Educating DNP students about critical appraisal and knowledge translation

Consumers expect that health care providers will use the best evidence when assisting them in making decisions about treatment options. Nurses at all educational levels report that they lack knowledge to critically appraise research studies and the skills to effectively implement evidence-based practice (EBP) in their clinical settings. Organizational culture and management support of innovation are critical factors in the adoption of EBP. Doctor of Nursing Practice (DNP) graduates can have a pivotal role in the transfer of knowledge to practice, yet critical appraisal and EBP competencies for DNP and Master of Science in Nursing (MSN) students have not been well differentiated in nursing curricula. Also students' attitudes toward EBP, self-efficacy beliefs, utilization, and knowledge gaps are rarely evaluated before courses are designed. This article reports on the development of a DNP-level EBP course to help students evaluate and apply research findings to clinical practice.

Preparing students for graduate study: an eLearning approach

This paper describes the development and preliminary evaluation of an eLearning program intended to provide incoming nursing students with the basic knowledge, skills and abilities needed to succeed in graduate-level, online coursework. Using Mayer's principles (2008) for the effective design of multimedia instruction, an open-access, self-directed, online program was developed. The Graduate School Boot Camp includes five online modules focused on learning strategies and time management, academic writing, technology, research, and library skills. To motivate and engage learners, the program integrates a fun, graphical sports theme with audiovisual presentations, examples, demonstrations and practice exercises. Learners begin with a self-assessment based on the Motivated Strategies for Learning Questionnaire or MSLQ (Pintrich et al., 1993). To assess change in knowledge levels before and after completing the program, learners take a pre-test and post-test. Preliminary findings indicate that the students found the information relevant and useful. They enjoyed the self-paced, multimedia format, and liked the option to return to specific content later. This innovative program offers a way to prepare students proactively, and may prove useful in identifying students at risk and connecting them with the appropriate resources to facilitate successful program completion.

Clinical skills education for graduate-entry nursing students: enhancing learning using a multimodal approach

This paper discusses the development of a new clinical skills course at a school of nursing and midwifery in London. The course, part of a two year pre-registration programme for graduates in other disciplines, adopted an innovative multimodal approach. This comprised a range of teaching, learning and assessment strategies designed to maximise comprehensiveness, complementarity and flexibility. The background to the development is discussed and each component is described in detail. A brief summary of relevant feedback generated from anonymous student evaluations is included. This provides important insights into the perceived strengths and weakness of the module from a learner perspective. The paper concludes by identifying proposed future developments and recommending wider applications of the multimodal approach within nursing and healthcare education on an international level.

Using standardized patients to strengthen nurse practitioner competency in the clinical setting

AIM

This paper serves as the outline for a simulation that nurse educators can use to better prepare graduate students for the clinical setting and ensure the student's essential competencies prior to clinical practicum.

BACKGROUND

Educators often struggle with whether nurse practitioner students are sufficiently prepared for their clinical practicum once they have successfully completed the didactic component of their coursework.

METHOD

This paper addresses the methods by which one institution uses standardized patients in a simulation laboratory to better prepare the graduate students for their first clinical practicum. The implications of using clinical simulation to enhance both student and faculty learning are addressed.

RESULTS

Simulation done prior to a student's clinical practicum prepares the student for patient cases in the clinical setting.

CONCLUSION

Clinical simulation can enhance the knowledge, skills, and attitudes that nurse practitioner students need in the clinical setting.

Stories are like water: an academic writing workshop for nurses

Traditionally, there is very little formal instruction in academic writing for nurses in graduate programs. We, the writing scholar and a nurse educator and PhD student at a major Canadian university, describe how we collaborated on developing and delivering a 1-day academic writing workshop for incoming master of nursing students. By sharing this description, we hope to motivate nursing faculty to offer similar workshops to address the dearth of writing instruction for graduate students in nursing and to improve scholarship outcomes.

Assessment of computer-related health problems among post-graduate nursing students

The study was conducted to assess computer-related health problems among post-graduate nursing students and to develop a Self Instructional Module for prevention of computer-related health problems in a selected university situated in Delhi. A descriptive survey with co-relational design was adopted. A total of 97 samples were selected from different faculties of Jamia Hamdard by multi stage sampling with systematic random sampling technique. Among post-graduate students, majority of sample subjects had average compliance with computer-related ergonomics principles. As regards computer related health problems, majority of post graduate students had moderate computer-related health problems, Self Instructional Module developed for prevention of computer-related health problems was found to be acceptable by the post-graduate students.

Succession planning for the future through an academic-practice partnership: a nursing administration master's program for emerging nurse leaders

A global nursing leadership shortage is projected by the end of this decade. There is an urgent need to begin developing emerging nurse leaders now. This article describes the work of an academic-practice partnership collaborative of nurse leaders. The goal of the partnership is to develop and promote an innovative enhanced nursing administration master's program targeted to young emerging nurse leaders, who have not yet moved into formal leadership roles. An action research design is being used in program development and evaluation. Qualities needed by emerging leaders identified through research included a need to be politically astute, competency with business skills required of nurse leaders today, comfort with ambiguity, use of a caring approach, and leadership from a posture of innovation. The current curriculum was revised to include clinical immersion with a nurse leader from the first semester in the program, a change from all online to online/hybrid courses, innovative assignments, and a strong mentorship component. Eighteen young emerging nurse leaders began the program in January 2012. Early outcomes are positive. The emerging nurse leaders may be uniquely positioned, given the right skills sets, to be nurse leaders in the new age.

Incorporating a health policy practicum in a graduate training program to prepare advanced practice nursing health services researchers

Health services research benefits from the active engagement of researchers and policy makers from generation through to application of research-based knowledge. One approach to help graduate students learn about the policy world is through participation in a policy practicum. This is an opportunity to work for a defined period of time in a setting where policy decisions are made. This article focuses on the integration of the policy practicum into graduate nursing education for advanced practice nurses. Ten graduate students and two postdoctoral fellows who had recently completed their practicums and three policy makers who had recently supervised students in provincial, federal, and international practicum projects were invited to submit a narrative about the experience. Based on qualitative analysis of the narratives, this article outlines objectives of the practicum, the policy practicum journey, student learning, and finally, the benefits and challenges of the experience.

Using e-learning to enhance nursing students' pain management education

CONTEXT

Absence of standardised pain curricula has led to wide diversity in the understanding and awareness of pain by healthcare students. Indeed pain management is frequently under-prioritised in nursing education, providing potential to negatively impact upon patient care. Yet the recent addition of Pain to the UK National Health Service's Essence of Care Benchmarks has highlighted the need to address this issue, and in response pain educators have called for the development of high quality, globally accessible e-learning resources in pain management.

OBJECTIVES

This study will determine the effectiveness of an e-learning intervention on pain management developed for nursing students.

METHODS

Two variants of an e-learning resource on pain management were developed, each containing the same core content but one with a section focusing on pain assessment and the other on pharmacological management. Nursing students (n=42) were randomly assigned to trial one resource, after which they undertook a questionnaire adapted (to ensure alignment with the content of the e-learning resources) from Ferrell and McCaffrey's Nurses Knowledge and Attitudes Towards Pain Survey. Scores were analysed for each resource and year of study, and compared with scores from a standard non-intervention group completing the questionnaire only (n=164).

RESULTS

Scores averaged 19.2% higher for students undertaking the e-learning resources (p<0.005). Specifically, undertaking the assessment resource improved assessment knowledge more, whilst assignment to the treatment resource particularly enhanced pharmacological knowledge (p<0.005). Correlation was found between year of study and pain knowledge.

CONCLUSION

Results support the effectiveness of the resources independent of voluntary-response bias. Conclusions recommend that introducing e-learning has substantial benefit to enhance pain education in nursing.

A study of the development of critical thinking skills using an innovative web 2.0 tool

BACKGROUND

Healthcare educators face numerous challenges including technological change, information overload, and the need to maintain clinical expertise and research knowledge across multiple specialities. Students also need to develop their capacity for critical thinking, using and discriminating between diverse sources of knowledge in order to advance their own practice.

OBJECTIVES

To investigate student perceptions of the affordances of a novel web 2.0-based tool--the Web Resource Appraisal Process (WRAP), designed to support the development of critical thinking skills, and to identify how student's understanding of critical thinking and their use of web 2.0 resources might inform the cross-disciplinary development of the WRAP.

DESIGN

A two phase, action research study of student perceptions of the WRAP and their ability to source and identify valid information sources.

SETTINGS

Implemented at the University of South Australia, development of the WRAP is an international project with the University of Westminster, UK.

PARTICIPANTS

Students from international locations participated in the project.

METHODS

A mixed methods approach was adopted involving a two phase action research study. In phase one, student perceptions of the WRAP were obtained using a modified course feedback questionnaire. This informed the development of a subsequent questionnaire used to survey student perceptions of their usage of online resources, the ease of access of such resources and their approaches to determining their validity.

RESULTS

Results suggest that students mainly use traditional resources when preparing work for assessment and they either do not understand the concept of, or do not exercise, critical thinking skills in such activities. However, the feedback from students using the WRAP, demonstrated that they found it instructive and useful.

CONCLUSIONS

To ensure that practice developments are based on authoritative evidence, students need to develop critical thinking skills which may be facilitated by tools such as the WRAP.

Facilitating scholarly writer development: the writing scaffold

PROBLEM OF INTEREST: Nursing faculty at a private, medium-sized university noted that students in their online Registered Nurse to Bachelor of Science in Nursing, hybrid Master of Science in Nursing, and online Doctor of Nursing Practice programs displayed varying scholarly writing abilities.

PURPOSE

This article proposes an evidence-based comprehensive support framework, or scaffold that can be used in nursing education to facilitate the development of scholarly writing abilities in students.

PRACTICE IMPLICATION

The writing scaffold is recommended for use by nursing faculty to facilitate the development of scholarly writing abilities within nursing, across nursing program levels, and across disciplines.

Social media use in nursing education

As technological advances continue to expand connectivity and communication, the number of patients and nurses engaging in social media increases. Nurses play a significant role in identification, interpretation, and transmission of knowledge and information within healthcare. Social media is a platform that can assist nursing faculty in helping students to gain greater understanding of and/or skills in professional communication; health policy; patient privacy and ethics; and writing competencies. Although there are barriers to integration of social media within nursing education, there are quality resources available to assist faculty to integrate social media as a viable pedagogical method. This article discusses the background and significance of social media tools as pedagogy, and provides a brief review of literature. To assist nurse educators who may be using or considering social media tools, the article offers selected examples of sound and pedagogically functional use in course and program applications; consideration of privacy concerns and advantages and disadvantages; and tips for success.

Effects of using simulation versus CD-ROM in the performance of ultrasound-guided regional anesthesia

The purpose of this study was to determine which method of teaching, CD-ROM, simulation, or a combination of both, was more effective in increasing the performance of ultrasound-guided regional anesthesia. No studies have investigated these methods. The framework for this study was critical thinking. The study was a prospective, mixed (between and within) subjects, experimental design. The sample consisted of 29 student registered nurse anesthetists randomly assigned to 1 of 3 groups: CD-ROM (n = 11), simulation (n = 11), and combination (n = 7). All groups were evaluated by the use of cadavers before and 2 months after the intervention using a valid and reliable instrument of performance. A repeated-measures analysis of variance indicated that the combination was significantly better than the CD-ROM and simulation (P < .05). The means and standard deviations for pretest and posttest results, respectively, were: CD-ROM, 33 +/- 7%, 41 +/- 9%; simulation, 35 +/- 10%, 49 +/- 13%; and combination, 36 +/- 8%, 64 +/- 17%. The baseline for each group was 0. Use of a combination of CD-ROM and simulation should be considered in teaching ultrasound-guided regional anesthesia techniques.

Anesthesia clinical performance outcomes: does teaching method make a difference?

The purpose of this study was to compare traditional methods of instruction to the use of audiovisual patient safety vignettes in terms of their impact on student registered nurse anesthetists' recall and subsequent clinical performance. These vignettes used simulated, crisis-oriented anesthetic events known to be associated with catastrophic patient outcomes. Using a randomized controlled crossover trial, 24 student registered nurse anesthetists encountered either a malfunctioning suction device vignette or a stuck expiratory unidirectional valve vignette. Recall and clinical performances were measured after exposure to a lecture and written case studies or to lecture and patient safety vignettes. Of the 24 students, 23 were able to recognize the malfunctioning components and take corrective action. In this research study, memory and clinical performance were significantly affected when the anesthesia provider incorporated the correct anesthesia apparatus checkout process and crisis management skills into practice. This research demonstrated that under the conditions of this study, teaching methods had an impact on some areas of clinical performance. In this study, crisis-oriented, anesthesia patient safety vignettes had the potential to affect recall and clinical performance in a simulated environment.

'Tech' versus 'talk': a comparison study of two different lecture styles within a Master of Science nurse practitioner course

BACKGROUND

Generation Y students have a strong preference for technology that has caused educators to re-evaluate their instructional techniques. Limited published literature exists evaluating the benefits of electronic lecture delivery to students enrolled within nursing degree programs, with no publications to date comparing traditional to blended learning modalities.

OBJECTIVES

To retrospectively compare student outcomes, including overall course grade and individual examination scores, between two cohorts of students utilizing two distinctly different methods of lecture delivery, traditional and blended.

METHODS

IRB approval was granted to retrospectively compare student outcomes from fifty-two students enrolled within Northeastern University's Master of Science Nurse Practitioner degree program. A total of 23 students were enrolled in the traditional section taught in 2010 and 29 students were enrolled in the blended section taught in 2011. Student'st-test was used to compare studied outcomes between each section. A p-value of ≤0.05 was considered to be statistically significant.

RESULTS

The students enrolled within blended course scored statistically significantly higher than their counterparts within the traditional course for three of the four studied outcomes, including overall course score.

CONCLUSIONS

This study demonstrates that nursing students enrolled within a more technologically advanced course may have improved performance over students enrolled in courses with traditional lecture styles given their generational preferences for learning.

Students' experiences of blended learning across a range of postgraduate programmes

The article describes the students' experiences of taking a blended learning postgraduate programme in a school of nursing and midwifery. The indications to date are that blended learning as a pedagogical tool has the potential to contribute and improve nursing and midwifery practice and enhance student learning. Little is reported about the students' experiences to date. Focus groups were conducted with students in the first year of introducing blended learning. The two main themes that were identified from the data were (1) the benefits of blended learning and (2) the challenges to blended learning. The blended learning experience was received positively by the students. A significant finding that was not reported in previous research was that the online component meant little time away from study for the students suggesting that it was more invasive on their everyday life. It is envisaged that the outcomes of the study will assist educators who are considering delivering programmes through blended learning. It should provide guidance for further developments and improvements in using Virtual Learning Environment (VLE) and blended learning in nurse education.

The use of high-fidelity simulation in the admissions process: one nurse anesthesia program's experience

Nurse anesthesia programs across the country are frequently in search of better selection criteria and more efficient evaluation systems. The goal is to select qualified applicants who will successfully complete the program and represent the profession of nurse anesthesia. The primary method of assessing the quality of candidates' noncognitive attributes at the Oakland University Beaumont Program of Nurse Anesthesia (Royal Oak, Michigan) was by face-to-face interviews. The admissions committee believed that high-fidelity simulation may be a valuable tool to improve the overall admission process. For the 2008 application interview process, high-fidelity simulation was used as a method of simultaneously evaluating candidates' cognitive and noncognitive attributes, in addition to the traditional face-to-face interview. On completion of the admission interview process, a retrospective research design was used to identify a possible correlation between high-fidelity simulation performance scores and other candidate characteristics. The findings of this pilot study revealed a positive correlation between simulation and face-to-face interview scores, suggesting that candidates who exhibited desirable noncognitive attributes in the face-to-face interview also performed well in the simulation environment. The use of high-fidelity simulation as an interview tool may provide an innovative adjunct for admission committees in assessment of candidates.

Where is the evidence that master's level nursing education makes a difference to patient care? A literature review

AIM

This paper reports on a literature review conducted to explore whether there is evidence that postgraduate nursing education at master's level affects patient care.

BACKGROUND

Continued nursing education has been shown to benefit nurses' development, though little research has been conducted in relation to patient benefit. It is increasingly widespread that nurses pursue education to master's level.

METHOD

Following a systematic review of the literature fifteen studies of mixed methodology and design were examined and data extracted using thematic analysis. Five common themes emerged relating to master's level nursing education that may ultimately affect patient care: increased confidence and self esteem; enhanced communication; personal and professional growth; knowledge and application of theory to practise; and analytical thinking and decision making.

CONCLUSION

It is apparent that there are positive gains for nurses who undertake postgraduate nursing study at master's level related to professional and personal qualities which may provide direct benefit to patients. The supportive evidence extracted from the literature was scant, however. Future research needs to focus on developing measurable and observable criteria against which the educational and skill based outcomes for master's level performance can be evaluated including constraints that may adversely affect a nurse's ability to apply knowledge and skills acquired.

Lessons learned from an accelerated post-master's nurse educator certificate program: teaching the practicum course

Nursing faces current and future shortages in the practice arena. The nurse educator shortage exacerbates the nursing shortage.This article describes an innovative and collaborative approach developed to increase the supply of nurse educators. An overview of the initial offering of this post-master's nurse educator certificate program, a grant-funded, cohort-based program, delivered online in an accelerated format, is provided. Particular attention is given to the nursing education practicum, a precepted teaching experience. This course is viewed as a culminating course, wherein the role transition from expert practitioner to novice educator occurs as students connect the experiential aspects of the practicum with knowledge gained in didactic courses and enter a new community of practice. Lessons learned and recommendations for future cohorts are discussed.