Outcomes of scenario-based simulation courses in nursing education: A systematic review and meta-analysis

OBJECTIVE

This study aimed to investigate the effects of scenario-based simulation courses on nursing students' professional knowledge, clinical practice skills, and self-confidence in learning.

DESIGN

A systematic review and meta-analysis.

DATA SOURCES

A literature search of six databases including CINAHL Plus with Full Text, Cochrane Library, Embase, Medline, PubMed, and Web of Science was performed on 28 February 2023.

REVIEW METHODS

The methodological quality of the studies included was assessed using RoB 2. A random-effects model was used for pooling effect size. The heterogeneity of each pooled analysis was quantified with I2. Egger's regression test was performed to assess publication bias in each pooled analysis.

RESULTS

Sixteen trials conducted between 2011 and 2022 were included in the final analysis. Scenario-based simulation courses significantly improved nursing students' professional knowledge (pooled SMD 0.66; 95 % CI 0.33-0.98; p < 0.001), clinical practice skills (pooled SMD 1.45; 95 % CI 0.96-1.94; p < 0.001), and self-confidence in learning (pooled SMD 0.37; 95 % CI 0.12-0.63; p < 0.001). Substantial heterogeneity was observed in the pooled analyses of professional knowledge and clinical practice skills.

CONCLUSION

Scenario-based simulation courses appeared to be beneficial for increasing nursing students' professional knowledge, clinical practice abilities, and self-confidence in learning. Therefore, simulation-based learning should be regarded as an essential component of the nursing curriculum as it improves nursing students' skills and prepares them for real-world practice.

Effects of videoconferencing intervention on stroke survivors: A systematic review and meta-analysis of randomised controlled studies

BACKGROUND

Videoconferencing has been proposed as an innovative telerehabilitation approach for stroke survivors, demand for which is growing.

AIM

To evaluate the efficacy of a videoconferencing intervention for stroke survivors.

DESIGN

Systematic review and meta-analysis.

METHODS

We conducted a systematic review of the literature in the databases Academic Search Complete, CINAHL, Cochrane Library, EMBASE, MEDLINE, PubMed, Ovid (and its companion UpToDate), and Web of Science published from January 1, 2002, to May 27, 2021. The methodologic quality of the included studies was evaluated using version 2 of the Cochrane risk-of-bias tool. A meta-analysis using a random-effects model calculated the pooled standardised mean difference (SMD) for using a videoconferencing intervention with stroke survivors and for the ability of survivors to perform activities of daily living (ADLs) and to maintain balance. The Stata software application (version 16.0: StataCorp LP) was used for the statistical analysis.

RESULTS

Nine studies with 603 participants were included in the analysis. Videoconferencing interventions were observed to be effective in improving the ability of stroke survivors to carry out their ADLs (SMD: 0.57; 95% confidence interval [CI]: 0.13 to 1.01) and to recover their balance (SMD: 1.96; 95% CI: 1.27 to 2.66).

CONCLUSIONS

Stroke survivors were able effectively to improve their ADL and balancing abilities. Further studies could consider the frequency, duration, and standard protocol for videoconferencing interventions.

RELEVANCE TO CLINICAL PRACTICE

This study could change the approach to patient support in future clinical practice and might constitute an alternative for improving care for stroke survivors in their homes or in long-term care facilities.

A systematic review and meta-analysis of outcomes of interprofessional education for healthcare students from seven countries

AIM

This study aimed to analyze the effectiveness of the learning outcomes of the interprofessional education (IPE) model for healthcare students.

BACKGROUND

Interprofessional education (IPE) is an important teaching and learning model that involves two or more professions engaging or working together to improve the knowledge of healthcare students. However, the specific outcomes of IPE for healthcare students are unclear as only a few studies have reported them.

DESIGN

A meta-analysis was conducted to draw broad conclusions on the impact of IPE on healthcare students' learning outcomes.

METHODS

The CINAHL, Cochrane Library, EMBASE, MEDLINE, PubMed, Web of Science, and Google Scholar databases were searched for relevant articles in the English language. To investigate the effectiveness of IPE, a pooled estimate of knowledge, readiness for and attitude toward interprofessional learning, and interprofessional competence were analyzed using a random effects model. The methodologies of the studies evaluated were assessed using the Cochrane risk-of-bias tool for randomized trials, version 2. Sensitivity analysis was performed to ensure the rigor of the findings. STATA 17 was used to perform the meta-analysis.

RESULTS

Eight studies were reviewed. IPE had a significant positive impact on healthcare students' knowledge (Standardized Mean Difference [SMD]: 0.43; 95% Confidence Interval [CI]: 0.21-0.66). However, its impact on readiness for and attitude toward interprofessional learning and interprofessional competence was nonsignificant and needs further investigation.

CONCLUSION

IPE enables students to develop their knowledge of healthcare. This study provides evidence that IPE is a better strategy for enhancing healthcare students' knowledge than traditional/discipline-specific teaching techniques.

Outcomes of problem-based learning in nurse education: A systematic review and meta-analysis

OBJECTIVE

To investigate the effectiveness of problem-based learning (PBL) in nursing students, including recently reported trials.

DESIGN

Meta-analysis was performed to obtain summary conclusions on the influence of PBL on nursing students' learning outcomes.

DATA SOURCES

Academic Search Complete, CINAHL, Cochrane Library, EMBASE, MEDLINE, PubMed, and Web of Science were searched for relevant studies from the period between database inception and March 3, 2022.

REVIEW METHODS

A random-effects model was used to generate pooled standardized mean differences (SMD) for critical thinking, problem-solving, and self-confidence. The heterogeneity of each variable in the pooled estimate was determined using a random-effects model.

RESULTS

Overall, PBL had a greater positive effect than traditional learning on critical thinking (SMD: 0.44; 95 % CI: 0.14-0.73), analysis (SMD: 0.72; 95 % CI: 0.84-1.25), and evaluation (SMD: 0.33; 95 % CI: 0.05-0.61). However, the impact of PBL on problem-solving and self-confidence need further investigation.

CONCLUSIONS

PBL appears to improve nursing students' critical thinking skills, especially their ability to analyze and evaluate. The findings of this study may be used as evidence of PBL being a more effective method than traditional/conventional learning techniques for increasing students' critical thinking.

A meta-analysis of studies of the effects of case management intervention for stroke survivors across three countries

PURPOSE

A stroke survivor who is discharged to home care faces many challenges during the transition from the hospital to home, including managing their care at home and engaging in rehabilitation and recovery. Case management was developed to ease the transition from hospital to home and help people with stroke cope with their care management challenges. However, the effects of case management intervention remain inconclusive. Case management was designed to direct care and may represent a novel method for reducing the burden of care. This study was designed to evaluate the effects of case management interventions on mental health outcomes, activities of daily living capacity, physical function, and social function among stroke survivors.

DESIGN

Systematic review and meta-analysis.

METHODS

This study included studies examining the impacts of case management interventions for stroke survivors that were published in English and identified by searching eight databases, from database inception to February 20, 2022. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used to pool effect sizes using a random-effects model (in Stata 16.0). The revised Cochrane risk-of-bias tool for randomized trials (RoB-2) was used to assess the methodological quality of each study.

FINDINGS

The inclusion criteria were satisfied by eight studies (including a total of 1119 stroke survivors). Case management had positive effects on mental health (SMD: 0.26; 95% CI: 0.07 to 0.45, p = 0.001) and activities of daily living (SMD: 0.68; 95% CI: 00.37 to 0.99, p < 0.001). However, no significant effects were observed for either physical function or social function.

CONCLUSION

Case management appears to enhance the mental health and activities of daily living among stroke survivors.

CLINICAL RELEVANCE

Case management interventions hold promise as efficient, cost-effective, and accessible strategies to positively influence care for stroke survivors. This intervention strategy could be applied to the hospital-to-home transition to guide care among this population.

Global prevalence of stigmatization and violence against healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis

PURPOSE

During COVID-19, stigmatization and violence against and between professional healthcare workers worldwide are increasing. Understanding the prevalence of such stigmatization and violence is needed for gaining a complete picture of this issue. Therefore, the purpose of this review was to update estimates of the prevalence of stigmatization and violence against healthcare workers during the pandemic.

DESIGN

A systematic review and meta-analysis was conducted.

METHODS

This review followed PRISMA guidelines and encompassed these databases: PubMed, Academic Search Complete, CINAHL, Web of Science, MEDLINE Complete, OVID (UpToDate), and Embase (from databases inception to September 15, 2021). We included observational studies and evaluated the quality of the study using the Joanna Briggs Institute methodology. Further, a random effects model was used to synthesis the pooled prevalence of stigmatization and violence in this study.

FINDINGS

We identified 14 studies involving 3452 doctors, 5738 nurses, and 2744 allied health workers that reported stigmatization and violence during the pandemic. The pooled prevalence was, for stigmatization, 43% (95% confidence interval [CI]: 21% to 65%) and, for violence, 42% (95% CI: 30% to 54%).

CONCLUSIONS

Stigmatization and violence during the COVID-19 pandemic were found to have affected almost half the studied healthcare workers. Healthcare professionals are more prone to be stigmatized by the community and to face workplace violence.

CLINICAL RELEVANCE

Health administrators and policymakers should anticipate and promptly address stigmatization and violence against and between healthcare workers, while controlling the spread of COVID-19. Health care systems should give serious attention to the mental health of all health providers.

Effects of telehealth interventions on performing activities of daily living and maintaining balance in stroke survivors: A systematic review and meta-analysis of randomised controlled studies

BACKGROUND

Stroke is one of the most common causes of disability worldwide. In recent years, diverse telehealth programmes for stroke survivors have suggested that this mode of rehabilitation could improve stroke survivors' abilities to perform activities of daily living (ADLs) and maintain balance. Although increasingly utilised in clinical and community settings, the effectiveness of telehealth interventions in stroke survivors remains inconclusive. This warrants investigation so that telehealth interventions are evidence-based and are not merely modalities of convenience.

AIM

To identify the effects of telehealth interventions on the ability to perform ADLs and maintain balance in stroke survivors.

DESIGN

A systematic literature review and meta-analysis were conducted in accordance with PRISMA guidelines.

METHODS

A systematic literature search was performed using seven databases for literature dated up to April 25, 2021. The revised Cochrane risk of bias tool for randomised trials was used to assess the methodological quality of the included studies. A meta-analysis was performed using a random-effects model to calculate the pooled effects of telehealth interventions. Stata 16.0 was used for the statistical analyses.

RESULTS

A total of 14 studies with 1,367 participants were included in the analysis. Overall, telehealth interventions were effective in improving stroke survivors' abilities to carry out their ADLs (standardised mean difference: .45; 95% confidence interval: .12 to .78); however, no significant effects were found on balance.

CONCLUSION

Telehealth interventions are beneficial for improving stroke survivors' performance of their ADLs. Future telehealth intervention trials should focus on identifying essential intervention delivery components that facilitate intervention adoption by clinicians and stroke survivors and sustain the positive effects on stroke survivors' performance of their ADLs in different settings.

RELEVANCE TO CLINICAL PRACTICE

It is essential to build flexibility in the telehealth-based intervention delivery protocol to meet individual stroke survivors' needs to motivate and enhance their ADL performance.