Exploring the meaning of undergraduate nursing students' experiences and confidence in clinical skills using video

Student access patterns for an online clinical skills procedural video library

CLINICAL RELEVANCE

Clinical skills training is essential in optometry curricula to develop core graduate entry competencies, including self-directed learning to facilitate life-long learning. Efficient and efficacious approaches are required to optimise student and educator time and resources.

BACKGROUND

A video library of optometric clinical skills was created in 2012 to support self-directed student learning and face-to-face training. Use of videos in higher education generally increased during the COVID-19 pandemic and has remained above pre-pandemic levels. This study aimed to capture and evaluate student access patterns in the library to determine which videos were accessed most, and if this changed with training stage and following the pandemic.

METHODS

Data on student viewing and critique submission were extracted for 71 videos from a clinical skills video library from 2018 to 2023. The number of videos viewed by students was analysed by year, cohort, video type (gold standard, scripted errors, summary, and student generated) and video category (history, screening, refraction, anterior segment, posterior segment and tonometry).

RESULTS

First-year students viewed the most videos, and this decreased significantly during and following the pandemic. Overall, the number of videos viewed decreased with increasing course stage. Video access, by category, aligned with the curriculum. Views were highest for gold standard and student videos. Viewing of scripted error videos and submission of critiques of procedural videos was low for all course stages and years.

CONCLUSION

A web-based video library of optometric clinical skills was used for self-directed learning, mostly by students early in their training. Similar resources developed in the future should align with curriculum and include exemplar and student-based videos. Exploration of student and educator perspectives regarding factors that impact engagement with the online library warrants investigation to facilitate optimal integration in post-pandemic times.

Developing student nurses' evaluative judgement in clinical practice tertiary education: A systematic scoping review of teaching and assessment methods

OBJECTIVES

This review aimed to systematically scope undergraduate or postgraduate tertiary higher education nursing students' clinical practice teaching and assessment methods to identify features that align with promoting students' evaluative judgement.

INTRODUCTION

Evaluative judgement is a new concept to nursing tertiary education. Currently, there are no published reviews of evaluative judgement in nursing clinical practice education. This review aims to assist nursing educators to operationalise the concept of evaluative judgement in clinical practice education. As such the starting point was to determine features of evaluative judgement in current clinical teaching and assessment designs.

INCLUSION CRITERIA

Peer reviewed qualitative or quantitative studies that have evaluated teaching and/or assessment of tertiary (university/higher education) pre-registration (undergraduate) or post-registration (postgraduate) nursing students' clinical practice.

METHODS

The systematic scoping review was prospectively registered systematic review (OSF DOI 10.17605/OSF.IO/PYWZ6) reported using PRISMA guidelines. A systematic search of five databases (Medline, Scopus, Web of Science, ProQuest, CINAHL) was conducted, limited from 1989 onwards and in English. Two reviewers independently screened titles and abstracts, then full text, with disagreements resolved with a third independent author. Data were extracted, including the frequency and methods of developing students' evaluative judgement across the categories of discerning quality, judgement process, calibration and feedback. A narrative synthesis was performed.

RESULTS

Seventy-one studies were included (n=53 teaching, n=18 assessment). Most of the included studies, included some, but not all, of the features to develop nursing students' evaluative judgment. For teaching methods, the most identified evaluative judgement features in the included studies were discerning quality (n=47), feedback (n=41) and judgement process (n=21). Only three studies included a method of calibration. For the assessment methods, feedback (n=16), discerning quality (n=15), judgement process (n=9) and calibration (n=4) were included. Many clinical practice teaching and assessment methods in nursing included features that develop students' evaluative judgement, with methods relating to discerning quality and feedback well embedded. Further adjustments are required to include methods to assist students to judge and calibrate their own performance.

CONCLUSION

This systematic scoping review identified that evaluative judgement in current nursing clinical teaching and assessment is not an overt aim. With minor adjustment to teaching and assessment design, nursing students could be better supported to develop their ability to judge the value of their own work.

The effect of audio-visual video with korotkoff sounds on anxiety levels and blood pressure measurement skills of nursing students: A randomized controlled study

AIM

This study was aimed to determine the effect of the audio-visual video created with korotkoff sounds on the anxiety levels and blood pressure measurement skills of nursing students.

BACKGROUND

Blood pressure measurement is the basis of nursing care and clinical decision. For this reason, it is stated that nursing students should specialize in this skill.

DESIGN

This research was conducted as a randomized controlled experimental study.

METHOD

This research was conducted with 130 (intervention group: 67, control group: 63) nursing students in the nursing department of a university in March 2022. Before the skill practice, the students in the intervention group listened to the korotkoff sounds using an audio-visual video containing the korotkoff sounds and then the practice was made. Data of the study were collected using the short version of the State-Trait Anxiety Inventory, the student introduction form and the blood pressure measurement evaluation form.

RESULTS

The mean age of the students was 19.41 (SD 1.75) in the intervention group and 19.20 (SD 1.04) in the control group. The State-Trait Anxiety Inventory mean scores of both groups were similar before the skill practice. At the end of the skill practice, the state anxiety score of the intervention group 0.56 (SD 1.03) was lower than the control group 1.30 (SD 1.81) and the difference was statistically significant (p < 0.05). When the blood pressure measurements of the students in both groups were compared, the rate of hearing korotkoff sounds and measuring blood pressure correctly was higher in the students in the intervention group and the difference was statistically significant (p < 0.05).

CONCLUSION

The korotkoff sounds presented with audio-visual video increased the skill levels of the students and reduced the anxiety level. In this direction; it is recommended to use audio-visual video containing korotkoff sounds for students to gain blood pressure measurement skills.

Development and evaluation of case video-based debriefing on a simulation of high-risk neonatal care for nursing students in South Korea: a mixed-methods study

BACKGROUND

The debriefing process after health care simulations should provide a psychologically safe learning environment for nursing students. Case video-based debriefing on a simulation of high-risk neonatal care can help nursing students feel psychologically safe and make learning more effective. In this study, we developed case video-based debriefing materials for a simulation of high-risk neonatal care for nursing students in South Korea and evaluated their effects.

METHODS

This mixed-methods study, consisting of a survey and an in-depth interview, was conducted between August and December 2022. The participants were 27 nursing students for the development of the case video-based debriefing and 51 nursing students for the evaluation of its effects (25 in the experimental group and 26 in the control group) at a university in South Korea. A case video-based debriefing on a simulation of high-risk neonatal care was developed, and the experimental group took part in case video-based debriefing. The participants' self-efficacy, critical thinking, state anxiety, and satisfaction with practice were examined. The experimental group's learning experiences were explored. Quantitative data were analyzed using the chi-square test, the unpaired t-test, and repeated-measures analysis of variance. Qualitative content analysis was conducted.

RESULTS

In the experimental group, critical thinking and satisfaction with practice increased to a greater extent than in the control group. However, the changes in self-efficacy and state anxiety were not significantly different between the experimental and control groups. Four categories were extracted from nursing students who participated in the case video-based debriefing: "learning facilitated by the simulation," "expanded learning," "safe learning environment," and "efficient utilization of case videos."

CONCLUSIONS

Case video-based debriefing on a simulation of high-risk neonatal care effectively enhanced nursing students' critical thinking and satisfaction with practice, and it will be utilized to improve nursing students' competency in high-risk neonatal care.

The effect of multimedia-based education in e-learning on nursing students' academic success and motivation: A randomised controlled study

BACKGROUND

Students who receive e-learning in nursing education state that they cannot learn the lessons effectively. This study aims to evaluate the effect of multimedia teaching materials on students' academic achievement and motivation in e-learning.

METHODS

The quasi-experimental study was performed on 70 students. The experimental group students were presented with multimedia materials, and the control group students were taught the e-learning course.

RESULTS

In this study, regarding the effect of multimedia-based education on students' Instructional Materials Motivation Survey, the mean score of the control group was 85.25 ± 11.95, and the mean score of the experimental group was 94.44 ± 11.82 after the intervention. A moderately significant positive correlation was found between the experimental group's average academic achievement and total scale scores.

CONCLUSION

The study results show that the participants accepted the important role of multimedia as practical learning compared to traditional learning methods. Given the impact of multimedia-based education on academic achievement, this approach can be used to teach other core subjects to nursing students.

Development of a Project-Based Learning Program on High-Risk Newborn Care for Nursing Students and Its Effects: A Quasi-Experimental Study

Project-based learning (PjBL) allows nursing students to participate in real problem-solving, construct knowledge, and improve their nursing skills in the process of accomplishing meaningful projects. This study was conducted to develop a PjBL program on high-risk newborn care for nursing students and evaluate its effects. A quasi-experimental study using a nonequivalent control group pretest-posttest design was employed between June and December 2021. The participants were 45 nursing students (24 in the experimental group and 21 in the control group). A PjBL program involving the creation of an educational video clip about high-risk newborn care for nursing students was developed, and the experimental group took part in PjBL. The participants' nursing competency for high-risk newborns, self-leadership, and practicum-related stress were assessed. In the experimental group, nursing competency for high-risk newborns increased and practicum-related stress decreased to a greater extent than in the control group. However, the change in self-leadership was not significantly different between the experimental and control groups. PjBL effectively improved students' nursing competency for high-risk newborns and decreased their practicum-related stress. PjBL will be utilized to enhance nursing students' expertise in high-risk newborn care.

A Game-Based Learning Approach in Digital Design Course to Enhance Students’ Competency

Digital Design is a laboratory course, and the educator must focus on the students’ need to know why they study the theory and mainly on the transition from knowledge-based learning to competency-based learning. This study consists of five surveys that were conducted during 2017–2021. First, we evaluated students’ learning outcomes in order to define possible learning problems. According to the literature, gamification can have a positive impact on students’ motivation and learning outcomes. Therefore, we used ready-made digital games in order to evaluate students’ satisfaction and willingness toward their integration in the educational process. This process was repeated in the next academic year. The feedback we received from the previous surveys has helped us to adapt to the new approaches of teaching due to the current pandemic caused by COVID-19. We proposed an online holistic environment based on Keller’s (1987) ARCS model and Malone’s (1981) motivational model, which was applied in distance learning. Each student participated in a student-centered learning experience. He took an active role and was self-manager of his learning process. He was given the opportunity to develop capabilities and strategies through practice and engagement in higher-order cognitive activities, acquire self-learning skills, learn how to solve problems, and participate in teamwork. This study’s innovation is that students experienced a combination of learning approaches: (a) a virtual lab consisting of simulation-based activities, which allowed students to access new laboratory experiences, (b) a project-based digital game without a processor, which developed their motivation, creativity, and hands-on ability, as opposed to the other relevant studies that use ready-made games, and (c) asynchronous videos as feedback, which ensured the educator’s emotional support and social presence. Finally, this study developed research to evaluate the effectiveness of this online holistic environment and used a questionnaire, which was created based on Keller’s Instructional Materials Motivation Survey tool. The results showed that its integration in distance learning is probable to motivate students to learn and affect positively their attention, relevance, confidence, and satisfaction.

Examining self-regulated learning of nursing students in clinical practice: A descriptive and cross-sectional study

BACKGROUND

How and how much learning occurs during the clinical practice process is connected with the concept of self-regulated learning. As a life-long learner, the nurse can explore learning strategies when he/she is a student, the first step in the nursing profession, by arranging and organizing his/her own learning. This contributes to the development of professional skills and competencies.

OBJECTIVES

This study aims to examine self-regulated learning towards clinical practice and the influencing factors in nursing students.

DESIGN

Descriptive cross-sectional design.

SETTINGS AND PARTICIPANTS

The research sample comprised 614 students in the nursing department in the 2019-2020 academic year.

METHODS

Data concerning the students' demographic characteristics and self-regulated learning were collected using the "Individual Information Form" and the "Self-Regulated Learning Scale for Clinical Nursing Practices". Personal characteristics were analyzed with numeric and percentage calculations, and some mean scores pertaining to the scale with ANOVA, Independent T and Logistic Regression Tests.

RESULTS

The mean total scale score of the students was 61.0 ± 10.7. The motivation and learning strategy scores of the first year students were reported to be significantly higher than the other students (p < 0.05). The mean scale score of females (61.7 ± 10.1) was significantly higher than that of males (58.5 ± 12.3) (p < 0.05). Moreover, it was found that fourth year students felt competent 3.8 times more than first year students (p < 0.05) (95% CI (OR) = 0.17-0.40).

CONCLUSIONS

Self-regulated learning was reported to be higher in females, first year students, those who had an interest in nursing, and those who see academicians as role models. Moreover, it was reported that fourth year students felt more competent than first year students. Considering that self-regulated learning will increase success in following constantly developing health technologies and changing scientific knowledge and adapting to the working environment, it is recommended to identify the factors affecting self-regulation and support students in this direction.

Blended learning program for the development of skills in the aspiration of artificial airways

Objective:

to develop and validate a blended learning program, of the inverted classroom type, on the aspiration of artificial airways.

Method:

applied and methodological research that involved technological production for teaching a Nursing Intervention, based on Vygotsky’s theoretical frameworks and on the Nursing Process. For elaboration and validation, a classic instructional design model was followed. The general and pedagogical requirements were validated, as well as those for videos and interface. For the analysis, the Content Validity Index and the First-order agreement coefficient were used.

Results:

34 experts participated, 27 of whom were nurses and seven were professionals in Information Technology. In the nurses’ opinion, the general and pedagogical requirements obtained a Content Validity Index of 0.99 and 0.98 was obtained for the videos and for the interface. The interface for the IT professionals was 0.94. All requirements showed almost perfect agreement.

Conclusion:

the teaching program was elaborated and validated by experts and constitutes an innovative proposal to train nurses. The mediation of teaching by means of duly validated technologies can favor learning and reaching positive results in the development of skills in the practice of aspiration of artificial airways.

Integrating technology in skills lab: Using smartphones for urinary catheter validation

Nurse educators are challenged to promote student success in all learning environments. Historically, students had increased anxiety associated with poor outcomes for indwelling urinary catheter skill validation. Faculty were looking for alternative ways to reduce stress, improve learning, and achieve successful student skill validations. The purpose of this process change project was to implement and evaluate an innovative teaching strategy of a psychomotor skill. Specifically, the integration of smartphone technology, self-evaluation, and peer feedback on indwelling urinary catheter skill validation was implemented and student perceptions of this strategy were evaluated. Throughout two, four-hour skills lab sessions, 81 students in the second semester of a baccalaureate program in nursing participated in peer pairs where they used smartphones to video and refine their indwelling urinary catheter skills through self-reflection and peer feedback. Students reported the utilization of technology and peer feedback positively enhanced learning and "decreased anxiety". However, students agreed integrating technology into a psychomotor skill validation was not without challenges. However, the benefits outweighed the challenges providing implications for nursing education to use smartphones to evaluate a psychomotor skill as a strategy to integrate technology, self-reflection, and peer feedback into a clinical skills lab environment.