A survey of first year student nurses' experiences of learning blood pressure measurement

An Analysis of Priorities in Developing Virtual Reality Programs for Core Nursing Skills: Cross-sectional Descriptive Study Using the Borich Needs Assessment Model and Locus for Focus Model

BACKGROUND

There are limitations to conducting face-to-face classes following the recent COVID-19 pandemic. Web-based education is no longer a temporary form of teaching and learning during unusual events, such as pandemics, but has proven to be necessary to uphold in parallel with offline education in the future. Therefore, it is necessary to scientifically organize the priorities of a learner needs analysis by systematically and rationally investigating and analyzing the needs of learners for the development of virtual reality (VR) programs for core nursing skills (CNS).

OBJECTIVE

This study aimed to identify the priorities of learners' needs for the development of VR programs for CNS using the Locus for Focus Model and Borich need assessment model.

METHODS

The participants included nursing students in South Korea who were in their second year or higher and had taken courses in fundamental nursing or CNS-related classes. The survey took place from May 20 to June 25, 2021. A total of 337 completed questionnaires were collected. Of these, 222 were used to conduct the final analysis. The self-report questionnaire consisted of 3 parts: perception of VR programs, demand for developing VR programs, and general characteristics. The general characteristics of the participants were analyzed using descriptive statistics. To determine the priority of the demand for developing VR programs for CNS, the Locus for Focus Model and the Borich priority formula were used.

RESULTS

In all, 7 skills were identified as being of the top priority for development, including intramuscular injection, intradermal injection, tube feeding, enema, postoperative care, supplying oxygen via nasal cannula, and endotracheal suction.

CONCLUSIONS

The analysis showed that nursing students generally needed and prioritized the development of VR programs for the nursing skills involving invasive procedures. The results of this study are intended to help in various practical education classes using VR programs in nursing departments, which are currently facing difficulties in teaching CNS on the web owing to COVID-19.

Self-confidence in clinical skill: A descriptive study of the perspective of first-year nursing students

AIM

The aims of this study were to: 1) identify the clinical skills that students self-identified as being important for preparing for their first-year clinical practicum and 2) explore first-year students' self-confidence when practising these self-identified skills.

BACKGROUND

First year clinical preparation courses in an undergraduate nursing curriculum are important for students to develop their self-confidence to prepare for their clinical placement experience.

DESIGN

A descriptive study design, using a digital workbook, was used to anonymously collect data from first year nursing students at a regional Queensland university.

METHODS

Participants were requested to: 1) self-identify clinical psychomotor skills that were practised in the first-year nursing laboratories; and 2) to rate their confidence with these skills.

RESULTS

Seven key practice areas: medication, manual handling, wound management, respiratory care, cardiac care, vital signs and infant care, were identified by participants as important to prepare for clinical practicum. Australian first-year nursing students being able to articulate psychomotor skills important for their initial clinical practicum maybe relevant to and inform nurse education internationally. Participants rated their self-confidence positively across these practice areas.

CONCLUSION

This study highlights that first-year nursing students can articulate nursing practice skills that are important for their clinical practice.

Evaluation of Simulation Outcomes

Simulation has been used in nursing education and training since Florence Nightingale's era. Over the past 20 years, simulation learning experiences (SLEs) have been used with increasing frequently to educate healthcare professionals, develop and increase the expertise of practicing professionals, and gain competency in key interprofessional skills. This chapter provides a brief overview of simulation evaluation history, beginning in the late 1990s, and the initial focus on learner self-report data. Using Kirkpatrick's Levels of Evaluation as an organizing model, four types of SLE evaluation are reviewed as well as suggestions for future research.

Nurse effects on measurement error in household biosocial surveys

Background

Biosocial survey data are in high demand, yet little is known about the measurement quality of health measures collected by nurses in respondents’ homes. Our objective was to analyze the degree to which nurses influence measurement in anthropometric and physical performance indicators collected from respondents in two nationally-representative UK biosocial surveys.

Methods

The English Longitudinal Survey of Ageing and the UK Household Longitudinal Study – Understanding Society were used to analyze fourteen anthropometric and physical performance measures covering weight, height, pulse, grip strength, and lung capacity. Cross-classified multilevel models were used to estimate “nurse effects” on measurement error.

Results

Overall, there is a medium effect of nurses on measurement. Across all measures collected in both studies, nurses explain around 13% of all measurement variation. Variation in specific measures range between approximately 2 and 25%. Grip strength and lung capacity are more heavily influenced by nurses than are height, weight, and pulse. Lastly, nurse characteristics explain only a very small proportion of nurse measurement variation.

Conclusion

Objective health measures collected by nurses in household biosocial surveys are susceptible to non-trivial amounts of measurement variation. Nurse ID numbers should be regularly included in biosocial data releases to allow researchers to account for this unnecessary source of variation. Further, researchers are advised to conduct sensitivity analyses using control variables that account for nurse variation to confirm whether their substantive findings are influenced by nurse measurement effects.

Comparison of the effects of two different teaching methods in blood pressure measurement training: a randomized controlled study

OBJECTIVE

To compare the effects of a high-fidelity simulator and conventional teaching model used during blood pressure measurement training on students' self-confidence, self-efficacy and anxiety levels.

METHODS

A randomized controlled trial design was used. The study was conducted on 59 first-year nursing students of a university in Amasya, Turkey. 'Self-Confidence Scale,' 'general Self-Efficacy Scale' and 'Beck Anxiety Scale' were used to collect the data. A high-fidelity simulator used in blood pressure measurement training was applied to the experimental group, while the conventional method in which the students practice on their peers was applied to the control group. Chi-square, Mann-Whitney U test and the Wilcoxon signed-rank test were used to determine the difference between the two groups' average.

RESULTS

No statistically significant difference was found between students' pre-test and post-test total scores of self-confidence, general self-efficacy and anxiety scales with the high-fidelity simulator and the conventional model (P > 0.05). A significant increase was noted in inner self-confidence and self-efficacy scores of the group working on the high-fidelity simulator (P < 0.05).

CONCLUSIONS

The high-fidelity simulator was effective on the students' increased levels of self-confidence and self-efficacy, whereas it was not effective on their anxiety levels. However, this study can also be conducted on a larger sample group using a variety of training methods.

Effect of a game-based virtual reality phone application on tracheostomy care education for nursing students: A randomized controlled trial

BACKGROUND

A game-based virtual reality phone application is used as a simulation to teach psychomotor skills in nursing education.

OBJECTIVE

This study aims at determining the effect of a game-based virtual reality phone application on tracheostomy care education for nursing students.

DESIGN

Single-blind randomized controlled trial conducted from March-April 2017.

SETTING

Department of Nursing, Faculty of Health Sciences, Central Anatolia of Turkey.

PARTICIPANTS

A total of 86 first-year nursing students registered in Fundamentals of Nursing-II were included in this study. The students were divided at random into two groups, control (n = 43) and experimental (n = 43).

METHOD

The data were collected with an informative features form, a tracheostomy care knowledge test and skill checklists, and a performance assessment form. The control group commenced the study first so that the students did not affect each other. After the students completed the theoretical class, laboratory class, and small group study, they had their knowledge test and skills evaluation. The application featured tracheostomy care and was designed in support of formal education. It was uploaded to the mobile phones of the experimental group at a different phase of the study from the control group. After the experimental group made use of this application for seven days, their last knowledge test and skills evaluation were conducted.

RESULTS

The results of this study determined that the suctioning a tracheostomy tube and peristomal skin care average final test scores of the students in the experiment group were higher than the average scores of the students in the control group; this was statistically significant (p = 0.017, p = 0.003).

CONCLUSION

The game-based virtual reality phone application was effective in teaching the skill of suctioning a tracheostomy tube for nursing students in the short term, and it is recommended that this application be used in psychomotor skill training.

A Mokken scale analysis of the peer physical examination questionnaire

Background

Peer physical examination (PPE) is a teaching and learning strategy utilised in most health profession education programs. Perceptions of participating in PPE have been described in the literature, focusing on areas of the body students are willing, or unwilling, to examine. A small number of questionnaires exist to evaluate these perceptions, however none have described the measurement properties that may allow them to be used longitudinally. The present study undertook a Mokken scale analysis of the Peer Physical Examination Questionnaire (PPEQ) to evaluate its dimensionality and structure when used with Australian osteopathy students.

Methods

Students enrolled in Year 1 of the osteopathy programs at Victoria University (Melbourne, Australia) and Southern Cross University (Lismore, Australia) were invited to complete the PPEQ prior to their first practical skills examination class. R, an open-source statistics program, was used to generate the descriptive statistics and perform a Mokken scale analysis. Mokken scale analysis is a non-parametric item response theory approach that is used to cluster items measuring a latent construct.

Results

Initial analysis suggested the PPEQ did not form a single scale. Further analysis identified three subscales: ‘comfort’, ‘concern’, and ‘professionalism and education’. The properties of each subscale suggested they were unidimensional with variable internal structures. The ‘comfort’ subscale was the strongest of the three identified. All subscales demonstrated acceptable reliability estimation statistics (McDonald’s omega > 0.75) supporting the calculation of a sum score for each subscale.

Conclusion

The subscales identified are consistent with the literature. The ‘comfort’ subscale may be useful to longitudinally evaluate student perceptions of PPE. Further research is required to evaluate changes with PPE and the utility of the questionnaire with other health profession education programs.

Promoting sustainability in quality improvement: an evaluation of a web-based continuing education program in blood pressure measurement

Background

The accuracy of blood pressure measurement is variable in office-based settings. Even when staff training programs are effective, knowledge and skills decay over time, supporting the need for ongoing staff training. We evaluated whether a web-based continuing education program in blood pressure measurement reinforced knowledge and skills among clinical staff and promoted sustainability of an existing quality improvement program.

Methods

Medical assistants and nurses at six primary care clinics within a health system enrolled in a 30-min online educational program designed to refresh their knowledge of blood pressure measurement. A 20-question pre- and post-intervention survey addressed learners’ knowledge and attitudes. Direct observation of blood pressure measurement technique before and after the intervention was performed. Differences in responses to pre- and post-module knowledge and attitudes questions and in observation data were analyzed using chi-square tests and simple logistic regression.

Results

All 88 clinical staff members participated in the program and completed the evaluation survey. Participants answered 80.6% of questions correctly before the module and 93.4% afterwards (p < 0.01). Scores improved significantly among staff from all job types. Licensed practical nurses and staff who had been in their current job at least a year were more likely to answer questions correctly than registered nurses and those in their current job less than a year. Attitudes toward correct blood pressure measurement were high at baseline and did not improve significantly. Prior to the intervention, staff adhered to 9 of 18 elements of the recommended technique during at least 90% of observations. Following the program, staff was more likely to explain the protocol, provide a rest period, measure an average blood pressure, and record the average blood pressure, but less likely to measure blood pressure with the arm at heart level and use the right arm.

Conclusions

We designed, implemented, and evaluated a web-based educational program to improve knowledge, skills, and attitudes in blood pressure measurement and use of an automated device among nurses and medical assistants in ambulatory care. The program reinforced knowledge related to recommended blood pressure measurement technique.

Trial registration

Retrospectively registered with ClincalTrials.gov on March 22, 2012; registration number NCT01566864.

Electronic supplementary material

The online version of this article (10.1186/s12875-017-0682-5) contains supplementary material, which is available to authorized users.

Effect of simulation on the ability of first year nursing students to learn vital signs

BACKGROUND

The acquisition of cognitive, affective and psychomotor knowledge and skills are required in nursing, made possible via an interactive teaching method, such as simulation.

OBJECTIVE AND DESIGN

This study conducted to identify the impact of simulation on first-year nursing students' ability to learn vital signs.

SETTING AND PARTICIPANTS

A convenience sample of 90 first-year nursing students enrolled at a University, Ankara, in 2014-2015.

METHOD

Ninety students enrolled for lessons on the "Fundamentals of Nursing" were identified using a simple random sampling method. The students were taught vital signs theory via traditional methods. They were grouped into experimental 1, experimental 2 and control group, of 30 students each. Students in the experimental 1 group attended sessions on simulation and those in the experimental 2 group sessions on laboratory work, followed by simulation. The control group were taught via traditional methods and only attended the laboratory work sessions. The students' cognitive knowledge acquisition was evaluated using a knowledge test before and after the lessons. The ability to measure vital signs in adults (healthy ones and patients) was evaluated using a skill control list.

RESULTS

A statistically significant difference was not observed between the groups in terms of the average pre-test scores on knowledge (p>0.050). Groups exposed to simulation obtained statistically significantly higher scores than the control group in post-test knowledge (p<0.050). The ability of the groups exposed to simulation to measure vital signs in healthy adults and patients was more successful than that the control group (p<0.050). This was statistically significant.

CONCLUSION

Simulation had a positive effect on the ability of nursing students to measure vital signs. Thus, simulation should be included in the mainstream curriculum in order to effectively impart nursing knowledge and skills.

Mental health and learning disability nursing students' perceptions of the usefulness of the objective structured clinical examination to assess their competence in medicine administration

The aim of this study was to evaluate mental health and learning disability nursing students' perceptions of the usefulness of the objective structured clinical examination (OSCE) in assessing their administration of medicine competence. Learning disability (n = 24) and mental health (n = 46) students from a single cohort were invited to evaluate their experience of the OSCE. A 10-item survey questionnaire was used, comprising open- and closed-response questions. Twelve (50%) learning disability and 32 (69.6%) mental health nursing students participated. The OSCE was rated highly compared to other theoretical assessments; it was also reported as clinically real and as a motivational learning strategy. However, it did not rate as well as clinical practice. Content analysis of written responses identified four themes: (i) benefits of the OSCE; (ii) suggestions to improve the OSCE; (iii) concern about the lack of clinical reality of the OSCE; and (iv) OSCE-induced stress. The themes, although repeating some of the positive statistical findings, showed that participants were critical of the university setting as a place to conduct clinical assessment, highlighted OSCE-related stress, and questioned the validity of the OSCE as a real-world assessment. The OSCE has an important role in the development of student nurses' administration of medicine skills. However, it might hinder their performance as a result of the stress of being assessed in a simulated environment.

First year nursing students' viewpoints about compromised clinical safety

OBJECTIVE

Undergraduate nursing students must uphold patient safety as a professional and moral obligation across all clinical learning experiences. This expectation commences at entry into the nursing program. As part of a larger study exploring undergraduate baccalaureate nursing students' understanding of clinical safety, this paper specifically focuses on first year students' viewpoints about unsafe clinical learning situations.

METHODS

Q-methodology was used. Sixty-eight first year nursing students participated in the ranking of 43 statements indicative of unsafe clinical situations and practices. Data was entered into a Q-program for factor analysis.

RESULTS

The results revealed a typology of four discrete viewpoints of unsafe clinical situations for first year students. These viewpoints included an overwhelming sense of inner discomfort, practicing contrary to conventions, lacking in professional integrity and disharmonizing relations. Overall, a consensus viewpoint described exonerating the clinical educator as not being solely responsible for clinical safety.

DISCUSSION

This information may assist students and educators to cooperatively and purposefully construct a clinical learning milieu conducive to safety.

A descriptive survey investigating pre-registration student nurses' perceptions of clinical skill development in clinical placements

BACKGROUND

Clinical skill development is essential to nurse education. Clinical skills are frequently taught in higher education institutions using clinical simulation. It is unclear if clinical skills are subsequently consolidated and developed in clinical placements.

OBJECTIVES

The aim of this survey was to evaluate pre-registration student nurses perceptions of the frequency of opportunities to practise, the level of supervision and assessment of, clinical skills in their clinical placements.

DESIGN

This was a cross-sectional survey design using an online, self-report questionnaire including a Likert-type scale and open ended comments.

PARTICIPANTS

Four hundred and twenty one students, from all year groups, from a university in the south of England on a wide variety of clinical placements participated.

METHODS

Participants evaluated the frequency of opportunity to practise, level of supervision and assessment of and feedback on performance of specific clinical skills. Clinical skills evaluated were measurement of vital signs, aseptic non-touch technique, assisting with eating and drinking, and assisting with comfort and hygiene. Data were analysed utilising Statistical Package for the Social Sciences Version 19.

RESULTS

The frequency of opportunities to practise skills in clinical placement was variable with some participants reporting that they never had opportunity to practise essential skills. Similarly the level of supervision and assessment was also inconsistent suggesting that participants frequently practised clinical skills unsupervised without being assessed as competent.

CONCLUSIONS

Inconsistencies in clinical skill development may lead to graduates who are not work ready and as a result, insufficient clinical competence potentially leads to unsafe practice and poor patient care. This calls for stronger partnerships between educators and clinical areas and the prioritisation of mentor preparation and education as well as organisational support in terms of mentor workload planning.

A survey of student nurses' and midwives' experiences of learning to use electronic health record systems in practice

AIM

The study aimed to investigate student nurses' and midwives' experiences of learning to use electronic health records (EHR) in practice.

BACKGROUND

Good record keeping and documentation are integral to nursing and midwifery practice. As EHRs become more widespread, student nurses and midwives need opportunities to access and learn how to use them in practice.

METHOD

A survey of nursing and midwifery students was conducted using questionnaires (n = 215) and three focus groups: one with midwifery students (n = 6); one with mental health nursing students (n = 5) and one with adult nursing students (n = 6). The University research ethics committee approved the study. The questionnaire data were analysed using SPSS v19. The focus group data were analysed thematically following transcription.

RESULTS

The results presented relate to two themes: 1) Preparation for using EHRs and skills development; 2) Access to EHRs and involvement. Students had variable experiences in relation to opportunities to access and use EHRs, training on EHR systems used in practice and guidance from mentors. Some mentors had concerns about students' legitimacy to access EHRs and verification of students' EHR entries was a challenging issue in some areas.

CONCLUSION

To promote opportunities for students to develop competence in using EHRs in practice, training on EHR systems in use, and clear processes for authorised access, are needed. Following the survey, the University and practice partners collaboratively established formalised EHR training for students with clear governance procedures for access and use.

Students' perspectives on their skills acquisition and confidence

AIM

To investigate students' perspectives on their skills acquisition and knowledge during the foundation year of their nursing programme, and whether this improved students' levels of competence and confidence.

METHOD

Two groups of nursing students (n=140) responded to a clinical acquisition skills survey (CASS) to elicit their perceptions of clinical skills acquisition. Additionally, students' competence levels were examined, drawing comparisons with the students' objective, structured clinical examination (OSCE) results.

RESULTS/FINDINGS

Students identified that the curriculum supported the acquisition of clinical skills, and clinical examination results confirmed that 95% of students were competent to pass their OSCE.

CONCLUSION

Students' responses to items that related to perceived confidence and competence levels were positive. This indicates that the introduction of clinical skills teaching and assessment within a university's simulation suites augmented with structured assessment within the clinical environment improved the acquisition of clinical skills.