EC Pulmonology and Respiratory Medicine

Background: The incidence of respiratory disease is increasing; all nurses will care for respiratory patients during their career. There is disparity in the teaching of pre-registration respiratory nursing education. In the UK, revised Nursing and Midwifery Council educational standards provided the opportunity to review provision of UK respiratory nursing education.

This study was conducted to assess and make educational recommendations on the teaching, learning and student nurses’ confidence to apply respiratory nursing skills in clinical practice at the point of qualifying (registration).

Method: A cross-sectional survey design. The survey was distributed to final year pre-registration nursing students in the UK via social media over a 10-week period (summer 2021), with 152 student responses across 29 Universities. Where available on social media, nursing departments in UK universities were contacted by one of the authors [NJR] to aid dissemination.

Results: Less than half of the students felt completely/fairly confident about their knowledge and understanding of respiratory anatomy and physiology (46.1%), respiratory pathophysiology (32.2%). Line of argument synthesis constructed four themes, around student confidence, aligning the quantitative and qualitative data:

• Disparity in teaching methods, application, and position in the programme,
• Positive respiratory learning experiences in clinical practice,
• Insufficient time and narrow disease scope of respiratory education,
• Application of personal learning experiences of respiratory illness.

Conclusion: We report lower levels of student confidence in key respiratory knowledge and skills, with disparity in UK HEI teaching.

 Keywords: Respiratory Nursing; Pre-Registration Nursing; Education in Practice; Curriculum Design

1. Cho SJ and Stout-Delgado HW. “Aging and lung disease”. Annual Review of Physiology 82 (2020): 433-459.
2. Momtazmanesh Sara., et al. “Global burden of chronic respiratory diseases and risk factors, 1990-2019: an update from the Global Burden of Disease Study 2019”. eClinicalMedicine 59 (2023): 101936.
3. World Health Organisation. “Top 10 causes of death” (2021).
4. Zhou W., et al. “Adaptations for aging at home in the UK: An evaluation of current practice”. Journal of Aging and Social Policy6 (2020): 572-589.
5. Miller NA., et al. “Disparities in access to health care among middle-aged and older adults with disabilities”. Journal of Aging and Social Policy4 (2014): 324-346.
6. NHS long term plan. “Respiratory Disease”. NHS England. NHS Long Term Plan (2021).
7. Chiner-Vives E., et al. “Short and Long-Term Impact of COVID-19 infection on previous respiratory diseases”. Archivos de Bronconeumología1 (2022): 39-50.
8. Jack K., et al. “The influence of role models in undergraduate nurse education”. Journal of Clinical Nursing23-24 (2017): 4707-4715.
9. Rashwan ZI. “Motivation inspiring confidence: effect of scenario-based learning on self-confidence among prelicensure nursing students”. Teaching and Learning in Nursing3 (2023): e1-e8.
10. Yorke J., et al. “Evaluation of the current landscape of respiratory nurse specialists in the UK: planning for the future needs of patients”. BMJ Open Respiratory Research 1 (2017): e000210.
11. British Thoracic Society (BTS) 2022. A Respiratory workforce for the future. SSN 2040-2023: British Thoracic Society Reports, Volume 13, Issue 2 (2022).
12. Nursing and Midwifery Council (NMC). “Standards for pre-registration nursing programme”. Updates April 2023. Standards for pre-registration nursing programmes - The Nursing and Midwifery Council (2018).
13. Roberts N., et al. “The research and education sub-committee published. informing future nursing: an exploration of respiratory teaching in the pre-registration nurse curriculum”. Nurse Education in Practice 57 (2021): 103254.
14. Braun V and Clarke V. “Conceptual and design thinking for thematic analysis”. Qualitative Psychology1 (2022): 3-26.
15. Sandelowski M., et al. “Defining and designing mixed methods research synthesis studies”. Research School1 (2006): 29.
16. Ebrahimi H., et al. “Barriers to support for new graduated nurses in clinical settings: A qualitative study”. Nurse Education Today 37 (2016): 184-188.
17. Parker V., et al. “New graduate nurses’ experiences in their first year of practice”. Nurse Education Today1 (2014): 150-156.
18. Al Mekkawi M., et al. "New graduate nurses’ readiness to practice: A narrative literature review". Health Professions Education3 (2020): 304-316.
19. Zhang Y., et al. “The effectiveness and implementation of mentoring program for newly graduated nurses: A systematic review”. Nurse Education Today 37 (2016): 136-144.
20. Ross AM., et al. “Spiralling evidence-based practice and outcomes management concepts in an undergraduate curriculum: A systematic approach”. Journal of Nurse Education6 (2009): 319-326.
21. Scurlock-Evans L., et al. “To embed or not to embed? A longitudinal study exploring the impact of curriculum design on the evidence-based practice profiles of UK pre-registration nursing students”. Nurse Education Today 58 (2017): 12-18.
22. Flenady T., et al. “Explaining transgression in respiratory rate observation methods in the emergency department: A classic grounded theory analysis”. International Journal Nursing Studies 74 (2017): 67-75.
23. Prigmore S., et al. “A professional development framework for respiratory nursing”. British Thoracic Society Reports1 (2020).
24. Šajnić A., et al. “Need and baseline for harmonising nursing education in respiratory care: preliminary results of a global survey”. Breathe (Sheff)3 (2022): 210172.