A simulation educational intervention to enhance preclinical family nurse practitioner student preparation.

ABSTRACT: Simulation has been shown to improve communication and psychometric skills in advanced practice nursing students. Little is known about the impact of a simulation educational intervention with a faculty-facilitated debriefing on the preparation of novice nurse practitioner students for their first clinical practicum. This article describes the development of an educational intervention to accomplish this. The simulation education intervention was implemented with preclinical nurse practitioner students designed to improve their preparation for their first precepted clinical experience. Students were surveyed preintervention and postintervention to explore their self-perception of confidence and preparation for clinicals looking at six domains: health history, physical examination, diagnostics, differentials, final diagnosis, and plan of care. Quantitative results were statistically significant for each domain. Qualitative findings gave deeper insight into the students' perceptions of how the intervention prepared them for clinicals. Advanced practice educators can use educational interventions such as this to prepare students for their first clinical practicums.

Doctor of Nursing Practice-prepared academics: Promotion and tenure-eligible?

ABSTRACT: Since the Doctor of Nursing Practice (DNP) was implemented, there has been ongoing discussion about whether or not DNP-prepared faculty are eligible for promotion and tenure. This column updates that discussion through input from two DNP-prepared faculty key informants.

Advancing Nurse Practitioner proficiency and confidence: An evaluation of postgraduate training in rural and medically underserved communities.

BACKGROUND: Nurse practitioners (NPs) are critical in delivering primary health care, especially in underserved and rural areas. Transitioning from academic training to practical application poses challenges, highlighting the need for structured post-licensure training (PLT). PURPOSE: To address the knowledge gap regarding the impact of PLT programs on the clinical development, confidence, and care delivery of NPs using an innovative evaluative approach. METHODOLOGY: Using a mixed-methods approach, this study engaged 19 NP fellows in quantitative and qualitative evaluations. Assessments of clinical skills and feedback were collected using the REDCap platform, focusing on mentorship and the practical application of skills. RESULTS: Quantitative analysis showed improvements in several domains: patient-centered care (median score increase from 8 to 10, p = .005), knowledge of evidence-based practice (median score from 8 to 9, p = .028), and health systems (median score from 8 to 9, p = .014). Qualitative feedback underscored the benefits of the program's structured support and practical learning experiences while revealing the need for improvements in mentor preparedness. CONCLUSIONS: The PLT program effectively advanced NP proficiency across various domains, particularly in patient-centered care and evidence-based practice. However, it also highlighted a crucial need for focused mentorship in developing leadership skills. The study's limited scope, dependence on self-reported measures, and specific statistical methods constrain the broader applicability of its findings. Future research should aim to validate these results across diverse settings and explore long-term outcomes. IMPLICATIONS: This study provides new perspectives on NP workforce development, emphasizing the importance of structured mentorship and training, especially in medically underserved communities.

The Role of Simulation in Graduate Nursing Education: Preparing Learners for Practice.

The effectiveness of simulation to reduce the theory-practice gap in graduate nursing education is supported by an extensive body of research, and numerous studies have demonstrated improved learner outcomes in such areas as clinical competence, confidence, and preparedness for practice. This paper explores the types of simulation-based education available for graduate nursing programs and provides examples of graduate nursing simulations that educators can use in their own programs to prepare clinicians for practice.

Digital Health Education and Training for Undergraduate and Graduate Nursing Students: Scoping Review.

BACKGROUND: As technology will continue to play a pivotal role in modern-day health care and given the potential impact on the nursing profession, it is vitally important to examine the types and features of digital health education in nursing so that graduates are better equipped with the necessary knowledge and skills needed to provide safe and quality nursing care and to keep abreast of the rapidly evolving technological revolution. OBJECTIVE: In this scoping review, we aimed to examine and report on available evidence about digital health education and training interventions for nursing students at the undergraduate and graduate levels. METHODS: This scoping review was conducted using the Joanna Briggs Institute methodological framework and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). A comprehensive search strategy was developed and applied to identified bibliographic databases including MEDLINE (Ovid; 1946 to present), Embase (Ovid; 1974 to present), CINAHL (EBSCOhost; 1936 to present), ERIC (EBSCOhost; 1966 to present), Education Research Complete (EBSCOhost; inception to present), and Scopus (1976 to present). The initial search was conducted on March 3, 2022, and updated searches were completed on January 11, 2023, and October 31, 2023. For gray literature sources, the websites of select professional organizations were searched to identify relevant digital health educational programs or courses available to support the health workforce development. Two reviewers screened and undertook the data extraction process. The review included studies focused on the digital health education of students at the undergraduate or graduate levels or both in a nursing program. Studies that discussed instructional strategies, delivery processes, pedagogical theory and frameworks, and evaluation strategies for digital health education; applied quantitative, qualitative, and mixed methods; and were descriptive or discussion papers, with the exception of review studies, were included. Opinion pieces, editorials, and conference proceedings were excluded. RESULTS: A total of 100 records were included in this review. Of these, 94 records were identified from database searches, and 6 sources were identified from the gray literature. Despite improvements, there are significant gaps and limitations in the scope of digital health education at the undergraduate and graduate levels, consequently posing challenges for nursing students to develop competencies needed in modern-day nursing practice. CONCLUSIONS: There is an urgent need to expand the understanding of digital health in the context of nursing education and practice and to better articulate its scope in nursing curricula and enforce its application across professional nursing practice roles at all levels and career trajectories. Further research is also needed to examine the impact of digital health education on improving patient outcomes, the quality of nursing care, and professional nursing role advancement. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.11124/JBIES-22-00266.

The use of artificial intelligence for graduate nursing education: An educational evaluation.

ABSTRACT: With artificial intelligence (AI) rapidly advancing, advanced practice nurses must understand and use it responsibly. Here, we describe an assignment in which Doctor of Nursing Practice (DNP) students learned to use generative text AI. Using our program and course outcomes, developed from the 2021 American Association of Colleges of Nursing (AACN) Essentials competency for DNP students to learn and use AI, we reviewed the literature seeking examples using ChatGPT for the DNP informatics course. No published examples existed to guide us toward infusing a ChatGPT assignment into the course. We developed a novel assignment that included a guide for students on how to use ChatGPT. Students were given time before the assignment to learn the AI/chatbot technology. They were then given the assignment and grading rubric. The assignment was to develop a tool for their current or future practice using ChatGPT. During the course faculty debrief, we learned that few students had questions and the assignment was clear. We also learned that students who sought to develop straightforward, uncomplicated patient tools succeeded with the technology. Those who sought to create something for complex patients had more challenges. Nursing education and practice will be influenced by the increasing prevalence of AI. This manuscript outlines an AI-based assignment for graduate nursing education intended for the students to become familiar with current AI and best practices for patient care. The assignment was well received by students. We plan to use it again in the next course offering.

Development and evaluation of a PICC virtual simulator in neonatal nursing: A randomized controlled trial.

BACKGROUND: Peripherally Inserted Central Catheter (PICC) is essential in neonatal care, especially for critically ill infants. Traditional training for neonatal PICC insertion faces challenges such as high costs and limited practice opportunities. Virtual simulation technology has emerged as a potential training tool, providing a realistic, risk-free learning environment. OBJECTIVES: The study aimed to assess the effectiveness of a virtual simulation teaching system in neonatal PICC care training, focusing on improving nursing students' knowledge， skills and interest in pediatric nursing. DESIGN: A quasi-experimental design was used, with assessments conducted before and after the activity. PARTICIPANTS: The study involved 58 graduate nursing students from China Medical University, divided into experimental and control groups. METHODS: The System Usability Scale (SUS) was utilized to assess teachers' experiences with the PICC virtual simulation software. Students' perceptions of the software and their interest in pediatric nursing were measured using Self-Administered Questionnaires. Furthermore, Theoretical and Operational Assessments were applied to determine the extent of students' knowledge and practical skills before and after experimentation. RESULTS: Teachers and students have favorably evaluated the software system, with notable improvements in theoretical scores following testing. While the virtual simulation system does not enhance practical skills, it does increase student interest in pediatric nursing and employment. CONCLUSIONS: This neonatal virtual simulation software serves as a complement to, rather than a replacement for, traditional clinical training. Its integration into educational programs significantly enhances learning outcomes.

To choose or not to choose a nurse practitioner fellowship: An opinion piece on why to choose.

ABSTRACT: New graduate nurse practitioners (NPs) often face a challenging learning curve, especially in specialized fields. The quality of clinical experiences and education varies widely across NP programs, and NP Fellowships offer an extension of formal education and clinical experiences. This editorial offers a personal perspective into the NP Fellowship experience and affirms their value to improve the standard of patient care and equip novice NPs for a sustainable career.

The 1-minute preceptor to improve diagnostic reasoning in a primary care nurse practitioner residency program.

BACKGROUND: The One-Minute Preceptor (OMP) model to teach diagnostic reasoning and Reporter, Interpreter, Manager, and Educator (RIME) framework to measure progress are used in physician training. Little is known about the use of these tools in nurse practitioner (NP) training. LOCAL PROBLEM: Precepting NP trainees at the Veterans Affairs (VA) is not standardized. A standardized approach to precepting NP residency trainees using the OMP model and RIME scoring was evaluated for improvement and helpfulness. METHODS: A quality-improvement project with two Plan-Do-Study-Act (PDSA) cycles were conducted over a 12-week period. Mean RIME scores, preceptor self-efficacy, and use of teaching skills were measured preintervention and postintervention. Data were analyzed using a paired sample t -test and descriptive statistics. INTERVENTIONS: A convenience sample of preceptors and trainees was recruited from a large VA medical center. A 1-hour workshop educated preceptors with role playing and return demonstrations on OMP techniques and RIME scoring. The teachings were applied to standardize precepting and assess diagnostic reasoning. Trainee self-scoring and results triggered conversations to fulfil the identified gaps. RESULTS: Mean RIME scores improved (1.62 [0.17] vs. 2.23 [0.38], p < .001) post 12-week intervention. Mean RIME scores improved between PDSA cycle 1 and cycle 2 (2.07 [0.25] vs. 2.48 [0.39], p < .001). Preceptors (91%) and trainees (100%) found the OMP model and RIME framework helpful. CONCLUSION: Use of the OMP improved diagnostic reasoning in NP trainees. The OMP and RIME framework provided standardization of precepting and trainee discussions on improvements.

Effect of narrative videos and mini-VR games in nursing smoking cessation training on empathy and self-efficacy of smoking cessation counseling: A randomized controlled trial.

BACKGROUND: Empathy and self-efficacy for smoking cessation counseling can be enhanced through smoking cessation training. Narrative videos and virtual reality (VR) games have been applied in medical education, but their application in smoking cessation training is limited and understudied. OBJECTIVES: To evaluate the effect of smokers' narrative videos and mini-VR games on nursing students' empathy towards smokers (State Empathy Scale), confidence in practicing empathy, self-efficacy in smoking cessation counseling, and learning satisfaction. DESIGN: An open-labeled randomized controlled trial, registration number: NCT05440877 (ClinicalTrials.gov). SETTING AND PARTICIPANTS: Master of nursing students from the University in Hong Kong who enrolled in a smoking cessation course. METHODS: All students attended a tutorial including case-based discussions and role-play. The intervention group could additionally access the narrative videos and mini-VR games of smokers' cases. Linear mixed models and Cohen's d were used to evaluate the intervention effect on the self-reported learning outcomes after the intervention. RESULTS: 26 students enrolled in this trial, with 13 in each trial arm. All completed the trial. Post-test state empathy scores were significantly higher in the control group than in the intervention group (Cohen's d = 0.814, p = 0.049). No significant group differences were observed in the change of confidence in practicing empathy (ß = -11.154, p = 0.073), self-efficacy (ß = 4.846, p = 0.096), and students' learning satisfaction (Cohen's d = 0.041, p = 0.917). Both groups showed a significant increase in self-efficacy post-test (p < 0.001). CONCLUSIONS: Narrative videos showing smoking scenes and reluctance to quit, and our mini-VR games may weaken nursing students' empathy towards smokers. Smoking cessation training involving narrative videos should be modified. Debriefing and guidance to understand smokers' difficulties and express empathy are needed. VR games for smoking cessation training can involve more frame stories and challenging tasks to increase engagement.

Real-world and game-based learning to enhance decision-making.

BACKGROUND: The evolving healthcare landscape necessitates highly qualified nurses equipped with a myriad of soft skills, including decision-making. Traditional teaching models have led to innovative, active methods that prioritise student participation and enhance crucial soft skill development, such as decision- making. Considering the recognised importance of improving clinical decision-making skills and the need for innovative training, a literature gap is present in assessing the effect of real world and game-based learning on decision-making abilities. OBJECTIVES: This study aimed to investigate the effect of real-world and game-based learning, specifically using case-based learning and escape room, on decision-making competence in postgraduate nursing students in academic and clinical settings. DESIGN: A descriptive, cross-sectional, quantitative intervention study was conducted, combining case-based learning and escape room methods sequentially. SETTINGS: The study was conducted among postgraduate nursing students at the University of Navarra in Spain. PARTICIPANTS: Sixty-six postgraduate nursing students, mostly women, participated in the study. METHODS: The study integrated case-based learning and escape room sequentially. Data were collected through an ad hoc online questionnaire, recorded escape times from the escape room, and academic scores. RESULTS: The study enrolled 66 participants with an average professional experience of 4.2 years. Academic results showed high scores in case resolution (average: 8.34) and knowledge tests (average: 9.21). Out of 11 groups, 81.8 % successfully escaped the escape room within 30 min, with positive questionnaire responses indicating enthusiasm, enjoyment and perceived effectiveness of the activities. CONCLUSIONS: Real-world and game-based learning significantly enhanced decision-making competence in postgraduate nursing students across academic and clinical settings, demonstrating the importance of diverse teaching methods. Further research, including comparative studies and longitudinal analyses, is needed to evaluate the educational benefits of integrating case-based learning and escape room methods in nurse education and to refine assessment tools while monitoring long-term student progress.

Integrating Strengths-Based Nursing and Healthcare in Pediatric Nursing Education: A Case Study of the Ghana-SickKids Partnership.

There is growing recognition of the critical role nursing leadership plays in healthcare. Integrating strengths-based approaches into nursing education enables positive learning settings and empowers nurses as leaders who foster healing and well-being for patients and their families. This paper describes an effort to integrate Strengths-Based Nursing and Healthcare (SBNH) and Strengths-Based Nursing and Healthcare Leadership (SBNH-L) into the development, implementation and evaluation of a postgraduate pediatric nursing program in Ghana. In the evaluation of the program in Ghana, three themes emerged related to strengths-based nursing: transformation of teaching and learning, impact on relationships with colleagues and impact on relationships with patients.

Collaborative learning linking nursing practice and education - Interview study with master's students and teachers.

BACKGROUND: Collaborative and innovative educational approaches are essential to building nurses' competencies in responding to healthcare challenges and to enhance high-quality nursing practice. Nurses are increasingly learning in various contexts, and thus, the understanding and organising of collaborative learning needs further exploration. AIM: To describe collaborative learning in nursing practice and education from the point of view of nurses, involved as students and teachers in master's education in nursing. DESIGN AND METHODS: Qualitative study using semi-structured focus groups involving 33 nurses as master's students and teachers from Estonia and Norway. The data were analysed using inductive content analysis. FINDINGS: The essence of collaborative learning in the context of nursing practice and education was identified as the aggregation of diverse learners' skills and reflections while working towards shared aims. This fostered the development of workplace competencies, professional attitudes, and personal growth. Organising collaborative learning requires careful planning and synchronisation between clinical and educational organisations. CONCLUSIONS: Collaborative learning is an inclusive method, aiding nurses at different phases of their career to gain knowledge and enhance their soft skills, and potentially reducing professional hierarchies. Further research is needed to develop methods for evaluating the outcomes of collaborative learning.

Qualitative comparative analysis of learning engagement among Chinese part-time master's students in nursing.

BACKGROUND: Graduate nursing education plays an important role in the development of an innovative nation. Such education benefits the health of the community by cultivating competent and highly skilled nurses who can provide safe and quality nursing care. The number of students pursuing nursing degrees in China is insufficient, to meet the social demand for advanced practice nurses. The part-time Master of Nursing Specialist program for students offers flexible learning options for working nurses. However, the relatively low level of learning engagement exhibited by this group has raised concerns among policy-makers and nursing educators. An in-depth study of the factors affecting the learning engagement of part-time Master of Nursing Specialist postgraduates, especially with regard to their combined effect, is expected to provide a basis for improving the level of learning engagement among such students. METHODS: This study used ability-motivation-opportunity-theory and fuzzy-set qualitative comparative analysis to analyze the relationships between five conditions (i.e., supportive campus environment, supportive work environment, student-faculty interaction, research motivation and time management ability) and learning engagement by reference to data collected from a sample of 225 part-time Master of Nursing Specialist students who were enrolled in China. RESULTS: The fuzzy-set qualitative comparative analysis results indicated that individual examples of these antecedent conditions were insufficient to influence learning engagement. In contrast, three combinations of the five conditions led to high levels of learning engagement, and substitutability and complementarity were observed among the various elements in the configuration. CONCLUSIONS: Research motivation, student-faculty interaction, a supportive work environment and time management are factors that can influence part-time postgraduates' learning engagement. Supervisors can enhance their research skills and expertise, hospitals can establish supportive environments for students, and students can strengthen their research motivation and time management abilities.

Branching Path Simulation for Pediatric Nurse Practitioner Students to Promote Critical Thinking: A Quasi-Experimental Study.

INTRODUCTION: Branching path simulation (BPS) is an active learning pedagogy incorporating gaming principles in a low-stakes, safe environment. No study has explored the use of BPS in advanced practice nursing education. This study measured pediatric nurse practitioner students' perception of the integration of BPS in one graduate-level course. METHOD: This study used a one group, post-test only quasi-experimental design with a convenience sample of 22 pediatric nurse practitioner students over 2 years enrolled in a university in the Pacific Northwest United States. RESULTS: Responses to BPS were positive: design (M = 4.8; SD ± 0.4), usability (M = 4.3; SD ± 1.0), self-confidence (M = 4.2; SD ± 0.8) and satisfaction (M = 4.8; SD ± 0.4). DISCUSSION: BPS was well received by learners. It not only provides immediate feedback and encourages students to identify their clinical management weaknesses and strengths but it also can be customized to needs in a course at a significant cost saving.

National evaluation of DNP students' use of the PICOT method for formulating clinical questions.

BACKGROUND: The intent of the PICOT (i.e., Population, Intervention, Comparison, Outcome, Time) method is to formulate focused clinical questions to facilitate the discovery of relevant evidence through systematic searching, with the components of the question serving as the foundation for the search. Doctor of Nursing Practice (DNP) graduates use evidence-based practices to institute changes in their organizations' systems and policies, thereby yielding positive effects on both patient and system outcomes. Given that the clinical question is the foundation of the evidence-based practice process, DNP graduates' competence in the PICOT method needs to be better understood. AIMS: This analysis aimed to describe how DNP students used the PICOT method to ask clinical questions in their DNP projects. METHODS: Project questions were retrieved from a subset (n = 129, 60.56%) of an existing national random sample of publicly available DNP projects spanning the years 2010 to 2021 from Commission on Collegiate Nursing Education-accredited schools (n = 213). Project questions using the PICOT method were further evaluated with a scoring system of 0 = no and 1 = yes for missing elements, formatting, directional outcome, and project purpose. Possible scores ranged from 0 to 8, with higher scores indicating more errors. Discussion among five researchers, until agreement was achieved, yielded consensus. RESULTS: Although the PICOT method was project author-identified in 66 (31.0%) projects, only four (6%) followed the PICOT method. All 66 (100%) were intervention questions. There were 2.74 (SD 1.55) mean errors, ranging from 0 to 6. No questions were missing P or O. Specific errors included missing I 3 (4.5%) or missing C 37 (56%), poor formatting 34 (51.5%), directional outcome 44 (66.7%), and project purpose 38 (57.6%). Thirty-three (50%) of the questions were missing T; however, T is not used for searching, so researchers recalculated the mean error without T (M = 2.24, SD = 1.28, range 0-5). LINKING EVIDENCE TO ACTION: Gaps in the accurate use of the PICOT method to construct clinical questions can lead to biased searches, inaccurate clinical problem identification, and, when used as the project purpose, jumping to non-evidence-based solutions. Academic faculty and clinical educators can mitigate these skewed outcomes and enhance their impact on quality outcomes by helping DNP-prepared nurses shore up this foundational skill.

Work-life balance and online student engagement among registered nurses enrolled in online graduate nursing education: a mixed methods study.

BACKGROUND: There is a growing number of online nursing graduate degree programs to address the professional development needs of working nurses. Work-related antecedents of online student engagement in graduate nursing studies are under-explored in the literature. AIM: The aim of the study is to examine the relationship among demographic and work characteristics, work-life balance (WLB), and online student engagement (OSE) among registered nurses enrolled in online graduate studies. METHODS: This study design is convergent-parallel mixed methods, utilizing a survey approach to collect both quantitative and qualitative data. The target population is students of an online Master of Arts in Nursing program at a university in Cabanatuan City, Philippines. Respondents were recruited via email. Google Forms were used for data collection. Non-parametric, inferential statistical tests were used to examine relationships among variables. Inductive qualitative content analysis was used to draw insights from open-ended responses. RESULTS: A total of 173 graduate students responded to the survey. Quantitative results indicate high levels of WLB (Mdn = 4.8, IQR = 1.5) and OSE (Mdn = 3.7-4.0, IQR = 0.5-1.0). WLB was significantly lower among females (U = 3297.5, p < 0.01). Emotion OSE was significantly higher for respondents with managerial positions (U = 2987.5, p < 0.05). WLB had significant low to moderate positive correlations with the domains of OSE (r = 0.22 to 0.32, p < 0.01). Qualitative findings reveal various appraisals of online learning and factors influencing work-life-study balance, such as work, personal life, and school. CONCLUSION: Work-life balance facilitates better online student engagement among graduate nursing students and is influenced by time management, work (i.e. job environment and stressors), personal (i.e. home life and leisure activities), and university factors (i.e. curriculum, modality, and professors). IMPACT STATEMENT: Empirical evidence on the link between WLB and OSE can inform graduate nursing academics in developing initiatives to ensure the timely completion of the degree program.

Transforming Nursing Education: Developing Augmented Reality Procedural Training.

The shortage of nursing faculty and the scarcity of clinical placements have compelled researchers to investigate innovative solutions for procedural development to bridge the gap between didactic teaching and clinical experiences. This feasibility study uses augmented reality (AR) with Microsoft HoloLens2 and Dynamics 365 Guides to train graduate nursing students on advanced nursing procedures, focusing on lumbar puncture. A convenience sample of 24 nurse practitioner students participated in the study. The System Usability Scale, Acceptability Scale, and Engagement Scale were used to assess participant's experiences and perceptions. The results are positive for the feasibility and acceptance of AR technology for procedural training. Participants found the HoloLens2 device easy to use and showed confidence in its functionality. The step-by-step instructions provided by Microsoft 365 Guides were understandable, useful, and satisfactory. The students reported high levels of engagement and found the AR experience to be helpful and motivating for learning. Faculty time was significantly reduced using the HoloLens2 for procedural training compared to traditional methods. This study demonstrates the potential for AR as an effective and efficient modality for nursing education. The findings support the integration of AR technology to enhance procedural development, address the challenges of limited clinical sites, and provide students with an immersive and self-paced learning experience. Additional studies will need to explore the impact of AR on clinical competency, patient outcomes, and cost-effectiveness. Overall, the use of AR technology may be useful and effective for nursing pedagogy.