Focusing on explicit debriefing for novice learners in healthcare simulations: A randomized prospective study

The effectiveness of serious games in nursing education: A meta-analysis of randomized controlled studies

OBJECTIVE

This systematic review and meta-analysis aimed to synthesize the effects of randomized controlled trials using serious gaming in nursing education on knowledge, skills, and confidence.

DESIGN

Systematic review and meta-analysis of randomized controlled trials.

DATA SOURCES

Randomized controlled trials published in English in PubMed, CINAHL, Web of Science, Scopus, Cochrane Library databases between 2000 and 2023.

REVIEW METHODS

Quality assessment was performed using the Joanna Briggs Institute Critical Appraisal Tool for Assessment of Risk of Bias for Randomized Controlled Trials and the review was reported according to the PRISMA-2020 protocol. The review was conducted by two independent reviewers.

RESULT

As a result of the database review, a total of 1886 studies were found and 8 studies were included in the meta-analysis. The use of serious games was found to have a low to moderate effect on the knowledge levels of nursing students (Hedge's g = 0.492; 95 % CI = -0.094-1.078), and a moderate effect on their skill (Hedge's g = 0.756; 95 % CI = 0.505-1.003) and self confidence levels (Hedge's g = 0.698; p = 0.362, 95 % CI = -0.801-2.196). The heterogeneity of the studies was found to be high for knowledge (I2 = 92 %), skill (I2 = 71.5 %) and self confidence (I2 = 95.9 %), and low for knowledge (p = 0.90; p = 0.29) and skill (p = 0.75; p = 0.69) in terms of bias analyses egger regression test and begg and mazumdar test, respectively.

CONCLUSION

The reviewed studies revealed that the use of serious games in nursing education has positive effects on knowledge, skills and self-confidence. In order to increase the reliability of the evidence, there is a need to increase the number of welldesigned randomized controlled trials using serious games and to examine the effects of these results in clinical practice with larger sample groups.

Hot Versus Cold Debriefing in a Nursing Context: An Integrative Review

BACKGROUND

Hot debriefing occurs shortly after simulations or real-life events, whereas cold debriefings occur after 24 hours. This integrative review examined the effects of hot versus cold debriefing after simulation on prelicensure students.

METHOD

Whittemore and Knafl's five-stage method was followed. Databases searched included PubMed, CINAHL, Scopus, and PsycINFO. The inclusion criteria were studies published in English that involved prelicensure nursing students and measured the effect of hot or cold debriefing.

RESULTS

Themes emerged from 10 studies and included clinical judgment and decision making, knowledge and skills, participant experiences, reflection, and psychological safety and self-efficacy.

CONCLUSION

Hot debriefing was preferred by participants, but cold debriefing resulted in higher knowledge and skills scores. In addition, students in the cold debriefing group were more conformable and in a safe environment compared with the hot debriefing group. Drawing a strong conclusion was difficult due to heterogeneity in study designs and methods. [J Nurs Educ. 2024;63(10):653-658.].

Approaches for boosting self-confidence of clinical nursing students: A systematic review and meta-analysis

Background

Self-confidence is a key element in successfully promoting achievement strivings among the healthcare workforce. Targeted interventions can strengthen this characteristic in nursing students, thus improving the quality of hospital services.

Objectives

We evaluated the effect of educational interventions on boosting self-confidence in nursing students using systematic review and meta-analysis.

Methods

A comprehensive search was used to screen the related studies in Scopus, PubMed, Embase, Web of Science, and PsycINFO. Peer-reviewed literature in English until June 2023 was reviewed. Inclusion criteria were controlled trials, either non-randomized studies of intervention (NRSI) or randomized (RCTs). Studies were assessed for methodological quality by the Cochrane Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) and the Cochrane "Risk of Bias" tool for RCTs (RoB 2.0) and quality assessment tool for before-after (pre-post) studies with no control group. The main outcome was the self-confidence score of nursing students because of educational methods or intervention/s. Using the inverse variance weights method, a pooled standardized mean difference (SMD) estimate with a corresponding 95% confidence interval (CI) was determined. Random-effects meta-analysis was used to assess conceptual heterogeneity using Stata.

Results

Twenty-two studies were selected involving 1758 participants and 940 cases of nursing students in the intervention group on boosting self-confidence (Fourteen Randomized controlled trials, Five Quasi-experimental, and three Before-After studies). The post-intervention self-confidence results in the nursing student's intervention group were significantly greater (SMD) (SMD for Controlled experimental design = 0.51; 95% CI = 0.14-0.89), (SMD for Quasi-experimental = 0.04; 95% CI = -0.33-0.41), (SMD for Before-After (Pre-Post) = 2.74; 95% CI = 1.85-3.63). The random-effect meta-analysis of 22 interventional studies determined that educational interventions are significantly associated with the improving self-confidence of nursing students. The intervention showed a moderate impact on the research units, according to Cohen's d results. Also, the results of simulation learning intervention (SMD = 0.42; 95% CI = 0.03-0.81) showed a significant relationship between intervention and outcome in studies.

Conclusions

Analysis of our findings revealed the successful impact of most interventional approaches in boosting self-confidence, especially in the long term. It can be concluded that self-confidence is a multifactorial concept that can be improved by using targeted combination intervention strategies.

Over twenty years of pedagogical research from Nurse Education in Practice: A bibliometric analysis from 2001 to 2023

AIM

To present a bibliometric overview of pedagogical research from Nurse Education in Practice from its inception in 2001 up until 2023.

BACKGROUND

Bibliometric methods are useful in analysing and understanding the characteristics of scientific publications in a particular field and the influence of specific journals. However, no bibliometric analysis of a nurse education journal has been undertaken to date which would highlight important research trends in this area of nursing and midwifery.

METHODS

A total of 2231 publications (articles and reviews only) from Nursing Education in Practice were retrieved from the Scopus database between 2001 and 2023. Several software applications including Microsoft Excel and VOSviewer were used to undertake bibliometric analysis on this dataset. Publication trends such as country analysis, author analysis, keywords analyses (cluster, content and trend analysis) were generated to help understand the volume and scope of pedagogical nursing and midwifery research in this journal.

RESULTS

There has been a steady increase in pedagogical research from Nurse Education in Practice since its launch in 2001 up until 2018, with a dip in publications in 2022 most likely due to the impact of restrictions during the coronavirus pandemic. The most prolific institutions publishing in the journal are mainly from the United Kingdom, Australia and the United States, with over eighty countries represented demonstrating its global reach and impact. Nursing students, nursing education, simulation and learning are some of the most frequent author keywords.

CONCLUSION

The diversity of pedagogies in nursing and midwifery education, clinical learning and supervision in practice environments, and competence and confidence when transitioning to practice are the most popular research areas in Nurse Education in Practice. This study informs nurse and midwife educators and scholars about the volume and scope of pedagogical research in nursing and midwifery. It also makes recommendations on how to improve aspects of scholarship in education and areas for future pedagogical research.

Pensamento reflexivo na enfermagem

Objetivo: compreender como o debriefing se constitui como elemento pedagógico no desenvolvimento do pensamento reflexivo na Enfermagem. Método: estudo de caso único, de abordagem qualitativa, desenvolvido no Centro de Simulación en Salud (CESISA) da Universidad de Costa Rica. Dados coletados entre agosto e outubro de 2018 através de análise documental, observação não participante e entrevistas semiestruturadas com professores, estudantes e técnicos. Resultados: os dados apontam que o debriefing se constitui como elemento pedagógico no desenvolvimento do pensamento reflexivo quando todos compreendem o papel desse método, buscam seguir a suposição básica de que todos são inteligentes e estão dispostos a melhorar, garantindo-se um ambiente seguro; quando todas as etapas da simulação são planejadas com objetivos claros de aprendizado; e quando o professor assume uma postura de facilitador. Conclusão: o debriefing é um elemento pedagógico que necessita de outros fatores associados para cumprir seu papel no desenvolvimento do pensamento reflexivo.