How does video case-based learning influence clinical decision-making by midwifery students? An exploratory study

The effect of role play prepared with video support on ethical decision-making and motivation levels of nursing students: A quasi-experimental study

Background: Since the increasingly complex structure of health care services brings many ethical problems, it is important to use different instructional technologies in the ethical education of future nurses.Aim: The aim of this study was to determine the effect of role play prepared with video support on ethical decision-making and motivation levels of nursing students.Research design: A quasi-experimental study with pretest-posttest design.Participants and research context: The research was conducted in the Nursing Department of a University located in Istanbul, Turkey between October 15 and November 15, 2024. The sample of the research consisted of 3rd year nursing students. Data were collected using the Descriptive Characteristics Form, the Nursing Dilemma Test, and the Instructional Material Motivation Scale for Single-Use.Ethical considerations: Permission was obtained from Bezmialem Vakif University Non-Interventional Ethical Research Committee and the institution where the study was conducted for the implementation of the research. Written and verbal consent was obtained from all participants in accordance with the Helsinki Declaration.Findings: While there was no difference between the students' Ethical Dilemma Test Principled Thinking pre-test and post-test scores, their Practical Consideration (p = .005) and motivation levels (p = .037) post-test scores were found to be higher. There was a weak but significant negative correlation between academic achievement and pre-test teaching material motivation levels (r = -0.375, p = .041).Discussion: The use of different teaching methods and techniques in ethics education in nursing is important for future nurses to find more practical solutions to the ethical problems they will encounter during patient care.Conclusion: The results of the study indicate that the use of video-supported role play can be effective in teaching ethics courses in nursing education.

Perceived efficacy of case analysis as an assessment method for clinical competencies in nursing education: a mixed methods study

BACKGROUND

Case analysis is a dynamic and interactive teaching and learning strategy that improves critical thinking and problem-solving skills. However, there is limited evidence about its efficacy as an assessment strategy in nursing education.

OBJECTIVES

This study aimed to explore nursing students' perceived efficacy of case analysis as an assessment method for clinical competencies in nursing education.

METHODS

This study used a mixed methods design. Students filled out a 13-item study-advised questionnaire, and qualitative data from the four focus groups was collected. The setting of the study was the College of Nursing at Sultan Qaboos University, Oman. Descriptive and independent t-test analysis was used for the quantitative data, and the framework analysis method was used for the qualitative data.

RESULTS

The descriptive analysis of 67 participants showed that the mean value of the perceived efficacy of case analysis as an assessment method was 3.20 (SD = 0.53), demonstrating an 80% agreement rate. Further analysis indicated that 78.5% of the students concurred with the acceptability of case analysis as an assessment method (mean = 3.14, SD = 0.58), and 80.3% assented its association with clinical competencies as reflected by knowledge and cognitive skills (m = 3.21, SD = 0.60). No significant difference in the perceived efficacy between students with lower and higher GPAs (t [61] = 0.05, p > 0.05) was identified Three qualitative findings were discerned: case analysis is a preferred assessment method for students when compared to MCQs, case analysis assesses students' knowledge, and case analysis assesses students' cognitive skills.

CONCLUSIONS

This study adds a potential for the case analysis to be acceptable and relevant to the clinical competencies when used as an assessment method. Future research is needed to validate the effectiveness of case analysis exams in other nursing clinical courses and examine their effects on academic and clinical performance.

Midwifery Students' Views on NANDA-I Diagnoses and Care Plans Used in Clinical Practice

BACKGROUND

Developing a care plan for patients is not specific to nursing or midwifery; it is the case in every situation where patients seek help from care providers. Midwifery students draw upon NANDA-I diagnoses while developing care plans (CPs) in clinical practices, and plan and apply their care accordingly. This study aims to identify the views of midwifery students on the NANDA-I diagnoses and CPs that they use in clinical practice.

METHODS

This descriptive and cross-sectional study was conducted with 222 students between September and December 2022. The research data were collected through face-to-face interviews using a questionnaire based on NANDA-I diagnoses and CPs. In line with the existing literature, the questionnaire was designed by two academicians who specialized in nursing fundamentals and midwifery. The questionnaire consisted of closed-ended (8 questions) and open-ended (7 questions) questions. Data analysis was performed with descriptive statistics and Pearson's chi-square test.

RESULTS

Of 222 students, 57.7% stated that they did not know the definition of a CP. It was found that 46.8% of the students felt inadequate at developing CPs. Furthermore, the students stated that they found the CP training provided during their undergraduate study partially sufficient, with a rate of 52.7%, and 16.7% of midwifery students offered suggestions about CP teaching. The number of midwifery-related diagnoses of which the students were aware was 19.

CONCLUSIONS

The study was beneficial in terms of identifying the deficiencies of the students related to NANDA-I diagnoses and developing CPs that might be overcome through education and observing the midwifery-related diagnoses that they used. It is of critical importance to educate midwifery students about midwifery-related NANDA-I diagnoses in order that they embrace midwifery diagnoses and CP learning.

Modelling the case-based learning preferences of undergraduate nursing students using a discrete choice experiment in China

PURPOSE

To investigate the preferences for case-based learning programmes among undergraduate nursing students.

METHOD

A questionnaire was designed based on a discrete choice experiment, and 227 undergraduate nursing students were investigated. In STATA 15.0 software, the data were statistically analysed using a mixed logit model.

RESULT

All attributes in our study were found to have a significant influence on undergraduate nursing students' preferences for case-based learning programmes. The students' preference for the CBL programme was influenced by the clinical internship experience and type of university. Furthermore, the most ideal scenario was found to be video case modality, unfolding delivery, provided by academic experts and clinical instructors, group size 9-11, adequate feedback, and fragmented case content.

CONCLUSION

The undergraduate nursing students' preferences for case-based learning programmes were affected by the provider, case modality, modality, group size, feedback, and case content. Our results can provide useful information for nursing educators to gain insight into student preferences and formulate case-based learning programs.

Simulated patient videos to supplement integrated teaching in competency-based undergraduate medical curriculum

The competency-based undergraduate medical curriculum in the preclinical years requires clinical topics to be taught using a linker clinical case for students to appreciate the clinical application of basic sciences. The objective of this study was to evaluate student and faculty satisfaction regarding the construct and delivery of an aligned and integrated curriculum that involved the use of linker clinical cases. We aimed at evaluating the perceptions and performance of students when paper cases were supplemented with a simulated patient (SP) video. This interventional study was conducted by inviting 250 medical students from the first professional phase from the 2020-2021 batch. Integrated modules were prepared for two clinical conditions: myocardial infarction (MI) and nephrotic syndrome (NS). The topic NS was taught with a paper-based case while the topic MI was supplemented with an SP video. Feedback from students and faculty was collected using a newly developed and validated questionnaire and focused group discussions. The students performed significantly better in the assessment conducted after the topic MI compared to NS. The majority of the students (80%) expressed a preference for the video to understand the clinical relevance when compared to the paper case. Overall, the students (83-87%) expressed satisfaction with integrated teaching sessions using clinical cases. Using linker clinical cases in an aligned and integrated preclinical curriculum allowed students to interrelate the subjects and apply them to clinical contexts. The SP videos prepared from an authentic setting facilitated learner engagement with a better understanding of the clinical relevance of the basic sciences.NOTE & NOTEWORTHY In this study, we have introduced linker cases to teach clinical correlation of basic sciences for integrated modules in the competency-based undergraduate medical curriculum. The novelty of our study is the inclusion of simulated patient video that was internally prepared and validated to supplement linker clinical paper cases in integrated modules.

Case-based learning interventions for undergraduate nursing students in a theoretical course: A review of design, implementation, and outcomes

BACKGROUND

Case-based learning (CBL) is a contextualized learning and teaching method that can facilitate active and reflective learning to develop critical thinking and problem-solving skills. However, nursing educators have some difficulty in creating a CBL environment that matches the diverse professional nursing curriculum and students' needs, including developing relevant cases and appropriate CBL implementation processes.

OBJECTIVE

To summarize the case design, implementation process, and their relationship with CBL effectiveness.

METHODS

Electronic databases of PubMed, Embase, Web of Science, CINAHL, China National Knowledge Infrastructure (CNKI) and Wanfang Data (a Chinese database) were searched from inception until January 2022. Study quality was assessed using the Mixed Methods Appraisal Tool. A qualitative synthesis was then conducted to summarize the study findings.

RESULTS

The systematic mixed studies review included twenty-one quantitative studies, five qualitative studies and two mixed methods studies. The case design and implementation process were indispensable parts of each study, but the application process of CBL in each study was slightly different, basically including case design, preparation, small-group interaction and exploration, collaborative efforts, teacher summary, assignment and teacher feedback. There were three themes in this review that indicate the effect of CBL on students, namely, knowledge, competence and attitude.

CONCLUSION

The present review analyzes the available literature and suggests that there is no common format for the case design and CBL implementation process, but demonstrates that they are an indispensable part of each study. This review provides conceptual procedures for nurse educators to design and implement CBL in nursing theoretical courses to improve the effectiveness of CBL.

A novel curriculum for the Same-Sex Marriage Act and Patient Right to Autonomy Act (SMPRA) module based on two new laws in Taiwan: a mixed-methods study

BACKGROUND

The establishment of laws has had a tremendous impact on holistic medical care. The Patient Right to Autonomy (PRA) Act and the Same-Sex Marriage Act have been passed in Taiwan, and both have sparked intense societal debate. The Same-Sex Marriage Act and PRA Act (SMPRA) teaching module was created for the Gender, Medicine, and Law (GML) course of the medical curriculum. This video trigger-assisted problem-based learning (VTA-PBL) software has integrated content on the aforementioned legislative proclamations. It upends conventional beliefs and fosters reflective practices on sexual rights and the right to representation among medical students. This study examined how the SMPRA module affected the knowledge and attitudes of medical students taking up the GML course.

METHODS

A simple pre-/post-test design evaluated the outcomes of the PBL module to examine the changes in knowledge and attitudes of medical students toward same-sex marriage rights. In 2019 and 2020, 126 and 49 5th-year medical students took up the GML course, respectively. The GML components included a video scenario representing advanced decision-making and a healthcare agency with a same-sex couple, a PBL discussion, and student feedback presentations. The mechanisms of feedback collection and measuring student knowledge and attitudes toward sexual rights differed between one cohort in 2019 and the other in 2020. Pre- and post-lecture tests were used in the first school year, whereas a post-lecture open-ended questionnaire survey was used in the second school year.

RESULTS

In total, 90 and 39 eligible questionnaires were received in the first and second school years, respectively, which corresponded to response rates of 71% and 80%. Students showed a better understanding of and positive enhancement of proficiency in legal and ethical content and relevant clinical practice. Qualitative analysis revealed that students viewed healthcare providers as checkpoints for conflicts of interest; medical ethics as the cornerstone of clinical practice; cultural background as a significant influence on decision-making; and empathetic communication as the cornerstone of relationships between patients, family members, and doctors.

CONCLUSION

The GML course of the SMPRA module fosters reflective practices on ethical and legal sexual rights issues.

Practical training using immersive roleplay and an intensive course on clinical ethics consultation in Japan

Background

Clinical ethics consultation (CEC) is not sufficiently widespread in Japan. A possible reason is that a practical training system for CEC has not been established. Hence, we have developed “immersive role-play (IR)” as a practical training program that applies a new theatrical technique, immersive theater, to role-play learning. Its characteristics include high fidelity in the use of a studio and actors and dynamic realism in the progression of the scenario to immerse learners in role-play learning.

Methods

We offered an intensive course on CEC for healthcare professionals from 2016 to 2019, with IR as part of the course curriculum. A questionnaire survey was administered to the participants regarding the educational effectiveness of IR. The questionnaire was anonymous, and participants responded on a 4-point Likert scale regarding their satisfaction with IR and their perception of its learning effects. An open-ended section at the end of the questionnaire asked about the effectiveness and areas for improvement of IR.

Results

The questionnaire survey showed good results in all categories: usefulness, satisfaction, understanding, and interest. In the questions that compared the learning to traditional role-play learning, the participants gave significantly high ratings, specifically for “realism,“ “seriousness,“ “understanding the importance of communication skills,“ and “understanding the diversity of the narratives.“ In the free-text responses, the most frequent response was that they learned a lot about the practical procedures for participation.

Conclusion

IR is sufficiently effective as a practical educational program, but not for everyone. It is suitable for those who are or will soon work as consultants. Conversely, beginners and intermediates who have not fully mastered the CEC theory and skills will need a stage-specific educational program separate from the IR.

[Digital and virtual support in the hermeneutic case-based learning in health professional education: A systematic review]

Digital and virtual support in the hermeneutic case-based learning in health professional education: A systematic review Abstract. Background: Nowadays, the digitization dominates almost all aspects of our lives, especially in the nursing field. The medial-supported teaching design program helps learners to be prepared for the digital challenges of their professional field. In addition, the concept of hermeneutic casework provides nurses with an expertise that can be applied individually and case-related. Virtual simulations can represent a realistic case scenario and extend the conventional concept of casework with modern technology. Aim: The aim of the review is, to identify national and international used types of virtual and digital medias in connection with the method of hermeneutic casework and describe its usefulness in health education. Methods: A literature review according to the design of a systematic review in the databases CINAHL, MEDLINE via PubMed, Cochrane and Springer Link has been conducted and complemented by the snowball principle. Results: Eleven publications were analysed. The results show predominantly positive effects, which can be divide into eleven areas. Conclusion: The use of virtual patients is considered in both empirical and media-didactic research as an effective and an efficient learning arrangement. In a positive and a negative sense, the results depend from the didactic and methodological preparation, the design of the learning modules and the quality of the medium as well as the teaching.

From Clinical Practice to the Classroom. Advantages and Disadvantages of Video and Paper Cases on the Motivation and Clinical Reasoning of Occupational Therapy Students

Case-based learning enables the application of theory to practice using real-life patient cases. The present study aims to compare the effect between video cases and paper cases on motivation for learning and knowledge acquisition to perform a clinical reasoning case exercise by occupational therapy students. A mixed-methods design was used with 120 students randomized into two groups. All students conducted a clinical reasoning case exercise on the same case, although in different presentation formats: paper case and video case. The quantitative measures of this study were the scores of motivation for learning from the Instructional Material Motivation Survey and the grades of a clinical reasoning case exercise. The qualitative part was based on the positive and negative aspects perceived by the participants. The results showed that the motivation for learning was significantly higher for the video case compared to the paper case, although there were no differences in the grades of the clinical reasoning case exercise between the two groups. The video cases were perceived as more relevant to professional practice and more informative in terms of non-verbal communication and context. In light of the results, teachers could use these two formats of presentation of cases with different objectives.

The Effects of Case-Based Teaching in Nursing Skill Education: Cases Do Matter

Nursing skill education plays a very important part for the nursing education. It's necessary to analyze the role of the case-based teaching (CBT) in nursing skill education, to provide insights into the nursing education. The sophomore nursing students who received nursing skill teaching from September 2019 to January 2020 were selected. The students either underwent traditional teaching (control group) or CBT (CBT group) intervention. The objective structure clinical examination (OSCE), autonomous learning ability, questionnaire for effects evaluation of CBT, and student's satisfaction level on CBT were analyzed. A total of 146 participants were included. There were no significant differences in the gender, age and the final exam score as freshman between 2 groups (all P > .05). The OSCE scores and autonomous learning ability in CBT group were significantly higher than that of control group (all P < .05). The most students favored the use of CBT, and most students were satisfied with CBT. CBT is beneficial to improve the nursing skill and comprehensive ability of students, and it's conducive to increase the interest of students, which merits application in nursing education.