The Impact of a Simulated Clinical Experience on CEGEP Nursing Students’ Perceptions of Self-Efficacy and Achievement

Abstract : Providing high-quality clinical experiences to prepare students for the complexities of the current health-care system has become a challenge for nurse educators. Additionally, there are concerns that the current model of clinical practice is suboptimal. Consequently, nursing programs have explored the partial replacement of traditional in-hospital clinical experiences with a simulated clinical experience. Despite research demonstrating numerous benefits to students following participation in simulation activities, insufficient research conducted within Québec exists to convince the governing bodies (Ordre des infirmières et des infirmiers du Québec, OIIQ; Ministère de L’Éducation supérieur, de la Recherche, de la Science et de la Technologie) to fully embrace simulation as part of nurse training. The purpose of this study was to examine the use of a simulated clinical experience (SCE) as a viable, partial pedagogical substitute for traditional clinical experience by examining the effects of a SCE on CEGEP nursing students’ perceptions of self-efficacy (confidence), and their ability to achieve course objectives. The findings will contribute new information to the current body of research in simulation. The specific case of obstetrical practice was examined. Based on two sections of the Nursing III-Health and Illness (180-30K-AB) course, the sample was comprised of 65 students (thirty-one students from section 0001 and thirty-four students from section 0002) whose mean age was 24.8 years. With two sections of the course available, the opportunity for comparison was possible. A triangulation mixed method design was used. An adapted version of Ravert’s (2004) Nursing Skills for Evaluation tool was utilized to collect data regarding students’ perceptions of confidence related to the nursing skills required for care of mothers and their newborns. Students’ performance and achievement of course objectives was measured through an Objective Structured Clinical Examination (OSCE) consisting of three marked stations designed to test the theoretical and clinical aspects of course content. The OSCE was administered at the end of the semester following completion of the traditional clinical experience. Students’ qualitative comments on the post -test survey, along with journal entries served to support the quantitative scale evaluation. Two of the twelve days (15 hours) allocated for obstetrical clinical experience were replaced by a SCE (17%) over the course of the semester. Students participated in various simulation activities developed to address a range of cognitive, psychomotor and critical thinking skills. Scenarios incorporating the use of human patient simulators, and designed using the Jeffries Framework (2005), exposed students to the care of families and infants during the perinatal period to both reflect and build upon class and course content in achievement of course objectives and program competencies. Active participation in all simulation activities exposed students to Bandura’s four main sources of experience (mastery experiences, vicarious experiences, social persuasion, and physiologic/emotional responses) to enhance the development of students’ self-efficacy. Results of the pre-test and post-test summative scores revealed a statistically significant increase in student confidence in performing skills related to maternal and newborn care (p < .0001) following participation in the SCE. Confidence pre-test and post-test scores were not affected by the students’ section. Skills related to the care of the post-partum mother following vaginal or Caesarean section delivery showed the greatest change in confidence ratings. OSCE results showed a mean total class score (both sections) of 57.4 (70.0 %) with normal distribution. Mean scores were 56.5 (68.9%) for section 0001 and 58.3 (71.1%) for section 0002. Total scores were similar between sections (p =0.342) based on pairwise comparison. Analysis of OSCE scores as compared to students’ final course grade revealed similar distributions. Finally, qualitative analysis identified how students’ perceived the SCE. Students cited gains in knowledge, development of psychomotor skills and improved clinical judgement following participation in simulation activities. These were attributed to the « hands on » practice obtained from working in small groups, a safe and authentic learning environment and one in which students could make mistakes and correct errors as having the greatest impact on learning through simulation.

EXPLICIT WRITTEN CORRECTIVE FEEDBACK AND LANGUAGE APTITUDE IN SLA: IMPLICATIONS FOR IMPROVEMENT OF LINGUISTIC ACCURACY

Most second language researchers agree that there is a role for corrective feedback in second language writing classes. However, many unanswered questions remain concerning which linguistic features to target and the type and amount of feedback to offer. This study examined two new pieces of writing by 151 learners of English as a Second Language (ESL), in order to investigate the effect of direct and metalinguistic written feedback on errors with the simple past tense, the present perfect tense, dropped pronouns, and pronominal duplication. This inquiry also considered the extent to which learner differences in language-analytic ability (LAA), as measured by the LLAMA F, mediated the effects of these two types of explicit written corrective feedback. Learners in the feedback groups were provided with corrective feedback on two essays, after which learners in all three groups completed two additional writing tasks to determine whether or not the provision of corrective feedback led to greater gains in accuracy compared to no feedback. Both treatment groups, direct and metalinguistic, performed better than the comparison group on new pieces of writing immediately following the treatment sessions, yet direct feedback was more durable than metalinguistic feedback for one structure, the simple past tense. Participants with greater LAA proved more likely to achieve gains in the direct feedback group than in the metalinguistic group, whereas learners with lower LAA benefited more from metalinguistic feedback. Overall, the findings of the present study confirm the results of prior studies that have found a positive role for written corrective feedback in instructed second language acquisition.

Does the global reporting initiative influence sustainability disclosures in Asia-Pacific banks?

This article examines sustainability disclosures by the major banks in the Asia-Pacific region (the six largest banks from each of four countries: Australia, Japan, China and India) during the period 2005–2012. The findings show sustainability disclosures by banks that participate in the global reporting initiative (GRI) are significantly higher than disclosures by those banks that have not participated in the GRI. Amongst those banks that have participated in the GRI there is a higher rate of disclosure by externally assured banks than by non-externally assured banks. Among the GRI participating banks, there was significant variation of disclosures between countries. Disclosures by Australian banks appeared to be significantly higher than disclosures by banks in any other countries under observation. The findings are discussed from a moral legitimacy perspective. Consistent with this view, the banks under study were responsive to the GRI, which is seen as an influential actor that shapes and reflects the expectations of the broader community. However, the role of the GRI in minimising country differences in disclosure by banks is not significant.

The Little Con-ference 2015

The Little Con is an artist led initiative and dedicated to the performance of dance improvisation. The Little Con-ference is a conference linked to The Little Con (organised by Dianne Reid)

Working in mental health

In all health professions, students are required to spend a certain number of hours in a healthcare setting working within their discipline-specific profession.

Handover between anaesthetists and post anaesthetic care unit nursing staff using ISBAR principles: a quality improvement study

A structured approach to communication between health care professionals contains introduction/identification; situation; background; assessment and request/recommendation (ISBAR). ISBAR was introduced into the post-anaesthetic care unit (PACU) of a large Victorian health service in 2013. The aim of this study was to measure the effect of an education program on ISBAR compliance. 

Can simple mobile phone applications provide reliable counts of respiratory rates in sick infants and children? An initial evaluation of three new applications

BACKGROUND: Respiratory rate is an important sign that is commonly either not recorded or recorded incorrectly. Mobile phone ownership is increasing even in resource-poor settings. Phone applications may improve the accuracy and ease of counting of respiratory rates. OBJECTIVES: The study assessed the reliability and initial users' impressions of four mobile phone respiratory timer approaches, compared to a 60-second count by the same participants. METHODS: Three mobile applications (applying four different counting approaches plus a standard 60-second count) were created using the Java Mobile Edition and tested on Nokia C1-01 phones. Apart from the 60-second timer application, the others included a counter based on the time for ten breaths, and three based on the time interval between breaths ('Once-per-Breath', in which the user presses for each breath and the application calculates the rate after 10 or 20 breaths, or after 60s). Nursing and physiotherapy students used the applications to count respiratory rates in a set of brief video recordings of children with different respiratory illnesses. Limits of agreement (compared to the same participant's standard 60-second count), intra-class correlation coefficients and standard errors of measurement were calculated to compare the reliability of the four approaches, and a usability questionnaire was completed by the participants. RESULTS: There was considerable variation in the counts, with large components of the variation related to the participants and the videos, as well as the methods. None of the methods was entirely reliable, with no limits of agreement better than -10 to +9 breaths/min. Some of the methods were superior to the others, with ICCs from 0.24 to 0.92. By ICC the Once-per-Breath 60-second count and the Once-per-Breath 20-breath count were the most consistent, better even than the 60-second count by the participants. The 10-breath approaches performed least well. Users' initial impressions were positive, with little difference between the applications found. CONCLUSIONS: This study provides evidence that applications running on simple phones can be used to count respiratory rates in children. The Once-per-Breath methods are the most reliable, outperforming the 60-second count. For children with raised respiratory rates the 20-breath version of the Once-per-Breath method is faster, so it is a more suitable option where health workers are under time pressure.

The fine art of conversation: the pragmatic skills of school-aged children with hearing loss

This chapter synthesizes the findings of a number of recent studies conducted by the authors. The focus will be on spoken interactions between school-aged students who are deaf and hard of hearing, and their hearing peers. Many of the participants in these studies have worn hearing aids and/or cochlear implants since infancy and have been educated in inclusive settings. The context of these studies includes face-to-face interactions during a question/answer game, in free conversation, and during an expository task. This chapter will examine the verbal and nonverbal conversational skills 'of these students within these different contexts. Using a range of quantitative and qualitative analyses, the development of pragmatic skills in students with hearing loss will be documented, and possible implications for language support and the development of social skills will be discussed.

Représentations identitaires chez un homme ayant purgé une longue peine : aspects stables et mobiles

Nombre de recherches portent sur la question de l’abandon de la délinquance et du processus de désistance qui la précède. Bien que les angles d’approche soient diversifiés, elles s’entendent pour dire que ce processus implique des changements sociaux autant que personnels. Ce mémoire s’est intéressé à la question des changements identitaires chez des individus qui avaient été condamnés à une longue peine d’emprisonnement et qui ont obtenu leur libération conditionnelle totale. Le principal objectif de ce mémoire est de comprendre en quoi les aspects permanents de l’identité et ceux qui sont modifiables sont à l’œuvre dans la trajectoire de changement d’un homme condamné à perpétuité pour meurtre et qui a obtenu sa libération conditionnelle totale. La méthode qualitative qu’est le récit de vie, et selon une perspective phénoménologique, a été utilisée afin d’atteindre les objectifs de cette recherche. Un homme condamné à une sentence de prison à vie, mais ayant obtenu sa libération totale a été rencontré en dix entretiens en profondeur d’une durée d’une heure à une heure et demie. Nous avons choisi de procéder à un nombre élevé d’entretiens de type semi-directifs afin de permettre l’approfondissement des propos de l’individu rencontré. Les résultats suggèrent que certaines représentations de l’identité restent stables dans le temps alors que d’autres se transforment au fil de la trajectoire de vie. En effet, de l’analyse du récit de vie de l’individu se dégagent deux représentations stables, qui marquent durablement l’identité de ce dernier dans sa trajectoire de vie, et quatre modifiables, qui se sont développées au cours de sa détention. Les résultats montrent aussi que les représentations stables semblent intervenir autant dans le processus criminogène que dans celui de la désistance.