Developing and integrating nursing competence through authentic technology-enhanced clinical simulation education: Pedagogies for reconceptualising the theory-practice gap

Bridging School and Practice? Barriers to the Integration of 'Boundary Objects' for Learning and Assessment in Clinical Nursing Education

Introduction

In clinical health professions education, portfolios, assignments and assessment standards are used to enhance learning. When these tools fulfill a bridging function between school and practice, they can be considered 'boundary objects'. In the clinical setting, these tools may be experienced as time-consuming and lacking value. This study aimed to investigate the barriers to the integration of boundary objects for learning and assessment from a Cultural-Historical Activity Theory (CHAT) perspective in clinical nursing education.

Methods

Nineteen interviews and five observations were conducted with team leads, clinical educators, supervisors, students, and teachers to obtain insight into intentions and use of boundary objects for learning and assessment. Boundary objects (assessment standards, assignments, feedback/reflection/patient care/development plan templates) were collected. The data collection and thematic analysis were guided by CHAT.

Results

Barriers to the integration of boundary objects included: a) conflicting requirements in clinical competency monitoring and assessment, b) different application of analytical skills, and c) incomplete integration of boundary objects for self-regulated learning into supervision practice. These barriers were amplified by the simultaneous use of boundary objects for learning and assessment. Underlying contradictions included different objectives between school and practice, and tensions between the distribution of labor in the clinical setting and school's rules.

Discussion

School and practice have both convergent and divergent priorities around students' clinical learning. Boundary objects can promote continuity in learning and increase students' understanding of clinical practice. However, effective integration requires for flexible rules that allow for collaborative learning around patient care.

Perspectives of clinical nurse educators on competency-based nursing teaching in blended learning environments during nursing internship: A descriptive qualitative study

AIM

To investigate the perspectives of clinical nurse educators regarding the challenges and essential elements of teaching competence in blended learning environments during nursing internships to inform the development of a competency-based teaching model.

BACKGROUND

Competency-based teaching and blended learning play important roles in enhancing the learning experience of nursing internship trainees. Internship trainees refer to nursing students undergoing supervised practical training in ‎clinical settings.‎ However, clinical nurse educators frequently encounter challenges in acquiring the necessary competence for successful implementation of blended learning strategies.

DESIGN

A descriptive‎ qualitative study.

METHODS

This study used semi-structured interviews with 11 certified nurse educators (CNEs) from diverse clinical disciplines in a tertiary hospital in China. Purposive sampling ensured diversity across key characteristics. Ethical approval was obtained and interviews were digitally recorded, transcribed and analyzed thematically. Theoretical saturation guided data collection, with precise measures taken to ensure confidentiality and anonymity. Thematic analysis, employing a constant comparison technique, systematically identified various themes related to blended teaching competence. This approach provided valuable insights into CNEs' perspectives and practices. The analysis involved theoretical sampling, line-by-line coding and comparative evaluation with supporting text materials.

RESULTS

The in-depth analysis of teaching competence among clinical nurse educators in blended learning settings during nurse internships revealed five key themes: professionalism, teaching literacy, subject expertise, information literacy and interpersonal communication.

CONCLUSION

These themes recognized clinical nurse educators' perspectives towards establishing a competency-based nursing teaching model for a blended learning environment for nurse internships. Moreover, these perspectives are also crucial in enhancing teaching literacy through effective instructional methods, engagement strategies and the promotion of critical thinking skills. Identifying these themes contributes to efforts to improve teaching effectiveness and enhance learning outcomes for internship trainees in a blended learning context.

Cocreation With Prelicensure Nursing Students of a Simulated Practice Placement

BACKGROUND

Cocreation is a collaborative process that uses problem-based learning to construct new initiatives. It has many known benefits associated with innovation in the development of programs, such as by creating simulations based on firsthand experiences.

METHODS

Thirty second-year prelicensure nursing students cocreated simulations and associated lesson plans for a simulated practice placement. They followed a 4-step process described in the article.

RESULTS

Cocreation combines lecturers' and students' unique skills and knowledge, creating programs based on the unique firsthand experiences of stakeholders. As the students take control of their own workloads, facilitators need to be adaptable in the support they provide, depending on the needs of the students.

CONCLUSION

The staged process provided a structure for the students to produce their simulations and lesson plans. The cocreation of the simulated practice placement provided an innovative educational model that supported student development and produced lessons and simulations based on stakeholder need.

Methodological approaches and competence areas of nursing students in virtual reality simulation research - A scoping review

OBJECTIVES

To analyze methodological approaches (theoretical frameworks, study designs, methods) and competence areas of nursing students in research on virtual reality simulations (VRS) with a high level of immersion.

METHODS

A scoping review was performed. A systematic search of the literature was conducted on MEDLINE, CINAHL and ERIC databases on 30/11/22. In addition, a manual search was utilized. The extracted data relating to the research questions was descriptively analyzed and results were narratively summarized.

RESULTS

In total 23 studies were included in the review. Selected studies employed a wide range of theoretical frameworks and research designs. The studies aimed to develop competences both through complex interventions where team-based skills are required in acute situations, and they described basic nursing interventions where individual skills are required in non-acute nursing care.

CONCLUSIONS

A significant amount of the selected studies did not utilize a learning theory or an instructional design framework as a basis for their research. More knowledge was found on training specific skills compared to facilitating the attitudes and values of the participants. Therefore, there is a need for further research on whether nursing students' attitudes and values can be supported through VRS with a high level of immersion.

Changes in evidence-based practice self-efficacy among nursing students and the impact of clinical competencies: Longitudinal descriptive study

INTRODUCTION

Evidence-based practice (EBP) is essential to ensure patient safety and improve the quality of nursing care. Nursing students' self-efficacy in employing EBP is crucial for the formation of a culture of EBP in healthcare organizations.

OBJECTIVE

This study aimed to investigate the changes in nursing students' self-efficacy in employing EBP and the extent to which clinical performance affects these changes.

METHODS

This study was a longitudinal descriptive study. Participants were nursing students who had received education on EBP theory and had clinical practice experience. Convenience sampling was used to select nursing students in their third year of study at a nursing college located in the southern region of Korea in 2020. The researcher measured EBP self-efficacy and clinical competence using an online survey tool at three time points (second semester of third year, first semester of fourth year, and second semester of fourth year). Multilevel modeling was used to identify factors affecting changes in EBP self-efficacy.

RESULTS

The results showed that nursing students' EBP self-efficacy increased over time. Nursing leadership (p = .022), nursing skills (p = .028), communication (p < .001), and nursing process (p = .003) were significant factors that affected the changes in EBP self-efficacy. Individual differences in initial levels and change rates were still observed.

CONCLUSION

Systematic education on EBP theory and practical training should be provided to nursing students from the beginning of their studies to graduation to deepen their EBP and clinical competence.

Formação profissional do técnico de enfermagem em segurança do paciente: estudo misto

Resumo Objetivo: analisar a formação de técnicos de enfermagem em segurança do paciente. Método: estudo de método misto paralelo convergente, em que elementos qualitativos e quantitativos foram concomitantemente implementados e igualmente priorizados, realizado em três colégios técnicos vinculados a uma instituição pública federal do Nordeste brasileiro. No qualitativo, realizou-se entrevista semiestruturada com 24 docentes e aplicou-se a análise temática. No estudo quantitativo, survey, utilizou-se instrumento para rastrear termos sobre segurança do paciente com 84 discentes. A interpretação geral dos dados realizou a combinação dos resultados e balizou-se no Guia Curricular de Segurança do Paciente. Resultados: emergiram duas categorias temáticas: Compreensão dos docentes acerca do tema segurança do paciente na formação de técnicos de enfermagem e Aplicação e projeção do ensino da segurança do paciente na formação de técnicos de enfermagem. No estudo quantitativo, dos 46 termos rastreadores, predominou a identificação de termos no contexto teórico-prático, nos Cursos A e C, totalizando 36 (78,3%) e 25 (54,3%), respectivamente. No Curso B, destacou-se ensino teórico, com 26 termos (56,5%). Conclusão: a formação profissional do discente técnico de enfermagem apresenta foco tecnicista e não contempla, integralmente, no processo ensino-aprendizagem, questões de segurança do paciente e, assim, configura-se desafio para as instituições formadoras e docentes.

Meeting the AACN's Essentials for Competency-Based Education With Hands-Free Video-Recorded Skills Assessment

BACKGROUND

In the American Association of Colleges of Nursing's updated Essentials, competency-based education (CBE) is the expected standard for nursing curricula. CBE approaches include observation, practice repetition, demonstration, and video supervision guided by a framework of competency, feedback, and self-reflection.

METHOD

The promotion of skills competency among nursing students was facilitated by self-regulated learning using video skills-based competency testing. Video surveillance enabled students to practice and self-test their competency skills.

RESULTS

Self-videotaping by students provided a comfortable learning environment for repeated practice and fostered clinical judgment and accountability. Students reported increased confidence, decreased anxiety, and improved performance. Students developed skills and attitudes regarding self-reflection and self-remediation. Additionally, faculty reported improved visibility, a more efficient workload, and greater achievement of student outcomes.

CONCLUSION

Integrating CBE and incorporating video technology during skills testing enhances the opportunity for students to demonstrate skills competency and gain comfort in their own skills acquisition. [J Nurs Educ. 2023;62(12):733-736.].

Formación profesional del técnico en enfermería en seguridad del paciente: estudio mixto

Resumen Objetivo: analizar la formación de los técnicos en enfermería en seguridad del paciente. Método: estudio de método mixto paralelo convergente, en el que los elementos cualitativos y cuantitativos fueron implementados simultáneamente y considerados con el mismo nivel de prioridad, realizado en tres escuelas técnicas vinculadas a una institución pública federal en el Nordeste brasileño. En el estudio cualitativo se realizó una entrevista semiestructurada a 24 profesores y se aplicó el análisis temático. En el estudio cuantitativo, survey, se utilizó un instrumento para detectar términos sobre seguridad del paciente con 84 estudiantes. Para la interpretación general de los datos se realizó la combinación de los resultados y se tomó como base la Guía Curricular de Seguridad del Paciente. Resultados: surgieron dos categorías temáticas: Comprensión de los docentes sobre la seguridad del paciente en la formación de técnicos en enfermería e Implementación y proyección de la enseñanza de la seguridad del paciente en la formación de técnicos en enfermería. En el estudio cuantitativo, en los 46 términos indicadores, predominó la identificación de términos en el contexto teórico-práctico, en las carreras A y C, con un total de 36 (78,3%) y 25 (54,3%), respectivamente. En la carrera B se destacó la enseñanza teórica, con 26 términos (56,5%). Conclusión: la formación profesional de los estudiantes de la carrera de técnico en enfermería tiene un enfoque técnico y no considera de forma integral los temas que tienen que ver con la seguridad del paciente en el proceso de enseñanza-aprendizaje, por lo que es un desafío para las instituciones formadoras y para los docentes.

Identifying best practices for virtual nursing clinical education: A scoping review

BACKGROUND

COVID-19 forced nurse educators across the world to rapidly shift clinical experiences from face-to-face to the virtual world without identification of best practices to guide this transition.

PURPOSE

The purpose of this review was to identify best practices in virtual clinical experiences for undergraduate and graduate nursing students using the Community of Inquiry model as a framework.

METHOD

A scoping review was conducted using the Joanna Briggs Institute Scoping Review process. Ten databases were searched systematically for literature related to virtual nursing student clinical experiences. The 36 articles retained for review were appraised using evidence-based rapid critical appraisal tools.

RESULTS

The literature suggests virtual clinical experiences may positively impact clinical reasoning and judgement; knowledge gain, retention, and application; affective learning; communication and teamwork; competence; engagement; confidence; and satisfaction. However, increased anxiety, frustration with technology and access, difficulty asking questions, and increased cost were reported. Additional considerations included appropriate faculty training, student support, and accreditation and board certification requirements. Standards related to virtual clinical experiences and simulation for advanced practice registered nurses needs further study.

CONCLUSION

Virtual clinical experiences resulted in positive student learning outcomes. Through the provision of quality virtual clinical experiences, nurse educators have the potential to maximize student learning and professional growth.

Effect evaluation of case-based learning with situated cognition theory on competence training for student nurses in pediatric surgery

Objective

The case-based learning with situated cognition theory (CBL-SCT) approach focuses on teaching over learning, making it suited to student nurse education. However, it is rare in student nurse training in pediatric surgery, and some subjective evaluations of the learning effect are still affected by the assessor. This study investigated the effect of the CBL-SCT approach on improving the nursing quality/safety and comprehensive performance of student nurses, and explored a method for analyzing the reliability of subjective evaluations.

Methods

Thirty-six student nurses were divided into a control group and an experimental group and received seven days of orientation via conventional and CBL-SCT training, respectively. The learning effect was evaluated via examining their implementation of nursing quality criteria within the following month and their comprehensive clinical performance after six months. Among the evaluation indicators, professional skills, job competency, and professional quality were evaluated by assessors, whose scores were tested for consistency using Cronbach's alpha.

Results

Among the 11 nursing quality criteria, the correct implementation of patient identification and communication (t = 2.257, P = 0.031), medication-checking (t = 5.444, P < 0.001), tumbles/bed-falling prevention (t = 3.609, P = 0.001), pressure injury prevention (t = 3.834, P = 0.001), catheter management (t = 3.409, P = 0.002), and nursing record writing (t = 2.911, P = 0.006) in the experimental group were all higher than in the control group. Six months after training, the experimental group was also higher in professional theory (t = 4.889, P < 0.001), professional skills (t = 2.736, P = 0.010), job competency (t = 5.166, P < 0.001), and professional quality (t = 16.809, P < 0.001). Cronbach's alpha test verified that the assessors' evaluations had good internal consistency and reliability for job competency (alpha = 0.847, 95% CI lower limit = 0.769), professional quality (alpha = 0.840, 95% CI lower limit = 0.759), and professional skills (alpha = 0.888, 95% CI lower limit = 0.822).

Conclusions

The CBL-SCT method can help student nurses quickly change their nursing role, and Cronbach's alpha test can verify the reliability of subjective evaluations, thus indirectly reflecting the training effect equitably and objectively.

Teaching strategies of clinical reasoning in advanced nursing clinical practice: A scoping review

AIM/OBJECTIVE

To report and synthesize the main strategies for teaching clinical reasoning described in the literature in the context of advanced clinical practice and promote new areas of research to improve the pedagogical approach to clinical reasoning in Advanced Practice Nursing.

BACKGROUND

Clinical reasoning and clinical thinking are essential elements in the advanced nursing clinical practice decision-making process. The quality improvement of care is related to the development of those skills. Therefore, it is crucial to optimize teaching strategies that can enhance the role of clinical reasoning in advanced clinical practice.

DESIGN

A scoping review was conducted using the framework developed by Arksey and O'Malley as a research strategy. Consistent with the nature of scoping reviews, a study protocol has been established.

METHODS

The studies included and analyzed in this scoping review cover from January 2016 to June 2022. Primary studies and secondary revision studies, published in biomedical databases, were selected, including qualitative ones. Electronic databases used were: CINAHL, PubMed, Cochrane Library, Scopus, and OVID. Three authors independently evaluated the articles for titles, abstracts, and full text.

RESULTS

1433 articles were examined, applying the eligibility and exclusion criteria 73 studies were assessed for eligibility, and 27 were included in the scoping review. The results that emerged from the review were interpreted and grouped into three macro strategies (simulations-based education, art and visual thinking, and other learning approaches) and nineteen educational interventions.

CONCLUSIONS

Among the different strategies, the simulations are the most used. Despite this, our scoping review reveals that is necessary to use different teaching strategies to stimulate critical thinking, improve diagnostic reasoning, refine clinical judgment, and strengthen decision-making. However, it is not possible to demonstrate which methodology is more effective in obtaining the learning outcomes necessary to acquire an adequate level of judgment and critical thinking. Therefore, it will be necessary to relate teaching methodologies with the skills developed.

Development and Application Evaluation of a Nursing Simulation Teaching Information System Based on Hospital Information Systems

BACKGROUND

The extensive application of hospital information systems in the current information-driven era suggests that nursing education should focus on information education.

METHODS

The newly developed hospital information system was used and evaluated by 544 students to explore the feasibility and necessity of such applications for teaching.

RESULTS

Overall, 97.1% of the students expressed satisfaction, and 96.0% supported simulated information education for nursing. The usability was good, with the system receiving a usability score of 72.625 ± 13.0907. The junior students had a higher score than the sophomores regarding system availability, and the difference was statistically significant.

CONCLUSIONS

Students generally had a high degree of satisfaction with the simulated information nursing education system and highly approved of the teaching method. However, the system needs to be upgraded.

Nursing technicians' professional training in patient safety: A mixed-methods study

OBJECTIVE

to analyze nursing technicians' training in patient safety.

METHOD

a convergent parallel mixed-methods study, where qualitative and quantitative elements were concomitantly implemented and equally prioritized, carried out in three technical colleges linked to a federal public institution in the Brazilian Northeast region. In the qualitative phase, semi-structured interviews were conducted with 24 professors and thematic analysis was applied. In the quantitative study, of the survey type, an instrument was used to screen terms about patient safety with 84 students. The results were combined during the general data interpretation, which was based on the Patient Safety Curricular Guide.

RESULTS

two thematic categories emerged: The professors' understanding about the theme of patient safety in nursing technicians' training; and Application and projection of the teaching of patient safety in nursing technicians' training. In the quantitative study, among the 46 screening terms, their identification in the theoretical-practical context predominated in Courses A and C, totaling 36 (78.3%) and 25 (54.3%), respectively. Theoretical teaching stood out in Course B, with 26 terms (56.5%).

CONCLUSION

professional training of Nursing Technician students has a technical focus and does not fully contemplate patient safety issues in the teaching-learning process and, thus, constitutes a challenge for training institutions and professors alike.

The Use of Interactive Technology to Improve Student Accuracy on Electrocardiographic Interpretation

ABSTRACT

Electrocardiography (ECG) instruction relies heavily on memorization of interpretation rules and lacks opportunities for hands-on practice. Consequently, nursing students struggle with ECG interpretation. In an online undergradute nursing course, we implemented interactive technology to facilitate kinesthetic pedagogy. Accuracy was evaluated at midterm and during final assessments by two experts using a standardized rubric. Students who engaged with interactive technology at both assessments demonstrated consistent accuracy of ECG interpretation; students who did not failed to demonstrate consistent accuracy with ECG interpretation. Incorporating interactive technology to facilitate psychomotor learning may be essential in improving the accuracy of ECG interpretation.

The Theory-Practice Gap in Nursing Education During the Pandemic Period from the Perspective of Stakeholders: A Qualitative Study

Objective: The purpose of this study was to understand the experience of theoretical and practical nursing education carried out by distance education during the COVID-19 pandemic and the theory-practice gap in nursing education in Turkey. Methods: This qualitative study used a descriptive qualitative study. This research was conducted with nursing lecturers and students from two universities in two different geographical regions. Lecturers and undergraduate students participated in the research. The data for the research were collected using the online Zoom program during four focus-group discussions. Results: Three main themes emerged for the categories of theoretical and practical education emerged during the study: strong structural conditions (technological integration and accessibility) both strong and weak structural conditions (asynchronous participation and changing comfort levels/routines) and weak structural conditions (cold contact and inequality of opportunity). Conclusion: This study revealed the strengths and weaknesses in the experience of distance nursing education and will guide future planning of nursing education programs and clinical fields.

Instruction strategies for drug calculation skills: A systematic review of the literature

BACKGROUND

Medication errors and unsafe medication practices are a leading cause of injury and avoidable harm worldwide.

OBJECTIVES

The aim of this review was to (i) explore and identify evidence-based strategies to teach medication calculation skills by determining the most common errors and assess the quality, level, and role of the evidence, and (ii) describe instruction strategies for drug calculation skills development or improvement based on seven research-based principles for smart teaching.

DESIGN

Systematic review.

DATA SOURCES

CINAHL, PubMed, and PsycINFO.

REVIEW METHODS

The review followed Whittemore and Knafl's framework steps with an assessment of the studies reporting using PRISMA, STROBE, COREQ and categorizing their methods by evidence hierarchy and roles. Two authors independently assessed eligibility and extracted data.

RESULTS

From the total 1793 articles, 51 studies met the eligibility criteria. The studies included 9210 nursing students/nurses and mainly used a quantitative approach (67.5%), followed by qualitative (22.5%) and mixed methods (10.0%), with the students/nurses doing arithmetic and conceptual mistakes. The findings presented were low levels of evidence III (23.5%) and V (41.2%), quality Level B (82.4%), and 47.1% focused on choosing the appropriate teaching and intervention approaches (role of the evidence). The teaching strategies addressed multiple smart teaching principles, but mainly prior knowledge (principle 1, 39.2%). The least used strategies were those addressing the levers that influence motivation and behaviors such as value, expectations, and environment climate (principle 3, 13.7%). Two studies addressed five principles simultaneously.

CONCLUSIONS

Regarding teaching strategies, the most recurring strategies were early diagnostic assessments on knowledge, anxiety and/or self-confidence, considering knowledge organization with scaffolding complex tasks, being explicit about objectives and expectations, and usage of e-learning. However, e-learning was mainly used after 2018. Considering the low levels and quality of evidence, we recommend higher levels of research design for future research. Randomized Controlled Trials could be conducted when randomizing teaching methods per semester or questions embedded in software. Web-base software could be used to support teaching and research approaches.

Medicinal chemistry: The key to critical thinking in pharmacotherapy

INTRODUCTION

Medicinal chemistry is a polarizing subject for pharmacy students where, if not embraced, future pharmacists may be limited in their role as drug experts. An understanding of medicinal chemistry and its structure-activity relationships creates a strong foundation upon which our knowledge of pharmacotherapy is built.

PERSPECTIVE

As the field of pharmacy has shifted to an increasingly clinical role, with an emphasis on patient care as a member of the interprofessional team, pharmacy has also seen an increase in postgraduate training, specifically residencies and fellowships. Pharmacy students noting this trend may depreciate medicinal chemistry early in the curriculum and place more focus on therapeutics and clinical rotations. However, forgoing the fundamental understanding of medicinal chemistry may hinder pharmacy students' current breadth and understanding, and the ability to rationalize future developments in their practice. Medicinal chemistry empowers pharmacists with the ability to reason through medications' impact versus simply memorizing their actions. Pharmacists play a unique role as drug experts, with advanced problem-solving and critical thinking skills that set them apart from drug references and search engines.

IMPLICATIONS

As the field moves towards pharmacists as a member of the clinical team, the faculty should integrate medicinal chemistry throughout the doctor of pharmacy curricula. Faculty without this ability for a curriculum change should consider integration in their content. The field of pharmacy must take care to not allow clinical knowledge to significantly overshadow the importance of medicinal chemistry or run the risk of saturating the field with underprepared pharmacists.

Approach to Developing a Core Competency Framework for Student Nurses in Saudi Arabia: Results from Delphi Technique

Background: Competence, while firmly established as a primary conceptual framework in nursing education, continues to lack clarity and uniformity across borders and contexts. While a wealth of research has been carried out on the various dimensions of this concept, including the drafting and implementation of frameworks for nursing competence, no unifying international framework has been forthcoming. Indeed, the continued development of more localized approaches, based on geography or specialization, would appear to be the most realistic objective. It is incumbent on nurse educationalists and researchers to build on existing frameworks and develop evidence-based tested methodologies for competence assessment in localized contexts. Currently, there is a dearth of such evidence-based frameworks in the Middle East and in the Kingdom of Saudi Arabia (KSA) in particular. This study aimed to formulate and validate a competence framework for undergraduate nursing students in KSA. Results: Following documentary analysis, framework drafting and a three round Delphi process, a consensus was reached as to elements, comprising six discrete domains, to be included. The identified competence domains provide a framework to guide the implementation of a competence-based assessment and move towards a competency-based curriculum for nursing education in KSA. Conclusions: The study concluded that providing a competency-based model and expanding and standardization of competency concept in different dimensions of nursing profession is a necessity; considering that clarification of the concept of competency, the recognition of its dimensions, characteristics and the factors affecting it help in determining the criteria and standardizing the competency tools.

Simulation-Based Learning Supported by Technology to Enhance Critical thinking in Nursing Students: Protocol for a Scoping Review (Preprint)

Background

Critical thinking is a crucial skill in the nursing profession, so teaching strategies and methodology must be carefully considered when training and preparing nursing students to think critically. Studies on simulation-based learning supported by technology are increasing in nursing education, but no scoping reviews have mapped the literature on simulation-based learning supported by technology to enhance critical thinking in nursing students.

Objective

The proposed scoping review aims to systematically map research on the use of simulation-based learning supported by technology to enhance critical thinking in nursing students.

Methods

The proposed scoping review will use the framework established by Arksey and O’Malley and will be reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping reviews. A systematic, comprehensive literature search was performed in the LILACS, ERIC, MEDLINE, EMBASE, PsycINFO, and Web of Science databases. Pairs of authors independently selected the articles by screening titles, abstracts, full-text papers, and extract data. The data will be analyzed and thematically categorized.

Results

The development of a comprehensive and systematic search strategy was completed in June 2021. The database searches were performed in July 2021, and the screening of titles and abstracts was completed in September 2021. Charting the data began in February 2022. Analysis and synthesis will be performed sequentially, and the scoping review is expected to be complete by May 2023.

Conclusions

The results of this proposed scoping review may identify gaps in the literature and provide an overview of research on the topic of simulation-based learning supported by technology to enhance critical thinking in nursing students. The research may identify nursing students’ reported barriers and enablers for learning critical thinking skills through simulation-based learning supported by technology, and the results may help educators enhance their educational approach through knowledge of students’ firsthand experiences and further development of successful teaching strategies in nursing education.

International Registered Report Identifier (IRRID)

DERR1-10.2196/36725

Bridging Didactic Learning and the Complexity of Practice Through Clinical Immersion: Evaluating the Sexual Assault Nurse Examiner Trainee Experience

In this article, we discuss the development and evaluation of the Vanderbilt Nursing Education Program for Sexual Assault Nurse Examiners (VEP-SANE), a 3-day clinical immersion (CI) program, including the lessons learned and the challenges experienced with the completion of two trainee cohorts. To bridge didactic learning and the complexity of practice, the VEP-SANE team designed an innovative, competency-based CI. Fifteen trainees from Cohort 1 and 19 trainees from Cohort 2 met requirements for CI participation. Trainees in Cohort 1 represented the advanced practice registered nurse specialties of emergency, women's health, and pediatrics. For Cohort 2 recruitment, enrollment was expanded to include family and midwifery advanced practice registered nurse specialties. Trainees were required to complete online training modules before CI participation. Online surveys assessed trainee perceptions about levels of knowledge and confidence related to sexual assault nurse examiner competencies (pre/post CI), each CI session, and the overall CI experience. Separate focused discussions were conducted with trainees and faculty after each CI. Both cohorts rated CI sessions as "excellent" or "very good" over 93% of the time. Perceived levels of knowledge and confidence increased from pre-CI to post-CI for both cohorts. Similar CI strengths were identified across trainees and faculty including speakers, high interactivity, safe environment, reality of cases, and surrogate practice. All trainees indicated readiness for preceptorships and interest in a virtual community of practice. Suggestions included more time for laboratory sessions, documenting photos, and interaction with individuals from the lesbian, gay, bisexual and transgender (LGBT) community and presenters. Future efforts focus on CI conversion to a virtual format because of the impact of COVID-19, increased VEP-SANE community of practice interaction, and expanded engagement with practicing sexual assault nurse examiners.

Simulation training and professional self-confidence: A large-scale study of third year nursing students

BACKGROUND

While hands-on training is a prerequisite for successful education of nursing students, constraints on clinical training availability and quality have increased focus on effects of in-school simulation training. However, existing research has produced inconsistent conclusions and the literature lacks high-powered evidence from controlled trials.

OBJECTIVES

To test effects of a simulation scheme on student professional self-confidence in technical and non-technical skills, as well as to investigate effects on knowledge acquisition and interaction with clinical training.

DESIGN

Field experiment, treatment is a three + two day simulation training scheme while control is a standard three hour simulation session. Self-confidence in a list of technical and non-technical skills is measured in three survey-rounds. Enriched with data on type of clinical training site and grade attainment.

SETTING

University College Copenhagen Department of Nursing, all third year students in 2019.

PARTICIPANTS

352 in cohort, out of which 316 participated and 311 answered first survey round (163 in treatment, 148 in control).

METHODS

Field experiment analyzed utilizing multivariate OLS regression analysis.

RESULTS

Students who receive increased simulation training report markedly higher levels of professional self-confidence immediately after training. This effect is double the size for confidence in technical skills, compared to non-technical skills. The effects on self-confidence in technical skills persist at the end of the following semester for those that receive low intensity clinical training. Students who receive the treatment see a small (and statistically uncertain) relative increase in grade attainment in the semester of treatment, but this difference dissipates over time.

CONCLUSIONS

Simulation training has substantial positive short-term effects for the professional self-confidence of nursing students and appears to have small positive effects on knowledge acquisition. Most of these effects are crowded out by other factors (notably intensive clinical training) over time but might have long-term positive effects for those that do not receive other intensive hands-on experiences. This is interpreted as an indication that simulation training can be used to compensate for uncertainties in providing sufficient training experiences outside of academic training.

Co-developing and implementing a community nursing simulated learning resource for undergraduate nursing students

Policy agendas across the developed world privilege systems transformation, notably shifting the balance of service provision from hospital to community settings. Primary and community health services have pivotal roles in the United Kingdom's longstanding policy ambition of healthcare services transformation, and it is imperative that undergraduate nursing students comprehend community settings as valuable learning environments, places of care and community nurses' roles therein. However, limited community placement learning opportunities means nursing students may be inadequately prepared to work in community settings at the point of initial registration. High fidelity simulated learning is well established within undergraduate nursing curricula. Currently, this learning approach predominantly focuses on acute and secondary care nursing and takes place in simulation centres. Within undergraduate nursing curricula there is limited evidence to support that community-based simulation is utilised with the result that students may struggle to recognise the value of learning opportunities in the community environment. This underpins the rationale for the development of this educational initiative which reflects current health policy agenda of care being provided closer to home. In addition, the new pre-registration 'Future nurse: Standards of proficiencies' (NMC, 2019) acknowledge that registered nurses need to be able to care for people in their own home and in the community setting. This paper describes the co-development and implementation of a pilot, community nursing focused, simulated learning resource within an undergraduate adult field nursing programme in Wales, UK. TWEETABLE ABSTRACT: How one university co-developed and implemented a community focused simulation resource for undergraduate nursing students.

Active learning pedagogy transformation: A whole-of-school approach to person-centred teaching and nursing graduates

In contemporary higher education contexts, active learning pedagogy pervades in discourses around designing quality student experiences. Transposing student bodies from passive to active participants in learning experiences is widely considered best practice in curriculum and pedagogical design. While literature on active learning is vast and recommendations on how to transform into an active learning approach abounds, such advice is often prescribed to individual teachers or courses. What remains unknown in this transformational space is how leadership for person-centred teaching can guide a whole school to shift philosophical presuppositions and take-up active learning as the guiding pedagogy. This paper describes the challenges, processes and steps for how one school, the School of Nursing at an Australian University, invoked transformational change through a philosophical and practice-based shift across all learning spaces (online/ face-to-face/ blended, undergraduate and postgraduate domains). This paper offers recommendations for other schools interested in establishing a whole-of-school commitment to an active learning pedagogy transformation underpinned by person-centred teaching.

Core educational components of interprofessional education in pediatric emergencies: An integrated review

PURPOSE

This study was conducted to explore the core educational components of interprofessional education (IPE) for pediatric emergencies to establish a basis for interprofessional simulation education.

METHODS

Using Whittemore and Knafl's integrative review method, we searched for studies in PubMed, Embase, Cochrane Library, CINAHL, and four South Korean databases (RISS, NDSL, DBpia, and KISS).

RESULTS

We identified 21 studies on the general characteristics of IPE in pediatric emergency situations and integrated the core components of IPE according to a PRISMA flowchart. Three core components were identified (individual-competent professionals, team-cooperative professions, and outcome-optimal achievement), with the subthemes of role and responsibility, clinical judgment, performance, leadership, communication, teamwork, patient safety, and quality improvement.

CONCLUSION

We recommend that IPE pediatric emergencies should contain the three dimensions of these core components to enhance individual and team performance and to promote optimal achievement in terms of patient outcomes. IPE programs should consider these characteristics and include a valid tool for evaluating the programs' effectiveness.

Development of clinical competence in nursing in simulation: the perspective of Bloom's taxonomy

OBJECTIVES

to investigate the scientific evidence on the use of Bloom's taxonomy for developing competence in nursing professionals and students in clinical simulation.

METHODS

integrative review of the National Library of Medicine (NLM), National Institutes of Health (NIH), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin American and Caribbean Literature in Health Sciences (LILACS), Web of Science and SCOPUS databases, using the Rayyan application.

RESULTS

a total of 871 studies were identified; four composed the sample. The development of clinical competence occurred through the coordination of knowledge, skills, and attitudes. To develop the cognitive domain, the objectives of knowledge and comprehension of the Bloom's taxonomy were mobilized. The psychomotor domain required development of the skills demanded by the proposed clinical care. The affective domain was developed through will and motivation to learn.

CONCLUSIONS

it is possible to develop clinical competence in nursing by adopting Bloom's taxonomy in each phase of clinical simulation.

Positive Outcomes of Rapid Freeware Implementation to Replace Baccalaureate Student Clinical Experiences

BACKGROUND

Loss of in-person clinical experiences due to the COVID-19 pandemic created the need for a rapid transition to online clinical education using virtual simulation, which has been shown to be an effective teaching-learning method. Standards of best practice for simulation provide a framework for implementation.

METHOD

Using free online simulation programs, 15 faculty members offered 3-hour synchronous sessions covering 20 different topics via an online meeting platform to 42 senior nursing students. Students were invited to complete an evaluation following each session.

RESULTS

Students collectively logged over 1,200 hours of simulation time attending approximately 100 sessions. Postsimulation evaluations captured students' responses to sessions. Students appreciated the opportunity to review content covered in previous semesters and engaged most when simulations followed a consistent structure, were interactive, and contained visually engaging materials.

CONCLUSION

Resourceful faculty responded quickly and creatively to the urgent need to transition to online clinical learning and created positive experiences for students. [J Nurs Educ. 2020;59(12):701-704.].

Including administrators in curricular redesign: How the academic-practice relationship can bridge the practice-theory gap

AIM

Health care administrators provided information through semi-structured interviews as to how one faculty of nursing (FoN) was preparing students for practice.

BACKGROUND

There is a long-standing disconnect between the nursing education and the clinical arena known as the theory-practice gap. The FoN wanted to redevelop their curriculum to better prepare students for practice and bridge the gap.

METHOD

Using developmental evaluation, 36 administrators were interviewed and asked about their expectations of newly graduated nurses, the FoN curriculum, and changes to be made.

RESULTS

Four themes were identified: entry to programme; curricular content, delivery and structure; clinical recommendations; and stronger relationships.

CONCLUSION

Strong academic-practice partnerships are still needed. The current lack of communication and partnership has compromised students' quality of education and their transition into the workforce.

IMPLICATIONS FOR NURSING MANAGEMENT

Leaders in both the education and practice settings can better prepare newly graduated nurses and bridge the theory-practice gap by co-creating a joint committee and creating more touchpoints with one another. A joint committee can develop appropriate entry-to-programme guidelines, discuss relevant trends in practice and shape the curriculum. Clinical experiences for students may also act as extra touchpoints whereby the two groups can discuss clinical mentorship needs and build stronger academic-practice relationships.

Clinical simulation for nursing competence development in cardiopulmonary resuscitation: systematic review

OBJECTIVE

to identify the effectiveness of clinical simulation for competence development regarding cardiopulmonary resuscitation in comparison with different teaching and learning strategies used in the education of nursing students.

METHOD

systematic review, performed on the databases PubMed®/MEDLINE®, LILACS, Scopus, CINAHL and Web of Science. The Rayyan QCRI application was used to select the studies, in addition to the instruments for assessing the methodological quality of Joanna Briggs Institute and the Medical Education Research Study Quality Instrument.

RESULTS

a total of 887 studies were identified, and five we included in the final sample. The included studies had good methodological quality by the assessment instruments. All of them had statistically significant results to develop competence through clinical simulation, when compared to other methods.

CONCLUSION

clinical simulation proved to be effective for the development of clinical competence in cardiopulmonary resuscitation of nursing students.

Bringing simulation to the classroom using an unfolding video patient scenario: A quasi-experimental study to examine student satisfaction, self-confidence, and perceptions of simulation design

BACKGROUND

Teaching strategies to promote experiential learning in the classroom are important to facilitate students' clinical reasoning abilities. Using video to simulate unfolding patient scenarios in the classroom has the potential to engage students through active learning and to enhance their ability to connect theory to practice.

OBJECTIVES

Study objectives were to: (1) Evaluate nursing students' satisfaction and self-confidence in learning and perceptions of the design of a simulated patient scenario delivered via video in the classroom and (2) Compare findings to students' satisfaction, self-confidence, and perceptions of the design of prior high-fidelity simulation experiences in the laboratory.

DESIGN

A quasi-experimental approach was used.

SETTING

The study setting was a nursing classroom at a University in the southeast United States.

PARTICIPANTS

Convenience sampling was utilized and 54 students in their final semester of a pre-licensure baccalaureate nursing program participated.

METHODS

The intervention was an unfolding video patient scenario delivered in the classroom. Prior to the intervention, participants completed two measurement tools to collect information about their satisfaction, self-confidence, and perceptions of the design of prior high-fidelity simulations. After the intervention, these tools were administered again to collect data about the video simulation experience in the classroom.

RESULTS

Participants had a higher level of satisfaction (p = 0.002) and self-confidence (p < 0.001) following the classroom intervention than for prior high-fidelity simulations in the laboratory. Student perceptions of the simulation design were more favorable for the classroom intervention than for prior laboratory simulations (p < 0.001).

CONCLUSIONS

Use of unfolding video patient scenarios in the classroom can promote student engagement in learning. Nurse educators should consider this teaching strategy that provides students with opportunities to connect and apply classroom content to patient care.