Clinical instruction and student outcomes

The Impact of Dedicated Education Model on Nursing Students' Outcomes: An Integrative Review

BACKGROUND

Dedicated education units (DEUs) provide an approach to clinical redesign in nursing education. However, the evidence supporting the application of the DEU model has not been systematically reviewed to assess the impact of this model on students' learning outcomes.

PURPOSE

This integrative review analyzed the evidence on the relationship between the DEU model and nursing students' learning outcomes.

METHODS

Electronic databases were searched for articles published between 1998 and 2019. Search terms used were dedicated education unit, academic collaboration, academic-practice partnership, and outcomes. A total of 24 articles informed this review.

RESULTS

Four categories emerged: clinical self-efficacy and confidence, teamwork and collaboration, knowledge and competency, and students' satisfaction.

CONCLUSION

The main findings support a positive relationship between the DEU model and students' learning outcomes. Research is still needed to investigate the impact of DEU models on students' problem-solving and clinical judgment.

A comparison of team-based learning and lecture-based learning on clinical reasoning and classroom engagement: a cluster randomized controlled trial

BACKGROUND

The lecture-based learning (LBL) implemented in most Indonesian nursing/midwifery schools underlies the students' lack of ability in clinical reasoning. Team-based learning (TBL) was proposed to improve the students' ability in clinical reasoning as it is applying a course concept of real complex scenarios. In this study, we aimed to assess and compare the effects of TBL and LBL of postpartum hemorrhage topics on the clinical reasoning and classroom engagement of midwifery students in Indonesia.

METHODS

We conducted a cluster randomized controlled trial to compare the effects of TBL and LBL. The unit was schools and random allocation was conducted using a simple random sampling method (i.e., coin flipping). There was 1 cluster in the intervention group (n = 62 students) and 1 cluster in the control group (n = 53 students). The students in the intervention group participated in a TBL class (90 min) three times, whereas the students in the control group attended an LBL class on postpartum hemorrhage topics. The primary outcome was the clinical reasoning on postpartum hemorrhage score measured at pre-test, post-test, and 2 weeks post-test. The secondary outcome was Classroom Engagement Survey (CES) score measured after each class finished. We used an unpaired t-test to evaluate the differences between the two groups. The baseline characteristics of the participants were compared using standardized difference.

RESULTS

We evaluated a total of 115 participants. Regarding the baseline characteristics, there was a small difference in the age, Grade Point Average and knowledge at pre-test between the intervention and control groups. The mean clinical reasoning on postpartum hemorrhage scores were significantly higher in the TBL students than in the LBL students at post-test (p < .001; Cohen's d = 1.41) and 2 weeks post-test (p < .001; Cohen's d = 1.50). The CES showed a significantly higher in the intervention group than in the control group.

CONCLUSIONS

TBL is an effective learning method for enhancing the clinical reasoning ability of students. This learning method allows for more independent and active learning. Having a strong background knowledge, and discussing cases comprehensively with peers can sharpen the clinical reasoning ability of students.

The impact of combining concept-based learning and concept-mapping pedagogies on nursing students' clinical reasoning abilities

BACKGROUND

Integrating contemporary teaching strategies into the nursing curriculum is an effective approach to enhance undergraduate clinical-judgment and reasoning abilities.

OBJECTIVE

This study aims to document the impact of blending the teaching strategies of concept-based learning and concept-mapping to enhance nursing students' clinical-reasoning abilities.

DESIGN

A quasi experimental design is used to guide data collection from second year students.

SETTING AND PARTICIPANTS

A consecutive sample of all students undertaking adult health nursing courses at a private university in Jordan and meeting the eligibility criteria resulted in (N = 40).

METHOD

Data was collected via a questionnaire and observation to reveal students' independence in both clinical-reasoning and clinical-judgment. General Clinical-Reasoning Behavior Scale, Independence in Clinical-Reasoning and Clinical-Judgment scales were completed by the students at the beginning and end of the courses.

RESULTS

Despite requesting extensive preparation time, concept-based learning and concept-mapping as student-centered approaches enabled the move away from a content laden approach towards constructing criteria against which various patients' encounters were reflected. This study documented enhancement in students' independence in clinical-reasoning and clinical-judgment as they learned to take command of the elements of their clinical-reasoning. Significant improvement in students' general clinical-reasoning behavior was also documented.

CONCLUSION

The data collection tools utilized in this study can be used as clinical teaching aides, hence maximizing the impact of blended teaching strategies by providing the faculty with specific feedback regarding students' clinical reasoning and judgment abilities. Institutionalizing these processes by initiating relevant policies and guidelines is essential to help students take command of their clinical-reasoning, maturity, and responsibility in a practice area that is constantly changing and evolving.

An International Scoping Exercise Examining Practice Experience Hours Completed by Nursing Students

BACKGROUND

There is global acceptance of the need for prelicensure nursing students to complete practice experience hours during their program of education. Yet questions remain about these practice experiences, including those related to duration.

METHOD

This article reports findings of a scoping exercise that compared the number of practice experience hours mandated for students undertaking courses that lead to RN licensure in Australia, New Zealand, the United Kingdom, and the United States.

RESULTS

Substantial differences were evident between the four countries regarding the number of mandated practice experience hours. There is no clearly linked research evidence to justify the decision made in relation to the mandated number of hours.

CONCLUSION

Internationally, there is a need to reexamine the rationale for mandating a minimum number of practice experience hours for students in programs of education that lead to licensing as an RN. [J Nurs Educ. 2019;58(1):33-41.].

Clinical Faculty Management of the Challenges of Being a Guest in Clinical Settings: An Exploratory Study

BACKGROUND

Clinical experience is a critical component of basic nursing education. Little research has focused on the perspectives of clinical faculty (CF) who engage in practical nursing education in challenging clinical settings associated with increased patient acuity and complexity.

METHOD

The aim of this qualitative study was to understand CF's perspectives of what supports and hinders their ability to foster baccalaureate nursing students' clinical education.

RESULTS

Findings indicate challenges related to CF being viewed as "guests" in the clinical settings, complicating communication with nursing staff about constructive learning experiences. CF receive support from other CF to assist in balancing student priorities and developing relationships with clinical staff .

CONCLUSION

CF success was linked to how well they advance the view of students and themselves as being an integral part of the nursing team. Further research is needed to understand how CF use their social capital to advance clinical nursing education.

Obstetrical staff nurses experiences of clinical learning

The clinical learning experience is used in nursing programs of study worldwide to prepare nurses for professional practice. This study's purpose was to use Naturalistic Inquiry to understand the experiences of staff nurses in an obstetrical unit with undergraduate nursing students present for clinical learning. A convenience sample of 12 staff nurses, employed on a Family Birth Center, participated in semi-structured interviews. The constant comparative method as modified by Lincoln and Guba was used to analyze data. Five themes related to staff nurses experiences of clinical learning were identified: Giving and Receiving; Advancing Professionally and Personally; Balancing Act; Getting to Know and Working with You; and Past and Present. This research highlights staff nurses' experiences of clinical learning in undergraduate nursing education. Staff nurses exert a powerful, long lasting influence on students. A need exists to prepare and judiciously select nurses to work with students. Clinical agencies and universities can take joint responsibility providing tangible incentives, financial compensation, and recognition to all nurses working with nursing students.

Pre-Course Simulation as a Predictor of Satisfaction with an Emergency Nursing Clinical Course

Recent research suggests that simulation education can effectively improve nursing students’ practical competence and can enhance educational outcomes. But very few studies have identified the relationships between pre-course simulation and course satisfaction. The purpose of this study was to determine whether pre-course simulations and other advanced learning modalities (i.e. pre-course e-learning, observation, and clinical placement skill performance) predicted students’ satisfaction with an emergency nursing clinical course. Second-year Korean nursing students (N = 284) participated in an integrated clinical course consisting of self-directed pre-course e-learning, a 2-hour pre-course simulation, and an 80-hour emergency room clinical placement with observation. Multiple regression analyses found that pre-course simulation, clinical placement skill performance, observation during the clinical placement, and pre-course e-learning accounted for 47.2% of the variance in course satisfaction. Notably, pre-course simulation made the largest contribution to course satisfaction, accounting for 29.1% of the variance. Pre-course simulation, skill performance, observation, and pre-course e-learning all significantly influenced learner satisfaction. Findings suggest that integrating simulation into the clinical curriculum may enhance clinical course satisfaction.

Teaching nursing psychomotor skills in a fundamentals laboratory: a literature review

AIM

The aim of this article is to determine the most effective methods of teaching psychomotor skills.

BACKGROUND

Research has pointed to a gap between nursing practice and nursing education. Due to a number of conditions, nursing students are learning basic skills in laboratories, rather than clinical settings.

METHOD

A literature review was conducted to evaluate studies published since 1995 that compared alternative and traditional methods of teaching skills to novice nursing students.

RESULTS

Of the 13 studies found, most assessed computer-related methods. A few examined alternatives, such as the use of standardized patients, high-fidelity manikins, and a mental-imaging technique.

CONCLUSION

Based on this limited evidence, it appears that teaching methods providing access to online interactive materials were significantly more effective than others.Three studies found that a combination of traditional lecture and demonstration methods plus computer use was more effective than either method alone.