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Vangone I, Arrigoni C, Magon A, Conte G, Russo S, Belloni S, Stievano A, Alfes CM, Caruso R. The efficacy of high-fidelity simulation on knowledge and performance in undergraduate nursing students: An umbrella review of systematic reviews and meta-analysis. NURSE EDUCATION TODAY 2024; 139:106231. [PMID: 38701671 DOI: 10.1016/j.nedt.2024.106231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 04/18/2024] [Accepted: 04/28/2024] [Indexed: 05/05/2024]
Abstract
OBJECTIVES This umbrella review aimed to consolidate the evidence base on the impact of high-fidelity simulation on knowledge and performance among undergraduate nursing students. DESIGN Umbrella review with meta-analyses of pooled effect sizes, followed by an additional meta-analysis of primary studies from the included systematic reviews, excluding overlapping results. DATA SOURCES Systematic searches were performed up to August 2023 in PubMed, Embase, and Cochrane Library. We included reviews that compared high-fidelity simulation against other learning strategies. REVIEW METHODS The risk of bias was assessed for each included systematic review (ROBIS tool) and primary study (RoB 2 or ROBINS-I as appropriate). Random-effect meta-analyses of meta-analyses were performed to estimate the pooled effects of high-fidelity simulation on knowledge and performance. Further random-effect meta-analyses of primary studies were conducted, with overlapping studies excluded (12 %). Subgroup analyses were performed to provide a more comprehensive analysis of the findings. Trim-and-fill analyses were conducted to adjust for potential publication bias. RESULTS Six systematic reviews were included and encompassed 133 primary studies (2767 and 3231 participants concerning performance and knowledge, respectively). The adjusted pooled effects for knowledge (SMD = 0.877, 95 % CI: 0.182 to 1.572) and performance (SMD = 0.738, 95 % CI: 0.466 to 1.010) closely aligned with those obtained from meta-analyzing the primary studies for knowledge (SMD = 0.980) and performance (SMD = 0.540), both showing high statistical heterogeneity. Traditional lectures represented the more common comparison. The subgroup analysis revealed significant differences in effect sizes across geographic locations, topics, types of control, and how interventions were reported. CONCLUSIONS The results provide robust evidence supporting the integration of high-fidelity simulation into undergraduate nursing programs to enhance students' knowledge and performance. The high reported heterogeneity may be attributed to variations in study contexts or methodologies. Future research should explore the optimal use of high-fidelity simulation in different educational and cultural contexts.
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Affiliation(s)
- Ida Vangone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Cristina Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, 27100 Pavia, Italy
| | - Arianna Magon
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy
| | - Gianluca Conte
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy
| | - Sara Russo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Silvia Belloni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, 27100 Pavia, Italy
| | - Alessandro Stievano
- Centre of Excellence for Nursing Scholarship, OPI of Rome, 00133 Rome, Italy; Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
| | - Celeste M Alfes
- Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, OH 44106, United States of America
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy.
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Quemada-González C, Flores Becerra-Martos E, Blenkarn M, Gutiérrez-Rodríguez L, García-Mayor S, León-Campos Á, Martí-García C. Nursing students' experience of approaching risk for suicide behaviour through simulated environments: A content analysis study. Arch Psychiatr Nurs 2024; 50:5-13. [PMID: 38789234 DOI: 10.1016/j.apnu.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/20/2024] [Accepted: 03/03/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Suicide is a major public health problem, especially among the young population. Nurses are in a unique position to prevent it due to their constant contact with patients. However, addressing suicidal behaviour can be complicated by the emotional responses it elicits. Simulation has been shown to be an effective tool to increase the self-confidence of nursing students in dealing with these sensitive situations in a safe environment prior to dealing with real patients. AIM To explore nursing students' perceptions, thoughts, and emotions about their performance in dealing with risk for suicidal behaviour through simulated scenarios. DESIGN Qualitative descriptive study. METHODS Students of Mental Health and Psychiatric II in the third year of the Nursing course at the University of Málaga were invited to explain their experience by answering a questionnaire of three open-ended questions following their participation in the simulated scenarios of the course. RESULTS A total of 72 students participated. Content analysis of the written responses identified three main themes: (i) Emotions experienced during the simulation; (ii) Self-criticism of the performance/intervention; (iii) Student evaluation of the learning experience. Most of the students indicated at some point during the clinical scenario, they had felt anxiety, proposing possible improvements in their own performance. The clinical scenario that elicited the most negative emotions was that of a person diagnosed with borderline personality disorder. CONCLUSION Clinical simulations contribute to a better understanding of nursing practice with mental health patients and the need for training in emotional and therapeutic communication skills among students.
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Affiliation(s)
| | | | | | - Laura Gutiérrez-Rodríguez
- Universidad de Málaga, Faculty of Health Sciences, Spain; Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Spain.
| | - Silvia García-Mayor
- Universidad de Málaga, Faculty of Health Sciences, Spain; Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Spain.
| | - Álvaro León-Campos
- Universidad de Málaga, Faculty of Health Sciences, Spain; Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Spain.
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Pereira LM, Mallela JL, Carroll AJ, Washburn JJ, Robiner WN. Psychologists and Integrated Behavioral Health Simulation Training: A Survey of Medical Educators and Perspectives of Directors of Clinical Training. J Clin Psychol Med Settings 2024; 31:304-315. [PMID: 38615281 DOI: 10.1007/s10880-024-10015-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 04/15/2024]
Abstract
It is well established that the integration of behavioral healthcare into the medical home model improves patient outcomes, reduces costs, and increases resident learning. As academic health centers increasingly integrate behavioral healthcare, targeted training for interprofessional collaboration around behavioral healthcare is needed. Simulation educational approaches potentially can provide this training. Health service psychologists are well-poised to support this because of their specialized training in integrated healthcare. The present exploratory study aimed to evaluate existing simulation programs and develop recommendations for integrated behavioral health training and evaluation. Directors of ACGME accredited residency programs that are high utilizers of the medical home model (Pediatrics, Internal Medicine, Medicine/Pediatrics, Family Medicine) as well as Psychiatry residencies and medical schools with membership in the Society for Simulation in Healthcare were recruited to complete a 26-item survey to assess program usage of psychologists as part of simulation training for integrated behavioral healthcare services. Of 79 participants who completed initial items describing their training program, only 32 programs completed the entire survey. While many academic health centers offered integrated team and behavioral health simulations, few utilized psychology faculty in design, implementation, and evaluation. Other behavioral health providers (psychiatrists, social workers) were often involved in medical school and pediatric residency simulations. Few institutions use standardized evaluation. Qualitative feedback and faculty-written questionnaires were often used to evaluate efficacy. Survey responses suggest that psychologists play limited roles in integrated behavioral healthcare simulation despite their expertise in interdisciplinary training, integrated behavioral healthcare, and program evaluation.
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Affiliation(s)
- Lila M Pereira
- Division of Hematology/Oncology/SCT, Department of Pediatrics, New York Medical College, 19 Skyline Dr, Rm1NH12, Valhalla, NY, 10595, USA.
| | - Jaya L Mallela
- Division of Hematology/Oncology/SCT, Department of Pediatrics, New York Medical College, 19 Skyline Dr, Rm1NH12, Valhalla, NY, 10595, USA
| | - Allison J Carroll
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jason J Washburn
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Chan CWH, Tang FWK, Cheng HY, Chow KM, Kwok ZCM, Li C, Zang Y, Chair SY. Effect of simulation-based zoom learning on clinical decision-making among undergraduate nursing students and experiences of students and instructors: A mixed methods study. Heliyon 2024; 10:e30039. [PMID: 38707455 PMCID: PMC11068600 DOI: 10.1016/j.heliyon.2024.e30039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 02/08/2024] [Accepted: 04/18/2024] [Indexed: 05/07/2024] Open
Abstract
Aim To determine the effect of simulation-based Zoom learning (SBZL) on perceived capabilities and clinical decision-making skills among undergraduate nursing students and to explore experiences of the instructors and students participating in SBZL. Background Nursing is a practice profession and students acquire clinical decision-making skills in clinical settings. However, the COVID-19 pandemic has disrupted conventional clinical learning activities. In this study, the outcomes of implementing SBZL in an undergraduate programme to support students' clinical learning were examined. Design A mixed methods design was employed. Methods This study recruited 195 final-year students to participate in the SBZL programme, which was developed based on the NLN Jeffries Simulation Theory to guide its design, implementation and evaluation. Case scenarios were developed and simulated through Zoom. Students' perceived capabilities, perceptions of the learning environment and clinical decision-making skills were assessed before and after SBZL. A historical control group of 226 previous final year students who had received a clinical practicum was included for comparison. Semi-structured interviews were conducted with 11 instructors and 19 students to explore their experiences of participating in SBZL. Results A total of 102 students completed the post-SBZL questionnaire. An increase in perceived creative thinking (mean difference = 0.24, p < 0.001) was observed post-SBZL. After SBZL, the perceptions of the learning environment were significantly improved. However, the SBZL group demonstrated lower perceived problem-solving capability than the control group (mean difference = 0.14, p = 0.007). Clinical decision-making was significantly improved in the SBZL group than in the control group (p < 0.001). Both the instructors and students reported positive experiences with SBZL, and highlighted challenges and factors for improving its implementation. Conclusions SBZL showed improvement in perceived creative thinking, perceptions of the learning environment and clinical decision-making. This innovative teaching and learning method can be valuable for nursing education in various regions to prepare students for real-life roles. Tweetable abstract Simulation-based Zoom learning is better than traditional teaching in improving clinical decision-making skills among undergraduate nursing students.
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Affiliation(s)
- Carmen Wing Han Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., China
| | - Fiona Wing Ki Tang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., China
| | - Ho Yu Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., China
| | - Ka Ming Chow
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., China
| | - Zoe Ching Man Kwok
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., China
| | - Caixia Li
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., China
| | - Yuli Zang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., China
| | - Sek Ying Chair
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., China
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Sessions LC, Kim HJ, Brewer KC, El-Banna MM, Farina CL. Intrinsic Factors and Psychological Safety Among Nursing Students During Simulation-Based Learning-A Correlational Design. Simul Healthc 2024:01266021-990000000-00120. [PMID: 38587358 DOI: 10.1097/sih.0000000000000795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
INTRODUCTION Well-designed simulation-based learning (SBL) experiences enhance students' self-confidence, self-efficacy, clinical judgment, and psychomotor skill development. An emerging concept in SBL research is psychological safety. There is currently no research on factors influencing psychological safety specifically related to the SBL environment, nor is there any literature found to determine whether intrinsic student characteristic, such as self-compassion and resilience, contributes to SBL learning outcomes. The aim of this study is to determine whether there is a relationship between nursing students' intrinsic characteristics (self-compassion, resilience, and anxiety sensitivity) and their psychological safety. METHODS Bivariate correlation was used to examine associations among sociodemographic variables and outcome variables. Multiple regression was used to determine the predictive nature of the sociodemographic variables. Assumptions for variables in multiple regression models were tested (normal distribution, heteroscedasticity, multicollinearity). All data were analyzed in SPSS, Version 28. The P value of significance was set at 0.05 for all analyses. RESULTS Most of the 118 participants were non-Hispanic (89%), White (65%), and females (95%). Results of the demographic bivariate analysis revealed no significant differences among this diverse group or semester in the curriculum for psychological safety. The multiple regression found self-compassion (β = 29, P = 0.004), anxiety sensitivity (β = -0.16, P = 0.049), and resilience (β = 0.26, P = 0.004) predict psychological safety. CONCLUSIONS The importance of creating a psychologically safe learning environment has been recognized as essential to best practices. Our findings suggest that an understanding of student characteristics that impact their perception of psychological safety will allow educators to develop strategies to better support learners in the simulation environment.
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Affiliation(s)
- Laura C Sessions
- From the Department of Nursing (L.C.S.), Towson University, Towson, MD; School of Nursing (H.J.K., M.E.-B., C.L.F.), The George Washington University, Ashburn, VA; and Towson University (K.B.), Towson, MD
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Martínez-Galiano JM, Gonzalez-Cabrera M, Rodriguez-Almagro J, Hernández-Martínez A. Evaluation of Knowledge and Competencies in Sexual and Reproductive Health Care Using an Escape Room with Scenario Simulations. NURSING REPORTS 2024; 14:683-694. [PMID: 38525698 PMCID: PMC10961789 DOI: 10.3390/nursrep14020052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/08/2024] [Accepted: 03/21/2024] [Indexed: 03/26/2024] Open
Abstract
To determine the usefulness of combining two methodologies (OSCE and escape room) in a scenario simulation to evaluate a subject, and determine the evaluation of the students of this experience. An observational cross-sectional study was carried out with students enrolled in a sexual and reproductive health-care course as a part of their nursing degree. The students had to solve four clinical cases based on the contents of the teaching practices of the subject by solving clues that led them to carry out procedures and techniques and provide care in scenario simulators. Students evaluated the experience using the GAMEX (Gameful Experience in Gamification) scale. Mean differences were estimated with their respective 95% confidence intervals. A total of 124 students participated. Of these, 63.7% (79) solved the clinical cases with their knowledge and skills. Most (80.6%, 100) students stated that they completely remembered and applied the knowledge of the topic during the game. Almost all (98.4%, 122) would recommend this experience. The dimensions with the best rating on the GAMEX scale were "fun", with an average score of 4.7 points (0.49), followed by "critical thinking", with 4.2 (0.59). Women presented statistically better scores than men (mean difference: 1.58; 95% CI: 0.55, 2.61). The OSCE combined with an escape room using scenario simulations may be a useful tool to evaluate the subject. In addition, the students were satisfied, had fun, and recommended the experience. This study was not registered.
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Affiliation(s)
- Juan Miguel Martínez-Galiano
- Department of Nursing, University of Jaen, 23071 Jaén, Spain;
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | | | - Julian Rodriguez-Almagro
- Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.R.-A.); (A.H.-M.)
| | - Antonio Hernández-Martínez
- Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.R.-A.); (A.H.-M.)
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Livshiz-Riven I, Hurvitz N, Nativ R, Borer A, Gushansky A, Eilig D, Kopitman A, Ziv-Baran T. Nursing students led simulations to improve healthcare workers' hand hygiene compliance. Contemp Nurse 2024:1-14. [PMID: 38470983 DOI: 10.1080/10376178.2024.2322994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 02/20/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Hand hygiene compliance (HHC) is recognised as a major factor in the prevention of healthcare-associated infections. Healthcare workers (HCWs) compliance is still suboptimal. Simulation as an educational strategy may contribute to improved performance. OBJECTIVE This study aimed to assess the effect of simulation interventions led by nursing students on HCWs' HHC. METHOD A prospective quasi-experimental design with before and after intervention measurements was implemented in an 1150-bed tertiary hospital. Four consecutive periods, measuring before and after HHC, were examined in four hospital divisions. For each division, unique simulation activities were developed and led by nursing students, educators, and hospital leaders. Sixty seven students and 286 healthcare workers, along with two nurse educators, participated in the simulation sessions. HHC of all HCWs in the divisions was assessed by hospital infection control personnel. RESULTS Hospital HHC rose across the four periods in all four divisions during this study. In three out of four periods and divisions, HHC increased significantly more in the simulation intervention groups compared to the overall hospital improvement. CONCLUSION Student-led simulation for HCWs is an additional effective method to improve HHC. Nursing managers should consider joining forces with nursing educators to enable students to become agents of change in healthcare settings and encourage further collaboration.
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Affiliation(s)
- Ilana Livshiz-Riven
- Department of Nursing, Recanati School for Community Health ProfessionsBen-Gurion University of the Negev, Beer-Sheva, Israel
- Quality Unit, Soroka University Medical Center, Beer-Sheva, Israel
| | - Nancy Hurvitz
- Department of Nursing, Recanati School for Community Health ProfessionsBen-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ronit Nativ
- Infection Control and Hospital Epidemiology Unit, Soroka University Medical Center, Beer-Sheva, Israel
| | - Abraham Borer
- Infection Control and Hospital Epidemiology Unit, Soroka University Medical Center, Beer-Sheva, Israel
| | - Alex Gushansky
- Infection Control and Hospital Epidemiology Unit, Soroka University Medical Center, Beer-Sheva, Israel
| | - Dynai Eilig
- Orthopaedic Department, Assuta-Ashdod Medical Center, Ashdod, Israel
| | - Alina Kopitman
- Obstetrics and Gynaecology, Soroka University Medical Center, Beer-Sheva, Israel
| | - Tomer Ziv-Baran
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv, Israel
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Senette CL, Dingley C, Doolen J, Gordon H. Fluctuating cohesion: A grounded theory study of nursing students engaged in a combined debriefing format. Nurse Educ Pract 2024; 76:103943. [PMID: 38554617 DOI: 10.1016/j.nepr.2024.103943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/25/2024] [Accepted: 03/11/2024] [Indexed: 04/02/2024]
Abstract
AIM This study explored the social processes enacted by nursing students when they engage in a combined format of structured peer debriefing followed by instructor-led debriefing after in-person simulation. The aim was to gain insight into nursing students' perceptions and how peer processes influenced reflection and learning. BACKGROUND Debriefing, a key component of clinical simulation, promotes development of nursing students' reflective processes and enhances learning. In-person group-debriefing led by faculty/instructors is the most used debriefing format in healthcare simulation education. Yet, recent studies indicate instructor-led formats may increase students' anxiety and limit their capacity for reflection, a crucial step in clinical reasoning and decision making. Investigations into learner-centered formats support peer debriefing as a reasonable alternative to traditional instructor-led debriefing. However, current peer debriefing studies provide little insight into the social interactions and processes supporting reflection and learning; and little theoretical basis exists for the integration of alternatives to instructor-led debriefing formats (such as peer debriefing) into simulation-based education. DESIGN This qualitative study used a Straussian grounded theory design. METHODS Senior-level baccalaureate and associate degree nursing students from an U.S. public university with first-hand experience using the combined format of peer debriefing followed by instructor-led debriefing were recruited to participate in focus-group interviews. Data gathered from semi structured interviews were analysed using the iterative process of constant comparison. Theory building was aided using memoing, theoretical sampling and conceptual diagramming. RESULTS The sample consisted of 34 students. Study findings revealed the core category of the constructed theory, 'Fluctuating cohesion', involved students' pervasive sense of going back and forth between a sense of unity (we-ness) and separatism (me-ness) while engaged in the combined debriefing format. The theory integrated five related categories: discovering the process, normalizing experiences, developing mutuality, dynamic balancing and engaging informal social connections. Findings illustrated the processes students enacted to take ownership for learning and proactively discuss their clinical decision-making with the instructor. In turn, reflection was enhanced by increased receptiveness to subsequent expert feedback. CONCLUSIONS The study findings demonstrated that augmenting instructor-led debriefing with peer debriefing leveraged the beneficial nature of peer interactions, promoted psychological safety, facilitated nascent team behaviors and enhanced reflective thinking. The resultant theory that was generated from the findings and grounded in participants' experience, provides a meaningful framework that may inform future learner-centered debriefing formats aimed at optimizing debriefing effectiveness.
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Affiliation(s)
- Carol Lynn Senette
- University of Nevada, Las Vegas School of Nursing, 4505 S. Maryland Pkwy, Las Vegas, NV 89154, USA; University of Alaska Anchorage School of Nursing, Health Sciences Building, 3795 Piper St, Anchorage, AK 99508, USA.
| | - Catherine Dingley
- University of Nevada, Las Vegas School of Nursing, 4505 S. Maryland Pkwy, Las Vegas, NV 89154, USA
| | - Jessica Doolen
- University of Nevada, Las Vegas School of Nursing, 4505 S. Maryland Pkwy, Las Vegas, NV 89154, USA.
| | - Howard Gordon
- University of Nevada, Las Vegas School of Nursing, 4505 S. Maryland Pkwy, Las Vegas, NV 89154, USA
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Fuller Switzer D, Knowles SG. Ethics: Crisis Standards of Care Simulation. Adv Emerg Nurs J 2024; 46:71-81. [PMID: 38285425 DOI: 10.1097/tme.0000000000000498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Ethical dilemmas exist with decision-making regarding resource allocations, such as critical care, ventilators and other critical equipment, and pharmaceuticals during pandemics. Triage artificial intelligence (AI) algorithms based on prognostication tools exist to guide these decisions; however, implicit bias may affect the decision-making process leading to deviation from the algorithm recommendations. Conflict within the ethical domain may be affected as well. A knowledge gap was identified within the Adult-Gerontology Acute Care Nurse Practitioner (AG-ACNP) curriculum regarding ethics in crisis standards of care (CSC) medical decision-making. Incorporating a CSC simulation looked to address this knowledge gap. A simulation-based learning (SBL) experience was designed as a critical access setting where CSC are in place and three diverse, medically complex patients in need of critical care present to the hospital where one critical care bed remains open. Given the complexity of the simulation scenario, a table-top pilot test was selected. Three AG-ACNP fourth-quarter students in their critical care rotation volunteered for the pilot test. Students were provided with the topic, "ethics crisis standards of care" and the article, "A catalogue of tools and variables from crisis and routine care to support decision-making during pandemics" by M. Cardona et al. (2021), to read in advance. Students were provided with the triage AI algorithm (M. Cardona et al., 2021) utilizing prognostication tools to prioritize which patient requires the critical care bed. The expectation was that implicit bias would enter the decision-making process, causing deviation from the triage AI algorithm and moral distress. The debriefing session revealed that students deviated from the triage AI algorithm, experienced implicit bias, moral distress, and utilized clinical judgment and experience to care for all three patients. The pilot test results support that a CSC SBL experience addresses a critical knowledge gap in AG-ACNP education and an SBL experience incorporating ethical decision-making curriculum with standardized patients should be developed and trialed as the next step.
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Affiliation(s)
- Diane Fuller Switzer
- Initiative in Ethics and Transformative Technologies, Seattle University College of Nursing, Seattle, Washington (Dr Fuller Switzer); and Seattle University College of Nursing, Seattle, Washington (Dr Knowles)
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Røykenes K, Kvernenes M, Giske T. Endeavouring interplay: a grounded theory study of how nurse educators' work with simulation-based learning. BMC Nurs 2023; 22:377. [PMID: 37821879 PMCID: PMC10568800 DOI: 10.1186/s12912-023-01546-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Simulation-based learning is frequently used as a teaching and learning strategy in nursing and other health professions educations, and educators have a key role as facilitators. This facilitator role provides them with a particularly relevant perspective to help us understand and theorize around the essence of simulation-based learning, and how it is approached. This study aims to explore nurse educators' experiences and strategies in simulation-based learning. METHOD Data were collected in 2018-2021 using in-depth interviews with eight nurse educators. Transcripts were analysed through constant comparison using Classical Grounded Theory approach. RESULT The participants' main concern was how to Maximize students' learning-space in simulation. To resolve this, four strategies were identified: legitimizing simulation, self-development, preparing students, and tailoring simulation. Legitimisation, and self-development were found to be important prerequisites for developing the learning space and were therefore defined as the background or context of the theory. Nurse students were the focus of the two remaining categories, preparing students and tailoring simulation, and are thus defined as being in the foreground of the theory. The dynamics of these four strategies were captured in the Grounded theory of Endeavouring interplay. CONCLUSION The theory of Endeavouring interplay illustrates the complexity educators are encountering when aiming to optimize simulation as a learning space for nurse students. The strategies used are adapted to the organisational climate, available resources and context, and include striving to legitimize simulation, pursue self-development in the role as facilitator, help students prepare for simulation-based learning, and tailor the simulation to both contextual factors and individual student needs.
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Affiliation(s)
- Kari Røykenes
- Institute of Nursing, Faculty of Health Studies, VID Specialized University, Bergen, Norway
| | - Monika Kvernenes
- Center for Medical Education and Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway.
| | - Tove Giske
- Institute of Nursing, Faculty of Health Studies, VID Specialized University, Bergen, Norway
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Pogson R, Henderson H, Holland M, Sumera A, Sumera K, Webster CA. Determining current approaches to the evaluation of the quality of healthcare simulation-based education provision: a scoping review. MEDEDPUBLISH 2023; 13:207. [PMID: 38188096 PMCID: PMC10767249 DOI: 10.12688/mep.19758.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2023] [Indexed: 01/09/2024] Open
Abstract
Background: With an increase in simulation being used in healthcare education, there is a need to ensure the quality of simulation-based education is high. This scoping review was conducted to answer the question: What are the current approaches to the evaluation of the quality of health-care simulation-based education provision? Methods: Databases PubMed, Cochrane, ERIC, CINAHL and Medline were searched in March 2023 to retrieve peer-reviewed healthcare research and review articles written in the English language within the last 20 years. All data were extracted from six studies, themed and presented in the main text and in tabular form. Results: Two scoping reviews, one systematic review and three research articles were included. Three main themes were found: adherence to existing design frameworks, lack of validation of these frameworks and lack of evaluation frameworks, and a proposed evaluation framework. Many of the excluded articles focussed on gaining participant feedback to evaluate simulation activities, rather than evaluating the quality of the design and implementation of the simulation. Conclusions: Benchmarking of current United Kingdom (UK) healthcare simulation against UK and international simulation standards is required to increase its quality, therefore, an agreed UK template framework to evaluate simulation packages is recommended.
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Affiliation(s)
- Rachel Pogson
- School of Medicine, Keele University, Keele, England, ST5 5BG, UK
| | - Helen Henderson
- School of Nursing, Midwifery and Paramedic Practice, Robert Gordon University, Aberdeen, Scotland, AB10 7QE, UK
| | - Matt Holland
- Library and Knowledge Service for NHS Ambulance Services in England, Bolton, BL1 5DD, UK
| | - Agnieszka Sumera
- Department of Acute Adult Care, University of Chester, Chester, England, CH1 4BJ, UK
- European Pre-Hospital Research Network (EPRN), Nottingham, England, UK
| | - Kacper Sumera
- European Pre-Hospital Research Network (EPRN), Nottingham, England, UK
- East Midlands Ambulance Service NHS Trust, Nottingham Trent University, Nottingham, England, NG11 8NS, UK
| | - Carl A. Webster
- European Pre-Hospital Research Network (EPRN), Nottingham, England, UK
- Institute of Health and Allied Professions, Nottingham Trent University, Nottingham, England, NG11 8NS, UK
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Downey D, Graber K, Lajoie D, Newman L, Weinstock P. Setting the Stage: Innovation in Port Access Education for Pediatric Emergency Nurses. J Emerg Nurs 2023:S0099-1767(23)00002-8. [PMID: 36872198 DOI: 10.1016/j.jen.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/12/2023] [Accepted: 01/17/2023] [Indexed: 03/06/2023]
Abstract
INTRODUCTION Pediatric port access can be challenging in the emergency department; however, it must be performed promptly and safely. Port education for nurses traditionally includes procedural practice on adult-size, tabletop manikins, which lacks the situational and emotional aspects inherent in pediatrics. The purpose of this foundational study was to describe the knowledge and self-efficacy gain from a simulation curriculum that promotes effective situational dialogue and sterile port access technique, while incorporating a wearable port trainer to enhance simulation fidelity. METHODS An educational intervention impact study was conducted using a curriculum integrating a comprehensive didactic session with simulation. A unique element included a novel port trainer worn by a standardized patient, along with a second actor portraying a distressed parent at the bedside. Participants completed precourse and postcourse surveys on the day of simulation and a 3-month follow-up survey. Sessions were video recorded for review and content analysis. RESULTS Thirty-four pediatric emergency nurses participated in the program and demonstrated an overall increase in knowledge and self-efficacy with port access that was sustained at the 3-month follow-up. Data revealed positive feedback regarding the participants' simulation experience. DISCUSSION Effective port access education for nurses requires a comprehensive curriculum integrating procedural aspects and situational techniques to address the components of a true port access experience involving pediatric patients and families. Our curriculum successfully combined skill-based practice with situational management, and promoted nursing self-efficacy and competence with port access in the pediatric population.
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13
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Mårtensson S, Knutsson S, Hodges EA, Sherwood G, Broström A, Björk M. Undergraduate nursing students' experiences of practicing caring behaviours with standardised patients. Scand J Caring Sci 2023; 37:271-281. [PMID: 35348240 DOI: 10.1111/scs.13077] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/16/2022] [Accepted: 03/12/2022] [Indexed: 11/30/2022]
Abstract
RATIONALE Undergraduate nursing students' learning opportunities to practice caring behaviours to assure compassionate and competent nursing practice with standardised patients are few. Earlier studies primarily focused on practicing communication skills in relation to mental health or developing psychomotor skills while caring for a patient with a specific diagnosis. AIM The study aim was to describe undergraduate nursing students' experiences of practicing caring behaviours with a standardised patient. METHOD A sample of forty-eight undergraduate nursing students in semester four at a school of nursing in southern Sweden, enrolled in a full-time, 5-week, on-campus elective caring behaviour course, were at the first and last week individually video-recorded during two caring behaviour simulations encountering a standardised patient. After observing each of their video-recordings, students completed written reflections focusing on their own compassionate and competent verbal and nonverbal caring behaviour. In total, 96 individual written reflections were analysed using qualitative content analysis to describe the experience. RESULTS One main theme emerged: The challenge of being mindfully present in patient encounters. Four themes further described the experience: A challenging but realistic learning experience, learning the impact of nonverbal behaviour, recognising the complexity of verbal behaviour, and learning to be with the patient instead of only doing for the patient. CONCLUSION When caring is intertwined with visible and realistic nursing practice in simulations using standardised patients it facilitates undergraduate nursing students learning compassionate and competent caring behaviour. The learning experience opened the students' eyes to the impact of practicing caring, recognising that being with is not the same as doing for the patient, and thus, how challenging it is to be mindfully present in patient encounters. Designing caring behaviour simulations with standardised patients is a feasible and efficacious educational learning didactic to facilitate students' learning caring behaviour and enhancing patients' experiences.
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Affiliation(s)
- Sophie Mårtensson
- Department of Nursing Science, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,CHILD research group, Jönköping University, Jonkoping, Sweden
| | - Susanne Knutsson
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Eric A Hodges
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Gwen Sherwood
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Anders Broström
- Department of Nursing Science, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
| | - Maria Björk
- Department of Nursing Science, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,CHILD research group, Jönköping University, Jonkoping, Sweden
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14
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Tamilselvan C, Chua SM, Chew HSJ, Devi MK. Experiences of simulation-based learning among undergraduate nursing students: A systematic review and meta-synthesis. NURSE EDUCATION TODAY 2023; 121:105711. [PMID: 36634505 DOI: 10.1016/j.nedt.2023.105711] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 01/01/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVES We aimed to examine the experiences of simulation-based learning (SBL) among undergraduate nursing students. DESIGN We conducted a systematic review and meta-synthesis on the experiences among undergraduate nursing studies who received SBL. DATA SOURCES We searched through six databases namely PubMed, CINAHL, Scopus, Web of Science, Embase, ProQuest, for qualitative studies published from January 2011 to January 2022. REVIEW METHODS A meta-synthesis was conducted according to the three-stage framework outlined by Thomas and Harden (2008). Critical appraisal was performed using the Critical Appraisal Skills Program (CASP) checklist. A standardised data extraction form was developed with reference from JBI Qualitative Assessment and Review Instrument Data Extraction Tools for Qualitative Research (JBI-QARI) checklist for data extraction. RESULTS Fifteen studies were included, and four themes emerged from the synthesis: (1) acquiring knowledge and skills through SBL; (2) positive experiences of using high-fidelity simulation (HFS) and virtual reality simulation (VRS) methods; (3) challenges encountered while using SBL methods and (4) drawing parallels between simulation and real clinical settings. CONCLUSION SBL allowed undergraduate nursing students to gain knowledge, acquire skills and have a positive SBL experiences. However, the provision of innovative strategies and resources for nursing students to overcome SBL-based challenges are still needed.
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Affiliation(s)
| | | | - Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - M Kamala Devi
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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15
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Sterner A, Nilsson MS, Eklund A. The value of simulation-based education in developing preparedness for acute care situations: An interview study of new graduate nurses' perspectives. Nurse Educ Pract 2023; 67:103549. [PMID: 36642012 DOI: 10.1016/j.nepr.2023.103549] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/22/2022] [Accepted: 01/03/2023] [Indexed: 01/15/2023]
Abstract
AIM This study aimed to explore how new graduated nurses experience a one-day simulation based education, contributing to providing care in acute situations two months after completion. BACKGROUND Simulation-based education is often offered to new graduated nurses as part of important workplace learning. Simulation-based education is a valid learning and teaching strategy and is suggested as a measure to improve nurses' ability in acute situations. However, studies are often conducted as pre-post evaluations immediately after completion of a simulation. Thus, knowledge of the clinical impact of simulation-based education on actual acute care situations could benefit both research and practice. DESIGN/METHOD During the winter of 2021-2022, 14 semi-structured interviews were conducted with newly graduated nurses two months after they completed the simulation-based education and the interviews were analyzed using thematic analysis. RESULTS The results are presented in three themes: a structured and shared strategy to handle acute situations, a developed role in acute situations and a more comprehensive understanding of acute situations. The results revealed that simulation-based education can contribute to the ability to care in acute situations in terms of action readiness and broad contextual understanding. CONCLUSION Simulation-based education can help develop the ability to care for patients in acute situations. However, differences in participant experiences must be acknowledged and processed in order for the implementation and outcome to be successful.
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Affiliation(s)
- Anders Sterner
- Faculty of Caring Sciences, Work Life and Social Welfare, University of Borås, 501 90 Borås, Sweden.
| | | | - Annika Eklund
- Department of Health Sciences, University West, 461 86 Trollhättan, Sweden
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16
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Nielsen A, Gonzalez L, Jessee MA, Monagle J, Dickison P, Lasater K. Current Practices for Teaching Clinical Judgment: Results From a National Survey. Nurse Educ 2023; 48:7-12. [PMID: 35926130 DOI: 10.1097/nne.0000000000001268] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Safe patient care is closely linked to clinical judgment. Concerns about inadequate practice readiness and the impending inclusion of clinical judgment items on the NextGen NCLEX have resulted in increasing interest and publications about teaching clinical judgment. However, little is known about actual current practices for teaching this skill. PURPOSE This research describes findings about current strategies to teach clinical judgment used in US prelicensure nursing programs. METHODS Cross-sectional methodology was used to survey program deans and directors across the United States. RESULTS Programs are using multiple strategies to teach clinical judgment. The most common strategies used include case studies and simulation. Participants believed strategies have a positive impact on student thinking, practice readiness, and program outcomes. They described insights into implementation of teaching for clinical judgment. CONCLUSION The results of this research provide foundational data to inform current teaching practices and further research for this essential skill.
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Affiliation(s)
- Ann Nielsen
- Associate Professor of Clinical Nursing Emerita (Dr Nielsen), Professor Emerita (Dr Lasater), Oregon Health & Science University, Portland, Oregon; Professor of Nursing (Ms Gonzalez), College of Southern Maryland, La Plata, Maryland; Associate Professor, Assistant Dean for Academics, Generalist Nursing Practice (Dr Jessee), Vanderbilt University School of Nursing, Nashville, Tennessee; Associate Professor (Dr Monagle), School of Nursing, MGH Institute of Health Professions, Boston, Massachusetts; and Chief Officer, Operations and Examinations (Dr Phillip Dickison), National Council of State Boards of Nursing, Chicago, Illinois
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17
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Knutsson S, Axelsson J, Lindqvist G. An application of the caritative caring approach – nursing students’ experiences of practising caring and uncaring encounters by simulation at a clinical training centre. Int J Qual Stud Health Well-being 2022; 17:2100610. [PMID: 35822434 PMCID: PMC9291673 DOI: 10.1080/17482631.2022.2100610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Purpose Nurses’ lack of competence to be caring affects patients’ health and patients describe a desire for more individual and compassionate care. Nursing education tends, however, to focus less on the caring approach in nursing practice and more on developing knowledge in psychomotor skills. The aim of this study was to describe nursing students’ experiences of simulating caring and uncaring encounters founded on the caritative perspective at a Clinical Training Centre (CTC). Method A qualitative, inductive approach using a qualitative latent content analysis. Written reflections of 49 students were analysed. Findings By intertwining reflection with acting and observation, the students experienced that they achieved an open mind and gained an understanding of how important it was to treat the patient based on a caring approach. To act, first uncaring and thereafter caring, gave them an awakening. The students were touched and an overwhelming feeling of suddenly understanding human uniqueness and vulnerability appeared. Conclusions To simulate caritative caring and uncaring encounters at the CTC enhanced students’ knowledge and understanding about caring and strengthened their prerequisites to acquire a caritative ontological basic view and attitude which in the long run may lead to an increased feeling of patient well-being in the encounter.
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Affiliation(s)
- Susanne Knutsson
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Johanna Axelsson
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Gunilla Lindqvist
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
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18
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Edgar AK, Macfarlane S, Kiddell EJ, Armitage JA, Wood-Bradley RJ. The perceived value and impact of virtual simulation-based education on students' learning: a mixed methods study. BMC MEDICAL EDUCATION 2022; 22:823. [PMID: 36451222 PMCID: PMC9709374 DOI: 10.1186/s12909-022-03912-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 11/21/2022] [Indexed: 05/19/2023]
Abstract
BACKGROUND Virtual simulations are used throughout healthcare training programs to enable development of clinical skills, however the potential for virtual simulation to enhance cognitive and affective skills is less well understood. This study explored pre-clinical optometry students' perceptions of the impact of virtual simulation on the development of core competency skills including patient-centred care, communication, scientific literacy, and evidence-based practice. METHODS A mixed methods study was conducted using pre-existing anonymized data from an electronic survey distributed to pre-clinical optometry students enrolled in the double degree Bachelor of Vision Science/Master of Optometry at Deakin University, Australia. The data were interpreted using descriptive statistics and qualitative analysis using constant comparison for thematic analysis. RESULTS A total of 51 responses were analyzed. Students reported that virtual simulation motivated them to become an optometrist (93%) and to learn beyond the course material (77%). Students reported that after participating in the virtual simulation, their core competency skills improved: patient-centered care (100%) evidence-based practice (93%) and clinical reasoning (93%). The themes identified through qualitative analysis were: enablers to cognitive experience in virtual simulation in optometry education, realism of the virtual simulation design, dimensions of fidelity in virtual simulations design replicated the complexity of the optometric environment, virtual simulation as an enabler for learning and assessment in optometry education, a place to develop cognitive and affective skills and application of learning in the virtual simulation developed an appreciation of future roles and professional identity. CONCLUSION Optometry students perceived virtual simulation in optometric education as a valuable training and assessment strategy enabled by qualities that generate contextual, cognitive, functional, task and psychological fidelity. The data provide insight to inform how optometry educators can incorporate simulation into the curriculum.
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Affiliation(s)
- Amanda K Edgar
- School of Medicine (Optometry), Deakin University, 75 Pigdons Road, Waurn Ponds, 3216, Australia.
| | - Susie Macfarlane
- Deakin Learning Futures, Deakin University, Burwood, VIC, 3125, Australia
| | - Elissa J Kiddell
- Deakin Learning Futures, Deakin University, Burwood, VIC, 3125, Australia
| | - James A Armitage
- School of Medicine (Optometry), Deakin University, 75 Pigdons Road, Waurn Ponds, 3216, Australia
| | - Ryan J Wood-Bradley
- School of Medicine (Optometry), Deakin University, 75 Pigdons Road, Waurn Ponds, 3216, Australia
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Fegran L, ten Ham‐Baloyi W, Fossum M, Hovland O, Naidoo JR, van Rooyen D(R, Sejersted E, Robstad N. Simulation debriefing as part of simulation for clinical teaching and learning in nursing education: A scoping review. Nurs Open 2022; 10:1217-1233. [PMID: 36352489 PMCID: PMC9912432 DOI: 10.1002/nop2.1426] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/01/2022] [Accepted: 10/09/2022] [Indexed: 11/11/2022] Open
Abstract
AIM To map the evidence of the simulation debriefing phase in simulation activities of nursing education, to address and inform clinical teaching and learning in nursing. DESIGN A scoping review. METHODS A systematic review of literature published between 2008-2021 was conducted using CINAHL & ERIC, MEDLINE, EMBASE, APA PsycInfo, the Cochrane Library and JBI Evidence synthesis. Inclusion criteria were primary studies published in English on simulation debriefing at all levels in nursing education. RESULTS Of 140 included references, only 80% (N = 112) framed simulation debriefing theoretically either by specific theories/models or as a literature review of the topic. A variety of simulation debriefing methods were identified; however, debriefing methods were only described in 79% (N = 110) of the references. There appears to be a gap in consensus concerning the theoretical or methodological frameworks characterizing simulation debriefing in nursing education. The majority of studies (86%) were conducted at a bachelor's degree level (N = 121).
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Affiliation(s)
- Liv Fegran
- University of Agder, Campus KristiansandKristiansandNorway
| | | | | | | | - Joanne R. Naidoo
- Nelson Mandela University, North CampusPort ElizabethSouth Africa
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Cant R, Ryan C. An Educator's Anthology of Virtual Simulation Applications for Nursing Curricula: A Mapping Review. Clin Simul Nurs 2022. [DOI: 10.1016/j.ecns.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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21
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El Hussein MT, Cuncannon A. Nursing students' transfer of learning from simulated clinical experiences into clinical practice: A scoping review. NURSE EDUCATION TODAY 2022; 116:105449. [PMID: 35777294 DOI: 10.1016/j.nedt.2022.105449] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 06/06/2022] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
AIMS This review aims to map available evidence regarding undergraduate nursing students' transfer of learning from simulation-based experiences into clinical practice. DESIGN Scoping review. DATA SOURCES We searched MEDLINE, CINAHL, and Google Scholar and conducted manual searches for eligible studies published between January 2016-December 2021. REVIEW METHODS We approached our review using Arksey and O'Malley's scoping review framework and collaboratively worked through the screening, selection, and collating processes. We resolved conflicts in search outcomes and data abstraction through discussion to reach a consensus. We reported our methods and results following the PRISMA-ScR reporting guideline. We used narrative review to outline and discuss results. RESULTS Thirty-two studies, spanning 9 reviews, 14 qualitative studies, 5 quantitative studies, and 4 mixed methods studies conducted in Aotearoa New Zealand, Australia, Canada, Israel, Norway, Spain, Turkey, the United Kingdom, and the United States, were included. Results are presented under three subheadings: conceptualization, measurement, and sustainability of learning transfer from simulation into clinical practice. CONCLUSIONS Although studies generally supported the value of simulation in bridging theory and practice and in developing students' knowledge and skills, there was a predominance of short-term and self-reported measures. Few studies explored distant outcomes of simulation. Further longitudinal research is needed to explore the longer-term processes by which learning transfer and integration occur, as well as the resulting impact on students' and nurses' clinical practice as well as clients' and population health outcomes. This review will be of interest to nursing educators, researchers, and clinicians who wish to support nursing students' learning.
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Affiliation(s)
- Mohamed Toufic El Hussein
- School of Nursing and Midwifery, Mount Royal University, Canada; Faculty of Nursing, University of Calgary, Canada; Medical Cardiology and Coronary Care Unit, Rockyview General Hospital, Alberta Health Services, Canada; Addiction and Mental Health, Alberta Health Services, Canada.
| | - Alexander Cuncannon
- School of Nursing and Midwifery, Mount Royal University, Canada; Faculty of Nursing, University of Calgary, Canada; Medical Cardiology and Coronary Care Unit, Rockyview General Hospital, Alberta Health Services, Canada; Addiction and Mental Health, Alberta Health Services, Canada
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Wang Y, Li X, Liu Y, Shi B. Mapping the research hotspots and theme trends of simulation in nursing education: A bibliometric analysis from 2005 to 2019. NURSE EDUCATION TODAY 2022; 116:105426. [PMID: 35679627 DOI: 10.1016/j.nedt.2022.105426] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/16/2022] [Accepted: 05/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Simulation-based nursing training has been used incorporated into nursing education for decades, however, there is limited information related to simulation research hotspots and theme trends over time. OBJECTIVES To investigate the research hotspots and theme trends of simulation in nursing education through bibliometric analysis. METHODS Relevant articles on simulation in nursing education published between 2005 and 2019 were retrieved from PubMed. The Bibliographic Item Co-occurrence Matrix Builder (BICOMB) was used to extract and quantitatively analyze the Medical Subject Headings (MeSH) terms and subheadings. The biclustering analysis was conducted using gCluto1.0 to identify the research hotspots. A strategic diagram was employed to reveal the development trend of the theme. RESULTS A total of 4102 publications were retrieved from PubMed showing an overall increasing trend. Based on the results, the United States was the most productive country (2868,55.7 %), the journal Nurse Education Today journal was the top journal concerning this field, and Cooper SJ and Holtschneider ME were authors with the highest number of publications on this topic. Quantitative and co-word biclustering analyses were used in this study. The research hotspots in recent 5 years were focused on: (1) interprofessional simulation in patient-care teams; (2) patient simulation in psychiatric nursing education; (3) virtual reality simulation (VRS) in midwifery and nursing education; (4) simulation in critical care nurses' continuing education/training, and (5) simulation in pediatric resuscitation education. The strategic diagram showed that the VRS in midwifery and nursing education might have a significant potential to become an emerging hotspot soon. CONCLUSION The research literature production of simulation in nursing education was increasing over the past 15 years. Through co-word biclustering analysis, five research hotspots were identified. Among them, simulation in psychiatric education and critical care continuing education had a central priority that researchers should pay further attention to, and VRS could be the major trend for future study. Furthermore, this study described the overall range of research interests and provided ideas for innovative and efficient research projects.
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Affiliation(s)
- Yanjie Wang
- School of Nursing, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning Province, PR China; School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China
| | - Xiaohan Li
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China.
| | - Yujia Liu
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China
| | - Bei Shi
- College of Basic Medical Science, China Medical University, Shenyang, Liaoning Province, PR China.
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Baxendale B, Evans K, Cowley A, Bramley L, Miles G, Ross A, Dring E, Cooper J. GENESISS 1-Generating Standards for In-Situ Simulation project: a scoping review and conceptual model. BMC MEDICAL EDUCATION 2022; 22:479. [PMID: 35725432 PMCID: PMC9208746 DOI: 10.1186/s12909-022-03490-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 05/23/2022] [Indexed: 05/04/2023]
Abstract
BACKGROUND In-Situ Simulation (ISS) enables teams to rehearse and review practice in the clinical environment to facilitate knowledge transition, reflection and safe learning. There is increasing use of ISS in healthcare organisations for which patient safety and quality improvement are key drivers. However, the effectiveness of ISS interventions has not yet been fully demonstrated and requires further study to maximise impact. Cohesive programmatic implementation is lacking and efforts to standardise ISS terms and concepts, strengthen the evidence base and develop an integrated model of learning is required. The aim of this study was to explore the current evidence, theories and concepts associated with ISS across all areas of healthcare and develop a conceptual model to inform future ISS research and best practice guidance. METHODS A scoping review was undertaken with stakeholder feedback to develop a conceptual model for ISS. Medline, OpenGrey and Web of Science were searched in September 2018 and updated in December 2020. Data from the included scoping review studies were analysed descriptively and organised into categories based on the different motivations, concepts and theoretical approaches for ISS. Categories and concepts were further refined through accessing stakeholder feedback. RESULTS Thirty-eight papers were included in the scoping review. Papers reported the development and evaluation of ISS interventions. Stakeholder groups highlighted situations where ISS could be suitable to improve care and outcomes and identified contextual and practical factors for implementation. A conceptual model of ISS was developed which was organised into four themes: 1. To understand and explore why systematic events occur in complex settings; 2.To design and test new clinical spaces, equipment, information technologies and procedures; 3. To practice and develop capability in individual and team performance; 4. To assess competency in complex clinical settings. CONCLUSIONS ISS presents a promising approach to improve individual and team capabilities and system performance and address the 'practice-theory gap'. However, there are limitations associated with ISS such as the impact on the clinical setting and service provision, the reliance of having an open learning culture and availability of relevant expertise. ISS should be introduced with due consideration of the specific objectives and learning needs it is proposed to address. Effectiveness of ISS has not yet been established and further research is required to evaluate and disseminate the findings of ISS interventions.
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Affiliation(s)
- Bryn Baxendale
- Trent Simulation & Clinical Skills Centre, Nottingham University Hospitals NHS Trust, Nottingham, Notts UK
| | - Kerry Evans
- Institute of Care Excellence, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Alison Cowley
- Nottingham University Hospitals NHS Trust, Research and Innovation, Nottingham, UK
| | - Louise Bramley
- Institute of Care Excellence, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Guilia Miles
- Trent Simulation & Clinical Skills Centre, Nottingham University Hospitals NHS Trust, Nottingham, Notts UK
| | - Alastair Ross
- Glasgow Dental School, University of Glasgow, Glasgow, UK
| | - Eleanore Dring
- Institute of Care Excellence, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Joanne Cooper
- Institute of Care Excellence, Nottingham University Hospitals NHS Trust, Nottingham, UK
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Sterner A, Skyvell Nilsson M, Jacobsson M, Eklund A. Ability to Care in Acute Situations-The Influence of Simulation-Based Education on New Graduate Nurses. J Emerg Nurs 2022; 48:515-524. [PMID: 35710590 DOI: 10.1016/j.jen.2022.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/05/2022] [Accepted: 05/25/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Simulation-based education is frequently used in transition programs for new graduate nurses. Simulation-based education is implemented as a measure to practice nursing skills, gain experience, and prepare nurses for caring in challenging situations, such as acute situations. However, concerns about the data supporting the use of simulation are obtained from small studies that do not use validated measurement scales. OBJECTIVE This study aimed to explore the influence of simulation-based education on new graduate nurses' perceived ability to provide care in acute situations. METHODS A total of 102 new graduate nurses participated in simulation-based education as a mandatory part of an introductory program. They completed a premeasurement and a postmeasurement using the Perception to Care in Acute Situations scale. The Wilcoxon signed-rank test and the paired samples t test were used to test the statistical significance of outcomes for the simulation-based education, with the alpha set at 0.05. Cohen's d formula was used to calculate the effect size. RESULTS The Wilcoxon signed-rank test on the total scale score showed that simulation-based education resulted in a statistically significant change in the nurses' perceptions of their ability to care in acute situations (N = 99; Z = 7877; P < .001). The paired samples t test showed that the mean posteducation score was significantly higher (P < .001) in the total score. Cohen's d formula (-1.24) indicated a large effect size on the total score. CONCLUSION Simulation-based education can provide an effective means of improving new graduate nurses' perceived ability to provide care in acute situations.
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Rouleau G, Gagnon MP, Côté J, Richard L, Chicoine G, Pelletier J. Virtual patient simulation to improve nurses' relational skills in a continuing education context: a convergent mixed methods study. BMC Nurs 2022; 21:1. [PMID: 34983509 PMCID: PMC8725454 DOI: 10.1186/s12912-021-00740-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 10/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Effective provider-patient communication is crucial to the delivery of high-quality care. Communication roadblock such as righting reflex is widely observed among providers and can lead to relational disengagement. In previous work, nurses felt ill-equipped to communicate effectively with HIV-positive patients to support medication adherence. Providing nurses with continuing education opportunities to improve their relational skills is a major target for optimizing the quality of care. Virtual patient simulation is one promising strategy that needs to be evaluated among graduate nurses. This study aimed to assess the acceptability of a virtual patient simulation to improve nurses' relational skills in a continuing education context. METHODS We conducted a convergent mixed methods study by combining a quantitative pre-experimental, one-group post-test design and a qualitative exploratory study. We used convenience and snowball sampling approaches to select registered nurses (n = 49) working in Quebec, Canada. Participants completed an online sociodemographic questionnaire, consulted the automated virtual patient simulation (informed by motivational interviewing), and filled out an online post-test survey. Descriptive statistics (mean, SD, median, interquartile range) were used to present quantitative findings. From the 27 participants who completed the simulation and post-test survey, five participated in a focus group to explore their learning experience. The discussion transcript was subjected to thematic analysis. At the final stage of the study, we used a comparison strategy for the purpose of integrating the quantitative and qualitative results. RESULTS Nurses perceived the simulation to be highly acceptable. They rated the global system quality and the technology acceptance with high scores. They reported having enjoyed the simulation and recommended other providers use it. Four qualitative themes were identified: motivations to engage in the simulation-based research; learning in a realistic, immersive, and non-judgmental environment; perceived utility of the simulation; and perceived difficulty in engaging in the simulation-based research. CONCLUSIONS The simulation contributed to knowledge and skills development on motivational interviewing and enhanced nurses' self-confidence in applying relational skills. Simulation holds the potential to change practice, as nurses become more self-reflective and aware of the impact of their relational skills on patient care. TRIAL REGISTRATION ISRCTN18243005 , retrospectively registered on July 3 2020.
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Affiliation(s)
- Geneviève Rouleau
- Faculty of Nursing, Université Laval, Pavillon Ferdinand-Vandry, 1050 De la Médecine Ave., Québec City, QC, G1V 0A6, Canada.
- Research Chair in Innovative Nursing Practices, 850 St-Denis St., Tour S, Montréal, QC, H2X0A9, Canada.
| | - Marie-Pierre Gagnon
- Faculty of Nursing, Université Laval, Pavillon Ferdinand-Vandry, 1050 De la Médecine Ave., Québec City, QC, G1V 0A6, Canada
- Vitam Research Center in Sustainable Health, Université Laval, 2525 De la Canardière Rd., Québec City, QC, G1J 0A4, Canada
- Population Health and Optimal Health Practices Axis, CHU de Québec-Université Laval Research Centre, 1050 Sainte-Foy Rd., Québec City, QC, G1S 4L8, Canada
| | - José Côté
- Research Chair in Innovative Nursing Practices, 850 St-Denis St., Tour S, Montréal, QC, H2X0A9, Canada
- Faculty of Nursing, Université de Montréal, 2375 Côte Ste-Catherine Rd., Pavillon Marguerite d'Youville, Montréal, QC, H3T 1A8, Canada
- Centre de recherche du Centre hospitalier de l'Université de Montréal, 850 St-Denis St, Tour S, Montréal, QC, H2X0A9, Canada
| | - Lauralie Richard
- Faculty of Nursing, Université de Montréal, 2375 Côte Ste-Catherine Rd., Pavillon Marguerite d'Youville, Montréal, QC, H3T 1A8, Canada
- Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, 55 Hanover Street, Dunedin, 9016, New Zealand
| | - Gabrielle Chicoine
- Research Chair in Innovative Nursing Practices, 850 St-Denis St., Tour S, Montréal, QC, H2X0A9, Canada
- Centre de recherche du Centre hospitalier de l'Université de Montréal, 850 St-Denis St, Tour S, Montréal, QC, H2X0A9, Canada
| | - Jérôme Pelletier
- Faculty of Nursing, Université Laval, Pavillon Ferdinand-Vandry, 1050 De la Médecine Ave., Québec City, QC, G1V 0A6, Canada
- Université du Québec à Rimouski, 300 Allée des Ursulines, Rimouski, QC, G5L 3A1, Canada
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Alharbi K, Alharbi MF. Nursing Students’ Satisfaction and Self-Confidence Levels After Their Simulation Experience. SAGE Open Nurs 2022; 8:23779608221139080. [DOI: 10.1177/23779608221139080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/23/2022] [Accepted: 10/30/2022] [Indexed: 11/19/2022] Open
Abstract
Background Nursing students should be well prepared before going to clinical setting as they provide direct care to patient. Simulation gives the learners the opportunity to be active learners who practice, train, and give a reflection on a specific experience. Objective To obtain an understanding of the human patient simulation experience and nursing students’ perceptions of satisfaction and self-confidence. Method Cross-sectional, descriptive design was undertaken. Using purposive sampling, 273 nursing students were enrolled in basic adult nursing courses at levels four and five at female nursing college at King Saud University, Riyadh, Saudi Arabia. A questionnaire was used to measure the demographic characteristics, simulation design characteristics, and simulation educational practice context. Student Satisfaction and Self-confidence in Learning Scale was used to measure students’ satisfaction and self-confidence. Bivariate analyses were utilized where needed and multiple linear regression analysis was performed to find the relationship between variables. Results The current study revealed overall, nursing students were satisfied and self-confident after their human patient simulation experience. A relationship was observed between demographic characteristics, simulation design characteristics, and simulation educational practice context with students’ satisfaction and self-confidence. Conclusion Simulation is an effective teaching strategy that prepares nursing students for real clinical practice. Findings provided policymakers with information on nursing students’ current levels of satisfaction and self-confidence that can lead to developing future policies.
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Affiliation(s)
- Kholoud Alharbi
- Nursing Department, Nursing College, King Saud University, Riyadh, Saudi Arabia
| | - Manal F. Alharbi
- Maternal & Child Health Department, Nursing College, King Saud University, Riyadh, Saudi Arabia
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Dix S, Morphet J, Jones T, Kiprillis N, O'Halloran M, Piper K, Innes K. Perceptions of final year nursing students transer of clinical judgement skills from simulation to clinical practice: A qualitative study. Nurse Educ Pract 2021; 56:103218. [PMID: 34619616 DOI: 10.1016/j.nepr.2021.103218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/09/2021] [Accepted: 09/26/2021] [Indexed: 11/27/2022]
Abstract
AIM To explore final year nursing student's ability to transfer clinical judgement skills to the clinical practice setting following immersive simulation. BACKGROUND Clinical judgement is considered a fundamental skill for nurses to ensure safe, quality care is delivered. In undergraduate nursing education where students have limited clinical experience, simulation-based education is an important educational strategy for introducing and developing these skills. Simulation allows for students to be exposed to repeated experiences and emotional responses to varying clinical situations. Despite this, there is a paucity of literature relating to students' ability to transfer clinical judgement skills from the simulated environment into clinical practice. DESIGN A naturalistic philosophical approach informed data collection in this qualitative phase of a larger study. METHODS Data were collected from students and nurse educators using semi-structured interviews as well as from facilitated simulation debriefs. Data were thematically analysed. RESULTS Four themes were identified which related to student knowledge, self-awareness and the clinical context: Safely collecting the data; Understanding the data to safely make decisions; Emotional intelligence; and Role variation. Students and educators held similar views on many of these elements. CONCLUSIONS Questioning was identified as a key component of nursing students' clinical judgements. There were challenges in assessing students' ability to link theory to practice in the clinical setting, despite evidence of this occurring in the simulated setting. Simulation prepares students for practice by exposing them to new experiences and stressors and therefore an effective educational technique for developing clinical judgement skills in this cohort.
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Affiliation(s)
- Samantha Dix
- Monash Nursing and Midwifery, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria 3199, Australia.
| | - Julia Morphet
- Monash Nursing and Midwifery, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria 3199, Australia; Monash Centre for Scholarship in Health Education (MCSHE), Monash University, Wellington Road, Clayton, Victoria 3800, Australia.
| | - Tamsin Jones
- Monash Nursing and Midwifery, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria 3199, Australia.
| | - Noelleen Kiprillis
- Monash Nursing and Midwifery, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria 3199, Australia.
| | - Monica O'Halloran
- Monash Nursing and Midwifery, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria 3199, Australia.
| | - Katie Piper
- Monash Nursing and Midwifery, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria 3199, Australia; Charles Sturt University, School of Nursing, Midwifery & Indigenous Health, Elizabeth-Mitchell Drive, Albury, NSW 2640.
| | - Kelli Innes
- Monash Nursing and Midwifery, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria 3199, Australia.
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Jessee MA. An Update on Clinical Judgment in Nursing and Implications for Education, Practice, and Regulation. JOURNAL OF NURSING REGULATION 2021. [DOI: 10.1016/s2155-8256(21)00116-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Chen HM, Liu HY, Chao SY. The effects of web-based situational learning on nursing students' transfer of learning in clinical practice. NURSE EDUCATION TODAY 2021; 105:105052. [PMID: 34256216 DOI: 10.1016/j.nedt.2021.105052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 04/30/2021] [Accepted: 06/30/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Transferring what has been learned in the classroom to clinical application is the main goal of nursing education. Our previous intervention study, in which a web-based interactive situational teaching strategy in a nursing ethic course was conducted as an experimental group, and the students in the class who were taught using a traditional teaching strategy was treated as the comparative group. The results, which were evaluated immediately after the class, showed that the web-based interactive situational teaching enhanced the students' competency in ethical reasoning and problem solving compared to traditional teaching. PURPOSE This study followed the previous study and aimed to compare the effects of the learning transfer between the two groups in clinical performance as reflected in their internship scores, clinical practice, and self-efficacy assessment. It also explored the factors influencing this transfer. METHOD A predictive correlation-based research design was adopted to compare the students' internship scores, clinical judgment abilities, and self-efficacy in clinical internships between two groups. The students' self-efficacy was measured using a self-administered structured questionnaire, while their internship scores and clinical judgment abilities were evaluated by their clinical instructors. The data obtained were statistically analyzed using SPSS 23 software. RESULTS The nursing students who participated in the web-based interactive situational teaching course did not significantly outperform those who received traditional teaching in their clinical judgment and internship scores. The main variable that significantly affected the clinical self-efficacy of nursing students was the degree of support from the internship instructors. CONCLUSION Nursing students' clinical performance is affected by multiple factors and is not solely determined by the curriculum or teaching strategies. The degree of instructor support during the internship process significantly affected the students' self-efficacy in clinical performance.
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Affiliation(s)
- Hsiao-Mei Chen
- Department of Nursing, Chung Shan Medical University / Department of Nursing, Chung Shan Medical Hospital, No.110, Sec.1, Jianguo N. Rd., Taichung City 40201, Taiwan, ROC.
| | - Hsing-Yuan Liu
- Department of Nursing, Chang Gung University of Science and Technology, No. 261, Wunhua 1st Rd., Gueishan Township, Taoyuan 33303, Taiwan, ROC./ Associate Research Fellow, Chang Gung Memorial Hospital, No.5, Fuxing St., Guishan Dist., Taoyuan City 33305, Taiwan, ROC..
| | - Shu-Yuan Chao
- Department of Nursing, HungKung University, No. 1018, Sec. 6, Taiwan Boulevard, Shalu District, Taichung City 43302, Taiwan, ROC.
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OADN Virtual Simulation Reviews: team collaboration to develop an online resource to assist nurse educators. TEACHING AND LEARNING IN NURSING 2021. [DOI: 10.1016/j.teln.2021.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Miller C, Deckers C, Jones M, Wells-Beede E, McGee E. Healthcare Simulation Standards of Best PracticeTM Outcomes and Objectives. Clin Simul Nurs 2021. [DOI: 10.1016/j.ecns.2021.08.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ting J, Garnett A, Donelle L. Nursing education and training on electronic health record systems: An integrative review. Nurse Educ Pract 2021; 55:103168. [PMID: 34411879 DOI: 10.1016/j.nepr.2021.103168] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 07/19/2021] [Accepted: 08/01/2021] [Indexed: 11/27/2022]
Abstract
AIM This integrative review aimed to synthesize evidence pertaining to interventions that have been used to facilitate nurse education and training on electronic health records. BACKGROUND Inadequate education and training can threaten the adoption of electronic health records and negatively impact the quality of nursing documentation. A review of the literature may help facilitate the development of evidence-based interventions for nursing education and training on electronic health records. DESIGN An integrative review framework was used to address the research question: What is the available evidence to inform best practices for nursing education and training on electronic health records? METHODS A systematic search was conducted in five databases: the Cumulative Index to Nursing and Allied Health Literature, Scopus, PubMed, CBCA Education, and ProQuest Education Database. Included articles were peer-reviewed studies, published in English, in which nurses participated in an electronic health record education or training intervention. RESULTS Fifteen articles, from a search conducted between 2010 and 2020, were reviewed. Findings identified a shift from classroom learning towards blended approaches for nursing education and training on electronic health records, incorporating methods such as e-learning, peer coaching, and simulation. Ongoing staff engagement is needed to develop interventions that allow nurses to integrate electronic health records into their daily workflows. Higher quality studies and more meaningful assessment of learning outcomes are needed to identify the most effective interventions to incorporate in blended learning strategies. CONCLUSIONS Consensus in the reviewed literature indicated that electronic health record education and training for nurses should be multipronged and targeted to nurses' clinical workflows. Key findings of this review identified a shift from classroom-based learning towards blended approaches for electronic health record education and training. Blended approaches often incorporated non-traditional methods that could support interactive and workflow-based content. These included e-learning, nurse superusers or peer coaches, and simulation training. The findings of this review also highlighted the need for early and ongoing involvement of frontline nurses during electronic health record education and implementation. However, more rigorous studies that assess both patient and organizational outcomes are needed to identify the most effective "cocktail" of blended learning strategies.
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Affiliation(s)
- Justine Ting
- FNB 2036, Arthur Labatt School of Nursing, Western University, London, Ontario N6A 5C1, Canada.
| | - Anna Garnett
- FNB 2036, Arthur Labatt School of Nursing, Western University, London, Ontario N6A 5C1, Canada.
| | - Lorie Donelle
- FNB 2036, Arthur Labatt School of Nursing, Western University, London, Ontario N6A 5C1, Canada.
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Luctkar-Flude M, Tyerman J, Verkuyl M, Goldsworthy S, Harder N, Wilson-Keates B, Kruizinga J, Gumapac N. Effectiveness of Debriefing Methods for Virtual Simulation: A Systematic Review. Clin Simul Nurs 2021. [DOI: 10.1016/j.ecns.2021.04.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kinsman L, Cooper S, Champion R, Kim JA, Boyle J, Cameron A, Cant RP, Chung C, Connell C, Evans L, McInnes D, McKay A, Norman L, Penz E, Rana M, Rotter T. The impact of web-based and face-to-face simulation education programs on nurses' response to patient deterioration: A multi-site interrupted time series study. NURSE EDUCATION TODAY 2021; 102:104939. [PMID: 33934038 DOI: 10.1016/j.nedt.2021.104939] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 12/13/2020] [Accepted: 04/19/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Nurses' response to patient deterioration in acute hospital wards is a priority issue. Simulation education programs improve nurses' knowledge and confidence, but the translation into better care is largely unknown for both web based (WB) and face to face (F2F) simulation programs. AIM To measure the impact of simulation education on nurses' response to patient deterioration in acute medical ward settings, and to compare the impact of WB and F2F versions. DESIGN An interrupted time series, non-randomised trial across four medical wards in Victoria, Australia. Wards were allocated to either web-based or face-to-face versions of the same simulation program, FIRST2ACT. Interrupted time series measurement for six fortnights both before and after the intervention were used to measure and compare responses to deterioration. Responses to patient deterioration were extracted from medical records and grouped into outcomes for escalation (e.g. initiation of clinical review), assessment and observation (e.g. increased recording of vital signs, conscious state and pain scores) and clinical interventions (e.g. oxygen administration). RESULTS 126 nurses (89%) participated across the four wards. 946 patient records (506 in the F2F; 440 in the WB group) were included in analyses. There were significant and sustained improvements between pre and post samples in outcomes for escalation (13.0% to 28.8%; p = 0.000) and assessment and observation (conscious state recorded increased from 91.1% to 100%; p = 0.000, and pain score recorded increased from 97.8% to 99.8%; p = 0.000). There were no differences between the web-based and face-to-face groups except in appropriate oxygen application which increased by 7.7% in the F2F group and decreased by 11.8% in the WB group (p = 0.046). CONCLUSIONS There was a significant improvement in nurses' response to patient deterioration following both versions of simulation, indicating that both have a role to play in supporting nurses' response to patient deterioration.
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Affiliation(s)
- Leigh Kinsman
- School of Nursing and Midwifery, University of Newcastle, Port Macquarie Base Hospital, Port Macquarie, NSW 2444, Australia.
| | - Simon Cooper
- Federation University Australia, Northways Rd., Churchill, VIC 3842, Australia.
| | | | - Jeong-Ah Kim
- Federation University Australia, University Drive, Mt Helen, VIC 3350, Australia.
| | - Jayne Boyle
- St John of God Health Care, Bendigo, PO Box 478, Bendigo, Victoria 3350, Australia.
| | - Amanda Cameron
- Latrobe Regional Hospital, 10 Village Ave, Traralgon, VIC 3844, Australia.
| | - Robyn P Cant
- Federation University Australia, Northways Rd., Churchill, VIC 3842, Australia.
| | - Catherine Chung
- Federation University Australia, Northways Rd., Churchill, VIC 3842, Australia.
| | - Cliff Connell
- Monash University, Room E2.31, Building E, Peninsula Campus, McMahons Road, Frankston, P O Box 527, Frankston, VIC, Australia.
| | - Lisa Evans
- St John of God Health Care Berwick, Gibb St, Berwick, Victoria 3806, Australia.
| | - Denise McInnes
- Central Gippsland Health Service, 155 Guthridge Parade, Sale, VIC 3850, Australia.
| | - Angela McKay
- University of Tasmania, Locked Bag 1322, Launceston, TAS 7250, Australia.
| | - Lisa Norman
- St John of God Health Care Berwick, Gibb St, Berwick, Victoria 3806, Australia.
| | - Erika Penz
- Division of Respirology, Critical Care and Sleep Medicine, University of Saskatchewan, Canada.
| | - Masud Rana
- Division of Respirology, Critical Care and Sleep Medicine, University of Saskatchewan, Canada.
| | - Thomas Rotter
- Healthcare Quality Programs, Queens' University, Kingston, Canada.
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Kelly MM, Tobias J, Griffith PB. Addressing Preterm Birth History With Clinical Practice Recommendations Across the Life Course. J Pediatr Health Care 2021; 35:e5-e20. [PMID: 33637388 DOI: 10.1016/j.pedhc.2020.12.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/12/2020] [Accepted: 12/18/2020] [Indexed: 12/19/2022]
Abstract
Preterm birthrates, coupled with excellent preterm birth survival rates, guarantee that every health care provider, regardless of specialty, is caring for patients who were born preterm. Patients and families may not share a preterm birth history however, eliciting this information is important for mitigating potential risk. Long-term health outcomes research supports health implications associated with preterm birth throughout the life course. Through an in-depth review of literature and validation from health care experts in pediatric and adult care, recommendations for primary care providers were developed. The aim was to enhance the identification of those born prematurely, empower health care providers to employ familiar screening strategies, and advocate for mitigations strategies with anticipatory guidance and health promotion. These recommendations advocate a paradigm shift toward proactive intervention, rather than the reactive practice of waiting for children to fail to meet specific milestones or begin to show comorbid tendencies.
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The Influence of preterm birth beyond infancy: Umbrella review of outcomes of adolescents and adults born preterm. J Am Assoc Nurse Pract 2021; 32:555-562. [PMID: 31651585 DOI: 10.1097/jxx.0000000000000248] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND PURPOSE In recent decades, increased neonatal survival has enabled research of long-term outcomes of those born preterm. The purpose of this article is to present the findings of an umbrella review, an examination of published systematic reviews and meta-analyses, to examine the outcomes of adolescents and adults born preterm. METHODS The research was guided by the Joanna Briggs Institute methodology for umbrella reviews. A systematic search of PubMed, CINAHL, and PsycINFO databases with the search years 2010 through September 2018 yielded 16 reviews for inclusion. CONCLUSIONS The 16 reviews included in this umbrella review represent five clinical outcomes: neurodevelopmental (3 reviews), mental/behavioral health (5 reviews), cardiovascular (4 reviews), pulmonary (3 reviews), and life experience outcomes (4 reviews). One review included data for multiple clinical outcomes. This umbrella review highlights the adolescent and adult risks related to cognitive scores, executive function, anxiety, depression, attention-deficit hyperactivity disorder, long-term effects on systolic blood pressure, low-density lipoproteins and cholesterol levels, pulmonary symptoms, including asthma, pulmonary function, radiographic changes in the lungs, sports and leisure participation, and educational attainment and employment. IMPLICATIONS FOR PRACTICE There is a preponderance of evidence that supports targeted screening for a history of preterm birth by all health care providers. This screening should facilitate the promotion of healthy lifestyles and improving psychosocial and neurodevelopmental difficulties through early and continued support services. Curricular and practice standards are advocated to support this change.
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Abstract
Simulation has been used in nursing education and training since Florence Nightingale's era. Over the past 20 years, simulation learning experiences (SLEs) have been used with increasing frequently to educate healthcare professionals, develop and increase the expertise of practicing professionals, and gain competency in key interprofessional skills. This chapter provides a brief overview of simulation evaluation history, beginning in the late 1990s, and the initial focus on learner self-report data. Using Kirkpatrick's Levels of Evaluation as an organizing model, four types of SLE evaluation are reviewed as well as suggestions for future research.
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Rogers B, Baker KA, Franklin AE. Learning Outcomes of the Observer Role in Nursing Simulation: A Scoping Review. Clin Simul Nurs 2020. [DOI: 10.1016/j.ecns.2020.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Rossler KL, Hardin K, Taylor J. Teaching Interprofessional Socialization and Collaboration to Nurses Transitioning Into Critical Care. Clin Simul Nurs 2020. [DOI: 10.1016/j.ecns.2020.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Interprofessional Simulation: From the Classroom to Clinical Practice. ANNUAL REVIEW OF NURSING RESEARCH 2020; 39:105-125. [PMID: 33431639 DOI: 10.1891/0739-6686.39.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Interprofessional simulation (IPS), frequently referred to in the literature as simulation-enhanced interprofessional education (IPE), has been widely studied in nursing and medical education. For decades, the literature has suggested IPE as a valuable strategy for enhancing communication and collaboration among health professionals. Interprofessional collaborative practice (IPCP) is foundational to developing high-functioning healthcare teams and can lead to reduced medical errors and increased patient safety. This chapter addresses IPS from both the academic and practice perspectives. The foundations of IPE and IPCP are reviewed, as well as the standards of best practice in simulation. Planning, development, and implementation will be discussed, including benefits, barriers, and possible solutions. Recommendations from relevant research on debriefing and evaluation of IPS are also reviewed. Outcomes from the growing body of research on IPS will be presented and include perceptions of interprofessional practice, better understanding of professional roles and responsibilities, development of communication and teamwork skills, and shared problem-solving and decision-making. Future implications and recommendations are provided based on the state of the science on IPS. Optimum design, implementation, and evaluation of IPS, along with a thorough understanding of the benefits, barriers, and opportunities, can help faculty and clinical educators prepare a collaborative healthcare workforce and reduce medical errors to ultimately improve patient outcomes.
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Franklin AE, Blodgett NP. Simulation in Undergraduate Education. ANNUAL REVIEW OF NURSING RESEARCH 2020; 39:3-31. [PMID: 33431635 DOI: 10.1891/0739-6686.39.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Simulation is an integral component of undergraduate nursing education because it allows for a safe, timely, and prescriptive approach to meet learning objectives at the levels of individual simulations, courses, and academic programs. This review of the literature provides an overview of steps taken to move simulation forward in undergraduate nursing education, and it highlights educational theories, research, best practices, and policy statements underpinning modern nursing simulation. This chapter outlines simulation and curriculum integration approaches and provides examples of participant, course, and program outcomes.
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Cant R, Levett-Jones T. Umbrella review: Impact of registered nurses' continuing professional education informed by contemporary reviews of literature. Nurse Educ Pract 2020; 50:102945. [PMID: 33321270 DOI: 10.1016/j.nepr.2020.102945] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 09/17/2020] [Accepted: 11/24/2020] [Indexed: 10/22/2022]
Abstract
This paper aims to explore and classify studies of the impact and effectiveness of continuing professional education for registered nurses, using existing reviews of literature. Four healthcare databases were searched for publications from 2010 to July 2019 and electronic keywords searches were conducted. Umbrella review methodology was applied and Kirkpatrick's Four-Level Model of training evaluation was used to synthesise results and explicate the levels of educational impact. Of 16 included reviews, 13 were of simulation-based education activities. Three reviews of experimental studies demonstrated strong positive evidence of education impact on nurses' learning. Objective evidence of transfer of knowledge and skills into practice included improved interprofessional team performance and less time taken to complete clinical tasks. Reports of practice improvements and intention to change practice provided further evidence of impact. A small number of individual studies measured impact on service delivery, reporting positive and neutral results. We conclude that nurses learn and newly acquired knowledge and skills are often transferred into practice. Collection of robust evaluative data after completion of education is limited by practical considerations such as access to learners, resources and time constraints. Further studies of translational impact are needed, specifically, of the impact on patient care.
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Affiliation(s)
- Robyn Cant
- School of Nursing and Healthcare Professions, Federation University Australia, Berwick, Victoria, Australia.
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Suikkala A, Leino-Kilpi H, Katajisto J. Nursing student-patient relationship - a 10-year comparison study in Finland. Int J Nurs Educ Scholarsh 2020; 17:/j/ijnes.2020.17.issue-1/ijnes-2019-0125/ijnes-2019-0125.xml. [PMID: 33151176 DOI: 10.1515/ijnes-2019-0125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 10/13/2020] [Indexed: 12/11/2022]
Abstract
Objective This study aimed to describe and compare the group-level findings from 2005-2006 and 2015-2016 regarding students' and patients' views of the nursing student-patient relationship and associated factors. Methods The data were in both cases collected using Student-Patient Relationship Scales. The data were analysed statistically. Results In both student cohorts, authoritative and facilitative student-patient relationships were reported by the students more frequently than mechanistic relationships. Authoritative relationships were most common in both patient cohorts, whereas facilitative relationships had become more frequent than mechanistic relationships. A positive change of views in the student and patient cohorts was found in factors associated with the relationship. Conclusion In order to strengthen a clinical learning culture that reflects a facilitative student-patient relationship, further research is needed on the processes and outcomes of that relationship.
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Affiliation(s)
- Arja Suikkala
- University of Turku, Department of Nursing Science, University of Turku, Turku, Finland and Diaconia University of Applied Sciences, Helsinki, Finland
| | - Helena Leino-Kilpi
- University of Turku, Department of Nursing Science, University of Turku, Turku, Finland, andTurku University Hospital, Turku, Finland
| | - Jouko Katajisto
- University of Turku, Department of Mathematics and Statistics, Turku, Finland
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Watkins A, Stein-Parbury J, Denney-Wilson E, Ward PB, Rosenbaum S. Upskilling Mental Health Nurses to Address the Burden of Poor Metabolic Health: A Mixed Method Evaluation. Issues Ment Health Nurs 2020; 41:925-931. [PMID: 32552212 DOI: 10.1080/01612840.2020.1744204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
People living with a severe mental illness experience a life expectancy gap compared to the rest of the population that is largely driven by preventable cardiovascular diseases stemming from lifestyle factors, and the side effects of psychotropic medications. Mental health nurses are well positioned to help address the gap using lifestyle interventions. However, many nurses don't prioritise delivering such care, or lack the skills and confidence to implement these strategies. This study used a mixed method approach to determine the effectiveness of 2-day metabolic workshops that aimed to provide nurses with the skills to provide lifestyle interventions. The quantitative component compares pre and post measures of attitudes, confidence, knowledge and perceived barriers of providing metabolic care using a validated tool (M-BACK) and the qualitative component to elicit more details of the needs, expectations and plans of participants. Fifty-six nurse participants demonstrated statistically significant improvements in M-BACK post scores (p < 0.001), with 53 of the 56 participants (95%) achieving improved M-BACK scores. Participants identified three primary barriers to delivering metabolic care, related to individual staff members, consumers, and system issues. Prior to the course participants stated they hoped to improve their knowledge, enhance their practical skills and provide education for others. Following completion of the course participants planned to implement lifestyle education and interventions for consumers, provide education and support to other staff and integrate metabolic health care into clinical reviews and planning. This study demonstrates that education on metabolic health care can be effective in improving the attitudes, confidence, and knowledge of mental health nursing in providing metabolic health care and a decrease in the perceived barriers to delivering that care.
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Affiliation(s)
- Andrew Watkins
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of Sunshine Coast, Birtinya, Queensland, Australia.,Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | - Jane Stein-Parbury
- Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | | | - Philip B Ward
- School of Psychiatry, UNSW Sydney, Sydney, New South Wales, Australia.,Liverpool Hospital, Schizophrenia Research Unit, Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Simon Rosenbaum
- School of Psychiatry, UNSW Sydney, Sydney, New South Wales, Australia
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Affiliation(s)
- Ashley Franklin
- Texas Christian University, Harris College of Nursing & Health Sciences, Fort Worth, TX 76129 USA
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Spies C, Botma Y. Optimising simulation learning experiences for mature, postgraduate nursing students. Nurse Educ Pract 2020; 47:102834. [PMID: 32927335 DOI: 10.1016/j.nepr.2020.102834] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 04/18/2020] [Accepted: 07/02/2020] [Indexed: 10/23/2022]
Abstract
Mature students do not always approach learning activities according to expected adult learner behaviour. In addition, they may have never experienced simulation as a learning opportunity before. This creates a unique opportunity for nurse educators to contextualise education principles that are most applicable to mature students' learning needs. Education action research was conducted with two groups of mature postgraduate students, using nominal and focus groups to optimise their simulation learning experiences. Results showed that mature students should be thoroughly oriented beforehand about simulation practice and what is expected of them during participation. Through scaffolding and a succession of at least six to 10 simulation sessions, learner independence and adult learner behaviour can be developed. Begin with less complex scenarios before moving to ones that are more complex - this will prevent cognitive overload. Keeping the simulation environment as authentic and reliable as possible will promote suspension of disbelief. A non-punitive debriefing model is essential for enhancing student engagement and motivating improved performance in follow-up simulation learning sessions. If nurse educators stay open and responsive to the learning needs of mature students, the advantages of learning through simulation can be realised fully.
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Affiliation(s)
- Cynthia Spies
- School of Nursing, Idalia Loots Building, University of the Free State, P.O. Box 99, Nelson Mandela Drive, Bloemfontein, 9300, South Africa.
| | - Yvonne Botma
- School of Nursing, Idalia Loots Building, University of the Free State, P.O. Box 99, Nelson Mandela Drive, Bloemfontein, 9300, South Africa.
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Holm A, Viftrup A, Karlsson V, Nikolajsen L, Dreyer P. Nurses' communication with mechanically ventilated patients in the intensive care unit: Umbrella review. J Adv Nurs 2020; 76:2909-2920. [PMID: 32893350 DOI: 10.1111/jan.14524] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 06/22/2020] [Accepted: 06/30/2020] [Indexed: 12/30/2022]
Abstract
AIM To conduct a review summarizing evidence concerning communication with mechanically ventilated patients in the intensive care unit (ICU). BACKGROUND ICU patients undergoing mechanical ventilation are unable to communicate verbally, causing many negative emotions. Due to changes in sedation practice, a growing number of patients are conscious and experience communication difficulties. DESIGN The umbrella review method guided by the Joanna Briggs Institute was applied. DATA SOURCES A systematic search was done in the Cochrane Library, the Joanna Briggs Institute database, Cinahl, Pubmed, PsycINFO and Scopus between January -April 2019. Search terms were 'nurse-patient communication', 'mechanical ventilation', 'intensive care', and 'reviews as publication type'. Literature from 2009-2019 was included. REVIEW METHODS Following recommendations by the Joanna Briggs Institute, a quality appraisal, data extraction, and synthesis were done. RESULTS Seven research syntheses were included. There were two main themes and six subthemes: (1) Characterization of the nurse-patient communication: (a) Patients' communication; (b) Nurses' communication; (2) Nursing interventions that facilitate communication: (a) Communication assessment and documentation; (b) Communication methods and approaches; (c) Education and training of nurses; and (d) Augmentative and alternative communication. CONCLUSION Nurse-patient communication was characterized by an unequal power relationship with a common experience - frustration. Four key interventions were identified and an integration of these may be key to designing and implementing future ICU communication packages. IMPACT Nurse-patient communication is characterized by an unequal power relationship with one joint experience - frustration. Four key interventions should be integrated when designing and implementing communication packages in the ICU. Findings are transferable to ICU practices where patients are conscious and experience communication difficulties.
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Affiliation(s)
- Anna Holm
- Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark
| | - Anette Viftrup
- Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark
| | | | - Lone Nikolajsen
- Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Pia Dreyer
- Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.,Department of Public Health, Section of Nursing Science, Aarhus University, Aarhus, Denmark.,University of Bergen, Bergen, Norway
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Kelly MM, Griffith PB. Umbrella Review of School Age Health Outcomes of Preterm Birth Survivors. J Pediatr Health Care 2020; 34:e59-e76. [PMID: 32660808 DOI: 10.1016/j.pedhc.2020.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/18/2020] [Accepted: 05/21/2020] [Indexed: 11/18/2022]
Abstract
Preterm birth affects approximately 10% of U.S. births, with survival rates close to 95%. All health care providers, regardless of population or setting, are treating preterm birth survivors. The purpose of this manuscript is to present an umbrella review of the health outcomes of 2- to 12-year-old children who were born preterm. The current umbrella review consisted of 29 reviews, 14 meta-analyses, eight systematic reviews, and seven described as both meta-analysis and systematic review. Studies were grouped into six health outcome categories: neurodevelopmental, motor and/or cerebral palsy, pulmonary, mental and/or behavioral health, quality of life and/or leisure, and eczema. The analysis supports a resounding recommendation to recognize preterm birth, at all gestations, as a risk factor to health and educational outcomes. Increased attention to developmental screenings is critical, specifically recognition that children who are on the lower ranges of normal may benefit from therapies or interventions that support the attainment of future skills.
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Baccalaureate nursing students' experiences with multi-patient, standardized patient simulations using telehealth to collaborate. J Prof Nurs 2020; 36:292-300. [DOI: 10.1016/j.profnurs.2020.03.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/17/2020] [Accepted: 03/19/2020] [Indexed: 10/24/2022]
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Rogers BA, Baker KA, Sapp A. Learning outcomes of the observer role in nursing simulation: a scoping review protocol. JBI Evid Synth 2020; 18:1051-1056. [PMID: 32813358 DOI: 10.11124/jbisrir-d-19-00172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The purpose of this study is to map the literature investigating learning outcomes that have been measured in the observer role in simulation. A scoping review will be completed to investigate the research question: What learning outcomes have been reported in nurses or nursing students participating in simulation while assigned to the observer role? INTRODUCTION Simulation-based learning experiences (SBLE) are being utilized more frequently to support learning with increasing numbers of nurses. Despite SBLE becoming more popular, resources and manikin availability are not meeting the demand placed on simulation programs in nursing schools and health care facilities. Programs are placing more learners in observational roles without knowing what learning can be expected. INCLUSION CRITERIA Studies will be considered if they investigated learning outcomes of any nursing population (e.g. pre-licensure nursing student, graduate nursing student, practicing nurse) placed in an observational role in simulation. Any simulation topic related to nursing care will be considered. The observer role may involve observing one's own or expert behavior. The SBLE may occur in a simulation lab, classroom, community, health care facility, or online setting. Studies that include health care professionals other than nurses will be excluded. Experimental, quasi-experimental, observational, and qualitative studies will be considered. METHODS The JBI methodology for scoping reviews will be followed. A three-step search strategy will be used to identify potentially relevant articles. Two independent reviewers will screen titles and abstracts, assess full-text studies against the inclusion criteria, and extract data. Results will be presented in a manner that aligns with the objective of the review.
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Affiliation(s)
- Beth A Rogers
- Harris College of Nursing & Health Sciences, Texas Christian University, Fort Worth, USA.,The Center for Translational Research: A JBI Centre of Excellence
| | - Kathy A Baker
- Harris College of Nursing & Health Sciences, Texas Christian University, Fort Worth, USA.,The Center for Translational Research: A JBI Centre of Excellence
| | - Alysha Sapp
- The Center for Translational Research: A JBI Centre of Excellence.,Mary Couts Burnett Library, Texas Christian University, Fort Worth, USA
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