Learning style impact on knowledge gains in human patient simulation

Can a high-fidelity simulation tutorial improve written examination results? Review of a change in teaching practice

BACKGROUND

Undergraduate nursing students prefer technology-based learning. Simulation has been used in nursing education to provide skills acquisition and clinical exposure. Can high-fidelity simulation (HFS) be used to teach tutorial content to prepare students for a written examination?

AIMS

To design a pilot HFS tutorial.

METHOD

203 second year undergraduate nurses were timetabled to attend an HFS tutorial. Examination results at first attempt were compared with the previous cohort's results.

RESULTS

81% of the students from the HFS tutorial cohort passed at the first attempt compared with 85% from the previous cohort.

CONCLUSION

The HFS tutorial needs to be developed further, incorporating simulation standards, to further assess its ability to improve a student's written examination results. Students found the post-simulation discussion difficult and wanted guidance in how to participate. Involvement of the university's skills and simulation team would be recommended for future cohorts to assist with design and facilitation.

Transcultural Translation and Validation of Lasater Clinical Judgment Rubric©

OBJECTIVES

to translate and cross-culturally validate the Lasater Clinical Judgment Rubric© (LCJR©) instrument for nursing students.

METHODS

the application of LCJR-PT© was preceded by a linguistic translation into Portuguese, based on the translation-back-translation method. This psychometric study involved 32 nursing students from a program in Portugal. Data were collected through observations of two independent observers during the performance of the practices developed by the students, through the scenarios validated by experts of high and of medium-fidelity simulation.

RESULTS

of the 64 observations obtained from the practices of nursing students, the value of intra-class correlations in the 4 aspects of the instrument exceeded 0.792. There was a global Cronbach's alpha of LCJR-PT© of 0.921 and 0.876 in Observers 1 and 2 respectively, with a statistically significant level of agreement.

CONCLUSIONS

the LCJR-PT© is a valid and reliable instrument, demonstrating a high potential for its use in clinical education and nursing research.

Student-Centered Reflection During Debriefing: A Mixed-Methods Study

BACKGROUND

Guided reflection during a debriefing after the simulation is a critical component of learning and is essential for clinical judgment development. However, the literature describing student-centered reflection during debriefing is only beginning to emerge.

PURPOSE

This study aimed to explore concordance between student-centered reflection concept characteristics and describe students' experiences related to reflection during an optimal simulation debriefing.

METHODS

This was a descriptive, mixed-methods study.

RESULTS

Quantitative responses (N = 175; 67% response rate) confirmed participants' concordance with student-centered reflection concept analysis attributes, antecedents, and consequences. Analysis of open-ended questions highlighted internal and external factors influencing students' reflections. A recurring theme was the importance of faculty and peers in creating a safe, supportive environment for reflections.

CONCLUSIONS

Findings support the concordance of student-centered reflection and provide valuable insights into the internal and external factors influencing this reflection.

Instruments to evaluate undergraduate healthcare student learning styles globally: A scoping review

BACKGROUND

Recognizing learning styles is important to maximizing learning outcomes and many instruments are available to investigate learning styles.

OBJECTIVE

To investigate instruments with evidence of validity and reliability most commonly used to evaluate undergraduate healthcare student learning styles globally.

METHOD

This scoping review of literature was guided by The Joanna Briggs Institute's recommendations for conducting scoping reviews and the PRISMA-ScR (extension for scoping reviews). The protocol is available for access.

DATA SOURCES

Databases searched included Cumulative Index to Nursing and Allied Health Literature, PubMed, Web of Science, and Scopus. Inclusion criteria were: fully accessible; written in English, Portuguese, or Spanish; and used reliable and/or validated instruments to describe healthcare student learning styles. Articles were excluded if the sample included healthcare professionals, there was no report of the instrument validity and reliability, or was not fully accessible. Data were extracted from each article and entered into Microsoft Office Excel documents for analysis.

RESULTS

Forty-seven articles were selected for full review, including cross-sectional, interventional, and longitudinal studies. Eleven instruments were identified with evidence of reliability and validity for assessing undergraduate healthcare student learning styles globally. The most frequently used instruments were Visual, Aural, Read-Write, and Kinesthetic; Kolb's Learning Styles Inventory; and the Honey-Alonso Questionnaire. Most instruments were developed based on a theoretical framework and/or model.

CONCLUSION

This scoping review adds to the literature an overview of available instruments which measure healthcare student learning styles with evidence of both reliability and validity. The results indicate the need for further studies to improve learning style instruments for use in intervention studies aimed at improving the teaching-learning process for healthcare students.

Analysis of learning styles in a laparoscopic technical skills course. Implications for surgical training

INTRODUCTION

Learning surgical techniques is a dynamic process. In the 1980s David Kolb described developed a learning model that enabled teaching styles to adapt for better learner outcomes. The aim of this study was to identify the Kolb learning styles of the participants in a laparoscopic technical skills course and to check see if there was any relationship with performance.

METHODS

An observational descriptive study was conducted with 64 participants in an intensive course in which they performed laparoscopic manual intestinal anastomoses. All completed Kolb's inventory of learning styles. For each anastomosis, join quality was assessed and the performing time recorded. After that, they were analyzed through statistical studies.

RESULTS

The most frequent learning style was assimilating type (39.1%). No significant differences were observed between different learning styles and gender, professional category, the time taken or the quality of the anastomoses.

CONCLUSIONS

Assimilating type was the most frequent Kolb learning style, with no differences observed between categories, age or gender. There is no relationship between the learning style of the participants and the results obtained in the course.

Canadian general internal medicine residents’ perception of a pedagogical tool of online cases in obstetric medicine

Background

Sufficient exposure to rarer medical problems around pregnancy is a challenge during short rotations in obstetric medicine (OM). A Canadian research group created online clinical cases, the CanCOM cases, to overcome this.

Methods

We conducted an exploratory study to document the use and perceived utility of the CanCOM cases. 77 residents doing an OM rotation participated in our study. We used a survey to document their perception of CanCOM cases (12 items, 7-point scale), clinical exposure to several conditions (pre and post rotation; 41 items, 7-point scale) and use of the educational tool (1 item, 4-option scale).

Results

CanCOM cases was perceived as an accessible and useful tool. Participants completed a median of 6/20 cases (range 1–20), and highly recommended the cases (6.48 ± 0.73 SD on a 7-point Likert scale).

Conclusion

Despite some technical limitations, CanCOM cases was shown to contribute to clinical exposure to rare but essential medical conditions.

Clinical Decision-Making in Nursing Scale (CDMNS-PT©) in nursing students: translation and validation

OBJECTIVES

to validate, for the Portuguese population, the Clinical Decision-Making Nursing Scale© (CDMNS©).

METHODS

this methodological study involved 496 nursing students who filled in a questionnaire created using sociodemographic and academic data, and the scale to evaluate the making of decisions in nursing.

RESULTS

the confirmatory factorial analysis showed that the adjustment of the factorial structure has good quality, being made up by three factors (X2/gl = 2.056; GFI = 0.927; CFI = 0.917; RMSEA = 0.046; RMR = 0.039; SRMR = 0.050). For the scale to be reliable, it had to include only the reliability of the scale required it to be constituted by 23 items, with correlation values that varied from 0.184 and 0.610, and a global Cronbach's Alpha of 0.851, which showed its good reliability.

CONCLUSIONS

the CDMNS-PT© is valid and reliable, showing a high potential to be used in clinical practice and investigation.

Reflection of Learning Styles on Students' Anxiety and Learning Levels in Simulation Education: An Obstetrics and Neonatology Nursing Experience

AIM

This study aimed to investigate whether the learning styles of nursing students affected their anxiety and learning levels during simulation education.

METHOD

This was a cross-sectional and quasi-experimental study, which included a total of 60 nursing students. The students received simulation education about labor management and first care of newborns. The Learning Styles Inventory III, the Trait Anxiety Scale, and a pretest were used before the simulation education, and the Perceived Learning Scale and a posttest were used after the simulation education to collect data.

RESULTS

According to data from the learning styles inventory, 81.6% of the students had a diverging learning style, 11.7% had an assimilating learning style, and 6.7% had an accommodating learning style. The mean state anxiety score was 49.83 ± 10.59 just before the simulation. The mean pretest score was 51.50 ± 16.96 and the mean posttest score was 54.17 ± 15.22. The perceived learning score was 35.45 ± 5.12. There was a significant difference in anxiety levels in terms of learning styles (p < .005).

CONCLUSION

Most of the students in this study had a diverging learning style. Their anxiety levels did not change depending on their learning styles. The pretest/posttest results and perceived learning levels showed that simulation helped to achieve learning in all types of learners.

Effects of simulation-based learning on nursing students' perceived competence, self-efficacy, and learning satisfaction: A repeat measurement method

BACKGROUND

Simulation-Based Learning is beneficial to nursing education. Nevertheless, recent studies have shown a side effect of being overwhelmed by repeated exposures to simulation. Thus, how many times simulation scenarios should be provided to students remains a question for nursing faculty.

OBJECTIVES

The objectives of this study were to (1) explore the changes in nursing students' perceived competence, self-efficacy, and learning satisfaction after repeated exposures to simulations, and (2) determine the acceptable frequency of SBL in the 'Integrated Care in Emergency and Critical Care' course.

DESIGN

A one-group repeated measurement experimental design with self-administered questionnaires in a convenient sample of senior nursing undergraduate students was used.

SETTINGS

Department of Nursing at a nonprofit university in southern Taiwan.

PARTICIPANTS

Seventy-nine out of 84 senior nursing students who enrolled in the course in 2019 volunteered to complete all measurements.

METHODS

After taking the baseline measurements (T0), students were exposed to 75-min simulation scenarios from Time 1 (T1) to Time 3 (T3) three weeks apart throughout the semester. Students' nursing competence, self-efficacy, and learning satisfaction were measured immediately after each exposure. Descriptive statistics, t-test and repeated measurement analysis of variance were used for data analysis.

RESULTS

There were statistically significant improvements from T0 to T3 (p < .001) in nursing competence, self-efficacy, and learning satisfaction scores after repeated exposures to simulation. When comparing scores from T1 to T2 and from T2 to T3, there was no significant difference.

CONCLUSION

Simulation based learning is effective in improving nursing students' perceived competence, self-efficacy, and learning satisfaction. While the primary changes occur at the first simulation effort, it is the accumulated multiple exposure experiences collectively improve students' learning outcomes. Multiple instructional strategies besides simulation are recommended to maintain nursing students' learning interests to achieve optimal learning outcomes of the course across a semester.

Nursing students' first experience of death: Identifying mechanisms for practice learning. A realist review

OBJECTIVES

Many studies regarding nursing student's first experience of facing the death of a patient have focused on classroom methods or exploring attitudes towards death and related fears or anxieties. This review is the first to identify the mechanisms that facilitate practice learning as a result of students' first time experience of handling a patient's death.

DESIGN

A realist review as a form of a systematic review of the literature.

DATA SOURCES

The literature search focused on the earliest death experience of baccalaureate nursing students and end-of-life care, using databases MEDLINE, CINAHL, SCOPUS, ERIC, PSYCINFO.

REVIEW METHODS

Three research questions were addressed following a five-step process of (1) defining the scope of review and developing a theoretical framework, (2) conducting a theory-driven purposive search for evidence, (3) appraising evidence and extracting data, (4) synthesizing data and drawing conclusions, and (5) disseminating findings; with iterative expert consultation and discussion to answer the five questions of any realist review: 'what works, for whom, in what circumstances, how and why'.

RESULTS

Thirteen publications were included. Practice learning involves both changes and context improvements to be assessed and discussed by managers, leaders, nurse educators-facilitators and students. The environment and nursing role models are an inherent part of practice learning. Further work is needed to theorize the twelve key outcomes laid out in this review. These proposals require further consensus and the inclusion of inputs from both students and nurses.

CONCLUSION

The student nurse receives contradictory messages during the first experience of facing the death of a patient under their care. Considering the importance of this experience, specific indicators should be developed to track and guarantee and the optimal achievement of required competencies.

Descriptive Study of Nursing Students' Learning Styles. Case Study of the Professional Bachelor's Degree Cycle in Nursing of the Higher Institute of Nursing Professions and Health Techniques of Casablanca, Morocco

Background:

Learning difficulties experienced by learners are among the most recurring problems in education and, without doubt, the most worrying. Thus, at the beginning of each year, we at the Higher Institute of Nursing Professions and Health Techniques of Casablanca, Morocco (ISPITSC) note the diversity of intrinsic characteristics in our students in the initial training of the Professional Bachelor's (PB) degree cycle in initial nursing training. We believe these characteristics are related to the varied difficulties of adaptation and learning encountered in the first year. However, a lack of knowledge of the learning styles adopted by our students prevents the teaching staff from detecting the difficulties encountered by the learners in assimilating new knowledge during the 3 years of their training course. The identification of these learning styles and subsequent readjustments in training would help improve the quality of training and guarantee an effective mobilisation of knowledge during various care activities, while allowing the acquisition of necessary skills in the context of quality care that meets the needs of patients.

Objective:

The objective of this study is to identify the learning styles of nursing students in the BP nursing cycle at ISPITS Casablanca in Morocco and to classify their origin and nature according to the typology described by Honey and Mumford.

Methods:

Our research used a diagnostic and screening instrument for learning styles developed by Honey and Mumford, the “Learning Style Questionnaire” (LSQ), an abbreviated French version of which (LSQ-Fa) has been translated by Fortin et al. A sample of 49 students received the data collection instrument.

Results:

The study obtained a response rate of 87.75% (43 students). The results are similar to the research that shows that reflector style is the preferred learning style of learners in PB nursing education. However, the study also identified an important category of students who have dual learning styles.

Conclusion:

Given the gap between learners' teaching style and learning style and its consequences for the assimilation of the knowledge provided, nursing educators should adapt their educational strategies to the particularities of their students in order to reduce learning difficulties and promote the effective mobilisation of knowledge in various complex learning situations.

Analysis of learning styles in a laparoscopic technical skills course. Implications for surgical training

INTRODUCTION

Learning surgical techniques is a dynamic process. In the 1980s David Kolb described developed a learning model that enabled teaching styles to adapt for better learner outcomes. The aim of this study was to identify the Kolb learning styles of the participants in a laparoscopic technical skills course and to check see if there was any relationship with performance.

METHODS

An observational descriptive study was conducted with 64 participants in an intensive course in which they performed laparoscopic manual intestinal anastomoses. All completed Kolb's inventory of learning styles. For each anastomosis, join quality was assessed and the performing time recorded. After that, they were analyzed through statistical studies.

RESULTS

The most frequent learning style was assimilating type (39.1%). No significant differences were observed between different learning styles and gender, professional category, the time taken or the quality of the anastomoses.

CONCLUSIONS

Assimilating type was the most frequent Kolb learning style, with no differences observed between categories, age or gender. There is no relationship between the learning style of the participants and the results obtained in the course.

Use of Learning Style Frameworks in Health Science Education

Objective. To review the literature regarding the use of learning style frameworks in health science education, with particular attention to learning outcomes and use for self-awareness. Findings. Of the 415 articles identified in an initial search of the literature, 31 articles involving learning style frameworks were included after screening titles, abstracts, and full texts. Multiple learning style frameworks, including VARK, Kolb Learning Style Inventory, Honey and Mumford Learning Style Questionnaire, and Pharmacist Inventory of Learning Styles, have been used in various health science education disciplines, including medicine, nursing, and pharmacy. Most publications were descriptive in nature, reporting the learning styles of the given student cohort. Most studies that attempted to find a correlation between learning style and learning outcomes found none. In cases where a correlation was found, it was weak or inconsistent with findings from other published studies. No identified studies described use of learning style frameworks for increasing self-awareness in learners. Summary. While several different learning style inventories have been used to assess health science education students, their utility for predicting learning outcomes appears to be weak. Using learning style inventories to improve learner self-awareness is an unexplored area of education and research.

The usefulness and acceptance of the OSCE in nursing schools

This qualitative study explores the usefulness and acceptance attributed by students and faculty members to an Objective Structured Clinical Evaluation (OSCE) administered to nursing undergraduates in Catalonia (Spain) for 10 years. Seventy undergraduate nursing students and twelve faculty members participated in the study. The data collection techniques included an open-ended questionnaire, a student focus group, and individualized faculty interviews. The students experienced the OSCE positively as a learning event that offered an opportunity for feedback that could help them master the required competencies. The OSCE increased students' responsibility by presenting them with a set of challenges that they had to tackle individually. Moreover, it reaffirmed their confidence in situations that closely resembled professional practice. Faculty members valued the ability of the OSCE to integrate and assess competencies, its objectivity, and the indirect information it provided on the effectiveness of the curriculum. The educational impact attributed to the OSCE and its acceptance among faculty and students suggest that it would be useful to re-implement it in the Bachelor's of Nursing in Catalan universities. Our findings may be of use to other nursing programs considering how to assess competency-based education, especially in the context of the European Higher Education Area.

The 2019 WACEM Expert Document on the Framework for Setting up a Simulation Centre

Almost every institution and academic medical center has its own simulation center today. It seems to have become a prerequisite and is incorporated into the guidelines of setting up new centers as well as in the upgrading and enhancement plans of existing institutions. In considering this, it is critical to consider the needs and demands of the healthcare population and staff the center will be serving. Setting up a simulation center is not an endeavor to be undertaken lightly. It entails a sustainable commitment in terms of political will, professional, educational and financial commitments. On the other hand, setting up a simulation center can be the most worthwhile and rewarding experience if the objectives and goals are met and effective learning occurs. The latter is an important element to be considered in the step toward nurturing an effective healthcare practitioner. In this paper, the principle author, who is the Director of the SingHealth Duke NUS Institute of Medical Simulation (SIMS) in Singapore, shares her views and experience of leading a world-class simulation facility. She has been involved in SIMS from its conception and is a strong advocate of medical education and lifelong learning. At the end of this paper, she shares a Checklist which puts together all the important considerations for anyone or any institution what is looking at setting up a simulation facility, a simulation-based training program, or even upgrading and upscaling their current simulation centre.

Implicaciones de los estilos de aprendizaje en el uso de didácticas en la práctica docente

Objetivo: analizar los estilos de aprendizaje de los estudiantes de enfermería y discutir sus implicaciones en el uso de didácticas en la práctica docente.Metodología: a través de un muestreo consecutivo se reclutaron estudiantes de primero, segundo, tercero y cuarto año de enfermería. Se aplicó el Cuestionario Honey-Alonso de Estilos de Aprendizaje y un cuestionario demográfico. Se efectuó análisis descriptivo y test de normalidad en todas las variables. Se emplearon las pruebas Mann-Whitney y Kruskal-Wallis para el análisis entre los estilos de aprendizaje y las variables demográficas. Se examinaron correlaciones interestilo mediante el coeficiente de Pearson. Finalmente, se discutió la influencia de los estilos de aprendizaje en el uso de didácticas en la práctica docente. El error tipo I fue fijado en < 0,05 % en todos los test. Resultados: participaron 169 estudiantes con edad media de 24,5 años y predominancia de sexo femenino (81,7 %). El estilo de aprendizaje predominante fue reflexivo (53,8 %). Se identificó que la edad influye en la preferencia de los estilos de aprendizaje (p = 0,03) y que los estilos activo y pragmático; reflexivo, teórico y mixto se correlacionan positivamente (p < 0,05).Conclusiones: el estilo de aprendizaje reflexivo fue el más utilizado, sin embargo, existen múltiples preferencias de estilos de aprendizaje entre los estudiantes de enfermería. El docentetiene el desafío de hacer uso de diversas estrategias didácticas para facilitar el aprendizaje individual y grupal.

Learning Style Preferences of Practicing Nurses

Nursing professional development practitioners are encouraged to consider incorporating preferred learning styles into professional development programs. However, conclusive evidence about preferred learning styles does not exist. This study describes the preferred learning styles of nursing staff. Results showed that learning style preferences existed and were correlated with satisfaction, years of experience, and gender. The results can be used to plan and deliver professional development opportunities that are engaging and promote retention of learning.

Innovation in Clinical Course Delivery and Impact on Students' Clinical Decision-Making and Competence

The purpose of this study was to explore the differences in clinical decision-making and clinical competence between two different cohorts of graduating baccalaureate nursing students from a traditional prelicensure program in the United States. A quasi-experimental design was used to compare students who had substituted their traditional medical-surgical clinical experiences with simulation (Cohort 1, n = 35) with students who had supplementary simulation in addition to their traditional clinical experiences (Cohort 2, n = 36). The findings demonstrated that when simulation was used as a supplement to traditional clinical experiences, participants performed better patient assessments.

Influence of genetic and non-genetic factors on acenocoumarol maintenance dose requirement in a Tunisian population

PURPOSE

We aimed to study potential variables involved in interindividual variability to acenocoumarol (AC) response in order to establish a pharmacogenetic algorithm (PA) that includes clinical and genetic factors to predict adequate AC dose to stabilize anticoagulation in a cohort of Tunisian patients.

METHODS

Genotyping of the CYP2C9, VKORC1, CYP4F2, and CALU polymorphisms was conducted on 246 patients using PCR-RFLP technique. AC normalized maintenance dose (NMD): ((mean maintenance dose/international normalized ratio (INR)) equilibrium) was calculated. The statistical study was carried out with SPSS V20.

RESULTS

A significant correlation was found between age, BMI, and daily AC dose (r = - 0.397; p < 0.001 and r = 0.215; p = 0.001, respectively). The carriers of mutated alleles CYP2C9*2 or CYP2C9*3 or VKORC1 haplotypes (H1 and H7) were associated with AC hyper-sensibility. After adjustment to potential covariates, these patients presented supra-therapeutic INR during treatment period and needed low AC dose (ORs* = 0.28 [0.06-0.60], p = 0.004; ORs* = 0.12 [0.04-0.05], p < 0.001; ORs* = 0.45 [0.24-0.84], p = 0.01; and ORs* = 0.28 [0.06-0.98], p = 0.049, respectively). However, carriers of VKORC1 haplotypes (H3 and H12) or mutated alleles CYP4F2 (rs2108622) or CALU (rs1043550) tend to resist to treatment, hence long period of therapy initiation, and must be treated with high AC dose (ORs* = 2.67 [81.12-5.91], p = 0.013; ORs* = 8.76 [1.07-76.26], p = 0.019; ORs* = 3.12 [1.01-9.63], p = 0.047; and ORs* = 3.96 [1.41-11.09], p = 0.009, respectively). A final multivariate regression model explained 48.1% of the global interindividual variability in AC dose requirement.

CONCLUSION

The PA demonstrated that VKORC1 and CYP2C9 polymorphisms contribution was more important than clinical factors. Applying the PA would allow dose adjustment to treat patients in a personalized manner.

Learning theories and tools for the assessment of core nursing competencies in simulation: A theoretical review

AIM

To identify the theories used to explain learning in simulation and to examine how these theories guided the assessment of learning outcomes related to core competencies in undergraduate nursing students.

BACKGROUND

Nurse educators face the challenge of making explicit the outcomes of competency-based education, especially when competencies are conceptualized as holistic and context dependent.

DESIGN

Theoretical review.

DATA SOURCES

Research papers (N = 182) published between 1999-2015 describing simulation in nursing education.

REVIEW METHODS

Two members of the research team extracted data from the papers, including theories used to explain how simulation could engender learning and tools used to assess simulation outcomes. Contingency tables were created to examine the associations between theories, outcomes and tools.

RESULTS

Some papers (N = 79) did not provide an explicit theory. The 103 remaining papers identified one or more learning or teaching theories; the most frequent were the National League for Nursing/Jeffries Simulation Framework, Kolb's theory of experiential learning and Bandura's social cognitive theory and concept of self-efficacy. Students' perceptions of simulation, knowledge and self-confidence were the most frequently assessed, mainly via scales designed for the study where they were used. Core competencies were mostly assessed with an observational approach.

CONCLUSION

This review highlighted the fact that few studies examined the use of simulation in nursing education through learning theories and via assessment of core competencies. It also identified observational tools used to assess competencies in action, as holistic and context-dependent constructs.

The impact of simulation sequencing on perceived clinical decision making

An emerging nursing education trend is to utilize simulated learning experiences as a means to optimize competency and decision making skills. The purpose of this study was to examine differences in students' perception of clinical decision making and clinical decision making-related self-confidence and anxiety based on the sequence (order) in which they participated in a block of simulated versus hospital-based learning experiences. A quasi-experimental crossover design was used. Between and within group differences were found relative to self-confidence with the decision making process. When comparing groups, at baseline the simulation followed by hospital group had significantly higher self-confidence scores, however, at 14-weeks both groups were not significantly different. Significant within group differences were found in the simulation followed by hospital group only, demonstrating a significant decrease in clinical decision making related anxiety across the semester. Finally, there were no significant difference in; perceived clinical decision making within or between the groups at the two measurement points. Preliminary findings suggest that simulated learning experiences can be offered with alternating sequences without impacting the process, anxiety or confidence with clinical decision making. This study provides beginning evidence to guide curriculum development and allow flexibility based on student needs and available resources.

Assessing Learning Styles of Graduate Entry Nursing Students as a Classroom Research Activity: A quantitative research study

BACKGROUND

A number of studies across different disciplines have investigated students' learning styles. Differences are known to exist between graduate and baccalaureate nursing students. However, few studies have investigated the learning styles of students in graduate entry nursing programs. .

OBJECTIVES

Study objective was to describe graduate entry nursing students' learning styles.

DESIGN/SETTING/PARTICIPANTS/METHODS

A descriptive design was used for this study. The Index of Learning Styles (ILS) was administered to 202 graduate entry nursing student volunteers at a southwestern university. Descriptive statistics, tests of association, reliability, and validity were performed. Graduate nursing students and faculty participated in data collection, analysis, and dissemination of the results.

RESULTS

Predominant learning styles were: sensing - 82.7%, visual - 78.7%, sequential - 65.8%, and active - 59.9%. Inter-item reliabilities for the postulated subscales were: sensing/intuitive (α=0.70), visual/verbal (α=0.694), sequential/global (α=0.599), and active/reflective (α=0.572). Confirmatory factor analysis for results of validity were: χ²(896)=1110.25, p<0.001, CFI=0.779, TLI=0.766, WRMR=1.14, and RMSEA =0.034.

CONCLUSIONS

Predominant learning styles described students as being concrete thinkers oriented toward facts (sensing); preferring pictures, diagrams, flow charts, demonstrations (visual); being linear thinkers (sequencing); and enjoying working in groups and trying things out (active),. The predominant learning styles suggest educators teach concepts through simulation, discussion, and application of knowledge. Multiple studies, including this one, provided similar psychometric results. Similar reliability and validity results for the ILS have been noted in previous studies and therefore provide sufficient evidence to use the ILS with graduate entry nursing students. This study provided faculty with numerous opportunities for actively engaging students in data collection, analysis, and dissemination of results.

"Clinical simulation as a learning tool in undergraduate nursing: Validation of a questionnaire"

BACKGROUND

Clinical simulation allows both students and professionals to perform their clinical practice in a safe environment, facilitating the standardization of contents and promoting the integration of theoretical knowledge into the clinical practice.

OBJECTIVES

To design and validate in Spanish the Satisfaction Scale Questionnaire with High-Fidelity Clinical Simulation, instrument created to assess the nursing students' satisfaction with the use of clinical simulation in training.

METHODS

The scale items were developed from a review of the literature. Content validity was established by an expert panel. This questionnaire was validated by 150 nursing students in the second year of the Bachelor Degree in Nursing at a Spanish university during the academic year 2013/2015. Lawshe formula was used to determine its validity, while for the construct validity a factor analysis was conducted using the principal component and Varimax rotation. Cronbach Alpha was used to determine internal consistency.

RESULTS

The questionnaire developed presents satisfactory internal consistency (alpha 0.857). The factorial analysis indicated a structure of eight principal components that explain the 62.85% of the total variance explained, and in turn each subscale presented acceptable internal consistency. Frequency analysis results show a satisfaction degree higher than 80%, emphasizing "the realism of the cases" (98.7%), that "many benefits are obtained as clinical simulation relates theory to practice" (98.7%), "priorities are established "(97.4%)," errors are corrected after debriefing" (93.4%), and "communication and teamwork improved" (90%).

CONCLUSIONS

The scale designed and validated on high-fidelity clinical simulation in the Spanish population is satisfactory and adequate. Nursing students at the University of Cantabria (Spain) reported a high satisfaction degree with clinical simulation, confirming its usefulness in the teaching–learning process.

Learning Styles: Impact on Knowledge and Confidence in Nursing Students in Simulation and Classroom

Nurse Educators must develop nursing curriculum with engaging learning strategies that promote the knowledge and confidence needed for safe, effective nursing practice. Faculty should explore new methods of teaching that consider how students learn. Studies have shown mixed results regarding student learning styles, academic achievement, and development of confidence in nursing practice. An experimental study using Felder and Soloman’s (2004). Index of learning styles instrument was conducted to examine nursing student learning styles and their impact on confidence and knowledge in traditional and high fidelity simulation settings. Findings revealed students were more likely to have active, visual, sensing, and sequential learning styles. Student confidence or knowledge did not significantly differ among the learning styles in either simulation or traditional classroom methods. Awareness of learning styles may aid faculty in adapting engaging teaching strategies. Further research is needed with larger samples to identify best approaches to enhance student learning within the context of learning styles.

Correlations Between Clinical Judgement and Learning Style Preferences of Nursing Students in the Simulation Room

BACKGROUND

Health care educators account for variables affecting patient safety and are responsible for developing the highly complex process of education planning. Clinical judgement is a multidimensional process, which may be affected by learning styles. The aim was to explore three specific hypotheses to test correlations between nursing students' team achievements in clinical judgement and emotional, sociological and physiological learning style preferences.

METHODS

A descriptive cross-sectional study was conducted with Swedish university nursing students in 2012-2013. Convenience sampling was used with 60 teams with 173 nursing students in the final semester of a three-year Bachelor of Science in nursing programme. Data collection included questionnaires of personal characteristics, learning style preferences, determined by the Dunn and Dunn Productivity Environmental Preference Survey, and videotaped complex nursing simulation scenarios. Comparison with Lasater Clinical Judgement Rubric and Non-parametric analyses were performed.

RESULTS

Three significant correlations were found between the team achievements and the students' learning style preferences: significant negative correlation with 'Structure' and 'Kinesthetic' at the individual level, and positive correlation with the 'Tactile' variable. No significant correlations with students' 'Motivation', 'Persistence', 'Wish to learn alone' and 'Wish for an authoritative person present' were seen.

DISCUSSION & CONCLUSION

There were multiple complex interactions between the tested learning style preferences and the team achievements of clinical judgement in the simulation room, which provides important information for the becoming nurses. Several factors may have influenced the results that should be acknowledged when designing further research. We suggest conducting mixed methods to determine further relationships between team achievements, learning style preferences, cognitive learning outcomes and group processes.

Nursing Students Achieving Community Health Competencies through Undergraduate Clinical Experiences: A Gap Analysis

In Canada, it is widely believed that nursing practice and health care will move from acute care into the community. At the same time, increasing numbers of nursing students are engaged in non-traditional clinical experiences for their community health rotation. These clinical experiences occur at agencies not organizationally affiliated with the health care system and typically do not employ registered nurses (RNs). What has yet to be established is the degree to which nursing students are actually being prepared for community health nursing roles through their community health clinical rotations. In this paper we report the findings of a mixed method study that explored the gap between desired and observed levels of competence in community health of senior nursing students and new graduates. The gap was quantified and then the nature of the gap further explored through focus groups.