Nursing education in the pandemic: A cross-sectional international study

The Effect of a Repeated Standardized Patient-Based End-of-Life Care Training Program on Nursing Students' Knowledge, Attitudes, and Emotions Toward End-of-Life Patients

BACKGROUND

Sufficient knowledge of end-of-life care, positive attitudes, and emotions regarding death and dying are essential criteria for showcasing favorable palliative care educational results to undergraduate nursing students. However, nursing students have negative attitudes toward end-of-life care and know little about it.

AIM

This study aimed to examine the effect of a repeated standardized patient-based training program (intervention) on nursing students' knowledge, attitudes, and emotions about end-of-life patients.

METHOD

This study adopted a pretest-posttest quasi-experimental research design. The sample consisted of 50 fourth-year nursing students divided into intervention (n = 25) and control (n = 25) groups. All participants attended the intervention. The intervention group attended the intervention twice, while the control group attended it only once. Data were collected using a personal information form, the Frommelt Attitudes Toward Care of the Dying Scale, the Positive and Negative Affect Schedule, and the End-of-Life Care Nursing Questionnaire. The data were analyzed using descriptive statistics, Pearson's Chi-square test, dependent groups t test, Pearson-Spearman, Mann-Whitney test, Wilcoxon test, and Friedman test.

RESULTS

The intervention helped participants learn more about end-of-life care (χ2 = 27.167, P = .000; F = 42.725, P = .000) and develop more positive attitudes toward end-of-life patients (F = 13.279, P = .000; F = 6.934, P = .000). The intervention also helped participants develop communication skills.

CONCLUSION

Universities should integrate repeated standardized patient-based into nursing curricula.

Distanced Large Group Simulations as a Learning Method for Interprofessional Collaboration

Digitalization in healthcare education has shifted simulation learning methods to distanced implementations. Successful transition to distance education requires effective communication and the teacher's good ability to use digital learning methods, as well as students' active interaction and motivation throughout the entire educational process. This study explores participants' experiences of online large group simulations as an approach for learning about interprofessional collaboration. A mixed method design was used in this study. Data from health and social care students and qualified professionals were collected using a questionnaire which contained statements presented on a five-point Likert scale and open-ended questions. The questionnaire was filled online by 100 students and professionals. The quantitative data were analyzed using descriptive statistical methods, and the open-ended questions were analyzed with inductive content analysis. As a result, the participants were satisfied with the large group simulation intended for learning interprofessional collaboration (mean = 4.42, SD = 0.759). The majority viewed it as a good learning method (95%) that is suitable for interprofessional collaboration learning (90%) and for promoting working together (82%). Digitally activated communication tools promoted interactive discussion and activated joint learning. However, only one activation tool was preferred instead of using two methods simultaneously. In conclusion, distanced large group simulations were evaluated to be a good method for learning interprofessional collaboration. This study was not registered.

Use of standardized patients in patient education practices of senior nursing students: A mixed-methods study

BACKGROUND

There is a need for innovative teaching practices in nursing education due to many factors, such as global changes, the rapid development of technology, the increasing number of students, and the recent pandemic.

OBJECTIVES

This research was conducted using standardized patients to evaluate the attitudes and skills of senior nursing students toward patient education practices following the implementation of a patient education training program.

DESIGN

Mixed-methods design.

SETTINGS

The study was conducted at a nursing faculty.

PARTICIPANTS

The sample of the study consisted of 47 senior nursing students.

INTERVENTION

The students participating in the study were given a four-hour patient education training that included the preparation of patient education, preparation of materials, and effective presentation.

METHODS

A descriptive information form prepared by the researchers, the Patient Education Implementation Scale (PEIS), the Turkish version of the Patient Education Materials Assessment Tool for Printable Materials (PEMATTR-P), and the presentation skill evaluation form (PSEF) were used to collect quantitative data. Semi-structured interview forms were utilized to collect qualitative data. SPSS for Windows v. 25.0 and MAXQDA20 were used for the data analyses. Results with a p value of <0.05 were considered statistically significant.

RESULTS

The post-test mean PEIS scores of the students increased in the total scale and in all subdimensions. A significant difference was found in the understandability and actionability of patient education materials evaluated with PEMATTR-P (p < 0.05). The mean PSEF score of the students was 85.14 ± 9.25 points. Within the scope of the research, two main themes, namely emotions and efficacy, were determined.

CONCLUSIONS

This study confirms that structured patient education training, including the use of standardized patients, is important for supporting and developing nursing senior students' attitudes and skills toward patient education.

Effectiveness synchronous e-learning in nursing education: A meta-analysis and subgroup analysis

AIM

This study aimed to identify the best available evidence of the effects of synchronous e-learning in nursing education through a meta-analysis and to compare mean effect sizes between study subgroups.

BACKGROUND

With the rapid development of synchronous e-learning, adequate preparation is essential, as the formulation of effective educational strategies is crucial for learners' success. However, rather than focusing solely on using technology to implement e-learning, instructors should design education programs that meet learning objectives while considering appropriate technologies and types of interactions.

DESIGN

A meta-analysis and a subgroup analysis were conducted.

METHODS

English and Chinese databases including PubMed, Embase, CINAHL, Web of Science, Cochrane Library and China National Knowledge Infrastructure were searched for relevant articles published between the inception of these databases through May 2023. The search included the establishment of these databases up until May 2023. Using a search strategy, we identified 3273 potentially relevant articles. Ten primary studies were included in the final analysis. We used random effect models to synthesize effect size (ES) and accommodate heterogeneity for the main effect. Sub-group analyses were conducted to analyze the variations in effect size to investigate possible causes of heterogeneity.

RESULTS

We found synchronous e-learning to be more effective compared with the control groups, with a pooled random-effects standardized mean difference of 0.51, which is a medium effect size. Regarding learning outcomes, the effect size of reactions to learning (ES = 0.91, confidence interval [CI] = 0.14, 1.67) was higher than that of the psychomotor domain (ES = 0.57, CI = 0.17, 0.98), cognitive domain (ES = 0.63, CI = 0.11, 1.15) and affective domain (ES = 0.40, CI = 0.03, 0.76). In terms of interaction types and study characteristics were more effective if the studies included learner-learner interaction (ES = 0.83, CI = 0.36, 1.29), developed regions (ES = 0.55, CI = 0.17, 0.94), undergraduate nursing students (ES = 0.56, CI = 0.32, 0.80), no randomization (ES = 0.75, CI = 0.40, 1.10) and funding support (ES = 0.78, CI = 0.41, 1.16).

CONCLUSIONS

Well-designed synchronous e-learning courses should consider learners' motivations and self-directed learning abilities by providing diverse learning resources and environments. Nurse educators should develop synchronous e-learning teaching strategies that include peer interaction. The affective domain of learning in synchronous e-learning needs to be developed and considered in future research.

The Effects of the COVID-19 Pandemic on Nursing Education Programs

BACKGROUND

The U.S. Boards of Nursing (BONs) collect annual report data from their nursing programs as part of their approval process. This paper highlights the 2020 and 2021 annual report data on the effect of coronavirus disease 2019 (COVID-19) on all nursing programs in 17 BONs in 2020 and 19 in 2021.

METHOD

Nursing programs answered 16 questions on the effect of COVID-19 on their programs. Because BONs require annual report data, all programs in the participating states answered the questions, which included 798 programs in 2020 and 929 in 2021.

RESULTS

Major disruptions in nursing education occurred during the pandemic. Clinical experiences and didactic classes were greatly affected, though alternative strategies were used. Student and faculty attrition rates were particularly high in 2021.

CONCLUSION

The authors call for a national forum where nurse leaders analyze what happened and make recommendations for future crisis events. [J Nurs Educ. 2024;63(5):312-319.].

Determining Self-Efficacy of Nurses Who Graduated From Distance Education Because of the COVID-19 Pandemic: A Multicenter Cross-Sectional Study

BACKGROUND

The current literature states that distance education has caused a lack of professional skills, regression of existing professional skills (Kaya & Akin Isik, 2021; Kürtüncü & Kurt, 2020), a lack of self-confidence, and feelings of inadequacy among nursing students (George et al., 2020). The current study examined the professional self-efficacy of nurses who graduated from distance education because of the coronavirus disease 2019 pandemic.

METHOD

This multicenter cross-sectional study was conducted between November 2020 and June 2022 with 164 nurses who graduated from distance education in 2020-2021 from three faculties of health sciences.

RESULTS

Professional self-efficacy of the nurses was found to be above average. Male nurses and nurses who believed distance education had a negative impact on their professional skills had significantly higher professional self-efficacy. Some nurses reported that their professional theoretical knowledge was insufficient and defined the effect of distance education on their professional skills as relatively negative.

CONCLUSION

Most of the nurses expressed that distance education had a negative effect on their professional self-efficacy and working life. [J Contin Educ Nurs. 2023;54(10):480-488.].

'Internet+' comprehensive nursing training course in the post-epidemic era-an exploration of the mixed teaching mode: a randomized trial

Objective

To explore the effect of the application of the 'Internet+' nursing teaching mode on the comprehensive teaching 'Fundamentals of Nursing'.

Trial design

Parallel design and convenient sampling were used to select vocational nursing students from the Nursing College of Capital Medical University.

Methods

Selected students were randomly divided into two groups. The control group consisted of 30 students in Grade 2020 higher vocational nursing education (traditional teaching mode). The observation group consisted of 30 students in Grade 2021 higher vocational nursing education (Internet+ mixed teaching mode). Training assessment results, automatic learning ability, professional identity, and satisfaction were compared between the two groups.

Results

Compared with the control group, the students in the observation group scored higher in the following operation practices: venous blood sampling, intradermal injection, cardiopulmonary resuscitation (CPR), sputum aspiration, and putting on and taking off robes (84.01 ± 0.87 vs. 92.14 ± 1.23; 91.41 ± 0.82 vs. 96.86 ± 0.27; 87.56 ± 0.31 vs. 93.91 ± 2.79; 88.11 ± 0.51 vs. 93.75 ± 0.29; and 82.29 ± 0.29 vs. 90.96 ± 0.34, respectively, with p < 0.05 for all scores). The total scores for autonomous learning ability and subjective satisfaction were also higher in the observation group compared with the control group (82.98 ± 4.72 vs. 93.17 ± 5.01 and 96.67% vs. 90.00%, respectively, with p < 0.05 for all scores).

Conclusion

In the post-epidemic era, the 'Internet+ hybrid teaching mode' was applied to comprehensive nursing teaching. This changed the traditional education mode, which focuses only on professional knowledge. The 'Internet+' teaching mode results showed that the professional, ideological, and political courses exhibited the same value guidance, which improved students' independent learning ability, practical operation ability, professional identity, and satisfaction.

Nurse Educators' Perceptions and Self-efficacy in Response to COVID-19: A Scoping Review

BACKGROUND

During the COVID-19 pandemic, nurse educators had to adapt quickly to required changes in nursing education following isolation mandates. Educators worked diligently to provide a quality remote/online educational experience with limited resources.

PURPOSE

The purpose of this review was to explore nurse educators' perceptions and self-efficacy toward the transformation from the traditional face-to-face teaching to remote/online teaching and simulation/laboratory modifications in response to the COVID-19 pandemic.

METHODS

A scoping review, informed by PRISMA-SCR guidelines, was performed in PubMed, Web of Science, CINAHL Complete, OVID MEDLINE, and Google Scholar.

RESULTS

There were 34 articles included in the final review, with 7 themes identified: teaching pedagogy, technology challenges, online teaching role, learning environment, leadership, clinical education, and well-being.

CONCLUSIONS

The review is relevant to nursing faculty across the globe. Planning for future pandemics should include self-care, use of evidence-based practices, protocols, and increased communication.

Supporting student success on the practical nurse (PN) licensure exam: The Health Education Systems Incorporated (HESI) PN Exit Exam Study

BACKGROUND

Practical Nurses or Vocational Nurses (PNs/VNs) complete a 12-month certificate program and must successfully complete the National Council Licensure Exam for Practical Nurses (NCLEX-PN) prior to practice. While the scope of their practice is more circumscribed than the Registered Nurse (RN), they contribute significantly to healthcare throughout the U.S.A. Current research to support their learning and success is needed. Elsevier's Health Education Systems Incorporated (HESI) PN Exit Exam (E2) has been used to determine students' NCLEX-PN readiness for over 20 years. Given regular updates to the NCLEX test plan, ongoing research is needed to assess the E2's continued predictive validity and examine E2 program policies to enhance PN/VN student success.

OBJECTIVES

To examine the predictive validity of the E2 on NCLEX-PN first-time pass rates (NCLEX-PN FTPR) and determine which E2-related program policies are related to higher E2 scores and NCLEX-PN FTPR.

METHOD

Sixteen PN/VN program directors participated in the study, providing E2 program policy information and NCLEX-FTPR outcomes for 1371 students who took the E2 between 2018 and 2021.

RESULTS

Students passed the NCLEX-PN 96-98 % of the time when they scored 900 or higher on the E2 and passed 94 %-96 % of the time when they scored 850 or higher. Out of 16 programs, most required E2 test preparation (n = 13, 81.25 %) and allowed students more than one E2 attempt (n = 11; 68.75 %). Requiring minimum E2 scores and specific E2 test preparation were associated with higher NCLEX-PN pass rates, in each case mediated by higher E2 scores. Requiring remediation for students with low initial E2 scores led to higher E2 scores but not higher NCLEX-PN pass rates.

CONCLUSIONS

This study provides evidence for program policies and educational resources to support students' NCLEX-PN success. Setting an expected performance benchmark and requiring PN students to engage in E2 preparation prior to their first attempt are recommended strategies emerging from this study.

Clinical judgment in new nurse graduates: identifying the gaps

OBJECTIVES

Clinical judgment has been identified as a key component of clinical practice. We sought to measure the elements of clinical judgment in new nurse graduates to identify future educational interventions.

METHODS

Lasater's clinical judgment rubric was adapted and distributed to nurse preceptors at two significant health care systems in central Illinois.

RESULTS

One hundred and six surveys were returned and one hundred and five of those were included in the study. New nurse graduates were found to be the lowest ranking in ability to identify significant data and calm, confident responses.

CONCLUSIONS

The findings can guide nurse educators to create innovative, targeted educational interventions to improve students' ability to identify important pieces of data and respond to challenging situations in a self-assured manner.

IMPLICATIONS FOR INTERNATIONAL AUDIENCE

Identifying and addressing the gaps to improve students' clinical judgment may facilitate NCLEX success and entry to practice.

Nursing lecturers' perception toward E-learning approaches used in nursing colleges: Scoping review

Background

Nursing colleges have traditionally taught students in hospitals and laboratories. COVID-19 compelled most nursing colleges to embrace e-learning without prior experience or preparation after 2020, which may influence nursing educators' views and attitudes toward its use.

Objective

This scoping review explores the nursing educators' perception of the e-learning approaches used in nursing colleges.

Design

A comprehensive review of five databases, Cochrane, Ebsco (Medline), PubMed, Science Direct, and Scopus, was conducted, adhering to the Joanna Brings Institute (JBI) standards full theme, utilizing preset eligibility criteria and adhering to the PRISMA Extension for Scoping review (PRISMA-ScR) recommendations.

Methods

This scoping review examined studies published in English from January 1st, 2017–2022. Three reviewers evaluated the eligibility of the literature and retrieved data to address the research question from prior literature. A content analysis was done.

Results

Thirteen articles with various hypotheses and models were reviewed. The review reveals that nursing educators are novices at using e-learning approaches in their classes due to their novelty in most nursing colleges. Nursing educators have a modest positive perception, with an optimistic perspective on e-learning effectiveness in theoretical course teaching, emphasizing that it is inappropriate in teaching clinical courses. The review demonstrates that e-learning faces numerous challenges that negatively impact educators' perceptions.

Conclusion

Institutional preparedness in terms of personnel through educator training, provision of necessary infrastructure, administrative support, and incentives are critical to improving the perception of the e-learning method and increasing its adoption in nursing colleges.

Faculty perceptions of the impact of the COVID-19 pandemic on new graduate nurses' transition to practice: A qualitative study

BACKGROUND

The COVID-19 pandemic disrupted nursing education worldwide. Most studies have focused on how the pandemic affected students. With an alarming workforce shortage, a better understanding of the pandemic's impact on new nurses is vital to proactively develop strategies to promote success of the profession's newest members.

PURPOSE

This study explored faculty perceptions of the pandemic's impact on new nurses' practice preparedness and recommendations for promoting effective transition to practice.

METHODS

Using an exploratory-descriptive qualitative approach and convenience sampling, 116 nurse faculty from across North Carolina, United States responded to open-ended questions within an electronic survey. Data were analyzed with thematic analysis.

RESULTS

Four themes emerged: 1) Less Hands-On, 2) Transition-to-Practice Opportunities, 3) Key Role of Preceptors, and 4) Provide Additional Support.

CONCLUSIONS

Findings provide strategies clinical nurses and leaders can implement to meet the needs of new nurses entering professional practice during the ongoing pandemic. Due to less hands-on learning, pandemic graduates may benefit from extended time with a trained preceptor and opportunities to focus on clinical reasoning, managing multiple patients, effective communication, and safe skill performance. Upon entering the clinical environment, pandemic graduates' inexperience may increase the likelihood of transition shock, requiring multi-faceted approaches for providing support.

Support nursing researchers' need from academic societies during COVID-19: A cross-sectional survey

The activities of nursing researchers have been constrained by the COVID-19 pandemic. Therefore, this study aimed to investigate the types of support and related factors that nursing researchers hope to receive from academic societies during the pandemic and to obtain suggestions for the role of academic societies in supporting nursing researchers and expanding research. An online survey was conducted with 1532 Japan Academy of Nursing Science members. The survey included 19 items of potential support from the society during the COVID-19 pandemic as well as open-ended questions. Data were analyzed statistically and qualitatively. For 9 of the 19 items, over 50% of respondents reported that they "needed" or "very much needed" support. Multivariate analysis results showed that younger respondents and those with family members requiring care were significantly more likely to report needs for some items. In the open-ended comments, there were several suggestions for activities, including "Lobbying for revision of regulations on research implementation." Nursing researchers expressed needs for support that reflect their demographic characteristics and situations, including collaboration across organizations and securing research-promotion and skill-development opportunities online.

Salutogenesis and COVID-19 pandemic impacting nursing education across SEANERN affiliated universities: A multi-national study

BACKGROUND

The COVID-19 pandemic has disrupted the lives of many. Particularly, nursing students experience greater stress as their normal curriculum is interrupted and some of them face the risk of being infected as frontline workers. Nursing faculty members may face similar struggles, in addition to developing teaching materials for online learning. Thus, it is important to examine the faculty members' and students' views on their ability to adapt during the pandemic to obtain a holistic view of how learning and training has been affected.

DESIGN

The descriptive cross-sectional quantitative design was used.

SETTINGS

Data were collected from Southeast and East Asian Nursing Education and Research Network (SEANERN) affiliated nursing institutions from January 2021 to August 2021.

PARTICIPANTS

A total of 1897 nursing students and 395 faculty members from SEANERN-affiliated nursing institutions in Cambodia, Hong Kong, Indonesia, Japan, Laos, Malaysia, Philippines, Singapore, Thailand and Vietnam were recruited for this study.

METHODS

Quantitative surveys were used to explore the satisfaction levels in education modalities, confidence levels, psychosocial well-being, sense of coherence and stress levels of nursing students and faculty members during the COVID-19 pandemic.

RESULTS

Participants were mostly satisfied with the new education modalities, although most students felt that their education was compromised. Both groups showed positive levels of psychosocial well-being, despite scoring low to medium on the sense of coherence scale and experiencing great stress. The participants' sense of coherence was positively correlated with their psychosocial well-being and negatively correlated with stress levels.

CONCLUSIONS

While the COVID-19 pandemic had negatively impacted the lives of nursing students and faculty members, most of them had a healthy level of psychosocial well-being. Having a strong sense of coherence was associated with better psychosocial health and lower stress levels. As such, it may be helpful to develop interventions aimed at improving the sense of coherence of nursing students and staff to help them manage stressors better.