Pediatric and Adolescent Gynecology Experience in OBGYN Residency Training across the United States.

STUDY OBJECTIVE: The purpose of this study is to better understand the pediatric and adolescent gynecology (PAG) experience from the obstetrics and gynecology (OBGYN) resident perspective and its impact on physician comfort with caring for younger patients. METHODS: This is a cross-sectional survey study of physicians enrolled in OBGYN residency programs in the United States. For each program, an internet search was also performed to identify the closest PAG providers. Chi-square and Fisher's exact tests were performed to compare categorical variables. This study was IRB approved. RESULTS: 74 resident responses from 42 unique OBGYN training programs were included. The majority (62%) of programs offered no PAG clinical experience. Of programs with no PAG clinical experience, 45% had unaffiliated self-identified PAG providers within 30 miles of their institution. Only 26% of residents reported having a dedicated PAG rotation. 68% of residents felt they did not have enough PAG exposure in training. Residents who had a dedicated PAG rotation were more comfortable caring for patients <7 years old (p=0.016) and patients 8-14 years old (p=0.019) than residents without a rotation. The majority (88%) of residents believe that PAG experience will be useful for their future practice. CONCLUSION: Residents with PAG training are more comfortable in caring for patients <14 years than those in programs who lack this training. Residencies without PAG-trained staff physicians could consider partnering with PAG-practicing community physicians with the aim of broadening clinical experience. Improvement in PAG education helps provide graduating obstetrician-gynecologists with the necessary knowledge to provide needed care to younger patients.

Impact of the use of a drug-drug interaction checker on pharmacist interventions involving well-known strong interactors.

OBJECTIVES: Several drug-drug interaction (DDI) checkers such as DDI-Predictor have been developed to detect and grade DDIs. DDI-Predictor gives an estimate of the magnitude of an interaction based on the ratio of areas under the curve. The objective of the present study was to analyse the frequencies of DDIs involving well-known strong interactors such as rifampicin and selective serotonin reuptake inhibitors (SSRIs), as reported by a clinical pharmacy team using DDI-Predictor, and the pharmacist intervention acceptance rate. METHODS: The pharmacist intervention rate and the physician acceptance rate were calculated for DDIs involving rifampicin or the SSRIs fluoxetine, paroxetine, duloxetine and sertraline. The rates were compared with a bilateral χ2 test or Fisher's exact test. RESULTS: Of the 284 DDIs recorded, 38 (13.4%) involved rifampicin and 78 (27.5%) involved SSRIs. The pharmacist intervention rate differed significantly (68.4% for rifampicin vs 48.8% for SSRIs; p=0.045) but the physician acceptance rate did not (84.6% for rifampicin vs 81.6% for SSRIs; p=1). Pharmaceutical interventions for SSRIs were more frequent when the ratio of the area under the drug concentration versus time curve in DDI-Predictor was >2. Pharmacists were more likely to issue a pharmacist intervention for DDIs involving rifampicin because of a high perceived risk of treatment failure and were less likely to issue a pharmacist intervention for DDIs involving an SSRI, except when the suspected interaction was strong. CONCLUSIONS: DDI checkers can help pharmacists to manage DDIs involving strong interactors. DDIs involving strong inhibitors versus a strong inducer differ with regard to their intervention and acceptance rates, notably due to the estimation of the magnitude of the DDI.

Registered Nurses' Knowledge of Intravenous Fluid Therapy at a Teaching Hospital in Namibia: A Cross-Sectional Survey.

Introduction: Insufficient knowledge of intravenous fluid therapy is a significant challenge contributing to morbidity and mortality in hospitalized patients. Nurses play a critical role in evaluating patients' fluid and electrolyte balance as well as in restoring fluid levels. Various studies have indicated a deficiency in nurses' knowledge of intravenous therapy, yet this remains understudied in many settings, including Namibia. Objectives: To assess nurses' knowledge of intravenous fluid therapy and to describe the variables associated with knowledge of intravenous fluid therapy at a teaching hospital in Namibia. Methods: A cross-sectional online survey involving 164 nurses who were recruited using total population sampling. Data were collected between September and November 2021, using a self-administered 14-item validated tool (α = 0.8). Data analysis was conducted using SPSSv28.0 software. Results: The majority of nurses (84%) in this study exhibited an insufficient level of knowledge regarding intravenous therapy, with only a minority (16%) demonstrating a moderately adequate understanding of intravenous fluid therapy. A significant positive correlation was found between educational qualification and knowledge of intravenous therapy (r = 0.21; p = .01). Conclusion: The study's results indicate a worrying trajectory in nurses' knowledge of intravenous therapy. These findings underscore the need for hospitals to establish comprehensive training programs for nurses to guarantee the provision of secure and efficient intravenous therapy. Additional research is needed to investigate how educational qualifications impact patient outcomes related to intravenous therapy.

Lesbian, gay, bisexual, and transgender clinical competence of physiotherapy students in Israel.

BACKGROUND: Clinical competence encompasses attitudes, skills, and knowledge regarding diverse client groups. Appropriate clinical competence requires an understanding of the cultural context in which healthcare is delivered. In conservative countries such as Israel, there is a noticeable scarcity of information regarding the clinical competency of physiotherapy students (PTSs) in effectively treating lesbian, gay, bisexual and transgender (LGBT) individuals. The objective of this study was to assess the level of LGBT clinical competence among PTSs in Israel. METHODS: Conducted through an anonymous online self-report survey, this study gathered personal and academic background information and self-reported data on previous LGBT education during undergraduate studies of PTSs. It utilized the Hebrew version of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS) questionnaire. Descriptive statistics were computed for all outcome measures. The internal reliability of the LGBT-DOCSS was assessed. Total scores of the LGBT-DOCSS, along with scores in each of the three subscales (clinical preparedness, knowledge, and attitudes), were compared across different levels of religiosity and gender. RESULTS: The sample comprised of 251 PTSs, with an average age of 25.57 ± 3.07 years (34.7% men, 65.3% women). All students reported a lack of LGBT community-related courses during their undergraduate studies. The translated Hebrew version demonstrated good internal consistency, with Cronbach's alpha ranging from 0.65 to 0.83. The LGBT-DOCSS total score was 4.55 ± 0.61 out of 7, indicating a low level of clinical competency. The highest mean score was in the attitudes subscale (6.55 ± 0.87), which was significantly higher than the scores for the knowledge subscale (3.14 ± 1.46) and clinical preparedness subscale (3.36 ± 0.86). Religiousness was significantly associated with clinical preparedness and attitudes. Men exhibited higher self-reported levels of knowledge and clinical preparedness, albeit with more negative attitudes compare to women. Sexual orientation was significantly associated with clinical competency, with PTSs who identified as heterosexual demonstrating a lower level of clinical competency compared to participants who identified as non-heterosexual. CONCLUSIONS: In Israel, PTSs demonstrated a low level of clinical competency in terms of self-reported knowledge and self-reported clinical preparedness but contrasting positive attitudes toward the LGBT community. Religiousness, gender and sexual orientation had a significant influence on competency levels.These preliminary findings highlight the urgent necessity to enhance the knowledge of PTSs regarding the LGBT community to improve their clinical competence. TRIAL REGISTRATION NR: Not applicable.

A dimensional analysis of experienced intensive care unit nurses' clinical decision-making for bleeding after cardiac surgery.

BACKGROUND: Bleeding following cardiac surgery is common and serious, yet a gap persists in understanding how experienced intensive care nurses identify and respond to such complications. AIM: To describe the clinical decision-making of experienced intensive care unit nurses in addressing bleeding after cardiac surgery. STUDY DESIGN: This qualitative study adopted the Recognition-Primed Decision Model as its theoretical framework. Thirty-nine experienced nurses from four adult intensive care units participated in semi-structured interviews based on the critical decision method. The interviews explored their clinical judgements and decisions in bleeding situations, and data were analysed through dimensional analysis, an alternative to grounded theory. RESULTS: Participants maintained consistent vigilance towards post-cardiac surgery bleeding, recognizing it through a haemorrhagic dimension associated with blood loss and chest drainage and a hypovolemic dimension focusing on the repercussions of reduced blood volume. These dimensions organized their understanding of bleeding types (i.e., normal, medical, surgical, tamponade) and necessary actions. Their decision-making encompassed monitoring bleeding, identifying the cause, stopping the bleeding, stabilizing haemodynamic and supporting the patient and family. Participants also adapted their actions to specific circumstances, including local practices, professional autonomy, interprofessional dynamics and resource availability. CONCLUSIONS: Nurses' decision-making was shaped by their personal attributes, the patient's condition and contextual circumstances, underscoring their expertise and pivotal role in anticipating actions and adapting to diverse conditions. The concept of actionability emerged as the central dimension explaining their decision-making, defined as the capability to implement actions towards specific goals within the possibilities and constraints of a situation. RELEVANCE TO CLINICAL PRACTICE: This study underscores the need for continual updates to care protocols to align with current evidence and for quality improvement initiatives to close existing practice gaps. Exploring the concept of actionability further, developing adaptability-focused educational programmes, and understanding decision-making intricacies are crucial for informing nursing education and decision-support systems.

Integrating mixed reality preparation into acute coronary syndrome simulation for nursing students: a single-group pretest-posttest study.

BACKGROUND: Timely and effective intervention within the 'golden hour'-the critical first 90 min after the symptom onset-is crucial for initiating life-saving treatment and reducing mortality in acute coronary syndrome (ACS). This highlights the need for nursing students to be proficient in ACS care, emphasizing the importance of preparatory training. This study enhanced traditional simulation methods by integrating a mixed reality (MR) preparation step, offering a more immersive learning experience. We aimed to evaluate the effectiveness of integrating MR preparation into ACS simulation education, focusing on enhancements in knowledge, self-confidence in learning, and self-efficacy in learning. Additionally, we examined performance, practice immersion, and satisfaction to comprehensively evaluate the MR application. METHODS: One-group pretest-posttest design was implemented in a convenience sample of thirty-nine senior nursing students from a university in South Korea in August 2022. We developed a simulation program integrating MR preparation into ACS simulation (IMRP-ACSS), which was validated through expert review for content validity. The students participated in the simulation program over six hours across two days, including a 40-minute individual session of MR-based simulation preparation using head-mounted displays (the HoloLens 2). Individual changes in knowledge, self-confidence in learning, and self-efficacy in learning evaluated by the survey were analyzed using paired t-tests. Additionally, group performance assessed using the checklist was analyzed. Immersion and satisfaction were measured with a tool and a 10-point Likert scale, respectively. RESULTS: Individually, participants demonstrated significantly increased knowledge (t = 11.87, p < .001), self-confidence in learning (t = 7.17, p < .001), and self-efficacy in learning (t = 4.70, p < .001) post-education. Group performance yielded a mean score of 56.43/70 ± 7.45. Groups scored higher in electrocardiogram interpretation, patient safety, and heparin administration. Participants reported a practice immersion level of 37.82/50 ± 9.13 and expressed satisfaction with the program, achieving an average score of 8.85/10 ± 1.35. CONCLUSION: Integrating MR preparation into ACS simulation enhanced nursing students' knowledge, self-confidence in learning, and self-efficacy in ACS care, providing a replicable and immersive learning experience. This method is an effective addition to nursing education, preparing students through comprehensive, technology-enhanced training.

An Observational Cross-Sectional Analysis of the Correlation between Clinical Competencies and Clinical Reasoning among Italian Registered Nurses.

Ability, knowledge, aptitude, and skill are the terms identified in the literature as the attributes of the concept of clinical competence. This implies that in order to act competently in their own context, the nurse must be able to make decisions which mainly depend on the ability to put clinical reasoning into practice. However, the evaluation of clinical reasoning in the various clinical-care activities of nursing competence is a necessary operation to prevent routine attitudes. From the perspective of an assessment of nursing competences, the aim of this study is to validate the relationship between the degree of competence recognized in a specific clinical setting and the amount of clinical reasoning executed by nurses. The study design was a cross-sectional observational design, following the guidelines of the Strengthening Reporting of Observational Studies in Epidemiology (STROBE) of observational studies. Both the Italian Nurse Competence Scale and the Nurse Clinical Reasoning Scale were used. The data was collected between 25 January and 5 March 2022. Four hundred twenty-four clinical nurses participated by completing and returning the questionnaires. The instruments underwent assessment to ensure internal consistency and test-retest reliability. Their validity was tested with the validity of known content, construct, and groups. This is supported by statistically significant correlations between the different variables examined and the scores of the different dimensions of the Italian Nurse Competence Scale and the Italian Nurse Clinical Reasoning Scale. The data collected showed an excellent average level of competencies and clinical reasoning, M = range of 72.24 and 63.93, respectively. In addition, we observed satisfactory scores across all dimensions of I-NCS (significance range: 0.000-0.014) and I-NCRS (significance range: 0.000-0.004). The understanding and development of clinical reasoning has also brought out new aspects that require further research. This study provides a fresh perspective on the correlation between clinical competences and clinical reasoning, representing a novel attempt to analyze their relationship.

Training students to serve as standardized patients in an objective structured clinical examination is feasible: A mixed-methods study.

AIM: This study aimed to evaluate examinees' perceptions of the performance of student standardized patients (SPs) and to explore student SPs' experiences. BACKGROUND: Objective structured clinical examination (OSCE) is a standard approach to the task of evaluating students' clinical competency that relies on SPs. However, professional SPs are characterized by high costs and insufficient availability. Training students to serve as SPs can help address this lack of OSCE resources. However, only preliminary evidence regarding this process and its feasibility has been reported. DESIGN: We used a concurrent mixed-method study design that included quantitative surveys and qualitative group interviews. METHODS: Our sample consisted of two-year Bachelor of Nursing program students and trained student SPs who were recruited in May 2021. We used a 5-item performance evaluation tool to assess the SPs' performance. The reliability of this evaluation tool was indicated by a Cronbach's α coefficient of.95. Descriptive statistics were used to assess the examinees' satisfaction with the student SPs' performance using SPSS 28.0 software. We used a semi-structured interview guide during a group interview; the interview was transcribed verbatim and analyzed via thematic analysis with the assistance of Microsoft Word software. RESULTS: Eighty-two nursing school students responded to the survey and 10 student SPs were included in a group interview. Nursing school students rated SPs' performance favorably. The mean score assigned to the SPs on the performance scale was 4.41 out of 5. The student SPs described the challenges and benefits that they experienced regarding their role. The challenges they described included 1) staying true to my role, 2) overcoming a physically overwhelming role and 3) facing the threat of insecurity. However, the corresponding benefits included 1) gaining rewards, 2) advancing nursing competency and 3) experiencing a sense of accomplishment. CONCLUSION: After undergoing training, the SPs performed well. They experienced a variety of challenges and obtained certain benefits. In health care education, recruiting students to serve as SPs is feasible.

Anesthesia for Patients With the Centrifugal-Flow Left Ventricular Assist Devices: A Content Validity Assessment.

Safely anesthetizing patients with left ventricular assist devices (LVADs) can be intimidating, particularly for novice anesthesia providers. Given the variety of complex issues anesthesia providers may encounter with patients, it would be impractical to expect expertise in every population. To combat the inevitable loss of knowledge, education experts recommend active learning techniques, including test-enhanced learning, active recall, and spaced repetition. To that end, this research team created an LVAD Assessment for Anesthesia, or LAmA tool, to be evaluated for content validity by eight experts. The LAmA tool and content validity assessment were distributed to two anesthesiologists and four nurse anesthetists in the cardiothoracic anesthesia department at a hospital in Northeast Ohio, as well as to two outside nursing research experts. Results were analyzed by the research team and the content validity index (CVI) was determined. A CVI of at least 0.875 was required for the tool to be valid, and final scores in the categories of relevance, clarity, and importance were all ≥ 0.9. The data from the validated tool were used to create a pocket reference on LVAD anesthetic management. Both educational assessments and pocket references have the potential to positively impact knowledge retention and patient outcomes, making them excellent clinical resources.

Faculty standardized patients versus traditional teaching method to improve clinical competence among traditional Chinese medicine students: a prospective randomized controlled trial.

BACKGROUND: Standardized patients (SPs) simulation training models have been widely used in various fields, the study of using SPs in Traditional Chinese medicine (TCM) is still a new filed. Previous studies have demonstrated the effectiveness of occupational SP for TCM (OSP-TCM), which has an increasingly problem of high time and financial costs. The faculty SPs for TCM (FSP-TCM) simulation training model may provide a better alternative. This study aims to test and determine whether FSP-TCM simulations are more cost-effective than OSP-TCM and traditional educational models to improve the clinical competence of TCM students. METHODS: This study was a single-blind, prospective, randomized controlled trial conducted between February 2023 and October 2023. The participants were randomized into FSP-TCM group, OSP-TCM group and traditionally taught group (TT group) in the ratio of 1:1:1. The duration of this training program was 12 weeks (36 credit hours). Formative and summative assessments were integrated to evaluate the effectiveness of teaching and learning. Three distinct questionnaires were utilized to collect feedback from students, SPs, and teachers at the conclusion of the course. Additionally, analysis of cost comparisons between OSP-TCM and FSP-TCM were performed in the study. RESULTS: The study comprised a total of 90 students, with no dropouts during the research. In the formative evaluation, students assigned to both the FSP-TCM and OSP-TCM groups demonstrated higher overall scores compared to those in the TT group. Notably, their performance in "physical examination" (Pa = 0.01, Pb = 0.04, Pc = 0.93) and "comprehensive ability" (Pa = 0.01, Pb = 0.006, Pc = 0.96) significantly exceeded that of the TT group. In the summary evaluation, both SP-TCM groups students outperforms TT group in the online systematic knowledge test (Pa = 0.019, Pb = 0.04, Pc = 0.97), the application of TCM technology (Pa = 0.01, Pb = 0.03, Pc = 0.93) and real-time assessment (Pa= 0.003, Pb = 0.01, Pc = 0.93). The feedback questionnaire demonstrated that both SP-TCM groups showed higher levels of agreement for this course in "satisfaction with the course" (Pa = 0.03; Pb = 0.02) and "enhanced TCM clinical skills" (Pa = 0.02; Pb = 0.03) than TT group. The SP questionnaire showed that more FSPs than OSPs in "provided professional feedback" (FSPs: strongly agree 30%, agree 50% vs. OSPs: strongly agree 20%, agree 40%. P = 0.69), and in "gave hints" during the course (FSPs: strongly agree 10%, agree 30% vs. OSPs: strongly agree 0%, agree 10%. P = 0.42). It is noteworthy that FSP-TCM was significantly lower than the OSP-TCM in overall expense (FSP-TCM $7590.00 vs. OSP-TCM $17415.60), and teachers have a positive attitude towards the FSP-TCM. CONCLUSION: FSP-TCM training mode showed greater effectiveness than traditional teaching method in improving clinical competence among TCM students. It was feasible, practical, and cost-effective, and may serve as an alternative method to OSP-TCM simulation.

Insights from a multi-country study: Lessons for future nursing education from community clinical practice amid the COVID-19 pandemic.

Background: The COVID-19 pandemic prompted adjustments in education, raising concerns about students' competency achievement. Despite these changes, aspects like student engagement (SE), basic needs fulfillment (BNF), and stress levels (SL) in nursing students during community-based clinical practice remain understudied. Objectives: This study aims to examine the relationships between students' competencies achievement (SCA), student engagement, basic needs fulfillment, and stress levels among nursing students engaging in community-based clinical practice during the COVID-19 pandemic. Design: and Methods: A cross-sectional online survey was conducted with 451 nursing students from Indonesia, Malaysia, and India. Online questionnaires assessing SCA, SE, BNF, and SL were administered between November and December 2021. Results: The study involved 131 participants from Indonesia, 138 from Malaysia, and 182 from India, with an average age of 22.52. Multivariate analysis, employing linear regression revealed that across the three countries, online student engagement demonstrated the strongest association with SCA (B: 0.701; p-value: 0.0001). However, specific factors-stress levels, learning methods, and study year-showed greater relevance in Indonesia, India, and Malaysia, respectively. Conclusions: The COVID-19 pandemic significantly impacted nursing students' teaching and learning experiences during clinical practice. Enhancing online engagement between academic lecturers and students is imperative for attaining clinical competencies.

Enriching nursing knowledge and practice in Jordanian government hospitals through basic life support simulation training: A randomized controlled trial.

Background: Healthcare providers must possess the necessary knowledge and skills to perform effective cardiopulmonary resuscitation (CPR). In the event of cardiopulmonary arrest, basic life support (BLS) is the initial step in the life-saving process before the advanced CPR team arrives. BLS simulation training using manikins has become an essential teaching methodology in nursing education, enhancing newly employed nurses' knowledge and skills and empowering them to provide adequate resuscitation. Objective: This study aimed to evaluate the potential effect of BLS simulation training on knowledge and practice scores among newly employed nurses in Jordanian government hospitals. Methods: A total of 102 newly employed nurses were randomly assigned to two groups: the control group (n = 51) received standard training, and the experimental group (n = 51) received one full day of BLS simulation training. The training program used the American Heart Association (AHA)-BLS-2020 guidelines and integrated theoretical models such as Miller's Pyramid and Kolb's Cycle. Both groups were homogeneous in inclusion characteristics and pretest results. Knowledge and practice scores were assessed using 23 multiple-choice questions (MCQs). Data were analyzed using one-way repeated measures ANOVA. Results: The results indicated significant differences in knowledge scores, F(2, 182) = 58.514, p <0.001, and practice scores, F(2, 182) = 20.134, p <0.001, between the control and experimental groups at all measurement times: pretest, posttest 1, and posttest 2. Moreover, Cohen's d reflected the effectiveness of BLS simulation training as an educational module, showing a large effect (Cohen's d = 1.568) on participants' knowledge levels and a medium effect (Cohen's d = 0.749) on participants' practice levels. Conclusion: The study concludes that BLS simulation training using the AHA-BLS-2020 guidelines and integrating theoretical models such as Miller's Pyramid and Kolb's Cycle significantly improves knowledge and practice scores among newly employed nurses, proving highly effective in enhancing their competencies in performing CPR. Implementing BLS simulation training in nursing education programs can significantly elevate the proficiency of newly employed nurses, ultimately improving patient outcomes during cardiopulmonary arrest situations. This training approach should be integrated into standard nursing curricula to ensure nurses are well-prepared for real-life emergencies. Trial Registry Number: NCT06001879.

A novel experiential work-based learning model in paediatric secondary care using entrustable professional activities to develop clinical knowledge and communication skills.

BACKGROUND: Initial education and training standards for pharmacists in Great Britain require early clinical exposure to patients using experiential work-based learning. However, there is poor evidence of this approach in some settings, such as paediatric care. The aim of this study was therefore to explore a novel model of experiential work-based learning for student pharmacists in a paediatric setting. METHODS: Fourth-year student pharmacists enrolled on a Master of Pharmacy programme were allocated five three-hour placement sessions at a paediatric hospital. Sessions consisted of a briefing, ward activities, scaffolded consultations with children and their carers, followed by a debriefing session with a clinical supervisor. Data were collected relating to the ward, patient details, student reported activities, learning outcomes and if follow up was required by a member of the clinical team. Data were cleaned, quality checked, then descriptive statistical analysis and inductive content analysis were conducted. MAIN FINDINGS: Seventy-four students took part in 28 individual sessions and 233 consultations were recorded. Consultations included a best-possible medical history (76%, n = 177), a satisfactory drug history (45%, n = 104), or discussed hospital discharge (11%, n = 26). Students were exposed to patients with diagnosed acute conditions (41%, n = 96) and chronic conditions (33%, n = 76), as well as children awaiting diagnosis (13%, n = 30). Students reported learning about the pathology, diagnosis and symptoms of paediatric conditions (48%, n = 81), medicines used in children (24%, n = 41), patient experiences of recieving care (15%, n = 25), carer experiences (2%, n = 3), the hospital environment (2%, n = 4), career progression (2%, n = 4), and experiences of social care (11%, n = 18). Findings were synthesised with existing entrustable professional activities from the literature to generate novel EPAs specific to paediatric settings. CONCLUSIONS: A paediatric setting offers a suitable environment to host experiential work-based learning in pharmacy education. Standards of initial education and training which require pharmacists to prescribe in Great Britain must recognise the importance of exposure to the health needs and experiences of children, young people's and carers prior to graduation.

Development and validation of a new satisfaction scale for objective structured clinical assessments (S-OSCA): A multicenter cross-sectional study.

BACKGROUND: Nursing clinical competence assessment has acquired a special relevance at the undergraduate and postgraduate levels in recent years. In this context, the Objective Structured Clinical Assessment (OSCA) has emerged as a valid and feasible method of assessing nursing competence. The Satisfaction with Nursing Skill Examination: Objective Structured Clinical Assessment (SINE-OSCA) scale is a valid and reliable 10-item measure that has been developed to evaluate nursing students' satisfaction with the OSCA in the Australian context. Given the importance that OSCA has gained in Spain, it is necessary to validate this tool to be used in one of the most spoken languages in the world. OBJECTIVES: The purpose of the study was to carry out a modification of the SINE-OSCA, cross-cultural adaptation and a psychometric analysis of the new S-OSCA with Spanish nursing students. DESIGN: A multicenter study of questionnaire development and validation was carried out in 2023 in four Spanish university nursing centers. The study was carried out in 3 phases: design, pilot implementation, and construct validation. PARTICIPANTS/SETTING: The total population of students from these centers amounted to 1350 students. The final sample consisted of 364 nursing students, selected by convenience sampling. METHODS: The process of translation and cultural adaptation of SINE-OSCA to the Spanish population was carried out following the guidelines proposed by Beaton et al. Content validation, Internal consistency and temporal reliability were evaluated. RESULTS: The S-OSCA presents values in the psychometric indicators (V AIKEN, Bland-Altman diagram, and IVC Lawshe) that exceed the cut-off values established even considering the lower limit of the confidence intervals. This spanish version of the SINE-OSCA has a Cronbach's alpha value that is slightly higher than that reported for that original version (0.928 CI 95 % (0.913-0.94)). Regarding temporal reliability, the S-OSCA scale was completed in 40 nursing students at two times separated by an interval of 15 days. The Intraclass Correlation Coefficient (ICC) obtained was 0.974 CI 95 % (0.952-0.986). CONCLUSIONS: The S-OSCA instrument proves to be robust enough to guarantee the quality of its results up to 15 days post-OSCA.

Factors to Effective Clinical Experience, Willingness to pursue Career in Rural Health Facilities among Nursing Students on Clinical Placement in Southeast Nigeria and Rural Development.

Objective: To describe the Factors to Effective Clinical Experience and Willingness to pursue Career in Rural Health Facilities among Nursing Students on Clinical Placement in southeast Nigeria. Methods: The study was conducted among 48 rural health centres and general hospitals with 528 respondents from different higher institutions of learning serving in these health facilities for their clinical experience. The study applied survey design and utilized questionnaire instrument for data collection. Results: Majority of the students (60%) agreed that their school lacked functional practical demonstration laboratory for students' clinical practice, 66.7% agreed that their school lab lacked large space for all the students to observe what is being taught, 79.9% that their school lab lacked enough equipment that can enable many students to practice procedures; majority of the students (79.9%) answered that the hospitals where they are on clinical placement lacked enough equipment needed for the students on each shift of practice, 59.9% agreed that student/client ratio in each ward during clinical experience periods was not enough for students' practice under supervision, while 73.3% indicated that their school lacked library with current nursing texts for references. Personal, socioeconomic and institutional factors explain the 76% of the variance of effective clinical experience and the 52% of the variance of the willingness to work in rural health facilities in the future if offered employment. Conclusion: The factors surrounding effective clinical experience in rural healthcare facilities in southeastern Nigeria are unfavorable and could discourage future nurses from working there. It is necessary to implement strategies to improve the management of these centers in order to promote the perspective of improving sustainable rural health in this region.

Advancement in knowledge and skills of nursing students in operation theatre procedures with mobile based learning.

Objective: To evaluate the effectiveness of mobile -based learning (MBL) in improving nursing students' knowledge and skills when performing procedures in the operating room. Methods: A quasi-experimental study with control group, pre- and post-intervention assessment was conducted. A total of 128 nursing students from India were recruited by purposive sampling and randomly assigned to the intervention (use of a telephone application containing videos on hand washing, surgical gown donning, gloving, and assisting during intubation) and conventional education groups. A validated Structured Knowledge Questionnaire and an Objective Structured Clinical Examination (OSCE) scale was used to assess nursing students' competencies in relation to operating room procedures and a mobile-based learning satisfaction opinion questionnaire was administered. Results: The findings showed that the improvement in the mean knowledge and skills score was greater in the intervention group than in the control group (p<0.001). The administration of the MBL was rated as highly satisfactory by 93.8% of the students exposed to this learning method. Conclusion: The MBL intervention was effective in improving nursing students' knowledge and skills in the evaluated operating room procedures.

Learning and achieving basic mental health competence in placement studies with the support of a tool: A qualitative study of student nurses' experiences.

Background: Learning basic mental health care competence is often challenging for the bachelor of science student nurses, and many lack basic mental health care competence to ensure safe and confident mental health care practice. Mental health assessment is an integrated part of this competence. Objective: The objective of this study was to explore and describe in depth how student nurses experience learning and achieving basic mental health competence while on mental health placement with the support of a learning tool. Design: An explorative and descriptive qualitative design was conducted to gain insight on how student nurses experienced learning basic mental health competence when on placement. Setting: A diversity of mental health placement settings in which student nurses were involved with patient care or welfare were approached; general psychiatric wards (n = 2), psychiatric ward for elderly people (n = 1), community mental health in-patient facilities (n = 2) and unconventional placements in the community (n = 9). Unconventional placements are a diversity of non-clinical service contexts. Participants: The participants comprised student nurses in their 3rd and final year while on mental health placement. Potential participants received information from course coordinators, the online learning platform, and from teachers in plenary. Using purposive sampling, 14 student nurses were recruited. Methods: Individual semi-structured interviews were conducted online and in person at two campuses of one university in Norway between August 2020 and December 2021. The interviews were transcribed and thematically analysed as described by Braun and Clarke. Results: Students expressed insecurity in a new clinical context. They engaged in new learning situations and realized the diversity of nursing practice. Unconventional placements were described as challenging contexts for learning basic mental health care competence. Conclusions: This qualitative study provided insight into how student nurses experience learning mental health assessment, and gaining relational, communicative, and ethical competence while on placement. Students revealed their insecurities and challenges in learning in a new context. Awareness of clinical learning opportunities on placement when preparing student nurses to learn basic mental health competence may help improve their confidence.