Scholarship – Exposing Undergraduate Nursing Students to Older Adults: A Qualitative Analysis

This episode of the NLN Nursing EDge Unscripted Scholarship track features guest Christine Pariseault. Learn more about her work, “Exposing Undergraduate Nursing Students to Older Adults: A Qualitative Analysis.”

Pariseault, Christine A.; Whitehouse, Christina R.; O’Connor, Melissa. Exposing Undergraduate Nursing Students to Older Adults: A Qualitative Analysis. Nursing Education Perspectives 45(3):p 169-171, 5/6 2024. | DOI: 10.1097/01.NEP.0000000000001157

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[Music] Welcome to this episode of NLN podcast Nursing EDge Unscripted the Scholarship  track. I'm your host, Dr. Steven Palazzo, a member of the editorial board for Nursing  Education Perspectives. Nursing EDge Unscripted and our track entitled Scholarship celebrates the  published work of select nurse Educators from the NLN's official journal Nursing Education  Perspectives and the NLN Nursing EDge blog. The conversations embrace the author's unique  perspectives on teaching and learning innovations and the implications for nursing program  development and enhancement. In this episode we will discuss how early exposure to geriatric care  concepts improves students perceptions of older adults. The article we will be discussing is  titled, Exposing Undergraduate Nursing Students to Older Adults: A Qualitative Analysis." The  article can be found in the May-June issue of Nursing Education Perspectives. The author of  the article is joining us for today's discussion. Dr. Christine Pariseault is an assistant professor  at the Widener University School of Nursing in Chester, Pennsylvania. Dr. Pariseault,  welcome! Thank you. I'm so pleased to be here with you today. Well, we're happy to have you  here to discuss your article. So tell us a little bit about what got you interested in this topic  and how this research came about. I've been really interested in older adults and older adult health  care and I had the opportunity to take clinical students to an older adult experience in a prior  position that I had held. We decided to do a pilot study of students in their sophomore year  going to a monastery, which was on the campus where I was working and having them involved in  the daily care of the friars there. This was done at the end of a four-day practicum that they had in  hospitals or nursing facilities and then they came to me and did this one-day practicum with  the friars in the monastery. It was really to get them to see older adults, see how they  interact, see their daily life and the research article dealt with it their students...  really their responses and what they were feeling from this experience and what they got out of  it and they compared going in and coming out and how they felt about interacting with older adults.  Great. Well it leads me to my first question so geriatrics tends to be the least popular  clinical rotation for students. It's not unique to where I'm at or where you're at. It's pretty consistent. It typically occurs in the student's first semester of the nursing program  and do you think there maybe is a better place to put geriatric exposure to maybe get students a  little bit more interested in the topic? I wouldn't say there's a better place. I think it has to be throughout. I think where it's placed early in curriculum is a good place because a lot of students have had some interactions with older adults. They have grandparents, they have parents, they have that base from their life, but I think it can't just live in the early days  of nursing curriculum. It has to be integrated throughout. When I say that I mean throughout  all of the med-surgs, throughout mental health nursing, community nursing, leadership  and nursing, and how health policy works with older adults. I think it has to be introduced and grown  all the way through the curriculum. There's just not one place for it to live. It is hard in the  beginning because I do think students will be like, I don't know if I like it or not. Some will be like,  wow, I really like it but that little snippet in the beginning really is just to get them in, get  them seeing it, and then work with them through the whole curriculum. I guess the question too is how to engage the faculty in the curriculum in a way that you develop intentional exposure,  intentional practice with geriatric population because they tend to go right from that first  exposure, very limited exposure usually in the first semester and then into their med-surg  and their specialty tracks and kind of even if they had like a little exposure to it that  first semester they don't typically see it again throughout the entire program and they get to the  end of the program and it's very difficult to get any excitement generated about them doing a  practicum in the geriatric setting. Right. That's a great point and with all of the mapping that we're doing to the AACN Essentials, I think faculty could really embrace this in that element and  map their courses with key things that carry the older adult care through. So I think as we as all  faculty are spending countless hours looking at our curriculum and mapping them out in our  syllabi and linking courses together that would be a great thing to put in. It could be an unfolding case  study. I think that's kind of a great doorway for faculty to really take a good look. You make a great point there. In our new curriculum, which starts this Fall, we've integrated geriatric  concepts throughout the curriculum in all areas of the curriculum and we are talking about  building in a case study like that throughout the curriculum, a standardized patient or a a simulated  patient that we can take through the entire program. So that leads us to the next question.  What strategies do you suggest to better engage students in geriatric care concepts? Oh, I think there's a lot of strategies. First, I would talk about research. I have had the  honor of being the honors program director for a few years at Widener University and it was  really good to teach students research and if we could get students involved in older adult  research I think that would be a great place to kind of connect some students. I say that, but  I also want to say I think within our nursing faculties we need to know who our older adult  specially people are on our faculty and really use them and tap into them just like we have our  peds people and we tap into them. I think we need to know who our older adult people are  and really tap into them, get these students looking at research topics that they can pull  into this faculty you know whether it's in their evidence-based practice course or a nursing  research course, I think that's a great place to start that scholarship going. Other places like  innovative type things, vSim is good that we've been using or the virtual reality. You know, the can't the name of it but the virtual reality and kind of giving them an older adult patient or  letting them see what it's like to be an older adult. I know when Covid hit we tried to do some of  that really creative stuff online with blurry screens and things so that they could see what  it's like to be visually impaired but I think virtual reality could be a really great way  to keep that engagement with students and older adults throughout. When they get to pop  

health, community involvement in older adult areas: 7:20

senior centers, churches, wherever the older adult  community is. The research that we're talking about today really showed the students fellowship  among the friars that we were dealing with, whether it was at a time of saying mass or it was  a time of lunch and breakfast where they all kind of came together and talked so getting  students to see seniors interacting with each other rather than just isolated med-surg rooms  would be good. Every curriculum is different but a lot of curriculums might have a specialized  senior elective. I know we do where seniors can choose an elective. I would love to see an older  adult elective that gets the students out there and working with older adults and letting  them see the reward of working with older adults so that it kind of keeps their interest going. I  think if they could see the reward of it and get those moments of collaboration with them, hear the  wisdom from our our older population and their take on the world, that's what I heard a lot  of when I took this pilot study group out. I think we just need to bring that to more  students. They were really enthralled with the wisdom that the friars told them from their life. Do you think they see a lack of opportunity for career pathways or employment  in the geriatric care kind of setting? I know we've talked about that before with some of my students  here and their concern really was - we don't see ourselves really in the role, we're not exposed  to any roles, and the roles we see are typically the the RN that's kind of behind the scenes.  You may have one or two RNs in a care facility. The majority of the RNs or maybe LPNs and CNAs  working so they have a hard time imagining what that role for the RN would look like and still  providing active interaction and care to the the clients that they're serving. Can you speak to that  at all or have any experience with that? I think that's a great point. They do tend to only  see this little tiny snippet of an RN maybe in a skilled nursing facility and they call that their  geriatric experience and they're not seeing you know nurse practitioners finely trained in  older adults, especially those really older adults. I don't think they're seeing a lot of that. I did  actually have one student of mine recently come to me who took a position on an older adult floor  in a Philadelphia city hospital and I was really excited about that opportunity for that population. Unfortunately I think it just gets blended into every other med-surg or every room and they  

just look at their assignments: 9:59

I have a, you know, such and such age patient, but I think we do need a  little bit more mentoring and role modeling of people who are experts in the field. Right. Well, just talk briefly about your findings. You talked about the students had some areas  of concepts they looked at like acceptance, age related changes, desire for independence, importance  of social networks, and enhanced perceptions of geriatric and gerontology in general. So if you  can just briefly ... what were the findings you had in those areas? My favorite was the social networking that they really just took off on the students. That was one of the first things they told me was how the friars interacted with each other at the dinner table, we brought them downstairs for a mass where they celebrated together, at the different events  throughout the day, that they really felt the social interaction was key with them knowing  each other and that was their first big takeaway. I think it was really valuable  for them to see older adults interacting because they're so used to their college interacting so  that was a big one. A lot of students felt very moved by the older adult telling them this is  how I adapted. I might not be able to walk down the hall by myself but I'm allowed to roll down  the hall by myself or I use this device and it keeps me still going. Or I have the  paper, they were sharing the newspaper a lot so they were very moved by the resilience the older  adult to adapt to their physical changing bodies and I think it really opened a lot of their  eyes to see like, oh, this is how the human keeps adapting. Right. They really, really liked that  and they just came to me, a couple of them, they're like, wow. I really thought I wanted to be a labor  and delivery nurse. I didn't realize that this was such a satisfying place to be with their  older adults. They were like -  this is great. They know each other. They were so  happy to be with us. There's so much to share, so it was really a very big awakening for many of them  and I hope that they carried that through their curriculum. I never did get to follow up like,  hey, where you going now the end of the curriculum because Covid kind of hit us, but I think it just  really kind of opened a lot of eyes for them to say this is something I really might want to look at. What future work do you have in your plans for this area? I would like to bring it to more collaboration and work in our curriculum. I teach advanced med-surg so  in that curriculum I like to have discussions about the concepts like what does sepsis look  like in a med-surg way and then I like to bring it into our older adults  or different safety needs. I'm working it in my curriculum. I teach a lot of patient safety,  which is a great place to put it, so I like to build that into my scenarios and case studies and as I'm mapping my courses personally I'm definitely putting it more into the interactive classroom experiences. That's great. Well, Dr. Pariseault, thank you so much for joining us for this interesting and insightful discussion today. I really appreciate your time and expertise  and broadening our understanding of this topic. And to our listeners, if you haven't have opportunity  yet, please take a look at Dr. Pariseault and colleagues article, "Exposing Undergraduate  

Nursing Students to Older Adults: 13:19

A Qualitative Analysis," and again, it can be found in the  May-June issue of Nursing Education Perspectives. Thank you so much again for joining us. Thank you.[Music]