Using simulation and electronic health records to train nursing students in prevention and health promotion interventions

Knowledge, Attitude, and Practice toward Skin Cancer Prevention and Detection among Jordanian Medical Students: A Cross-Sectional Study

Introduction. Skin cancer is one of the most growing types of cancer, especially in the Mediterranean, even though it is a preventable disease. The purpose of this study is to assess medical students’ knowledge, attitude, and practice about skin cancer prevention and detection. Methods. A cross-sectional study was conducted using a validated structured questionnaire covering the areas of knowledge, attitude, and practice of the study participants. Results. The study involved 1530 students; 55.3% were females. Most of the students possessed proper knowledge about skin cancer (81%). The most prevalent skin cancer risk factors were sun exposure during the day (83.5%) and immunosuppression (71.2%). More than half of the students did not have any habits of skin examination (61.5%). 20% of the students never used sunscreen, while only 20% of them avoided sun exposure during day hours. Conclusion. The general level of the medical students’ knowledge of skin cancer and its risk factors appeared to be higher than what is found in other studies; it is reasonable as the study participants were medical students. However, the protective behavior from the sun was inadequate when compared to the level of knowledge reported. Additional education about the behavior toward sun exposure and protection against skin cancer may be needed to be implemented in the dermatology curriculum.

Evaluation of undergraduate students’ nursing assessment and communication skills through an objective structured clinical examination within a high-fidelity simulation using a student-simulated patient†

Objective

To evaluate nursing students’ assessment and communication skills through an objective structured clinical examination (OSCE) within a high-fidelity simulation using a student-simulated patient (SSP) and analyze the validity, reliability, degree of difficulty, and discriminability of the OSCE.

Methods

A descriptive study was conducted at one nursing school in Macao. All scenarios were designed using a high-fidelity simulator combined with SSPs. A convenience sample of 54 baccalaureate nursing students completed the OSCE. The nursing assessment OSCE checklist (NAOC) and the communication evaluation rubric (CER) were used as observational measurements with three-point Likert scales (2 = Achieved, 1 = Partly achieved, 0 = Not completed/Incorrect).

Results

Difficulty coefficients of the exam were 0.63 for nursing assessment skills and 0.56 for communication skills. The discrimination index of the majority items of the NAOC (86.4%) was >0.20, showing a better to good discriminability. The items of the CER had satisfactory indexes of item discrimination (from 0.38 to 0.84). Students received high scores in conducting blood oxygen saturation and cardiac and lung auscultation but low scores in vomiting and diarrhea assessment. Students presented good communication skills in eye contacting and listening, but culture assessment needs to be improved. The students with experiences in simulation or simulated patient (SP) interactions had better assessment and communication skills than students without those experiences. There was a positive relationship between nursing assessment and communication skills (r = 0.67, P = 0.000).

Conclusions

SSPs were involved in enhancing the realism of interactions in simulated scenarios. Nursing students can conduct nursing assessments specific to patient conditions, explain the conditions to the patient, and ensure that the patient remains informed at all times of the precautions to be taken. However, students’ cultural awareness and some communication skills need further training. With moderate difficulty and high discrimination index, OSCE showed satisfactory reliability and validity.

Use of academic electronic medical records in nurse education: A scoping review

BACKGROUND

Use of academic electronic medical records is internationally recognised as a means for preparing health professional students for the digital healthcare environment. Reported practice benefits include skills for electronic documentation, health informatics, point-of-care clinical decision support systems, as well as preparation for information technology-enabled clinical settings, while challenges include lack of access to simulation software, faculty-related barriers, limited finances and educational software costs. However, little is known about best practices related to its use within pre-licensure or entry-to-practice nursing curricula and impact on clinical practice outcomes.

OBJECTIVE

This review sought to explore how academic electronic medical records are used in entry-to-practice nursing curricula.

DESIGN

A scoping review guided by the Joanna Briggs Institute three-step search strategy, exploring existing publications and grey literature.

INCLUSION CRITERIA

Quantitative and qualitative studies related to use of academic electronic medical records in pre-licensure nurse education.

INFORMATION SOURCES

A range of databases were searched including CINAHL, Medline, Proquest Central, ERIC, ScienceDirect, PubMed, IOS Press, as well as grey literature, reference lists and handsearching.

REVIEW METHODS

The search yielded 580 articles, from which inductive thematic analysis of 34 included studies was conducted.

RESULTS

Included articles were nine qualitative, 21 quantitative and five mixed methods studies. Most originated from the USA. Academic electronic medical records are mainly used to teach documentation, safe use of health technology, and for clinical preparation. Most are used for fundamental or junior levels courses, with problem-based learning and simulation embedded. Institution's technology resources and faculty capability are essential to implementation.

CONCLUSIONS

There is a need for more research that examines optimal timing and duration of use of academic electronic medical records in curricula, and their impact on critical thinking and clinical performance. Finally, there is a need to explore greater academic-clinical partnerships in the education process.

Effectiveness of Health Guidance Simulation in Community Settings for Public Health Nursing Students: A Preliminary Study

Introduction

Simulation-based learning is a relatively new concept in public health nursing education, and little is known about the efficacy of this approach for teaching of health guidance. Objective: The aim of this study was to evaluate the effectiveness of health guidance simulation in community settings for public health nursing students.

Methods

Using a pre/post-test design, 29 public health nursing students in their third year participated in a high-fidelity simulation program with standardized patients. We developed six scenarios on health guidance for three themes (mother and child, tuberculosis, and adult occupational health) and practice guidelines for the standardized patients to act and assist in understanding of the purpose of the course. Data were collected at baseline and after the simulation sessions through evaluation sheets that the students placed in a designated box on campus. Changes in the level of self-confidence of the students were evaluated based on the “practical skills required for public health nurses and achievement level at graduation” of the Ministry of Health, Labor and Welfare, and the skills in the minimum requirements for public health nurse education defined by the Japan Association of Public Health Nurse Educational Institutions.

Results

The total score for self-confidence and the mean self-confidence scores for health guidance skills for mother and child, tuberculosis, and adult occupational health nursing were significantly higher post-test compared to pre-test (p < 0.001).

Conclusion

These results indicate that high-fidelity simulation focused on health guidance in community settings can bridge the gap between theoretical knowledge and practice of students.