Learning to nurse: combining simulation with key theory

A scoping review of undergraduate anatomy and physiology education: approaches to evaluating student outcomes in the United States

Studies document difficulties undergraduate pre-nursing and allied health students face when learning human anatomy and physiology (A&P) course content. A comprehensive synthesis exploring the teaching practices within the course and how those practices are evaluated is warranted. This scoping literature review identified 78 journal articles investigating teaching practices, and we charted their research methods, student outcomes, and institutional contexts. Content analysis found the teaching practices described most frequently in A&P education research literature involved multiple aligned changes across the curriculum, including student activities, course delivery, and assessments. Critical appraisal of study methodologies revealed that most studies in undergraduate A&P were longitudinal, included comparison groups, and used simple inferential statistics. In contrast, few studies listed limitations of their research, collected data from multiple institutions, or reported student demographic data. We believe these factors pose notable limitations to the interpretation of A&P education studies across institutional contexts. The results of this review identify future lines of inquiry to enrich existing evidence about pedagogical interventions in A&P courses.

Human anatomy curriculum reform for undergraduate nursing students: An exploratory study

This study aims to cultivate students' independent learning capacity, promote the interdisciplinary integration of "nursing + anatomy," and establish a curriculum system to enhance applied nursing abilities based on project-based teaching reform of everyday clinical nursing operations. A total of 151 second-year (class of 2021) undergraduate nursing students at a Chinese university were selected for this study. By adjusting the curriculum, reconstructing the teaching contents, employing the "hybrid + flip" teaching method based on BOPPPS (bridge-in, outcomes, preassessment, participatory learning, post-evaluation, summary), and implementing a teaching system based on the "three re-three linkage," a Human Anatomy curriculum with a focus on basic anatomical knowledge was developed and connected with nursing clinical operation practice. The restructuring of the course content received unanimous recognition from both the teaching staff and the students. Notably, students in the class of 2021 achieved significantly higher grades than did students in the class of 2020, who received traditional face-to-face instruction (p < 0.01). These results indicate enhanced clinical application skills among the former group of students. following the implementation of instructional reforms during one semester, students exhibited notable improvements in motivation, program implementation, self-management, and interpersonal communication. A statistically significant increase in overall scores for self-directed learning capacities over the preinstructional period was observed (p < 0.05). Furthermore, the findings of the student satisfaction surveys reflected highly favorable perceptions of the enriched instructional format, high levels of course engagement, frequent faculty-student interactions, and augmented overall competence. The practical implementation of the reform in the context of a Human Anatomy course for undergraduate nursing students led to significant positive outcomes, thereby enhancing the effectiveness of teaching and learning. Students' clinical application abilities and self-directed learning capacities notably improved, while overall satisfaction with the course remained high.

Factors associated with practice readiness among newly qualified nurses in their first two years of practice

BACKGROUND

Newly graduated nurses undergo stress and role adjustment as they transition into practice during the first year and continue to struggle beyond the first year. Determining their practice readiness can aid in the development of interventions to facilitate workplace readiness for nurses in their first two years entering the nursing profession.

OBJECTIVES

To examine (i) extent of practice readiness of new nurses in their role; and (ii) associations between nurses' practice readiness and demographic and occupational variables, and reasons for choosing nursing profession.

DESIGN

A cross-sectional study.

SETTINGS AND PARTICIPANTS

A total of 445 registered nurses who graduated within the last two years and working in an academic medical centre in Singapore.

METHODS

Participants completed an online questionnaire with questions from Casey-Fink Readiness for Practice Survey and questions related to key competencies for future practice.

RESULTS

More than half (57.5 %) identified at least three skills and procedures which they were uncomfortable performing independently as they transition into the clinical practice, including: (i) responding to emergency (ii) tracheostomy care; and (iii) chest tube care. The top three reasons for choosing nursing as a career were: (i) nursing is a stable industry (54.2 %); (ii) I want to help people (52.1 %); and (iii) able to work anywhere in the world (44.3 %). Nurses were most concerned with areas of trials and tribulations (42.5 %) and clinical competency (36.6 %). When compared to nurses in their first-year post-graduation, those working in their second year reported more confidence in the ability to problem solve (p = 0.003), care for a person who is dying (p = 0.004), and less difficulties in prioritizing care needs (p = 0.04). They also perceived themselves as a good problem solver (p = 0.03).

CONCLUSIONS

It is critical to continue supporting nurses' practice readiness beyond their first year of practice in their confidence and development of skills of higher complexity.

Difficulties and innovations in teaching anatomy and physiology in nursing

AIM

This study aimed to clarify the difficulties and innovations in anatomy and physiology education from the perspective of faculty members in charge of anatomy and physiology education in Japanese nursing universities.

BACKGROUND

Many nursing students have difficulty acquiring anatomy and physiology knowledge and applying it in clinical situations; therefore, effective teaching and learning methods for anatomy and physiology must be provided in nursing education.

DESIGN

This study followed a cross-sectional observational design using a web-based self-administered questionnaire.

METHODS

A web-based self-administered open-ended survey regarding the difficulties and innovations in teaching anatomy and physiology in nursing was conducted involving nursing faculty members at universities in Japan. After inviting 280 nursing universities to participate in the survey, 37 completed questionnaires were collected and descriptively analyzed.

RESULTS

In approximately 30% of the universities, multiple professions were involved in collaboratively teaching anatomy and physiology. Furthermore, 59.5% of the universities offered a combination of didactic lectures and laboratory learning. Difficulties in teaching anatomy and physiology included the limitations of the physical teaching environment, the difficulty of teaching the importance of anatomy and physiology in nursing practice, the difficulty of adjusting educational content to learner readiness, and the difficulty of terminology and concepts specific to anatomy and physiology. Innovations used in teaching anatomy and physiology from a nursing perspective included integrating anatomy and physiology with related disciplines, encouraging students to visualize human anatomy in three dimensions, and linking anatomy and physiology to clinical nursing practice.

CONCLUSION

Despite some difficulties in teaching the subjects, faculty members have implemented effective educational methods on their own. Due to the various constraints of the learning environment, it is difficult for students to learn anatomy and physiology on campus in depth and acquire a deep understanding of its significance in clinical practice. Therefore, educational involvement that fosters students' self-directed learning skills and encourages flexible learning is expected. In addition, by collaborating with multiple disciplines to provide anatomy and physiology education, the participants of this study innovated pedagogies for teaching nursing students about the usefulness of anatomy and physiology and motivated their students. Moving forward, teachers need to relate their knowledge of anatomy and physiology to actual nursing care and clinical cases and convey the importance of deeply understanding anatomy and physiology in nursing practice to support their students' active learning.

Impact of high-fidelity simulation exposure of nursing students with their objective structured clinical examination: A quasi-experimental study

AIM

The study aimed to establish the impact of high-fidelity simulation (HFS) in the objective structured clinical examination (OSCE) of nursing students enrolled in four undergraduate courses (medical-surgical, critical-care, maternal-health and paediatric nursing).

DESIGN

This quasi-experimental research study was performed during the midterm and final OSCEs of nursing students at the institution, and their OSCE performance was assessed.

METHODS

The students were divided into two: those who were exposed to HFS in addition to their clinical training and the other group who underwent clinical training without HFS exposure.

RESULTS

The combined mean midterm and final OSCE results of the group of nursing students with HFS exposure and those without HFS exposure were 92.58 and 82.66, respectively, with a mean between-group difference of 9.92% (p < .01). Our findings reveal that the HFS exposure in addition to clinical training enhanced the students' OSCE performance.

Flipped classroom improves Omani nursing students performance and satisfaction in anatomy and physiology

BACKGROUND

Nursing students struggle with anatomy and physiology course because of the complicated terminology and the difficulty in handling large amounts of information. New, innovative instructional strategies must be integrated into nursing education to improve nursing students' performance in this challenging bioscience course. The aim of this study was to determine the impact of an innovative teaching strategy, the flipped classroom, on the performance and satisfaction of Omani nursing students in an anatomy and physiology course.

METHODS

A quasi-experimental design was used with two classes of 112 first-year nursing students at the College of Nursing, Sultan Qaboos University, Oman. Online videos and active-learning activities about the respiratory system were developed and implemented in an anatomy and physiology course with 53 first-semester nursing students. The control group consisted of a previous cohort of 59 students enrolled in the same course but taught with a traditional lecture approach. The impact of the flipped classroom strategy was measured by students' performance on the final examination and students' self-reported satisfaction. Wilcoxon signed-rank and Mann-Whitney U tests were used to compare students' academic performance.

RESULTS

Our results showed that the performance of the flipped classroom group was better than that of the traditional lecture group. The mean scores of students instructed with the flipped classroom method on the respiratory system items in the final examination were significantly higher than those of the control group, U = 1089.00, z = - 2.789, p < .005. Moreover, the results of a survey showed that nursing students were satisfied with the flipped classroom method. Overall, 68 to 78% of students agreed or strongly agreed that the flipped classroom method improved their learning and increased their interest in the course.

CONCLUSION

Compared with the didactic lecture format, flipped classroom strategy improved Omani nursing students' performance in and satisfaction with an anatomy and physiology course. These results show that the flipped classroom is an important teaching strategy in nursing education.

Graduate Nurses' Perception of the Effect of Simulation on Reducing the Theory-Practice Gap

Graduate nurses employed in high-acuity areas can experience a deficit in integrating theoretical concepts in the clinical environment, which is known as the theory-practice gap; this may result in a risk to patient safety with the potential for negative outcomes. Most existing literature address the existence of the theory-practice gap and the benefit of simulation from a faculty perspective. The purpose of this study was to explore the theory-practice gap from the perspectives of graduate nurses based on their experiences and to determine their perceptions of simulation in prelicensure programs as a strategy to address and reduce the gap prior to entry to practice. Cognitive constructivism was the conceptual framework that guided this study. A qualitative phenomenological design was used to explore the lived experiences of 13 graduate nurses with 2 years of less clinical experience by engaging in semistructured interviews. Data analysis revealed that all the graduates experienced the theory-practice gap on their transition to independent clinical practice with variations in degree. In addition, the graduates voiced aspects of their programs which contributed to reducing the challenges experienced during the transition period. The crucial finding was graduate nurses perceived the theory-practice gap could be reduced through the use of high-fidelity simulation utilizing scenario-based learning exercises in prelicensure programs prior to entry to practice.

Using high fidelity simulation to increase nursing students' clinical postpartum and newborn assessment proficiency: A mixed-methods research study

OBJECTIVE

The objective of this study was to explore the benefits of using High Fidelity Simulators (HFS) to teach maternal postpartum and newborn assessment skills to student nurses before they interacted with actual hospital patients.

DESIGN

This descriptive, observational study employed a mixed-method design using a Qualtrics online survey instrument.

SETTING

The study was set at a Midwestern university.

PARTICIPANTS

The study used a convenience sample of third-year BSN nursing students (n = 132).

METHODS

After participating in an HFS experience and completing a maternity clinical rotation, students took an online Qualtrics survey evaluating the benefits and drawbacks of the HFS experience.

RESULTS

Students valued the HFS experience at an average score of 3.82 on a Likert Scale of 1-5. Open-ended questions identified three themes: psychomotor learning leading to skill acquisition, affective learning, and simulation restructuring to provide more time, better instructor preparation, and smaller groups.

CONCLUSION

This study's data supports the use of HFS to enhance nursing care and education, with special attention given to instructional consistency. Practicing new assessment skills in a non-threatening, safe environment gives students expertise and confidence while promoting the development of critical thinking skills.

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.

The value of simulation-based learning in pre-licensure nurse education: A state-of-the-art review and meta-analysis

Simulation modalities are numerous in nursing education, with a need to reveal their range and impact. We reviewed current evidence for effectiveness of medium to high fidelity simulation as an education mode in pre-licensure/pre-registration nurse education. A state-of-the-art review and meta-analyses was conducted based on a systematic search of publications in English between 2010 and 2015. Of 72 included studies, 43 were quantitative primary studies (mainly quasi-experimental designs), 13 were qualitative studies and 16 were reviews of literature. Forty of 43 primary studies reported benefits to student learning, and student satisfaction was high. Simulation programs provided multi-modal ways of learning. A meta-analysis (8 studies, n = 652 participants) identified that simulation programs significantly improved clinical knowledge from baseline. The weighted mean increase was 5.0 points (CI: 3.25-6.82) on a knowledge measure. Other objectively rated measures (eg, trained observers with checklists) were few. Reported subjective measures such as confidence and satisfaction when used alone have a strong potential for results bias. Studies presented valid empirical evidence, but larger studies are required. Simulation programs in pre-licensure nursing curricula demonstrate innovation and excellence. The programs should be shared across the discipline to facilitate development of multimodal learning for both pre-licensure and postgraduate nurses.