Concept analysis: confidence/self-confidence

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.

Preparing for practice, the effects of repeated immersive simulation on the knowledge and self-efficacy of undergraduate nursing students: A mixed methods study

AIM

The aim of this study was to compare the effects of two immersive simulation-based education instructional designs, immersive simulation with team deliberate practice and immersive repeated standard simulation, when delivered over the same time on the knowledge and self-efficacy of nursing students.

BACKGROUND

Implementing immersive simulation-based education is not without its resource challenges, making it prohibitive for simulation educators to include it in their curricula. Subsequently, there is a need to identify instructional designs that meet these challenges.

DESIGN

A two-stage mixed methods approach was used to compare the two instructional designs.

METHODS

In stage one, data were collected using questionnaires and differences estimated using analysis of covariance. In stage two, data were collected from two focus groups and analysed using a qualitative content analysis approach. Data were collected as part of a doctoral study completed in 2019 and was analysed for this study between 2022 and 2023. The justification for this study was that the identification of effective designs for immersive simulation remains a key research priority following the increase in allowable simulation hours by the Nursing and Midwifery Council.

RESULTS

In stage one, there was no statistical significance in the participant's knowledge or self-efficacy between the models. In stage two, four themes were identified: vulnerability, development of knowledge, development of self-efficacy and preparation for placement. In contrast to stage one, participants reported that the repeated nature of both designs reinforced their knowledge base increased their self-efficacy, reduced their anxiety levels, and helped them to prepare for placement.

CONCLUSION

The results inferred that both designs had a positive impact on the participants. Overall, participants reported that it helped them prepare for placements. Based on the findings, wherever possible, repeated immersive simulation-based education designs should be used and not a standalone immersive simulation-based education scenarios. If resources allow, this could be either a repeated scenario, or if there are resource constraints to use, over the same time, immersive simulation with team deliberate practice, or a similar model. Thus, giving a potential return on investment, one that supports simulation educators making those sensitive decisions regarding the inclusion of immersive simulation with team deliberate practice in their curriculum. Further research is needed into this area to ascertain the design features that maximise this impact and support a move away from standalone scenarios to an approach that uses repetitive immersive simulation.

Cognitive abilities and medical students' practice of physical exams: A quasi-experimental study

BACKGROUND

To highlight the importance of clinical simulations and simulated laboratories for student training, especially in physical examination teaching.

OBJECTIVE

To evaluate the gains obtained by medical students in their cognitive and practical performance of physical examinations (abdominal, cardiological, and pulmonary), as well as satisfaction and self-confidence in what they have learned, after concentrated practice developed in a skills and simulation laboratory.

DESIGN AND SETTING

A quantitative and quasi-experimental study in which 48 students were evaluated at the Faculdade de Odontologia de Bauru, São Paulo, Brazil.

METHODS

A quantitative and descriptive study was conducted with regularly enrolled 2nd year medical students over 18 years of age who had content prior to data collection regarding anamnesis and physical examination remotely taught in a Moodle virtual learning environment. For data collection, the participants were subjected to a concentrated period of skill training (abdominal, cardiological, and pulmonary). Every day after the skill training session, they were subjected to a practical evaluation and completed a theoretical test before and after the practical activities. At the end of all activities, they answered the instrument to assess the simulated practices (self-confidence and satisfaction).

RESULTS

Among the 49 students evaluated, positive and significant theoretical and practical gains were identified in all three components (abdominal, cardiological, and pulmonary) (P = 0.000), as well as in the general evaluation (Theoretical 1 and Theoretical 2) (P = 0.000), satisfaction, and self-confidence (P = 0.000).

CONCLUSION

Concentrated laboratory practice resulted in positive improvements in students' physical examination skills.

Effects of simulation in improving the self-confidence of student nurses in clinical practice: a systematic review

BACKGROUND

Considering the positive influence of simulation from previous literature may encourage educators to regard it as a valuable teaching strategy in nursing schools. This literature review aims to investigate whether the use of simulation improves undergraduate nurses' self-confidence during clinical practice.

METHODOLOGY

This study employed a literature-based design. Five academic databases, including CINAHL, EBSCO, ProQuest, PubMed and Medline, were utilised to extract relevant studies using appropriate keywords and Boolean operators. Studies published in the last 15 years (2005-2020) were included in the search. Studies were retrieved using the Exclusion and Inclusion criteria. The Critical Appraisal Skills Programme (CASP) was used to critically appraise the studies.

RESULTS

A total of 15 primary research studies were extracted for review. Four major themes emerged from the review: Improved self-confidence to carry out clinical tasks, Increased ability to work in teams, Improved self-confidence to perform community work and Improved self-confidence in communicating with patients and team members.

CONCLUSION

Clinical simulation is a useful tool in increasing the self-confidence of nursing students to perform clinical tasks, make clinical judgements, communicate with patients and team members and improve their teamwork. To improve the quality of care received by patients, it is recommended that clinical simulations be integrated into the nursing curriculum in Saudi Arabia. Increasing the confidence of students has been shown to be associated with greater confidence in performing clinical tasks.

Applying Sequential Pattern Mining to Investigate the Temporal Relationships between Commonly Occurring Internal Medicine Diseases and Intervals for the Risk of Concurrent Disease in Canine Patients

Sequential pattern mining (SPM) is a data mining technique used for identifying common association rules in multiple sequential datasets and patterns in ordered events. In this study, we aimed to identify the relationships between commonly occurring internal medicine diseases in canine patients. We obtained medical records of dogs referred to the Konkuk University Veterinary Medicine Teaching Hospital. The data used for SPM included comorbidities and intervals between the diagnoses of internal medicine diseases. Additionally, we estimated the 3-year risk of developing an additional disease after the initial diagnosis of a commonly occurring veterinary internal medicine disease using logistic regression. We identified 547 canine patients diagnosed with ≥ 1 internal medicine disease. The SPM-based analysis assessed comorbidities and intervals for each of the five most common internal medical diseases, including hyperadrenocorticism, myxomatous mitral valve disease, canine atopic dermatitis, chronic kidney disease, and chronic pancreatitis. The highest values of the association rule were 3.01%, 6.02%, 3.9%, 4.1%, and 4.84%, and the shortest intervals were 1.64, 13.14, 5.37, 17.02, and 1.7 days, respectively. This study proposes that SPM is an effective technique for identifying common associations and temporal relationships between internal medicine diseases, and can be used to assess the probability of additional admission due to the development of the subsequent disease that may be diagnosed in canine patients. The results of this study will help veterinarians suggest appropriate preventive measures or other medical treatments for canine patients with medical conditions that have not yet been diagnosed, but are likely to develop in the short term.

Role of physical activity and health-related fitness on self-confidence and interpersonal relations in 14-year-old adolescents from secondary school settings: DADOS study

BACKGROUND

The effect of physical activity (PA) and physical fitness (PF) on self-confidence and interpersonal relations in adolescents is uncertain.

AIM

To analyzed the associations of PA and PF with self-confidence and interpersonal relations in adolescents.

SAMPLE

A total of 268 (138 boys) adolescents (13.9 ± 0.3 years) from the DADOS study were included in the analysis.

METHODS

PA was evaluated using GENEActiv accelerometers and the health-related PF components by the ALPHA health-related fitness test battery. The levels of self-confidence and interpersonal relations were determined by the Behavior Assessment System for Children Level 3.

RESULTS

The associations of PA levels and PF components with self-confidence reported positive associations of moderate-vigorous PA (MVPA), standing long jump, and 20-m shuttle run (shuttle run test) tests (all p < 0.05), and negative association of 4 × 10-m shuttle run test (4 × 10-m test), but only the 4 × 10-m test remained significant in the adjusted model for the whole sample and only in boys (p ≤ 0.01) when analyzed by sex. Regarding interpersonal relations, positive associations of standing long jump and shuttle run test (all p < 0.05), and negative association of 4 × 10-m test were found in all the adolescents. The shuttle run test was associated with interpersonal relations in boys independently of confounders. PA levels were not associated with interpersonal relations.

CONCLUSION

A higher level of lower-limb muscle strength, speed-agility, and cardiorespiratory fitness might improve self-confidence and interpersonal relations in adolescents, but these relationships seem to be influenced by sex, body mass index, and pubertal status. Speed-agility and cardiorespiratory fitness seem to have a stronger impact on boys. MVPA may improve self-confidence in adolescents.

Neonatal Fragile Skin: Novel Use of Simulation to Improve Knowledge and Confidence for Neonatal Nurse Practitioner Students

BACKGROUND

Infants with fragile skin pose challenges to neonatal providers, including the difficult nature of securing lifesaving devices. A paucity of information exists supporting best simulation practices in educating neonatal nurse practitioner (NNP) students on how to care for infants with fragile skin.

PURPOSE

To evaluate whether simulation improved student knowledge and self-confidence related to caring for infants with fragile skin.

METHODS

This quality improvement project included a pre/posttest survey with a sample of 14 NNP students. Participants practiced application of a multilayered dressing to secure a catheter to a neonatal manikin. Knowledge and self-confidence were measured before and after simulation.

RESULTS

Correct responses on posttest survey knowledge items increased along with students' confidence ratings following simulation. Students reported high levels of satisfaction with the simulation experience.

CONCLUSIONS

Simulation of caring for fragile skin allows NNP students the opportunity to improve self-confidence, knowledge, and performance of a necessary skill for NNPs.

Encountering suffering in digital care: a qualitative study of providers' experiences in telemental health care

BACKGROUND

Encountering patients who are suffering is common in health care, and particularly when providing mental health care. Telehealth technologies are increasingly used to provide mental health care, yet little is known about the experiences of providers when encountering patients who are suffering within remote care. The present study explored health care providers' lived experiences of encountering patient suffering during telemental health care.

METHODS

A qualitative phenomenological approach was used to uncover participants' experiences. In-depth interviews were conducted with a purposive sample of physicians, psychologists, and therapists who used telemental health in varied clinical practices in Sweden. Data were analyzed using descriptive phenomenology.

RESULTS

Telehealth care with patients who were suffering was experienced by providers as loose connections, both literally in compromised functioning of the technology and figuratively in a compromised ability connecting emotionally with patients. Providers' lived experiences were explicated into the following aspects: insecurity in digital practice, inaccessibility of the armamentarium, and conviction in the value of telehealth care. Interpersonal connection between patient and provider is necessary. Worry and guilt arose for providers with fears that technology would not work, patient status was deteriorated, or the care needed could not be delivered. Providers overcame barriers in telehealth encounters, and expressed they perceived that patients appreciated the care received, and through it found relief.

CONCLUSIONS

This study brings an understanding of experiences in providing telemental care for patients who are suffering. Providers experience challenges in connecting with patients, and in accessing tools needed to enable reaching the goals of the caring encounter. Efforts to ensure functioning of technology, comfort with its use, and accessibility of tools might be some accommodations to support providers for successful and rewarding telehealth care encounters.

Psychosocial effects of hypnosis in patients with obesity: a pilot randomized controlled trial

The usefulness of hypnosis in patients with obesity needs to be better understood in terms of various outcomes, in addition to weight loss. The aim of this research was to investigate the effects of hypnosis and self-hypnosis in combination with nutrition education for patients with obesity, as opposed to nutrition education alone, on the secondary outcomes of quality of life (QoL), coping strategies, and self-esteem within a randomized controlled trial (RCT). Eighty-two participants were included in this study (84.3% were women), with 41 in each group. Further, 70 participants had completed treatment. The intervention consisted of eight group sessions (about one every two weeks). Participants completed self-reported questionnaires assessing their QoL, coping strategies, and self-esteem (SF-36, CISS, SEI) before and after the intervention. Non-parametric analyses were performed. Both groups had comparable characteristics at inclusion (sociodemographic information, clinical information, and scores for the self-reported scales). At eight months (i.e. two months after intervention completion), patients from the hypnosis group used more task-oriented coping (p < .001), less emotion-oriented coping (p < .01) and distraction (p < .05), and had more energy/less fatigue (p < .001) compared to the group who did not undergo hypnosis. Other improvements were observed in the hypnosis group, but there were no significant differences compared with the non-hypnosis group in terms of QoL dimensions and general self-esteem. In conclusion, hypnosis and self-hypnosis in combination with nutrition education seem to be promising interventions to help patients deal with obesity, especially by improving their coping strategies.

Meeting the Needs of Older Adults with Mental Ill-Health in Non-Psychiatric Care Settings: Self-Rated Confidence in Helping and its Co-Variates within a Multiprofessional Study Sample

In this paper we sought to explore health and social care professionals' self-rated confidence in helping older adults with mental ill-health in non-psychiatric care settings. A cross-sectional survey study was performed exploring the participants' (n = 480) confidence in helping. Confidence in helping was analyzed together with background characteristics and selected explanatory variables, such as the workplace and work experience of the participants, their personal experiences of and attitudes to mental ill-health, as well as their knowledge in mental ill-health among older adults, by means of descriptive statistics and logistic regression analysis. We found that approximately half (55%) of the participants were confident in helping older adults with mental ill-health. The odds ratios for being confident in helping were significantly associated to the workplace of the professionals, professionals' attitude to and experience of mental ill-health, and knowledge of mental health among older adults. To increase confidence in helping older adults with mental ill-health, we recommend confidence-building interventions, for example, educational programs, through which knowledge of mental health among older adults is increased and negative attitudes are challenged, especially within the context of specialist somatic healthcare.

Effect of High-Fidelity Simulation on Self-Satisfaction and Self-Confidence Among Nursing Students

Introduction

Newly graduating nurses should be able to enter clinical practice as safe, accurate, competent, and compassionate professionals in health care settings that necessitate them to be learners who can easily get familiar with a broad diversity of clinical practice settings.

Purposes

The purpose of this study was to evaluate the effect of high-fidelity simulation experiences on self-satisfaction and self-confidence among the pediatric nursing students.

Methods

A quasi-experimental design, post-test, was carried out through the recruitment of a convenience sample of 150 nursing students from Arab American University. The students were randomly assigned to the study (n  =  75) or control (n  =  75) groups. Data were collected using learner satisfaction and self-confidence scales.

Results

The results of the post-test revealed that there was a significant difference between both groups in self-satisfaction (t (148)  =  11.14, P < .001) and self-confidence (t (148)  =  13.04, P < .001). The mean score of self-satisfaction for the study group (22.45  ±  2.27) was higher than control group (16.80  ±  3.76). Also, the study group' mean self-confidence score (35.72  ±  3.49) was higher than the control group (27.28  ±  4.39).

Conclusion

High-fidelity simulation was confirmed to be an helpful tool to keep an effective and safe learning method for pediatric nursing students, thus increasing their satisfaction and confidence.

Nurses’ confidence in starting a new venture, startup or project in the context of nurse-led hackathons: Results of prehackathon survey

Background

A hackathon framework has been successfully applied to solving health care challenges, including COVID-19, without much documented evidence of nurses' baseline or acquired confidence.

Purpose

To understand differences in baseline confidence levels in starting a new venture, startup or project in the context of nurse-led hackathons.

Method

A retrospective secondary analysis of a presurvey of hackathon participants from two NurseHack4Health (NH4H) events held in 2021.

Discussion

Male nurses and international nurses were more confident than the U.S.-based nurses. When comparing the 75% of participants who had not attended a hackathon previously to the 25% of participants who had, there was an increased confidence level among non-nurses and among participants with the previous hackathon, datathon, and ideation experience.

Conclusion

If hackathons can help nurses identify strengths, add new expertise and boost confidence, it may empower nurses to pursue their ideas more effectively, aid professional growth, and provide affirmation of innovator self-identity.

Current study on the influence of psychological factors on returning to sports after ACLR

It is considered that psychological factors are important in determining exercise regression outcomes of patients with anterior cruciate ligament reconstruction (ACLR). This review summarizes the definition and research progress of current undefined psychological factors related to returning to sports (RTS) after ACLR, as well as the application of corresponding measuring scales, and common psychological interventions in the field. The aim is to understand and clarify the impact of psychological factors in the ACL injury and rehabilitation, and to provide a theoretical basis for the application of psychological evaluation and intervention in the later stage. It is believed that there are still many prospects for the research in this field.

Influence of Teaching Styles on the Learning Academic Confidence of Teachers in Training

The objective of this research was to analyze the mediation of academic engagement and the satisfaction of basic needs between teaching styles and academic confidence amongst teachers during initial training. The research design was observational, descriptive, cross-sectional, and non-randomized. In total, 920 university students in initial teacher training participated (61.85% women) (M_age = 24.73; SD = 5.34). The scales of interpersonal teaching styles, the satisfaction of basic psychological needs, academic engagement, and academic confidence were used, and a structural equation analysis with latent variables was carried out. The results highlight the important mediating role played by the satisfaction of basic psychological needs between the autonomous support style and the academic confidence of the trainee teachers. This research also highlights the importance, both for teachers and researchers, of using an autonomous support style, as well as the creation of a context for encouraging the satisfaction of basic psychological needs, to promote academic confidence in initial teacher training programs at university.

Self-Esteem: A Concept Analysis

The concept of self-esteem has been discussed in various disciplines. It is necessary to broaden the conceptualization to reach a better understanding in nursing discipline. The purpose of this paper is to explore the concept of self-esteem following Walker and Avant's concept analysis method. The concept analysis method consists of eight linear steps. The author addresses the self-esteem phenomenon from a nursing perspective due to its various uses. The analysis helps to expand the knowledge of self-esteem and enhance nursing science. Roy's adaptation model is used as a philosophical scheme to provide a scientific nursing definition.

The Effectiveness of Inquiry and Practice During Project Design Courses at a Technology University

Among the many teaching methods, inquiry-based teaching is considered to be an effective way for students to learn and solve problems on their own. However, most of the research related to inquiry-based teaching and learning has concentrated mainly on K-12 education, while few to no studies have focused on the application of inquiry-based teaching and learning in project design courses at university level. Therefore, in order to expand the understanding of the application effect of inquiry-based teaching at university level, this study adopted the quasi-experimental design method, and through the purposive sampling method, 20 students from the Department of Fashion Design at a University of Science and Technology were invited to participate in this study. During the 9-month period, teaching experiments were carried out using two inquiry models, QC/ADEAC and QD/ODEAC. First, when participants were thinking of a creative topic, they followed the process: Question (Q), Collection/Analysis (C/A), Discussion (D), Explanation (E), Amendment (A), and Confirmation (C) in the course. During the production process, the participants were allowed to improve on their work through the process of Question (Q), Doing/Observation (D/O), Discussion (D), Explanation (E), Amendment (A), and Confirmation (C). The teacher became a true guide, so that the participants could explore and work out how to improve their designs through independent inquiry and practice. In this study, questionnaires were administered to participants at five important stages of the design project: “theme development,” “color development,” “first Work,” “second Work,” and “third Work.” The results of the five surveys showed that the participants’ curriculum interest, curriculum value perception, and curriculum confidence in the inquiry program all increased.

Factors associated with low childbirth self-efficacy for normal birth among women attending an urban prenatal clinic in Eastern Uganda

OBJECTIVE

While childbirth self-efficacy is a very important feature for normal birth, this concept has received limited scholarly attention, particularly in developing countries. This study explored childbirth self-efficacy and the associated factors amongst pregnant women.

DESIGN

A descriptive cross-sectional study. We used the Childbirth Self-Efficacy Inventory to assess childbirth self-efficacy for normal birth. and determined the associated factors.

SETTING

Jinja regional referral hospital, Uganda.

PARTICIPANTS

425 pregnant women at ≥ 28 weeks of gestation were included.

MEASUREMENTS

Participants with summated self-efficacy scores ≥ median were considered to have high childbirth self-efficacy, and those with less than the median summated score were considered to have low childbirth self-efficacy. Bivariate and multivariate binary logistic regressions were used to determine the factors associated with low childbirth self-efficacy.

FINDINGS

The Childbirth Self-Efficacy Inventory items consistently measured childbirth self-efficacy with a Cronbach's α 0.934. Childbirth self-efficacy scores ranged from 84 to 303 with a median score of 233 and a mean score of 228.7 (SD: 40.9). Dissatisfaction with prenatal care (aOR = 2.687; 95% CI: 1.124-6.427; P = 0.026), perception of community social support for women during childbirth as lacking (aOR = 2.274; 95% CI: 1.159-4.458; P = 0.017) and use and/or intention to use herbal medicines in the current pregnancy (aOR = 2.850; 95% CI: 1.553-5.232; P = 0.001) were associated with low childbirth self-efficacy for normal birth.

CONCLUSION AND IMPLICATIONS FOR PRACTICE

Low childbirth self-efficacy for normal birth was associated with dissatisfaction with prenatal care, lack of community social support for women during childbirth and use or intention to use herbal medicines in the current pregnancy. Identifying the associated characteristics and developing interventions for low childbirth self-efficacy is of clinical importance to promote normal birth.

Effects of a Self-Directed Clinical Practicum on Self-Confidence and Satisfaction with Clinical Practicum among South Korean Nursing Students: A Mixed-Methods Study

In self-directed learning, students take the initiative to identify learning goals, choose learning strategies, and evaluate learning outcomes. This study aimed to explore the effects of a self-directed clinical practicum on nursing students' self-confidence and satisfaction with the clinical practicum. This mixed-methods study used a non-equivalent control group with a pre- and post-test quasi-experimental design and content analysis. Participants were 111 nursing students (experimental group = 55, control group = 56). Quantitative (self-confidence and satisfaction with the clinical practicum) and qualitative (reflective diaries) data were collected. The experimental group had significantly increased scores for self-confidence and satisfaction with the clinical practicum compared with the control group. Four themes regarding the experience of the self-directed clinical practicum were identified: perceived linking of academic knowledge and practice, perceived development of nursing competency, enjoying the clinical practicum, and establishing nursing identity as a student. The self-directed clinical practicum developed as part of this study was found to be an effective education method for nursing students.

Effects of simulation technology-based learning on nursing students' learning outcomes: A systematic review and meta-analysis of experimental studies

BACKGROUND

Gaps between theory and clinical practice represent challenges for nursing students during their learning processes. Providing simulation technology-based learning for nursing students is essential for modern nurse education, but evidence of efficacy remains scarce.

OBJECTIVES

To determine the effects of simulation technology-based learning for nursing students.

DESIGN

A systematic review and meta-analysis.

METHODS

This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Five databases (CINAHL, Embase, MEDLINE, PubMed, and Web of Science) were electronically searched through May 30, 2021. Eligibility criteria included nursing students, simulated technology-based learning as the primary intervention, and randomised controlled trials or quasi-experimental studies published in English. The methodological quality of included studies was evaluated by the Cochrane risk-of-bias tool. Comprehensive Meta-Analysis Version 3.0 was used to conduct a meta-analysis using the random-effects model. Begg's and Egger's tests were performed to assess publication bias, and sensitivity analysis performed using a remove one study method.

RESULTS

A total of 17 studies were included in this study. Simulated technology-based learning significantly increased nursing student knowledge acquisition (standard mean difference [SMD]: 0.72, 95% confidence interval [CI]: 0.25-1.18, p < 0.001), enhanced student's confidence (SMD: 0.50, 95% CI: 0.02-0.99, p = 0.043), and increased student's satisfaction in learning (SMD: 0.81, 95% CI: 0.61-1.00, p < 0.001). Subgroup analyses showed that receiving simulation by manikins simulator had a greater effect on knowledge acquisition (SMD: 1.01, 95% CI: 0.27-1.74, p = 0.007).

CONCLUSIONS

Simulation technology use may meet the expectations of undergraduate nursing students and prepare them for clinical practice, representing an opportunity to fill gaps between theory and clinical practice while simultaneously developing new teaching scenarios.

Student’s confidence in mental health practice before and after psychiatry rotation: a follow up study

ABSTRACT Objectives The primary objective was to measure the effect of psychiatry rotation in students self-confidence (SC) for managing mental health (MH) issues. Methods An eighteen questions version of “Preparation for Hospital Practice Questionnaire” (PHPQ) adapted for MH was applied before, after and six months later the psychiatry rotation. Sociodemographic and experience with mental illness was measured as confounding factors. Results Hundred and ten students were recruited and four factors were identified: “Diagnosis elaboration and basic care” (F1), “Crisis management and prevention” (F2), “External sickness determinants” (F3) and “Personal distress with clinics” (F4). Cronbach Alpha ranged from 0.71 to 0.90. Previous MH training were not frequent (9.09%), and associated with better SC in F2 (after p < 0.05, 6m p = 0.03). Previous mental disorder was frequent (42.16%), and associated with more SC on F2 (p < 0.01) and F3 (p = 0.03) before course, but only on F3 after (p < 0.01) and not 6 months later. Male gender had more SC in F4 (p < 0.01) before course, but after course and 6m later female gender became more SC in F1 (after p = 0.02, 6m p = 0.01) and equivalent in F4. All factors had higher scores after and 6 months later (p < 0.001). The class considered that an interview script is very important for their SC, and improves assistance (mean > 9.0/10.0). Conclusion Obligatory rotation in MH improved SC in students. Previous training and gender were related with long lasting effects in SC.

The Assessment Rationale of Postgraduate Medical Trainees With Incongruent Self and Faculty Assigned Entrustment Scores

Background

Self-assessment is a central skill in competency-based medical education (CBME) and should be fostered in order to promote life-long learning. One measure that will guide the development of self-assessment is the alignment between it and external expert assessment. In this study, we explored the qualitative themes in the self-assessment rationale among trainees with incongruent self and faculty-assigned entrustment scores.

Methods

A total of 40 postgraduate medical trainees completed a four-scenario summative objective structured clinical examination (OSCE) as part of a simulation-based resuscitation curriculum in December 2017. After each scenario, an assessment involving an entrustment score and narrative rationale was completed by both trainee (self) and faculty. The differences between the trainee and faculty scores were calculated for each scenario and summed to give a single “incongruence score”. Trainees who consistently scored themselves higher than the faculty were said to have a “positive-incongruence score” and those scoring below the faculty were said to have a “negative-incongruence” score. Through this method, 10 trainees with the highest and lowest scores were assigned to each group and their narrative rationales were coded and thematically analyzed.

Results

The content of the self-assessment narrative rationale differed between the two groups. Trainees in the positive-incongruence group focused on the concepts of speed and situational management, while trainees in the negative-incongruence group commented on lack of support, and a need to improve communication, diagnosis, and code blue management. The quality of the self-assessment rationale also differed between groups. Trainees in the negative-incongruence group provided higher-quality comments that were more detailed and granular.

Conclusion

We found differences in the content and quality of the self-assessment rationale between trainees whose self and faculty-assigned assessment is incongruent. This provides insight into how these groups differ and has valuable implications for the development of curricula targeting self-assessment skills.

The relationships of nursing students’ satisfaction and self-confidence after a simulation-based course with their self-confidence while practicing on real patients in Vietnam

PURPOSE

Simulation teaching refers to the replication of real-life scenarios, enabling students to practice nursing skills and learn actively in a safe environment. It also helps students control their anxiety and fears when caring for real patients. This study investigated the relationships of Vietnamese nursing students’ self-confidence in clinical practice with their satisfaction and self-confidence in simulation-based practice.

METHODS

This cross-sectional descriptive study included 182 nursing students. The data collection included 2 separate stages with 2 main questionnaires. The Student Satisfaction and Self-Confidence in Learning Scale was used to measure students’ satisfaction and self-confidence after learning in the simulation room. The Confidence Scale was used to measure students’ self-confidence when first performing techniques on actual patients. Data were analyzed by descriptive and Pearson correlation statistics.

RESULTS

Students’ satisfaction and self-confidence during the simulation course were quite high (mean±standard deviation [SD], 4.06±0.48 and 4.11±0.46 out of 5.0, respectively). In contrast, their confidence when first practicing on a patient was moderate (mean±SD, 3.19±0.62 out of 5.0). Students’ satisfaction showed moderate and weak positive correlations with self-confidence in pre-clinical practice and in clinical practice (r=0.33, P<0.001 and r=0.26, P<0.001, respectively).

CONCLUSION

Simulation has become an effective teaching strategy that can help nursing students be well-prepared for clinical placements in Vietnam. An effective nursing education strategy is needed to enhance the satisfaction and self-confidence of nursing students in simulation and then in clinical practice to help achieve professional engagement and development.

Preliminary Data on Trauma Knowledge, Confidence, and Stress During Navy Trauma Training

INTRODUCTION

The Navy Trauma Training Center (NTTC) is a military-civilian partnership that provides advanced trauma training for application across the range of military operations while exposing military medical personnel to high-volume and high-acuity trauma. Few published data evaluate the outcomes of military-civilian partnerships, including NTTC. The purpose of this study is to evaluate the knowledge, confidence, and stress of NTTC participants before, at mid-point, and after completion of the program. Participants include corpsmen (HM), nurses (RNs), physician assistants (PAs), and physicians (MDs).

MATERIALS AND METHODS

These are preliminary data from an ongoing prospective, observational study with repeated measures. Included are participants that complete NTTC training. Pre-training measures include a demographic questionnaire, trauma knowledge test, Confidence survey, and the Perceived Stress Scale. These same instruments are completed at mid-training and at the conclusion of the NTTC curriculum. Data were analyzed using paired t-tests and linear mixed models.

RESULTS

The sample was composed of 83 participants (49 HM, 18 RNs, 4 PAs, and 12 MDs. Knowledge and confidence increased from baseline to post-NTTC for each clinical role (P < .05). Stress for all roles was low and stable over time (P > .05).

CONCLUSIONS

These preliminary data suggest that, as expected, trauma-related knowledge and confidence increase significantly with training at NTTC. Stress was low and stable over time. These data from a small sample of participants indicate NTTC training is increasing participants' trauma knowledge and confidence to care for trauma casualties. Continued collection of data in the ongoing study will allow us to determine whether these early findings persist in the overall study sample and may help inform the optimal length of training needed.

Self-confidence as a predictor of senior dental student academic success

PURPOSE

Noncognitive indicators, such as personality type and self-confidence, have been used as predictors of achievement. Accordingly, we investigated whether self-confidence in clinical skills predicts academic success among predoctoral senior dental students.

METHODS

Two consecutive cohorts (N = 336) of predoctoral senior dental students were invited to rate their self-confidence in clinical procedures twice: at the beginning and at the end of the academic year. Academic performance in clinical assessments was retrieved from scholastic records. Multiple linear regression models were constructed to predict clinical assessment grades using self-confidence scores as a predictor after controlling for possible confounders.

RESULTS

Self-confidence scores in clinical procedures were positively correlated with clinical and academic performance. Self-confidence in clinical procedures and grade point averages were consistent predictors of student performance. Additionally, self-confidence had improved at the end of the senior year (p = 0.003).

CONCLUSIONS

Self-confidence in clinical procedures was a predictor of future clinical success. Therefore, fostering and nurturing the confidence of students and integrating self-confidence assessment into the curricula at relevant timepoints should be a goal in dental education. Moreover, self-assessment of confidence in clinical skills could be used to guide students and graduates in developing their own personal development plan.

The creation of a confidence scale: the confidence in managing challenging situations scale

Background

Self-confidence and self-efficacy are vital psychological constructs that can affect a student’s performance.

Aims

To measure the level of confidence in nursing students in managing challenging situations in clinical practice settings.

Methods

In order to develop the scale three focus groups were conducted: with registered nurses, third year student nurses and service users. Focus group frameworks included: challenging behaviours, managing challenging situations and preparing students to manage challenging situations. Themes in relation to challenging situations that emerged from the focus groups, in conjunction with Nursing and Midwifery Council standards and expert discussions were used to create the confidence scale. The Confidence in Managing Challenging Situations Scale consists of two parts with 21 items in total. Both parts were measured by way of a five-point Likert scale. The scale was utilised to determine the level of confidence of students both pre and post a teaching intervention.

Results

The confidence in managing challenging situations scale had good internal consistency, with a Cronbach’s alpha coefficient reported of 0.86. Exploratory factor analysis was used to support the scale validation process.

Conclusions

The Confidence in Managing Challenging Situations Scale is a successful measure of confidence for nursing students in healthcare settings. It can be applied in alternative healthcare settings for the identification of confidence levels in those student nurses learning in care settings.

Supporting the development of information literacy skills and knowledge in undergraduate nursing students: An integrative review

BACKGROUND

Undergraduate nursing students have the opportunity to develop information literacy skills while at university so they can work effectively in an increasingly information-intensive clinical environment. This can be achieved through learning how to effectively search for required information, critically evaluate it, apply and reference it. Librarians working in academic libraries can assist with this essential skill development through library instruction, delivery and support.

OBJECTIVES

The aim of this integrative review was to undertake an analysis of the peer-reviewed research in the context of library instruction programs delivered in undergraduate nursing courses. A synthesis of the key themes was also undertaken.

METHODS

This paper takes the form of an integrative review. Four library databases were systematically searched for research articles investigating 'library instruction' within 'undergraduate nursing' courses. The search strategy was based on synonyms for these two concepts.

RESULTS

A total of 26 articles based on 25 studies were identified for review. Research was undertaken in a number of different countries with the most being in the United States of America (8). Total participants were 2820 nursing students. Sixteen of the studies were a quantitative approach, three were qualitative and six were mixed methods. A range of data collection methods were used that included surveys, interviews, focus groups and an observational study. One study was a randomised controlled trial and one used a mixed methods final year thesis analysis. The year level of participants varied with most being in the first year of their course (12 studies). Six studies were a mix of year levels. The four key inter-related themes identified were: collaboration, course-integration, linking to assessments, and confidence.

CONCLUSION

There is evidence to suggest a positive relationship between library instruction and information literacy skill development. Sustained training and support across year levels provides the opportunity for positive student outcomes.

Informed self-assessment versus preceptor evaluation: a comparative study of pediatric procedural skills acquisition of fifth year medical students

BACKGROUND

Simulation training is widely used in medical education as students rarely perform clinical procedures, and confidence can influence practitioners' ability to perform procedures. Thus, this study assessed students' perceptions and experiences of a pediatric skills program and compared their informed self-assessment with their preceptor-evaluated performance competency for several pediatric clinical procedures.

METHODS

A total of 65 final-year medical students attended a weeklong pediatric skills training course by the University of Tripoli that used a manikin and various clinical scenarios to simulate real-life cases. Participants completed questionnaires self-assessing their performance skills, while examiners evaluated each students' competency on five procedural skills (lumbar puncture, nasogastric tube insertion, umbilical vein catheterization, intraosseous access, and suprapubic aspiration) using an objective structured clinical examination (OSCE) model. Differences between agreement levels in question responses were evaluated through a nonparametric chi-square test for a goodness of test fit, and the relationship between confidence levels and the OSCE scores for each procedure was assessed using Spearman's rank-order correlation.

RESULTS

All participants completed the informed self-assessment questionnaire and OSCE stations. The frequency differences in agreement levels in students' questionnaire responses were statistically significant. No significant differences were found between students' self-assessment and preceptors' evaluation scores. For each procedure's passing score rate, umbilical vein catheterization had the highest passing rate (78.5%) and nasogastric tube placement the lowest (56.9%). The mean performance scores were above passing for all procedures. The Wilcoxon signed-rank test revealed no significant differences between participants' self-assessment and their preceptor-evaluated competency; students correctly perceived and assessed their ability to perform each procedure.

CONCLUSIONS

High competence in several life-saving procedures was demonstrated among final-year medical students. The need for consistent and timely feedback, methods to increase medical students' confidence, and further development and improvement of competency-based assessments are also highlighted.

Dental hygiene graduates' educational preparedness: Self-confidence ratings of the CDHA baccalaureate competencies

PURPOSE

In 2015, the Canadian Dental Hygienists Association (CDHA) published the first Canadian Competencies for Baccalaureate Dental Hygiene Programs (CCBDHP). To date, there is little evidence to support that baccalaureate graduates have gained these abilities. The purpose of the study was to investigate the confidence levels of baccalaureate graduates in their ability to demonstrate the CCBDHP.

METHODS

An online, anonymous study was conducted with the 2013-2016 graduates of the University of British Columbia to rate their confidence level in the 13 competency domains and associated 110 sub-competencies of the CCBDHP based on a 5-point scale ranging from not confident to confident.

RESULTS

Thirty of the 84 graduates responded to the survey for a 36% response rate. The mostly confident and confident scores were added to determine the number of sub-competencies within each domain in which 75% to 100% of respondents identified such confidence. The competency domains in which graduates expressed the highest confidence included Collaboration (100%), Communication (100%), Clinical Therapy (100%), Disease Prevention (100%), Oral Health Education (90%), Professionalism (90%), Research Use (90%) and Leadership (90%). They expressed the least confidence in the competency domains of Health Promotion (50%), Advocacy (22%) and Policy Use (0%).

CONCLUSION

These data provided the UBC faculty with important insights into the educational preparedness of baccalaureate graduates. The findings are also relevant for other Canadian programmes and contribute to a larger national dialogue about the CCBDHP and the transition of graduates into practice.

Development and Testing of the Preparation for Labor and Birth Instrument

OBJECTIVE

To develop and assess the reliability and validity of a new instrument used during the third trimester of pregnancy to measure women's confidence in their ability to achieve physiologic birth, the Preparation for Labor and Birth (P-LAB) instrument.

DESIGN

Two-phase instrument development study that consisted of item generation and a prospective field test.

SETTING

Field testing occurred in five midwestern U.S. prenatal clinics.

PARTICIPANTS

Participants in the field test were 203 nulliparous and parous pregnant women who intended to give birth vaginally.

METHODS

Psychometric testing consisted of test-retest reliability testing and assessments of content validity, face validity, and construct validity. We measured construct validity using exploratory factor analysis and correlation with the Sense of Coherence Scale.

RESULTS

The 22-item P-LAB showed good content validity, good internal consistency, and stability over time. All items had content validity index scores greater than or equal to 0.8, and the total instrument content validity index was 0.95. We identified four factors related to women's confidence in their ability to achieve physiologic birth: Planned Use of Pain Medication, Relationship With Care Provider and Supportive Birth Environment, Beliefs About Labor, and Labor Support (social and professional). Cronbach's alpha coefficient for the four extracted factors were .93, .76, .73 and .74, respectively. Intraclass correlation [95% confidence interval] for the total questionnaire was .92 [.88, .94]. We found no linear association between total P-LAB scores and sense of coherence.

CONCLUSION

Our findings demonstrate acceptable initial psychometric properties for the P-LAB instrument. Additional testing is required to evaluate the instrument's construct, convergent, and divergent validity.

Speech and language therapists' reflections on developing and maintaining confidence in tracheoesophageal speech rehabilitation

BACKGROUND

The management of tracheoesophageal speech (TES) rehabilitation is an area of speech and language therapists' (SLTs) clinical practice where knowledge and skills are primarily developed through postgraduate workplace experience and training. Although recent research suggests clinicians in Australia perceive there is adequate access to workplace training, little is known about how clinicians develop and/or maintain clinical confidence when working in this specialist caseload.

AIMS

To investigate factors that contribute to development of clinician confidence as well as the factors that impact on improving and maintaining confidence when working in the clinical area of TES rehabilitation.

METHODS & PROCEDURES

SLTs working in an Australian clinical service and in a current or recent caseload including patients using TES were eligible to participate. A total of 36 SLTs were recruited and then grouped by level of experience (novice n = 15, intermediate n = 7, experienced n = 14). Ten focus groups of 60-min duration were conducted each with three to four participants from the same experience level. A semi-structured interview guide was used to facilitate the discussion of issues relating to training and confidence; however, only the content pertaining to clinical confidence is reported. Thematic analysis was used to analyse the transcripts.

OUTCOMES & RESULTS

Four themes were identified as contributing to the development of confidence: training, exposure, accessing support and mentorship, and leadership opportunities. Three themes were identified as critical for improving or maintaining clinical confidence: ongoing management of a caseload, ongoing support and further learning. An additional overarching theme was the desire for SLTs to classify or quantify their level of confidence, typically using a numeric scale or in years of clinical experience. The impact of varying contexts and caseloads on confidence levels was highlighted by all participants, but particularly those in the novice focus groups.

CONCLUSIONS & IMPLICATIONS

The findings highlight the fact that the acquisition and maintenance of confidence is an ongoing consideration for SLTs, both those starting out and those with years of clinical experience. With patient presentation increasing in complexity, the importance of understanding contributing factors for gaining and maintaining confidence should be considered alongside postgraduate training and the provision of ongoing support for SLTs working in this specialized clinical area, regardless of experience level.

Satisfaction and self-confidence in the learning of nursing students: Randomized clinical trial

ABSTRACT Objective: To identify and compare satisfaction and self-confidence in the learning of nursing students from the use of simulation and traditional teaching in adult immunization scenarios in the context of Primary Health Care Methods: A randomized controlled clinical trial. Thirty-four undergraduate nursing students from a Brazilian federal public university participated in the study. The students were allocated in two groups: dialogical exposition and training of skills (control) and dialogical exposition, training of skills and simulation (experimental). Student Satisfaction and Self-Confidence in Learning scale was applied after receiving the interventions. In the analysis of satisfaction and self-confidence in learning, the Mann-Whitney test was used for a level of significance of 5%. Results: Traditional teaching strategies and simulation promote satisfaction and self-confidence in students’ learning. The experimental group presented higher mean values in most of the variables of both subscales. However, there was no statistical significance in the learning satisfaction subscale (p-value ≥ 0.05) and self-confidence in learning (p-value ≥ 0.05) between the experimental and control groups. Conclusion and implications for practice: Because they generate satisfaction and self-confidence, simulation and traditional strategies can be mutually used in nursing training.

Self-confidence in the care of critically ill patients: before and after a simulated intervention

OBJECTIVE

To evaluate the self-confidence of nurses in the care of critically ill patients, before and after a simulated intervention.

METHOD

A quasi-experimental study was carried out with 103 nurses who participated in a workshop on the care of critically ill patients in the first semester of 2016. A clinical simulation pedagogical instrument was used throughout the event, and self-confidence was assessed by the Portuguese version of the Self-confidence Scale (SCSvp).

RESULTS

Most participants reported not being prepared to provide first care to critically ill patients, which was carried out during care practice. The participants presented a significant increase in self-confidence after the simulated intervention (p<0.001) in the cardiac, neurological, and respiratory dimensions.

CONCLUSION

Simulation has proved to be an effective strategy for the development of individuals' self-confidence, which contributes to the improvement of skills required for professional practice.

Factors Affecting the Development of Confidence Among Surgical Trainees

OBJECTIVE

The objective of this study was to explore and better characterize the factors affecting confidence during surgical training.

DESIGN

This was a qualitative research study in which we conducted semistructured interviews with surgical residents to explore factors affecting their confidence.

SETTING

This study was conducted at the University of Alberta Hospital, a tertiary care center located in Edmonton, Alberta, Canada.

PARTICIPANTS

Residents from the University of Alberta General Surgery residency program were invited to participate from each postgraduate year (PGY) 2, 3, and 4 for a total of 7 participants (3 PGY-2, 3 PGY-3, and 1 PGY-4; 3 male, and 4 female). We excluded residents who had completed or were currently enrolled in dedicated research years.

RESULTS

Resident confidence was found to be influenced by internal and external factors operating before, during, and after a particular surgical task. Internal factors incorporated personal experiences (including operative experience), personal expectations, self-perception, and individual skill development. External factors involved feedback, patient outcomes, relationships with staff, and working within a supportive environment. Interestingly, residents discussed external social factors more than case volume, technical skills, or underlying knowledge. Residents did not feel that their personal lives (e.g. marital status or having children) directly affected their surgical confidence. Regardless of the factor itself, positive experiences helped build and maintain confidence by providing feelings of reassurance, encouragement, comfort, and acceptance.

CONCLUSIONS

Surgical confidence is influenced by a range of internal and external factors. Understanding these factors can help educators improve learning experiences for residents and accelerate their progress towards being confident, independent surgeons.

Children's description of pain through drawings and dialogs: A concept analysis

AIM

To present a concept analysis of pain in children's drawings and dialogs.

INTRODUCTION

The complexity and subjectivity of the concept of pain in children remain ambiguous. As a result, children are exposed to inappropriate diagnosis and inadequate treatment. Children can describe or draw their painful experiences. Analysing the concept of pain based on children's experiences can help identify, assess and properly manage and treat pain in children.

DESIGN

Concept analysis.

METHODS

Walker and Avant's framework for concept analysis was used in this current study.

RESULTS

Major aspects of pain revealed in this concept analysis are affected by children's different concerns about pain. The description of pain in children with chronic diseases or chronic pain is completely different from that in healthy children. Children perceive pain to be internal, external and emotional. Pain in children is associated with poor psychological and emotional conditions, which add new features and aspects to the concept of pain. Children's descriptions and drawings of pain indicate different concepts of pain in their minds. From the perspective of children, pain has an identity that is formed based on reality.

CONCLUSION

When developing pain evaluation tools, it is necessary to address the characteristics of pain. In the case of chronic pain, emotional effects of pain on children's psyche need extra attention. Child-based pain management guidelines can then be formulated with the results of relevant concept analyses. Pain assessment is a major part of pain management in children. By considering the characteristics of the concept of pain, the efficiency and usefulness of developed tools can be enhanced to create advancement in paediatric pain management.

The Relation of Satisfaction, Self-Confidence and Emotion in a Simulated Environment

Clinical simulation allows discussions about improving the quality on the patient’s care. This method have effectiveness on what concerns to satisfaction, self-confidence and student motivation. However, during the assessment, the students have emotional reactions that have tended to be overlooked. In view of this, this article seeks to identify and describe the relationship of the emotions observed by facial expressions and assess their degree of satisfaction and self-confidence by carrying out simulated practices among the nursing students. The analysis based on the scales showed high satisfaction and self-confidence levels, and it was found that the predominant basic emotion was anger, which is caused by other correlated emotions like tension and stress. This divergence between the identified emotions opens up space for further investigations about the level of motivation and the stimulus tolearning that these emotions can provide, and the extent to which they can lead to satisfaction and self-confidence.

Effects of high-fidelity simulation based on life-threatening clinical condition scenarios on learning outcomes of undergraduate and postgraduate nursing students: a systematic review and meta-analysis

OBJECTIVE

The purpose was to analyse the effectiveness of high-fidelity patient simulation (HFPS) based on life-threatening clinical condition scenarios on undergraduate and postgraduate nursing students' learning outcomes.

DESIGN

A systematic review and meta-analysis were conducted based on the Cochrane Handbook for Systematic Reviews of Interventions and its reporting was checked against the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist.

DATA SOURCES

PubMed, Scopus, CINAHL with Full Text, Wiley Online Library and Web of Science were searched until July 2017. Author contact, reference and citation lists were checked to obtain additional references.

STUDY SELECTION

To be included, available full-texts had to be published in English, French, Spanish or Italian and (a) involved undergraduate or postgraduate nursing students performing HFPS based on life-threatening clinical condition scenarios, (b) contained control groups not tested on the HFPS before the intervention, (c) contained data measuring learning outcomes such as performance, knowledge, self-confidence, self-efficacy or satisfaction measured just after the simulation session and (d) reported data for meta-analytic synthesis.

REVIEW METHOD

Three independent raters screened the retrieved studies using a coding protocol to extract data in accordance with inclusion criteria.

SYNTHESIS METHOD

For each study, outcome data were synthesised using meta-analytic procedures based on random-effect model and computing effect sizes by Cohen's d with a 95% CI.

RESULTS

Thirty-three studies were included. HFPS sessions showed significantly larger effects sizes for knowledge (d=0.49, 95% CI [0.17 to 0.81]) and performance (d=0.50, 95% CI [0.19 to 0.81]) when compared with any other teaching method. Significant heterogeneity among studies was detected.

CONCLUSIONS

Compared with other teaching methods, HFPS revealed higher effects sizes on nursing students' knowledge and performance. Further studies are required to explore its effectiveness in improving nursing students' competence and patient outcomes.

Nurses' confidence in providing and managing care for older persons with depressive symptoms or depression in long-term care facilities: A national survey

The prevalence of depressive symptoms among older residents in long-term care facilities (LTCFs) is high. Nurses are the main healthcare providers in LTCFs and also the persons responsible for detecting changes in residents' mental function and providing subsequent care. Therefore, it is necessary to understand nurses' knowledge, attitudes, and confidence regarding care for older residents with depressive symptoms or depression. This study aimed to understand nurses' level of knowledge of late-life depression, attitudes towards depression, and confidence levels in caring for older adults with depressive symptoms or depression in LTCFs. A cross-sectional descriptive and correlational research design was used. A nationwide self-report survey was conducted in 2016. Ultimately, 556 valid questionnaires were returned. The study found that LTCF nurses' knowledge about late-life depression was poor, and they also lacked confidence in managing and caring for older persons with depressive symptoms or depression, but nurses' attitudes towards depression were neutral or slightly positive. Moreover, nurses who had greater confidence in providing care for older persons with depression were those with more positive attitudes towards depression, a greater interest level in taking care of older adults with depression, less late-life depression knowledge, longer nursing experience in LTCFs, and a greater interest level in late-life depression issues, and who had read late-life depression pamphlets or taken courses or classes in late-life depression. The findings suggest an urgent need to develop strategies to improve nurses' late-life depression knowledge and increase their confidence in providing care to older residents with depressive symptoms or depression.

Self-confidence for the initial management of health issues in schools: construction and validation of a visual analogue scale

Abstract Objective: To describe the construction and validation of a visual analogue scale of teachers' self-confidence with regard to the initial management of health issues in schools. Method: A methodological study was developed based on theoretical (items' construction and content validation), empirical (semantic analysis and pilot test), and analytical procedures (internal consistency analysis). The project was approved by a research ethics committee. Results: The scale consisted of 12 items regarding the main health issues in schools, presented content validity index of 100% in the second round, was understood by the target audience, and presented high internal consistency among items (Cronbach's alpha of 0.89). Conclusion and implications for practice: An easy-to-use tool that proved to be relevant to meet the dimension of teachers' self-confidence in the initial management of health issues in schools. The scale may contribute to the planning of systematized and effective educational strategies among teachers.

Trends in Research on Simulation in the Teaching of Nursing: An Integrative Review

AIM

The aim of the study was to identify and reflect on evidence regarding the use of simulation in nursing education.

BACKGROUND

The use of simulation as a teaching strategy in nursing is expanding. It is important to check the evidence deriving from research.

METHOD

Departing from a guiding question, an international literature search was undertaken between January 2008 and March 2014 in Portuguese, English, and Spanish.

RESULTS

Out of 160 articles, 68.1 percent used simulated teaching to develop clinical reasoning; 31.9 percent used it to train skills. Most (about 91.8 percent) discussed positive aspects related to the use of simulation, including support for the teaching process and increased self-efficacy and self-confidence.

CONCLUSION

The studies indicate that appropriate tools are needed to measure the true impact of the strategy on the teaching of nursing care and the training needed to use simulation as a teaching strategy.

Enhancing women's confidence for physiologic birth: Maternity care providers' perspectives

OBJECTIVE

The aim of this research study was to explore MCP's beliefs and attitudes about physiologic birth and to identify components of antenatal care that providers believe may impact a woman's confidence for physiologic labor and birth.

METHODS

This qualitative descriptive study included maternity care providers (N=31) in the Midwestern United States. Providers participated in semi-structured interviews to describe their beliefs about physiologic birth, their role in providing information to women and specific care practices to promote women's confidence for physiologic birth.

FINDINGS

Six themes emerged including: positive beliefs about physiologic birth, trusted relationship with provider, woman centered care, education and knowledge, barriers to confidence, and antenatal practices to enhance confidence. Variations in beliefs occurred amongst providers with different training (i.e., physicians and midwives).

CONCLUSION

Maternity care providers, including midwives, family physicians and obstetrician-gynecologists, overwhelmingly support a physiologic approach to labor and birth. These providers had a number of suggestions about how antenatal care could be enhanced in an effort to increase women's confidence during the antenatal period. Supporting physiologic birth is imperative for providers who wish to enhance outcomes for mothers and babies.

A Methodological Review of Confidence Measurement Scales for Dietitians Working with Individuals

Confidence is frequently used to assess practitioner effectiveness, and its evaluation requires valid and reliable domain-specific tools. However, the quality of existing measures is unknown. This review identifies studies measuring dietitians' confidence in working with individuals; assesses psychometric (measurement) qualities of relevant tools; and identifies areas for future research. Seven electronic databases, the internet, and reference lists were searched to identify the development or use of relevant confidence measurement scales. A quality assessment of psychometric properties was conducted using guidelines developed by Terwee and colleagues. Of the 15 measures reviewed, 4 were subject to factor analysis. Overall, content validity was strong. However, many measures rated poorly due to lack of factor analysis, inadequate sampling, or poor reporting. Of the dietetics-specific instruments, the Dietetic Confidence Scale and Nutrition Counselling Self-Efficacy Scale received the best ratings. The General Self-Efficacy Subscale also rated highly due to validation with the general population. This article highlights the need for dietitians to incorporate evidence-based methods into practice evaluation and instrument development. Dietitians need an awareness of the terminology and key criteria used to evaluate instrument quality to effectively collaborate with statisticians and scale development experts, and critically evaluate the quality of existing measures. Future scale development and reporting must incorporate psychometric evaluation, such as factor analysis, which should be used to explore and/or confirm scale dimensionality. There is broad scope for future methodological research with existing and new measures for nutrition and dietetics practitioners.

Validation of self - confidence scale for clean urinary intermittent self - catheterization for patients and health - caregivers

Objective

To validate a measurement instrument for clean intermittent self-catheterization for patients and health-caregivers.

Material and Methods

Methodological study of instrument validation performed at a Rehabilitation Center in a University hospital for patients submitted to clean intermittent self-catheterization and their health-caregivers. Following ethical criteria, data were collected during interview with nurse staff using a Likert question form containing 16 items with 5 points each: “no confidence”=1, “little confidence”=2, “confident”=3, “very confident”=4 and “completely confident”=5. Questionnaire called “Self-Confident Scale for Clean Intermittent Self-catheterization” (SCSCISC) was constructed based on literature and previously validated (appearance and content).

Results

The instrument was validated by 122 patients and 119 health-caregivers, in a proportion of 15:1. It was observed a good linear association and sample adequacy KMO 0.931 and X2=2881.63, p<0.001. Anti-image matrix showed high values at diagonal suggesting inclusion of all factors. Screen plot analysis showed a suggestion of items maintenance in a single set. It was observed high correlation of all items with the total, alpha-Cronbach 0.944. The same results were obtained in subsamples of patients and health-caregivers.

Conclusion

The instrument showed good psychometric adequacy corroborating its use for evaluation of self-confidence during clean intermittent self-catheterization.

Test Anxiety in the Nursing Skills Laboratory: A Concept Analysis

BACKGROUND

The concept of test anxiety has been well documented within the health education literature, with much of the literature addressing the clinical environment and simulation laboratories. Minimal exploration of test anxiety has been conducted within the context of a nursing skills laboratory.

AIM

This concept analysis of test anxiety will provide clarity to the meaning and use of this concept within the nursing educational setting of a controlled skills laboratory.

METHOD

Walker and Avant's (2005) framework was used to identify the defining attributes, antecedents, and consequences of test anxiety and applied in model, borderline, and contrary cases, and empirical referents.

CONCLUSIONS

Understanding the concept of test anxiety will enable nurse educators to develop strategies to reduce student anxiety during testing in the skill laboratory. These insights can lead to positive changes within the nursing curricula and may benefit those students who experience testing anxiety.