Outcomes of Concept-Based Curricula: An Integrative Review.

BACKGROUND: Complexity and change in health care environments, the rapid pace of knowledge generation, and changing education policy have led to national calls for change in nursing education. Many nursing programs have adopted a concept-based curriculum (CBC) to address these challenges. Yet, much is still uncertain about the outcomes and effectiveness of CBC, which requires large scale, time-consuming, and resource-intensive change. METHOD: This integrative review assesses the outcomes of CBC in nursing higher education with a focus on the comparison of CBC to traditional curricula. RESULTS: The four relevant themes that emerged after an extensive literature review were critical thinking/clinical judgment, NCLEX-RN© (National Council Licensure Examination for Registered Nurses) pass rates, graduation rates, and student satisfaction scores. Overall, the evidence base is not robust. A valid and reliable tool to measure clinical judgment is needed. The review specifically addresses CBC effects on student critical thinking and clinical judgment, traditional outcome metrics, (NCLEX-RN success, graduation rates, and student satisfaction), and other perceived benefits. CONCLUSION: The authors found promising results on the effect CBC may have on critical thinking and clinical judgment and other perceived benefits. Findings were inconclusive on traditional outcome metrics. [J Nurs Educ. 2024;63(X):XXX-XXX.].

Impact of COVID-19 on New Graduate Nurses' Transition to Practice: Loss or Gain?

BACKGROUND: The COVID-19 pandemic disrupted nursing education and required modification of instructional methods and clinical experiences. Given the variation in education, rapid transition to virtual platforms, and NCLEX-RN testing stressors, this cohort faced unique losses and gains influencing their transition into clinical practice. PURPOSE: This study examined the impact of COVID-19 and preparedness for professional practice of 340 new graduate nurses (NGNs) at an academic medical center. METHODS: This was a mixed-methods descriptive study focusing on how clinical experience loss or gains in the final semester affected the fears, concerns, and recommendations for NGNs. RESULTS: More than half (67.5%, n = 295) of NGNs reported changes to clinical experiences, ranging from 0 to 240 hours transitioned to virtual (n = 187; median, 51; interquartile range, 24-80). NGNs fear missing important details or doing something wrong in providing patient care. They identified the need for preceptor support, guidance, teaching, and continued practice of skills. CONCLUSION: Recommendations are clear communication with leadership, advocacy from the nurse residency program, and targeted clinical and emotional support for NGNs.

Point-of-care technology: integration for improved delivery of care.

The growing complexity of technology, equipment, and devices involved in patient care delivery can be staggering and overwhelming. Technology is intended to be a tool to help clinicians, but it can also be a frustrating hindrance if not thoughtfully planned and strategically aligned. Critical care nurses are key partners in the collaborations needed to improve safety and quality through health information technology (IT). Nurses must advocate for systems that are interoperable and adapted to the context of care experiences. The involvement and collaboration between clinicians, information technology specialists, biomedical engineers, and vendors has never been more relevant and applicable. Working together strategically with a shared vision can effectively provide a seamless clinical workflow, maximize technology investments, and ultimately improve patient care delivery and outcomes. Developing a strategic integrated clinical and IT roadmap is a critical component of today's health care environment. How can technology strategy be aligned from the executive suite to the bedside caregiver? What is the model for using clinical workflows to drive technology adoption? How can the voice of the critical care nurse strengthen this process? How can success be assured from the initial assessment and selection of technology to a sustainable support model? What is the vendor's role as a strategic partner and "co-caregiver"?

Identifying at-risk nursing students using a midcurricular examination.

The purpose of this study was to investigate the usefulness of the midcurricular HESI examination in identifying at-risk students early in their nursing program. The sample included baccalaureate nursing graduates from two university programs in the southeastern United States (n = 256). A quasi-experimental design was used to determine how well the midcurricular HESI predicted outcomes on the HESI E(2) and the NCLEX-RN passing status while controlling for demographic and institutional covariates. The study used logistic regression and multiple linear regression to analyze the hypotheses. The midcurricular HESI examination was found to be a statistically significant predictor of NCLEX-RN outcome both before (P = .044) and after (P = .041) controlling for demographic factors. The study further found a statistically significant relationship between the midcurricular HESI and the HESI E(2) examinations (P < .001). In the post hoc analyses, students from the Accelerated and Fast Track degree programs scored significantly higher than did students in the Traditional Track on the midcurricular HESI examination. There were no statistically significant differences in HESI E(2) scores or NCLEX-RN outcomes among the degree tracks. As anticipated, there was a statistically significant difference in both midcurricular HESI (P < .043) and HESI E(2) (P < .016) scores between students who passed and those who failed NCLEX-RN. This study indicates that the midcurricular HESI examination is very useful in predicting outcomes in baccalaureate nursing education programs.

Point-of-care technology: preserving the caring environment.

Driven by an urgent need to improve the safety and quality of care provided in our increasingly complex health care system, health information technology has taken a central role in the health care system. The technology used at the point of care undoubtedly changes the process of nurse and patient interactions. These technologies have the potential to improve patient care while helping clinicians harness the explosive knowledge growth accelerating us into the 21st century. However, both clinicians and patients experience frustration and negativity associated with our increased dependence on technology. How has our technology-rich environment influenced the caring behaviors identified as the core of nursing practice? This article will explore these issues, examine and discuss solutions offered in the scientific literature, and make suggestions for future research.