Integrating an Online Statistics Course With a Graduate Nursing Research Course for Enhanced Learning

BACKGROUND

Exploration for innovative pedagogical techniques to teach statistics led to examination of the Open and Free Courses offered through the Carnegie Mellon University Online Learning Initiative (CMU OLI). This study examined the impact of the CMU OLI statistics course on graduate nursing students' course grades and course evaluations.

METHOD

This retrospective study of a hybrid course compared three teaching modalities for statistics: 1) face-to-face workshop, 2) CMU OLI course, and 3) CMU OLI course plus online discussions.

RESULTS

Mean grade point averages increased sequentially and significantly. Individual students' grades improved and student evaluations of instruction mean scores for critical thinking, teaching effectiveness, overall course rating, and overall learning increased significantly (p < .01).

CONCLUSION

Future studies are needed that build knowledge of how open and free online courses can be used in nursing education to facilitate retention of content, allay statistics anxiety, and increase student motivation toward research. [J Nurs Educ. 2020;59(4):227-230.].

Applying Complexity Science as a DNP Quantum Leader

As Doctor of Nursing Practice (DNP) students and graduates begin to apply new knowledge in real-life situations, they are transforming their organizations. The impact of DNP projects is noted by measurable outcomes in diverse settings. This article presents 4 unique clinical/organizational examples of DNP projects. The authors have identified an application of complexity science and leadership theory in their practice changes. In addition, they share their thoughts and feelings as emerging leaders.

Educational characteristics and content of postgraduate nurse practitioner residency/fellowship programs

BACKGROUND

Nurse practitioner (NP) residency/fellowship programs are an emerging industry across the country.

PURPOSE

This study aimed to conduct an in-depth exploration about postgraduate NP residency/fellowship programs in the United States and to gain an understanding of program characteristics, educational content, and implementation methods to assist NPs to transition to practice.

METHODS

This exploratory study used a quantitative design to conduct an online survey of program directors of NP residency/fellowship programs to collect data about program characteristics to assist graduates to transition to practice. Descriptive statistics were calculated for continuous variables, whereas frequency and percentage were calculated for categorical variables.

RESULTS

Nurse practitioner residency/fellowship programs lack consistency in standards for educational content and delivery methods. Only 26% of the programs were accredited, and the programs were not consistently based on nationally recognized competencies. Ninety percent of the programs relied on didactic and clinical supervision delivery methods. More than 90% of the residents/fellows cared for adults older than 65 years of age and managed chronic diseases. Family Nurse Practitioner was the most commonly cited population track offered (73%). Nurse practitioner residency/fellowship programs are sparsely offered in the most rural states with underserved populations.

IMPLICATIONS FOR PRACTICE

This study provides data and insight into the emerging industry of postgraduate NP residency/training programs for educators and employers. In addition, it informs regulators and decision makers about the quality and consistency of programs and the impact of programs on the care delivered by new graduate NPs.

An innovative course to prepare advanced practice registered nurses to spearhead quality and safety initiatives for older adults

ABSTRACT

Current trends dictate that advanced practice registered nurses (APRNs) must be competent to address quality/safety issues specific to older adults. A gap analysis and review of key competencies in an adult-gerontology APRN-Doctorate of Nursing Practice (DNP) curriculum prompted the design and evaluation of an innovative online course, Quality and Safety for the Aging Adult. Course objectives align with key competencies, including graduate-level Quality and Safety Education for Nurses (QSEN) and the DNP Essentials. The course purpose was to prepare adult-gerontology APRN-DNP students as leaders to promote quality/safety outcomes for aging adults. The six-step Knowledge-to-Action Framework guided course development and evaluation. Select graduate-level QSEN competencies were used to construct a 20-item Quality and Safety Survey (4-point Likert scale) (Cronbach's alpha, 0.916). This survey was used during week 1 (pre) and week 15 (post) of the semester to evaluate students' preparation and confidence to perform key QSEN competencies. Significant improvements (p < .000) between pre/post scores on the Quality and Safety Survey were found across five classes. Students felt more prepared and confident to apply selected QSEN competencies on course completion. Moreover, nearly 60% (primary care) and nearly 35% (acute care) adult-gerontology APRN students selected the older adult population for their DNP projects. The Quality and Safety for the Aging Adult course positively influenced five classes of adult-gerontology APRN-DNP students. Integrating QSEN competencies with gerontology and quality/safety content is an effective strategy to prepare APRNs to lead quality/safety initiatives in aging adults. This innovative online course offers a successful model for innovative DNP education of adult-gerontology APRNs.

Student Perception of the Flipped Classroom in Nursing Education

As nurse educators consider new pedagogy for teaching nursing, the students' views and perceptions must be considered. Many studies and commentaries have been written to date on the flipped classroom in nursing education, but few have used research methods to tease out student views of this teaching approach. The purpose of this study was to investigate student perceptions of the flipped classroom using a phenomenological approach. Students who had experienced traditional lecture instruction and the flipped classroom in the same semester were asked about their perceptions and comparisons of the two instructional methods. Qualitative analysis of fifteen individual interviews and two focus groups revealed seven themes, each encompassing a rich data set to inform nurse educators about student perceptions of the flipped classroom. This research informs educators on the effects of launching innovative teaching and learning strategies while considering the audience within the classroom.

Advanced Practice Nursing student knowledge in obesity management: A mixed methods research study

BACKGROUND

Obesity, the most prevalent chronic disease affecting multiple systems, is associated with increased mortality and a decreased life expectancy.

OBJECTIVES

The purpose of this study was to identify Advanced Practice Nursing (APN) students' confidence of obesity management as well as satisfaction of APN curriculum on and curricular recommendations regarding obesity management.

DESIGN

Modified convergent mixed-methods design.

SETTING

A university-based college of nursing in the Deep South.

PARTICIPANTS

Graduate APN Students.

METHODS

An exploratory mixed methods online survey was administered to APN students. The survey included demographics; confidence in obesity management; knowledge of pharmacological treatment; self-reported height and weight; experiences and challenges related to obesity management; and suggestions of curricular content changes for the treatment of obesity that would increase student expertise and confidence.

RESULTS

Ninety-nine surveys were completed by 94 female and five male APN students aged 26 to 61 years. The majority (70.7%) were white with BMIs ranging from 19.57 to 51.37 (x̅=27.81). Areas where students were least comfortable were prescribing anti-obesity medications and accurately billing for obesity management. Fourteen percent of APN students reported feeling that their graduate nursing education program did not prepare them well in obesity management, 25.3% reported feeling slightly well prepared, 32% reported feeling moderately well prepared, and 27.8% reported feeling very well or extremely well prepared. Qualitative responses accentuated insecurity in areas such as initiating a discussion on obesity management with patients who have obesity.

CONCLUSIONS

Overall, APN students requested that their curriculum incorporate more instruction on how to begin the discussion of weight loss and provide clear evidence-based guidelines that include diet, exercise, and medication options. An efficient way to affect the management and treatment of obesity is to ensure that the next generation of providers is thoroughly prepared to implement the best evidence-based obesity management for patients.

Prevalence of Telehealth in Nursing: Implications for Regulation and Education in the Era of Value-Based Care

Value-based care theoretically catalyzes the business case for telehealth. Hence, the purpose of this study was to define the proportion of a statewide nursing workforce who self-reported telehealth or telephonic nursing as their primary work setting in a U.S. state undergoing rapid transitions to value-based care. We conducted a secondary analysis of a 2017 statewide nurse relicensure survey (n = 10,851), overall response rate 99%. The focus of the analysis was registered nurses who reported that they were currently working in Vermont or serving residents of the state (n = 8,457). Analysis was limited to descriptive statistics. We found that 18.4% of respondents (n = 1,556) reported their employment status as "telehealth/ working as a telephonic nurse." Responding to a different question, 17.2% (n = 1,458) defined "telehealth/telephonic" as their primary work setting. Thus, nearly one fifth of nurses practicing in the state were employed in telehealth, a role for which there is scant preparation in nursing education. The multistate practice of roughly one third of these nurses highlights the importance of the Enhanced Nurse Licensure Compact and raises questions about global telenurse practice. Taken as a whole, these findings have profound implications for health care policy development and implementation, ongoing workforce development and analyses, nursing regulation, education, and continuing education. New and renewed skills are needed to provide safe, effective, culturally relevant telehealth, and virtual care.

Learning experience of nursing students in a clinical partnership model: An exploratory qualitative analysis

BACKGROUND

Clinical teaching models are crucial for nursing students' learning experiences as students learn and socialise in a complex clinical context. An innovative clinical partnership model, employing hospital-based clinical teachers to provide supervision and university teachers to liaise with students, has been developed to facilitate clinical teaching and enhance learning experiences.

OBJECTIVES

The study aims to explore nursing students' learning experiences under this clinical partnership model.

DESIGN

An exploratory qualitative study using focus group interviews.

PARTICIPANTS

Twenty-eight pre-registration nursing students at undergraduate and postgraduate level participated in this study.

METHODS

Students formed four groups with each consisting of six to eight students. Semi-structured interviews were conducted to explore students' experiences and perceptions of clinical learning in the clinical partnership model. The data analysis was guided by an inductive approach using content analysis.

RESULTS

The narrative data relates to the clinical learning environment and experience. Nursing students found the clinical partnership model provided a conducive learning context facilitating their adaption to the new environment and integration with the healthcare team. Though students spent time developing mutual understanding with their clinical teachers, they were satisfied with the ample opportunities to practise and learn from their teachers. They appreciated the fact that teachers enriched their learning through bridging the theory-practice gap and acting as role models.

CONCLUSION

The clinical partnership model enriches students' learning experiences. It provides a student-centred learning approach and supportive clinical environment which engages nursing students in learning.

Interprofessional education telephone simulation for campus-based pharmacy students and distance-learning family nurse practitioner students

BACKGROUND

Interprofessional education (IPE) is an essential component of healthcare professions' curriculum but is often difficult to provide due to scheduling issues, cost, different learning formats, and lack of access to other health care professions. To meet the school of pharmacy's need to have IPE with prescribers and the school of nursing's need to provide IPE to distance-learning students, a telephone-based IPE activity was created. The goals of the simulation activity were to provide students a forum to practice communication skills, work to maintain a climate of mutual respect, and forge interdependent relationships with another profession.

INTERPROFESSIONAL ACTIVITY

Each student in a team completed a survey rating the other professional students and qualitative data was collected. Individual care plans were evaluated for appropriateness of therapy, monitoring, and follow-up recommendations. Achievement of the effective communication outcome was evaluated through student survey data, qualitative comments, and concordance of care plans among team members. Concordance was determined based on whether the team was in complete agreement.

DISCUSSION

Qualitative data revealed the goals of mutual respect and interdependent relationships between professions were achieved. The majority of students agreed that effective communication was achieved; however, discordance of the patient care plans between team members suggested ineffective communication.

IMPLICATIONS

The simulation activity met IPE accreditation needs of both pharmacy and nursing profession in a creative method to address barriers of location, cost, scheduling, and lack of access to other healthcare professions.

Health policy engagement among graduate nursing students in the United States

AIM

The aim was to understand how health policy education is currently being delivered in the United States' graduate nursing programs.

METHODS

This exploratory cross-sectional design used an anonymous online survey to target graduate nursing students attending American Association of College of Nursing (AACN) member institutions.

RESULTS

Over 75% of the sample (n = 140) reported taking a dedicated health policy course and 71.5% ( n = 131) of the sample responded that a health policy course was required and an equal distribution among master's and doctoral students. There was no significant difference between type of graduate degree sought and the requirement to take a health policy course ( P = 0.37). For students involved in health policy, there was a greater proportion of master's students involved at the state level, than doctorate of nursing practice (DNP) or PhD students ( P = 0.04).

CONCLUSIONS

Health policy and advocacy education are important aspects of graduate nursing curriculum and have been integrated into curricula. Graduate nursing students at all levels reported that health policy AACN Essential competencies are being included in their program, either as stand-alone health policy courses or integrated health policy learning activities during matriculation.

A Framework for Integrating Oncology Palliative Care in Doctor of Nursing Practice (DNP) Education

Doctor of Nursing Practice (DNP) faculty play a critical role in preparing students to meet the complex needs of the nation as the number of cancer rates and survivors rise (National Cancer Institute, 2018) and as an unprecedented number of older Americans enter into the healthcare system with complicated comorbidities (Whitehead, 2016). Palliative care has dramatically expanded over the past decade and has been increasingly accepted as a standard of care for people with cancer and other serious, chronic, or life-limiting illnesses. Advanced practice registered nurses (APRNs) are recognized as important providers of palliative care (Walling et al., 2017). A 2-day course was held with support from the National Cancer Institute to enhance integration of palliative oncology care into DNP curriculum. The course participants (N = 183), consisting of DNP faculty or deans, practicing DNP clinicians, and students, received detailed annotated slides, case studies, and suggested activities to increase student engagement with the learning process. Course content was developed and delivered by palliative care experts and DNP faculty skilled in curriculum design. Participants were required to develop goals on how to enhance their school's DNP curriculum with the course content. They provided updates regarding their progress at integrating the content into their school's curriculum at 6, 12, and 18 months post course. Results demonstrated an increase in incorporating oncology palliative care in DNP scholarly projects and clinical opportunities. Challenges to inclusion of this content in DNP curricula included lack of: perceived time in curriculum; faculty educated in palliative care; and available clinical sites.

The relationship between knowledge management and creativity in bachelor degree compared to master degree nursing students

OBJECTIVES

To investigate the relationship between knowledge management and creativity in undergraduate compared with master degree nursing students.

METHODS

This cross-sectional study was conducted with nursing students of the faculty of nursing and midwifery in an urban area in the southeast of Iran from August 2017 to January 2018. In this study, 180 students were selected using a simple random sampling method (Bachelor degree=120 and Master degree=60). Data was collected using the Nonaka and Takeuchi̛s knowledge management and Randsip's Creativity questionnaires.

RESULTS

There was a direct and significant relationship between knowledge management and creativity in the students (r=0.47 in Bachelor degree and r=0.36 in Master degree). The mean scores of knowledge management dimensions and creativity were higher in the master degree students.

CONCLUSIONS

There was a relationship between knowledge management and creativity in the bachelor and master degree students. It is necessary to corroborate the Efforts for the implementation of strategies for the knowledge management in all its dimensions. Therefore, the education environment can help with the development of students' knowledge and skills.

Impact of a critical care postgraduate certificate course on nurses' self-reported competence and confidence: A quasi-experimental study

BACKGROUND

Postgraduate education is said to support the development of nurses' professional competence and confidence, essential to the delivery of safe and effective care. However, there is a shortness of empirical evidence to demonstrate an increase to nurses' self-reported confidence and competence on completion of critical care postgraduate certificate-level education.

OBJECTIVES

To explore the impact of a critical care postgraduate certificate course on nurses' self-reported competence and confidence. To explore the psychometric properties and performance of the Critical Care Competence and Confidence Questionnaire.

DESIGN

A quasi-experimental pre/post-test design.

PARTICIPANTS

A total population sample of nurses completing a critical care postgraduate certificate course at an Australian University.

METHODS

The Critical Care Competence and Confidence Questionnaire was developed for this study to measure nurses' self-reported competence and confidence at baseline and follow up. Descriptive and inferential statistics were used to explore sample characteristics and changes between baseline and follow-up. Reliability of the questionnaire was explored using Cronbach's Alpha and item-total correlations.

RESULTS

There was a statistically significant increase in competence and confidence between baseline and follow-up across all questionnaire domains. Satisfactory reliability estimates were found for the questionnaire.

CONCLUSIONS

Completion of a critical care postgraduate certificate course significantly increased nurses' perceived competence and confidence. The Critical Care Competence and Confidence Questionnaire was found to be psychometrically sound for measuring nurses' self-reported competence and confidence.

Essentials of Ambulatory Care: An Interprofessional Workshop to Promote Core Skills and Values in Team-based Outpatient Care

Introduction

Team-based, interprofessional approaches to outpatient care are critical to high-quality patient care. However, few specific educational interventions promoting these skills in graduate level health care trainees have been described to date.

Methods

University of Minnesota faculty from the Schools of Medicine, Pharmacy, and Nursing created an interprofessional workshop experience exploring core concepts in outpatient care for graduate level trainees in pediatrics, family medicine, medicine-pediatrics, internal medicine, graduate-level nursing, and pharmacy. We focused on four key content areas: teamwork, systems thinking, the patient-centered health care home, and patient-centered communication. The workshop included brief didactics, role-plays, team-based experiences, and interactive skill practice. Participants completed an end-of-day survey reflecting on knowledge and attitude.

Results

From 2014-2017, nine workshops reached 305 trainees. Survey results from the 2015-2016 academic year are representative of our overall results and revealed that learners found the content high yield, and that they valued the opportunity to learn with their interprofessional colleagues. Improvements in perceived knowledge were noted in all domains. Trainees also reported increased skills, with 81% reporting both increased confidence in working within the interprofessional team, and change in attitude, and 90% reporting increased interest in working with their interprofessional colleagues after the workshop.

Discussion

Creating an opportunity for postgraduate level trainees from a variety of disciplines and professions to convene and focus on interprofessional team-based skills can fill a gap in interprofessional learning as they enter practice. Trainees were able to draw on their everyday experiences and find common ground with their interprofessional colleagues.

Transforming classroom questioning using emerging technology

Classroom questioning is a common teaching and learning strategy in postgraduate nurse education. Technologies such as audience response systems (ARS) may offer advantage over traditional approaches to classroom questioning. However, despite being available since the 1960s, ARSs are still considered novel in many postgraduate nurse education classroom settings. This article aims to explicate the attitudes of postgraduate nursing students in an Irish academic teaching hospital towards classroom questioning (CQ) and the use of ARSs as an alternative to traditional CQ techniques. The results of this small-scale study demonstrate that ARSs have a role to play in CQ in the postgraduate setting, being regarded by students as beneficial to learning, psychological safety and classroom interaction.

Understanding the impact of eating disorders: using the reflecting team as a learning strategy for students

This article outlines how the application of a reflecting team from systemic family therapy practice was used as a learning strategy for a postgraduate programme for healthcare students. The programme was designed to increase the students' skills, knowledge and awareness of the needs of people with eating disorders, and their families. There were some benefits to this learning strategy. Students reported that the use of a reflecting team enabled them to gain a deep understanding of the emotional impact of eating disorders on individuals and their carers. However, as this method of learning was new to the students, they needed some initial instruction on the approach. During the programme of study, it became evident that the health professionals were deeply affected by the experiences of people with eating disorders. This would suggest that possibly it was the presence of the sufferers themselves as part of the reflecting team that provided the pivotal learning opportunity, rather than the reflecting team per se.

Utilisation of academic nursing competence in Europe - A survey among members of the European Academy of Nursing Science

BACKGROUND

In line with national and international strategies in Europe, the number of nurses with a doctoral degree has increased. The European Academy of Nursing Science (EANS) has for 18years delivered a three-year doctoral summer school for nurses. Questions have been raised in terms of how academic nurses' competencies are used and in what positions.

AIM

To understand the progression of nurses' academic careers following completion of the EANS Summer School and to picture how research and academic skills of the nurses are being used for research and/or other fields in nursing.

METHODS

We commenced a cross-sectional survey. Former EANS Summer School participants were invited to take part in the online survey with questions developed specifically for this study. The study conformed to the principle of good clinical research practice and was reviewed and approved by the EANS Board.

RESULTS

Of 380 former participants, 308 were eligible for participating in the survey. A total of 140 (45%) responded. The respondents originated from 21 countries. Sixty-nine percent had their main position in universities or university colleges and 25% in healthcare organisations. More than 80% were involved in research, teaching and supervision, and 26% were involved in direct client/patients care while 71% reported doing postdoctoral research where descriptive research designs dominated. The research topics covered a large variety of aspects in clinical nursing, education, development and theory.

CONCLUSION

The EANS Summer School is an example of an effort to improve nurses' academic competencies. The survey indicates that the competencies of academically trained nurses in Europe primarily are used in universities and educational institutions. However, a large proportion is working close to and in collaboration with clinical practice. Evidence of the legacy of having undergone the EANS Summer School includes using advanced research methods and collaboration with the international EANS network.

Leveraging Graduate Academic-Practice Partnerships to Transform Health System Outcomes

Academic and clinical site partnerships are not new. However, many of these have not resulted in graduates of nursing education programs who are prepared to fulfill their full potential as newly employed professionals. This article describes an education program for Doctorate of Nursing Practice (DNP) students in which the students, under the close supervision of academic faculty, utilize their statistical analyses and complex system coursework to study and address "wicked" problems faced by health care organizations. This partnership between academia and practice is benefitting practice partners, students, and patients.

Effect of training in advanced trauma life support on the kinematics of the spine: A simulation study

More than 7.5 million people in the world are affected by spinal cord injury (SCI). In this study, we aimed to analyze the effect of training in advanced trauma life support (ATLS) on the kinematics of the spine when performing different mobilization and immobilization techniques on patients with suspected SCI. A quasi-experimental study, clinical simulation, was carried out to determine the effect of training in ATLS on 32 students enrolled in the Master's program of Emergency and Special Care Nursing. The evaluation was performed through 2 maneuvers: placing of the scoop stretcher (SS) and spinal board (SB), with an actor who simulated a clinical situation of suspected spinal injury. The misalignment of the spine was measured with the use of a Vicon 3D motion capture system, before (pre-test) and after (post-test) the training. In the overall misalignment of both maneuvers, statistically significant differences were found between the pre-test misalignment of 62.1° ± 25.9°, and the post-test misalignment of 32.3° ± 10.0°, with a difference between means of 29.7° [(95% confidence interval, 95% CI 22.8-36.6°), (P = .001)]. The results obtained for the placing of the SS showed that there was a pre-test misalignment of 65.1° ± 28.7°, and a post-test misalignment of 33.2° ± 10.1°, with a difference of means of 33.9° [(95% CI, 23.1-44.6°), (P = .001)]. During the placing of the SB, a pre-test misalignment of 59.0° ± 28.7° and a post-test misalignment of 33.4° ± 10.0° were obtained, as well as a difference of means of 25.6° [(95% CI 16.6-34.6°), (P = .001)]. The main conclusion of this study is that training in ATLS decreases the misalignment provoked during the utilization of the SS and SB, regardless of the device used.

A qualitative study on communication between nursing students and the family members of patients

BACKGROUND

When caring for a family as a unit, it is as crucial to communicate with the family members of a patient as it is with the patient. However, there is a lack of research on the views of nursing students on communicating with the family members of patients, and little has been mentioned in the nursing curriculum on this topic.

AIM

The aim of this study was to explore nursing students' experiences of communicating with the family members of patients.

DESIGN

A qualitative descriptive study.

METHODS

A total of 42 nursing students (21 undergraduate year-two students and 21 were master's year-one students) from one school of nursing in Hong Kong participated in in-depth individual interviews. Content analysis was adopted. The trustworthiness of this study was ensured by enhancing its credibility, confirmability, and dependability.

RESULTS

Two main themes were discerned. The first, "inspirations gained from nursing student-family communication", included the following sub-themes: (a) responding to enquiries clearly, (b) avoiding sensitive topics, (c) listening to the patient's family, and (d) sharing one's own experiences. The second, "emotions aroused from nursing student-family communication", had the following sub-themes: (a) happiness, (b) anger, (c) sadness, and (d) anxiety.

CONCLUSIONS

More studies on the perspectives of nursing students on communicating with family members should be conducted, to strengthen the contents and learning outcomes of nursing student-family communication in the existing nursing curriculum.