Undergraduate interprofessional education using high-fidelity paediatric simulation

BACKGROUND: High-fidelity simulation is becoming increasingly important in the delivery of teaching and learning to health care professionals within a safe environment. Its use in an interprofessional context and at undergraduate level has the potential to facilitate the learning of good communication and teamworking, in addition to clinical knowledge and skills.

METHODS: Interprofessional teaching and learning workshops using high-fidelity paediatric simulation were developed and delivered to undergraduate medical and nursing students at Queen's University Belfast. Learning outcomes common to both professions, and essential in the clinical management of sick children, included basic competencies, communication and teamworking skills. Quantitative and qualitative evaluation was undertaken using published questionnaires.

RESULTS: Quantitative results - the 32-item questionnaire was analysed for reliability using spss. Responses were positive for both groups of students across four domains - acquisition of knowledge and skills, communication and teamworking, professional identity and role awareness, and attitudes to shared learning. Qualitative results - thematic content analysis was used to analyse open-ended responses. Students from both groups commented that an interprofessional education (IPE) approach to paediatric simulation improved clinical and practice-based skills, and provided a safe learning environment. Students commented that there should be more interprofessional and simulation learning opportunities.

DISCUSSION: High-fidelity paediatric simulation, used in an interprofessional context, has the potential to meet the requirements of undergraduate medical and nursing curricula. Further research is needed into the long-term benefits for patient care, and its generalisability to other areas within health care teaching and learning.

Assessing the evidence: Student response system versus computer based testing for undertaking multiple choice question assessment in undergraduate nursing education

There is a dearth of evidence focusing on student preferences for computer-based testing versus
testing via student response systems for summative assessment in undergraduate education.
This quantitative study compared the preference and acceptability of computer-based testing
and a student response system for completing multiple choice questions in undergraduate
nursing education. After using both computer-based testing and a student response system to
complete multiple choice questions, 192 first year undergraduate nursing students rated their
preferences and attitudes towards using computer-based testing and a student response system.
Results indicated that seventy four percent felt the student response system was easy to use.
Fifty six percent felt the student response system took more time than the computer-based testing
to become familiar with. Sixty Percent felt computer-based testing was more users friendly.
Seventy Percent of students would prefer to take a multiple choice question summative exam
via computer-based testing, although Fifty percent would be happy to take using student response
system. Results are useful for undergraduate educators in relation to student’s preference
for using computer-based testing or student response system to undertake a summative
multiple choice question exam

Collective learning within nursing clinical groups /

This qualitative study examined collective learning within nursing clinical groups. Specifically, it explored the influence of the individual on the group and the impact of the group on the individual. The study was organized using the concepts from Debbie Kilgore's theory of collective learning (1999). The sample consisted of 1 8 second-year university nursing students and 3 clinical instructors. Data were collected via individual interviews with each participant and researcher's observations during a group conference. The interviews were tape-recorded, transcribed, and analyzed using key concepts from Kilgore's framework. Several interesting findings emerged. Overall, it appeared that individual components and group components contributed to the quality and quantity of collective learning that occurred in the groups. Individually, each person's past group experiences, personality, culture, and gender influenced how that individual acted in the group, their roles, and how much influence they had over group decisions. Moreover, the situation which seemed to cause the greatest sense of helplessness and loss of control was when one of their group members was breaking a norm. They were unable to deal with such situations constructively. Also, the amount of sense of worthiness (respect) and sense of agency (control) the member felt within the group had an impact on the person's role in group decisions. Finally, it seemed that students felt more connected with their peers within the clinical setting when they were close with them on a personal and social level. With respect to the group elements, it seemed that the instructors' values and way of being were instrumental in shaping the group's identity. In group 2, there were clear examples of group consciousness and the students' need to go along with the majority viewpoint, even when it was contrary to their own beliefs. Finally, the common goal of passing clinical and dealing with the fears of being in the clinical setting brought solidarity among the group members, and there seemed to be a high level of positive interdependence among them. From the discussion and analysis of the findings, recommendations were given on how to improve the learning within clinical groups.

Management decision-making in nursing

This study developed a new, valid and reliable evaluation instrument to measure the level, type and pattern of management decisions of fifteen nursing students. The management decision score achieved using this instrument was correlated with two psychological determinants of management decision making: creativity and problem-solving ability. The instrument was a written patient management problem in case format, answered by a free form written response. The student responses were classified for type of management decision according to the sub-categories of technical, inter-personal, environmental and unique. Using statistical analysis a significant difference was found in the type of management decisions most frequently selected by the study sample. The students predominantly selected technical type decisions. This preference for one type of management decision may be due to a number of psychological and environmental factors. These factors may program and mold the type of management decisions student nurses make early in their career. Low but positive correlations were found between the total management score and the two psychological tests. This finding supports the authors cited in the literature who state that although creativity augments the type of management decision making, it is not present or encouraged widely in the nursing profession. These factors are worth considering when the profession becomes concerned over ritualization and lack of individuality in patient care. The tool is easy to administer, lends itself to a variety of professional settings and shows promise with further refinement for computer application.

Análisis ecocardiográfico de la función sistólica del ventrículo izquierdo por médicos no cardiólogos con un dispositivo de bolsillo

Se realizó un estudio transversal, se incluyeron 3 residentes no cardiólogos y se les dio formación básica en ecocardiografía (horas teóricas 22, horas prácticas 65), con recomendaciones de la Sociedad Americana de Ecocardiografia y aportes del aprendizaje basado en problemas, con el desarrollo de competencia técnicas y diagnósticas necesarias, se realizó el análisis de concordancia entre residentes y ecocardiografistas expertos, se recolectaron 122 pacientes hospitalizados que cumplieran con los criterios de inclusión y exclusión, se les realizo un ecocardiograma convencional por el experto y una valoración ecocardiográfica por el residente, se evaluó la ventana acústica, contractilidad, función del ventrículo izquierdo y derrame pericárdico. La hipótesis planteada fue obtener una concordancia moderada. Resultados: Se analizó la concordancia entre observadores para la contractilidad miocárdica (Kappa: 0,57 p=0,000), función sistólica del ventrículo izquierdo (Kappa 0,54 p=0.000) siendo esta moderada por estar entre 0,40 – 0,60 y con una alta significancia estadística, para la calidad de la ventana acústica (Kappa: 0,22 p= 0.000) y presencia de derrame pericárdico (Kappa: 0,26 p= 0.000) se encontró una escasa concordancia ubicándose entre 0,20 – 0,40. Se estableció una sensibilidad de 90%, especificidad de 67%, un valor predictivo positivo de 80% y un valor predictivo negativo de 85% para el diagnóstico de disfunción sistólica del ventrículo izquierdo realizado por los residentes.

Facilitation of learning in specialist nursing training in the PICU : the supervisors´ concerns in the learning situation

With the aim to unfold nurses’ concerns of the supervision of the student in the clinical caring situation of the vulnerable child, clinical nurses situated supervision of postgraduate nursing students in the Pediatric Intensive Care Unit (PICU) are explored. A qualitative approach, interpretive phenomenology, with participant observations and narrative interviews, was used. Two qualitative variations of patterns of meaning for the nurses’ clinical facilitation were disclosed in this study. Learning by doing theme supports the students learning by doing through performing skills and embracing routines. The reflecting theme supports thinking and awareness of the situation. As the supervisor often serves as a role model for the student this might have an immediate impact on how the student applies nursing care in the beginning of his or her career. If the clinical supervisor narrows the perspective and hinders room for learning the student will bring less knowledge from the clinical education than expected, which might result in reduced nursing quality.

THE INTERNATIONAL CLASSIFICATION OF PUBLIC HEALTH NURSING PRACTICES - CIPESC (R): A PEDAGOGICAL TOOL FOR EPIDEMIOLOGICAL STUDIES

The CIPESC (R) is a tool that informs the work of nurses in Public Health and assists in prioritizing their care in practice, management and research. It is also a powerful pedagogical instrument for the qualification of nurses within the Brazilian healthcare system. In the teaching of infectious diseases, using the CIPESC (R) assists in analyzing the interventions by encouraging clinical and epidemiological thinking regarding the health-illness process. With the purpose in mind of developing resources for teaching undergraduate nursing students and encouraging reflection regarding the process of nursing work, this article presents an experimental application of CIPESC (R), using meningococcal meningitis as an example.

Global health competencies for nurses in the Americas

This article reports the findings from an online survey of nursing faculty from the United States, Canada, Latin America, and Caribbean countries to identify their perceptions about global health competencies for undergraduate nursing students. A list of global health competencies for medical students developed by the Association of Faculties of Medicine of Canada Resource Group on Global Health and the Global Health Education Consortium was adapted for nurses and translated from English to Spanish and Portuguese. The competencies were divided into six subscales, and respondents rated each competency on a 4-point Likert scale, with high scores reflecting strong agreement that the competency was essential for undergraduate nursing students. E-mail invitations and links to the online survey were distributed using a nonprobability convenience sampling strategy. This article reports findings only from the respondents to the English and Spanish surveys. The final sample included 542 responses to the English survey and 51 responses to the Spanish survey. Cronbach's alpha reliability coefficients for the subscales ranged from .78 to .96. The mean values for all 6 subscales and for each of the 30 items were greater than 3.0 for the respondents to the Spanish survey, and the mean values for 27 of the items were greater than 3.0 for the respondents to the English survey. These findings suggest that respondents perceived the competencies as essential global health competencies for undergraduate nursing students in the Americas. Narrative comments written by respondents indicate additional competencies and specific concerns about adding additional content to an already full curricula. Results of this study can be used to guide faculty deliberations about global health competencies that should be incorporated in the nursing curricula.

Optimizing the learning potential for the distance learning students

The distance learning programme has made its entrance into nursing education, and many see it as a break with the education’s traditions of teaching in the classroom, in practise rooms and at the patient’s bedside (Chaffin & Maddux 2004). Traditionally, many of the technical skills and personal qualities that nurses must acquire are learned through interaction with others. The distance learning programme has therefore given rise to some new problems and challenges, and this article discusses some of these. Empirically, the article builds on a comparative study of three student nurse classes from two Danish nursing schools, including one based on the distance learning programme. By following both distance learning and traditional nursing students in their clinical training, light is cast upon the differences and similarities that may exist in the clinical skills and competences that the students gain under the two programmes. Theoretically the article builds on Etienne Wengers theory on learning in communities of practice, focusing on the relationship between experience and competence in learning related communities of practice (Wenger 1998;Wenger 2004) . The article contributes with findings that are related to the differences between the programmes and the different types of students that each programme attracts. The article argues that an increased didactic and pedagogical focus upon the field of tension between experience and competence will enable an optimisation of the learning conditions of the distance learning students in their clinical teaching. The article, in conclusion, thus places focus on the questions surrounding teaching design in relation to the distance learning programme.

Evidence Based Nursing Research Project

Introduction: A need for baccalaureate prepared nurses to find and use evidence in practice exists. Whereas using this evidence in practice may be a masters level expectation, current practice demands that baccalaureate prepared nurses acquire a basic understanding of how to use evidence in practice. Nursing students at the senior level have had exposure to critiquing research, however, they have difficulty translating evidence to practice. [See PDF for complete abstract]

Interprofessional Education in Anatomy: Learning Together in Medical and Nursing Training

Teamwork and the interprofessional collaboration of all health professions are a guarantee of patient safety and highly qualified treatment in patient care. In the daily clinical routine, physicians and nurses must work together, but the education of the different health professions occurs separately in various places, mostly without interrelated contact. Such training abets mutual misunderstanding and cements professional protectionism, which is why interprofessional education can play an important role in dismantling such barriers to future cooperation. In this article, a pilot project in interprofessional education involving both medical and nursing students is presented, and the concept and the course of training are described in detail. The report illustrates how nursing topics and anatomy lectures can be combined for interprofessional learning in an early phase of training. Evaluation of the course showed that the students were highly satisfied with the collaborative training and believed interprofessional education (IPE) to be an important experience for their future profession and understanding of other health professionals. The results show that the IPE teaching concept, which combines anatomy and nursing topics, provides an optimal setting for learning together and helps nurses and doctors in training to gain knowledge about other health professionals’ roles, thus evolving mutual understanding.

An electronic record system in nursing education: evaluation and utilization

The main objective of the present work is to analyze the results of the utilization and evaluation of the LORETO Record System (LRS), providing improvement areas in the teaching-learning process and technology, in second year nursing students. A descriptive, prospective, cross sectional study using inferential statics has been carried out on all electronic records reported by 55 nursing students during clinical internships (April 1º-June 26º, 2013). Electronic record average rated 7.22 points (s=0.6; CV=0.083), with differences based on the clinical practice units (p<0,05). Three items assessed did not exceed the quality threshold set at 0.7 (p<0.05). Record Rate exceeds the quality threshold set at 80% for the overall sample, with differences based on the practice units. Only two clinical practice units rated above the minimum threshold (p <0.05). Record of care provision every 3 days did not reach the estimated quality threshold (p <0.05). There is a dichotomy between qualitative and quantitative results of LRS. Improvement areas in theoretical education have been identified. The LRS seems an appropriate learning and assessment tool, although the development of a new APP version and the application of principles of gamification should be explored.

Simulating Nursing: Rhetoric, Materiality, and Disciplinary Learning

Thesis (Ph.D.)--University of Washington, 2016-06

Achievement of generic baccalaureate student nurses using computer -assisted instruction simulations during a nursing review course

The use of computer assisted instruction (CAI) simulations as an instructional strategy provides nursing students with a critical thinking approach for evaluating risks and benefits and choosing correct alternatives in "safe" patient care situations. It was hypothesized that using CAI simulations during an upper level nursing review course would have a positive effect on the students' posttest scores. Subjects (n = 36) were senior nursing students enrolled in a nursing review course in an undergraduate baccalaureate program. A limitation of the study was the small sample size. The study employed a modified group experimental design using the t test for independent samples. The group who received the CAI simulations during the physiological system review demonstrated a significant increase (p $<$.01) in the posttest score mean when compared to the lecture-discussion group score mean. There was no significant difference between high and low clinical grade point average (GPA) students in the CAI and lecture-discussion groups and their score means on the posttest. However, score mean differences of the low clinical GPA students showed a greater increase for the CAI group than the lecture-discussion group. There was no significant difference between the groups in their system content subscore means on the exit examination completed three weeks later. It was concluded that CAI simulations are as effective as lecture-discussion in assisting upper level students to process information for clinical decision making. CAI simulations can be considered as an instructional strategy to supplement or replace lecture content during a review course, allowing more efficient use of faculty time. It is recommended that the study be repeated using a larger sample size. Further investigations are recommended in comparing the effectiveness of computer software formats and various instructional strategies for other learning situations and student populations. ^

The Importance of Work-Life Balance Opportunities and Support from the Perspective of Nursing Stu-dents in Dalarna, Sweden

There is a shortage of nurses leading to challenges in recruitment in Sweden and many other countries. Especially for less populated regions recruitment can be chal-lenging. Nurses often face difficulties with work-life balance (WLB). This study aims to identify the importance of WLB opportunities and support that make a work-place attractive from the perspective of nursing students studying in Dalarna. A questionnaire was distributed via email to 525 students enrolled in the nursing bach-elor program at Dalarna University. They were asked to rate the importance of 15 sub questions regarding WLB opportunities and support. These sub questions were asked in order to analyze the importance of 15 components regarding WLB oppor-tunities and support. 196 students (37 percent) answered the questionnaire. Three WLB components, working from home, childcare and rooms for breastfeeding, were found to be not important to nursing students studying in Dalarna. This was reason-able due to the profession of nursing and the WLB support provided by the Swedish government. Cultural factors, such as the organization being positive towards using WLB opportunities and support, were more important than structural factors, such as the possibility to work part-time. Moreover, to have a manager that is supportive towards using WLB opportunities and support was found to be the most important factor and having workplace practical support such as childcare was found least im-portant. Furthermore, contrary to the expected results, no statistical significance was found on the influence on the importance of all combined relevant WLB opportuni-ties and support by the sociodemographic variables; gender, semester of studies, age, having children, months of work experience and work experience in the healthcare sector. However, nine individual components were found to be influ-enced by one or more sociodemographic variables. Therefore, some recommenda-tions on how to target specific groups of individuals were made. However, the con-clusion of the study is that, regardless of the sociodemographic variables and gov-ernmental support, organizations should offer new nurses opportunities and support to gain a balance between work and life, especially in terms of cultural factors.