div></div><div><h3>Aim</h3><div>This study explored third-year nursing students’ experiences using AR (HoloLens with HoloPatient) for patient case simulations in a clinical decision-making seminar.</div></div><div><h3>Methods</h3><div>A qualitative explorative design was employed. Four focus groups with 58 third-year students were conducted. Data were analyzed using thematic analysis (Braun & Clarke) to identify experiences and perceptions related to AR use.</div></div><div><h3>Results</h3><div>Students reported initial fascination and increased motivation. AR offered a safe, low-stress environment that supported observation and clinical decision-making. However, technical barriers, including software delays and limited usability, along with the absence of interactive and multisensory features, constrained realism and hindered the practice of essential professional skills.</div></div><div><h3>Conclusion</h3><div>AR shows promise as an engaging tool for nursing education, particularly for clinical decision-making. Nevertheless, limitations in interactivity and technical functionality restrict its full educational potential. Enhancing AR interactivity and developing pedagogically grounded integration frameworks are recommended for future use.</div></div>","PeriodicalId":46287,"journal":{"name":"Teaching and Learning in Nursing","volume":"21 4","pages":"Pages e1666-e1670"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stephen McNally, Diana Jefferies, Lucie Ramjan, Aileen Pamonag Lane, Paul Glew, Wenpeng You
{"title":"Building empathy and competence in suicide risk assessment: nursing students’ debriefing experiences from an arts-based simulation program","authors":"Stephen McNally, Diana Jefferies, Lucie Ramjan, Aileen Pamonag Lane, Paul Glew, Wenpeng You","doi":"10.1016/j.teln.2026.05.005","DOIUrl":"10.1016/j.teln.2026.05.005","url":null,"abstract":"<div><h3>Background</h3><div>This study evaluates how reflective debriefing prepares nursing students for complex clinical scenarios while fostering empathy and resilient care.</div></div><div><h3>Aim</h3><div>To explore students’ debriefing experiences and examine variations based on demographic characteristics.</div></div><div><h3>Methods</h3><div>This cross-sectional study involved second-year nursing students completing a questionnaire that incorporated the Debriefing Experience Scale. Analysis utilized exploratory factor analysis and logistic regression.</div></div><div><h3>Results</h3><div>Analysis identified two primary factors: Facilitator Support and Learning Guidance, and Emotional Processing and Environment. Logistic regression revealed significant associations between student backgrounds, specifically gender and country of birth and their experiences with learning and emotional processing. Sufficient debriefing time and facilitator communication were also strongly linked to demographic backgrounds.</div></div><div><h3>Conclusions</h3><div>Arts-based simulation combined with structured debriefing effectively improved learning for suicide risk assessment. Integrating reflective debriefing into nursing curricula is a powerful strategy for preparing students for complex scenarios while fostering empathy.</div></div>","PeriodicalId":46287,"journal":{"name":"Teaching and Learning in Nursing","volume":"21 4","pages":"Pages e1527-e1532"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mental health experiences of rural allied health and nursing students: A qualitative-dominant mixed-methods study","authors":"Karey Lyn Maciha EdD, MPH, NREMT","doi":"10.1016/j.teln.2026.05.011","DOIUrl":"10.1016/j.teln.2026.05.011","url":null,"abstract":"<div><h3>Background</h3><div>Mental health challenges among students in health professions education have been widely documented, with rural students facing unique barriers such as isolation, stigma, and limited access to resources. Despite the growing need for healthcare providers in rural regions, the connection between rural living and student well-being has remained underexplored.</div></div><div><h3>Methods</h3><div>A qualitative, subjectivist-inductive design was used to examine the experiences of allied health and nursing students at a rural community college in Southeast New Mexico. Data were collected through an anonymous online survey and analyzed thematically using Intellectus software following Braun and Clarke’s framework.</div></div><div><h3>Results</h3><div>Thirty-four students participated, representing diverse backgrounds and educational levels. In analyzing their responses, 5 themes emerged: (1) persistent academic pressure; (2) limited access and structural barriers; (3) stigma and reluctance to seek help; (4) reliance on adaptive coping and peer support; and (5) desire for institutional and community support.</div></div><div><h3>Conclusions</h3><div>Findings underscore the need for targeted support within rural community colleges. Embedding stigma reduction, resilience training, and responsive faculty engagement into curricula may enhance student well-being and workforce sustainability.</div></div>","PeriodicalId":46287,"journal":{"name":"Teaching and Learning in Nursing","volume":"21 4","pages":"Pages e1539-e1542"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Experiences of first-year nursing students using community volunteers as simulated participants for teaching safe medication administration: A cross-sectional survey","authors":"Hugh Davies PhD, MHM, PG Dip (Intensive Care), GradCert Academic Practice, GradCert Clinical Simulation, B Nurs, RN, Lea Aboo PhD Candidate, MClinNursEd, PostGradDip(Psychology), RN, Kristi Nicholls MSc (Adv. Clin. Practice & Nursing Ed), GradCert Nursing Practice (Oncology), BSc (Nursing), RN, Martina Costello PhD, MSN (Clinical Nursing), PG (Clinical Nursing), GradCert Academic Practice, RN, Carol Crevacore PhD, MHPed, GCTT, BN, RN","doi":"10.1016/j.teln.2026.05.007","DOIUrl":"10.1016/j.teln.2026.05.007","url":null,"abstract":"<div><h3>Aims</h3><div>To explore responses of first-year nursing students to simulated participant methodology and the level of difficulty playing the role of patient experienced by community volunteers.</div></div><div><h3>Background</h3><div>Absence of therapeutic relationships between nurse and patient threatens medication safety. Simulation-based learning provides a safe environment for students to practice medication administration.</div></div><div><h3>Design</h3><div>Cross-sectional survey incorporating Mezirow’s transformative learning theory.</div></div><div><h3>Methods</h3><div>First-year Bachelor of Science Nursing students participated in a simulated medication administration scenario supported by volunteers playing the role of patients. A Likert and open-ended post-simulation questionnaire measured students’ perceptions of realism in the performance of simulated participant volunteers. Simulated participant volunteers were surveyed on the level of difficulty they experienced.</div></div><div><h3>Results</h3><div>One hundred and ten students and 9 simulated participant community volunteers completed the questionnaire. Participants rated the activity positively. Students were able to contextualize the importance of effective communication. Playing the role of patient was not considered hard, but some community volunteers felt uncomfortable providing student feedback.</div></div><div><h3>Conclusion</h3><div>Use of community volunteers provided a realistic clinical skills activity for students to practice medication administration.</div></div>","PeriodicalId":46287,"journal":{"name":"Teaching and Learning in Nursing","volume":"21 4","pages":"Pages e1533-e1538"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nora Hernandez-Pupo PhD, RN, COI, TNCC, Sherrilyn Coffman PhD, RN, CNE, COI, June Eastridge EdD, MSN, RN, CNE, COI
{"title":"Embedding growth mindset principles to strengthen remediation in nursing programs","authors":"Nora Hernandez-Pupo PhD, RN, COI, TNCC, Sherrilyn Coffman PhD, RN, CNE, COI, June Eastridge EdD, MSN, RN, CNE, COI","doi":"10.1016/j.teln.2026.07.001","DOIUrl":"10.1016/j.teln.2026.07.001","url":null,"abstract":"<div><h3>Background</h3><div>Remediation in nursing education is often reserved for students identified as academically at risk and is frequently implemented after significant performance deficits emerge. Stigma, fear of failure, and diminished self‑efficacy may further discourage students from engaging in support. This article reframes remediation through a growth‑mindset lens and advocates for its proactive integration before academic decline occurs.</div></div><div><h3>Innovation</h3><div>This educational innovation describes three teaching-learning approaches implemented in a Bachelor of Science in Nursing program in the southwestern United States: collaborative testing, writing‑based remediation, and NCLEX‑RN remediation. These approaches integrate growth‑mindset principles into routine coursework by promoting reflection, identifying knowledge gaps, fostering metacognitive awareness, and encouraging active engagement in learning. In this model, remediation is redefined as helping students learn what they do not yet know.</div></div><div><h3>Implications</h3><div>Integrating remediation into routine coursework may normalize continuous learning, reduce stigma, and strengthen resilience, clinical reasoning, and self-directed learning.</div></div><div><h3>Conclusions</h3><div>A growth‑mindset approach may transform remediation from a deficit‑based intervention into a proactive strategy that supports student success, retention, and NCLEX‑RN preparation. Further research is needed to evaluate its impact on educational outcomes.</div></div>","PeriodicalId":46287,"journal":{"name":"Teaching and Learning in Nursing","volume":"21 4","pages":"Pages e1500-e1506"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chen Dong MSN, RN, Zhu Chongkuan BSN, RN, Wang Lei MSN, RN, Zhang Yuhuan MSN, RN, Pan Yanyan MSN, RN, Lian Ailing MSN, RN
{"title":"The mediating role of critical thinking between cognitive flexibility and patient safety competency in intern nursing students","authors":"Chen Dong MSN, RN, Zhu Chongkuan BSN, RN, Wang Lei MSN, RN, Zhang Yuhuan MSN, RN, Pan Yanyan MSN, RN, Lian Ailing MSN, RN","doi":"10.1016/j.teln.2026.07.004","DOIUrl":"10.1016/j.teln.2026.07.004","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive flexibility is associated with patient safety competency of intern nursing students, just as critical thinking may play a role in patient safety competency. But the relationship between the 3 is unclear.</div></div><div><h3>Methods</h3><div>Cognitive flexibility, critical thinking, and patient safety competency scales were tested on 495 intern nursing students using a cross-sectional study. The structural equation model was used to test the intermediate hypothesis.</div></div><div><h3>Results</h3><div>The scores of cognitive flexibility, critical thinking, and patient safety competency were (66.35±3.63), (213.65±7.04), and (155.60±6.13), respectively. The structural equation model showed that critical thinking played a partial mediating role in the relationship between cognitive flexibility and patient safety competency of intern nursing students, and the mediating effect value was 0.171, accounting for 47.37% of the total effect.</div></div><div><h3>Conclusion</h3><div>It is recommended to develop targeted intervention strategies to enhance the patient safety competency of intern nursing students, with particular attention to improving cognitive flexibility and critical thinking.</div></div>","PeriodicalId":46287,"journal":{"name":"Teaching and Learning in Nursing","volume":"21 4","pages":"Pages e1677-e1682"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prelicensure nursing students’ experiences of an opioid overdose simulation","authors":"Galen Ziegler MS, RN, Amanda Girardi PhD, RN, Sharon Curran MS, RN, Briana Snyder PhD, RN","doi":"10.1016/j.teln.2026.05.021","DOIUrl":"10.1016/j.teln.2026.05.021","url":null,"abstract":"<div><h3>Background</h3><div>The United States is experiencing an epidemic of opioid overdose deaths. Opioid overdose has become a leading cause of injury mortality. There remains a lack of information regarding effective strategies to prepare prelicensure nursing students for critical situations with this patient population.</div></div><div><h3>Method</h3><div>This research study aimed to describe the experiences of prelicensure nursing students in a high-fidelity simulated opioid overdose scenario. A descriptive, multisite study was conducted with 77 prelicensure nursing students. One group of Associate-Degree Nursing students (n = 47) completed the simulation with a manikin, while the other group of baccalaureate nursing students (n = 30) completed their simulation with a standardized patient. Postsimulation survey data were analyzed using descriptive statistics and thematic analysis.</div></div><div><h3>Results</h3><div>All students perceived the simulation as highly valuable. Quantitative findings indicated consistently high postsimulation perceptions of competence and confidence. Qualitative themes highlighted the perceived value of applying clinical knowledge, enhancing therapeutic communication skills, and increasing competence in managing crises.</div></div><div><h3>Conclusion</h3><div>High-fidelity simulation is a well-received and valued pedagogical approach for improving prelicensure nursing students' preparedness for managing opioid overdose events. Integrating robust, evidence-based simulation training into nursing curricula is a vital step in equipping future nurses with the necessary skills for this healthcare crisis.</div></div>","PeriodicalId":46287,"journal":{"name":"Teaching and Learning in Nursing","volume":"21 4","pages":"Pages e1571-e1574"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Service-learning with women’s narratives in nursing education: A mixed-methods study on learning about obstetric violence","authors":"Desirée Mena-Tudela, Ainoa Biurrun-Garrido","doi":"10.1016/j.teln.2026.07.029","DOIUrl":"10.1016/j.teln.2026.07.029","url":null,"abstract":"<div><h3>Background</h3><div>Nursing education often lacks structured approaches to address obstetric violence (OV), an institutional form of mistreatment undermining women’s autonomy, informed consent, and dignity.</div></div><div><h3>Purpose</h3><div>To explore how a narrative-based service-learning intervention supports nursing students’ understanding of OV and the development of ethical and gender-sensitive competencies.</div></div><div><h3>Methods</h3><div>A mixed-methods cross-sectional exploratory study was conducted with undergraduate nursing students (n = 42). The intervention consisted of a narrative-based service-learning session incorporating women’s lived experiences. Baseline data were collected using ad hoc items and the PercOV-S scale, and qualitative data were analyzed through inductive thematic analysis.</div></div><div><h3>Results</h3><div>Students showed strong conceptual understanding of OV, particularly regarding rights, autonomy, and informed consent. However, recognition of routine, protocolized practices as potentially harmful was more variable. OV was mainly defined as a violation of rights and associated with dehumanized care. Recommendations focused on informed consent, respectful communication, continuity of care, education, and women’s empowerment.</div></div><div><h3>Conclusions</h3><div>Service-learning with women’s narratives promotes critical reflection and ethical, gender-sensitive learning, highlighting its potential as a pedagogical strategy to address hidden dimensions of obstetric violence in undergraduate nursing education.</div></div>","PeriodicalId":46287,"journal":{"name":"Teaching and Learning in Nursing","volume":"21 4","pages":"Pages e1748-e1754"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Supporting nursing students for whom English is an additional language in undergraduate nursing education: An integrative review","authors":"Bianca Doczi","doi":"10.1016/j.teln.2026.07.033","DOIUrl":"10.1016/j.teln.2026.07.033","url":null,"abstract":"<div><h3>Objectives</h3><div>To synthesize current literature examining strategies that support students for whom English is an additional language (EAL) in undergraduate nursing education.</div></div><div><h3>Design</h3><div>Integrative review.</div></div><div><h3>Data sources</h3><div>CINAHL, PubMed, ERIC, Scopus, and Google Scholar were searched for studies published between 2016 and 2025.</div></div><div><h3>Review methods</h3><div>Studies were included if they examined EAL students in nursing or higher education and described instructional or supportive strategies applicable to nursing education. Twenty-four studies met inclusion criteria and were synthesized using thematic analysis.</div></div><div><h3>Results</h3><div>Four themes emerged: linguistically responsive teaching strategies, linguistically accessible assessment, inclusive learning environments and affective support, and peer support and leadership opportunities. Multimodal instruction, active learning, linguistically modified assessment items, supportive faculty relationships, and structured peer mentoring were associated with improved comprehension, engagement, and persistence among EAL learners.</div></div><div><h3>Conclusions</h3><div>Supporting EAL nursing students requires coordinated strategies addressing linguistic, academic, and psychosocial dimensions of learning. Implementing linguistically responsive teaching and inclusive learning environments may improve educational outcomes and help prepare a diverse nursing workforce.</div></div>","PeriodicalId":46287,"journal":{"name":"Teaching and Learning in Nursing","volume":"21 4","pages":"Pages e1857-e1867"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}