Needs Assessment Survey for Stroke Care Core Competency-Based Training for Neuroscience Nurses.

BACKGROUND: Assessment of stroke care core competency for neuroscience nurses is crucial for developing training programs to improve the quality of care for patients who have a stroke. The goal of this study was to determine the priorities for competency-based training using an importance-performance analysis of stroke care core competency among neuroscience nurses. METHOD: A cross-sectional descriptive survey was conducted using a convenience sample of 154 neuroscience nurses. Differences in importance and performance scores were analyzed with paired t tests. The training priority was determined using the importance-performance matrix. RESULTS: The overall performance score was significantly lower than the importance score. The highest priority areas of training were (a) principles of stroke care and (b) cardiovascular and respiratory effects. CONCLUSION: Competency-based continuing education is needed in implementing stroke best practices for neuroscience nurses to achieve optimal competency. [J Contin Educ Nurs. 2024;55(2):63-68.].

Perceived trauma nursing core competency, interprofessional collaborative competency, and associated barriers among regional trauma center nurses.

INTRODUCTION: As key members of interprofessional teams working in complex settings, nurses in trauma centers require trauma nursing core competency. PURPOSE: This study sought to determine the levels and relationships of the perceived importance and performance of trauma nursing core competency, as well as the interprofessional collaborative competency and associated barriers among Korean regional trauma center nurses. METHODS: This cross-sectional, descriptive, and correlational survey involved a convenience sample of 190 Korean trauma center nurses. Data were collected using a web-based self-reporting questionnaire about the perceived importance and performance of trauma nursing core competency, as well as the interprofessional collaborative competency and associated barriers. Data were analyzed using descriptive statistics, Pearson's correlation, and multiple regression (Enter method) analyses. RESULTS: The perceived performance and importance of interprofessional collaborative competency, the perceived importance of trauma nursing core competency, and the perceived barriers to resources, training, competency, and interest significantly affected trauma nursing core competency performance, accounting for 64.5 % of the variance. CONCLUSIONS: Training programs are needed to improve the core and interprofessional collaborative competencies of trauma nurses. Individual, team, and organizational approaches are essential to addressing the perceived barriers. The effects of training programs on the core competency of trauma nurses should be validated.

Factors Affecting Nursing Students' Reflective Thinking During Simulation Debriefing.

BACKGROUND: Although reflective thinking is regarded as an important learning aspect of debriefing, the factors that can affect reflective thinking during simulation debriefing remain unclear. PURPOSE: This study aimed to identify factors affecting reflective thinking during simulation debriefing among nursing students. METHODS: This study used a cross-sectional descriptive survey design with a convenience sample of 198 Korean nursing students. Participants completed a structured web-based self-administered questionnaire regarding the reflective learning continuum, psychological safety, learner communications skills, and debriefing process design. Multiple regression analyses were used to identify the factors affecting reflective thinking. RESULTS: Significant factors were debriefing process design, learner communication skills, student-to-student interactions, and instructor-to-student interactions. Psychological safety did not affect the reflective thinking of nursing students. CONCLUSIONS: Nurse educators should design and implement strategies to maintain effective debriefing processes, improve communication skills, and facilitate student-to-student and instructor-to-student interactions to promote reflective thinking during simulation debriefing.

Effects of Prebriefing Using Online Team-Based Learning in Advanced Life Support Education for Nurses.

An effective prebriefing strategy is needed that can improve the learning outcomes of nurses in advanced life support education. This study aimed to identify the effects of prebriefing with online team-based learning on hospital nurses' knowledge, performance, and self-efficacy in advanced life support education. A nonequivalent control group pretest-posttest design was adopted. Nurses in the experimental group (n = 26) participated in prebriefing using online team-based learning followed by self-directed learning, whereas nurses in the control group (n = 27) experienced only self-directed learning before advanced life support education. Wilcoxon signed-ranks tests were used to identify the posttest-pretest differences of the study variables in each group. Both groups showed improved knowledge, individual performance, and self-efficacy after the education. Nurses in the experimental group reported higher self-efficacy scores compared with those in the control group. There were no differences between the experimental and control groups in knowledge, individual performances, or team performance. Online team-based learning as a prebriefing modality resulted in greater improvements in self-efficacy in advanced life support education.

Perceived Importance and Performance of Critical Care Nursing Competency by Nurses' Clinical Expertise.

Background and Purpose: To enhance critical care competency, it is necessary to develop and apply a clinical expertise-based competency training program. This study aimed to identify the perceived importance and performance of critical care nursing competency and the training priorities of competency-based training programs by nurses' clinical expertise. Methods: This was a cross-sectional descriptive survey with a convenience sample of 236 intensive care unit nurses. The critical care nursing competency of nurses was measured. Training needs were determined using an importance-performance analysis. Results: Competency areas with high training priority on the importance-performance matrix were skin assessment, emotional support, Code of Ethics, and collaboration for novice nurses, skin assessment and patient education for advanced beginner nurses, skin assessment and decision-making for competent nurses, and patient education and interprofessional collaboration for proficient nurses. Implications for Practice: Different training needs were identified according to the self-reported level of clinical expertise at four levels. Nursing administrators and educators should provide competency-based continuing education programs based on high-priority training areas according to the nurses' clinical expertise.

Design Optimization of Additive Manufactured Edgeless Simple Cubic Lattice Structures under Compression.

This study proposed an optimization framework and methodologies to design edgeless lattice structures featuring fillet and multipipe functions. Conventional lattice structures typically experience stress concentration at the sharp edges of strut joints, resulting in reduced mechanical performance and premature failure. The proposed approach aimed to improve the compression behavior of lattice structures by introducing edgeless features. Through finite element analysis, the optimized fillet edgeless simple cubic unit cell with a fillet radius to strut radius ratio of 0.753 showed a 12.1% improvement in yield stress and a 144% reduction in stress concentration. To validate the finite element analysis, experimental compressive tests were conducted, confirming that the introduction of edgeless functions improved the compressive strength of lattice structures manufactured through additive manufacturing. The optimized fillet edgeless simple cubic lattice structure exhibited the most effective improvement. This approach has promising potential for lattice structure applications.

Healthcare providers' support and outcomes in hemodialysis patients: The mediating effect of health literacy.

OBJECTIVE: This study aimed to identify the mediating effect of health literacy (HL) on the relationship between healthcare providers' support and outcomes in patients on hemodialysis. METHODS: A convenience sample of 149 hemodialysis patients participated in a cross-sectional survey. Mediation analysis with the percentile bootstrap method was used to identify the mediating effect of HL on the relationship between healthcare providers' support and patient outcomes. RESULTS: Healthcare providers' support and HL were significant predictors of patient outcomes. HL mediated the relationship between healthcare providers' support and patient outcomes. CONCLUSION: The HL of hemodialysis patients is essential in the relationship between healthcare providers' support and patient outcomes. Patient educators should implement a multifaceted HL-tailored intervention strategy to improve the HL of hemodialysis patients. PRACTICE IMPLICATIONS: Hemodialysis patients' HL is a crucial mediating factor in the relationship between healthcare providers' support and patient outcomes. A multifaceted HL-tailored intervention strategy is needed to improve HL and, thus, health outcomes among hemodialysis patients.

Nursing students' achievement emotions in association with clinical practicums and alternative learning.

OBJECTIVES: This study aimed to identify and compare nursing students' achievement emotions associated with clinical practicums and alternative learning during the COVID-19 pandemic. METHODS: This cross-sectional, descriptive study enrolled 236 nursing students. Participants completed a web-based, self-administered survey regarding achievement emotions. Wilcoxon signed-rank tests were used to calculate mean differences in achievement emotions associated with clinical practicums and alternative learning. RESULTS: Nursing students who undertook e-learning reported higher negative achievement emotions than those who experienced other alternative learning modalities. Higher achievement emotions were associated with clinical practicums than with alternative learning. The most frequently reported negative emotions were anxiety associated with clinical practicums and boredom with alternative learning. CONCLUSIONS: Nurse educators should design and implement supportive clinical learning experiences to engender productive achievement emotions. Implications for an international audience: Nurse educators should play roles in providing well-designed and supportive clinical learning environments to help nursing students regulate achievement emotions.

Knowledge, barriers, and training needs of nurses working in delirium care.

BACKGROUND: Nurses' competency in delirium care is important because delirium can extend hospitalization and increase patient mortality. AIM: This study aimed at identifying and comparing the perceived knowledge, barriers, importance, performance, and training priorities between the intensive care unit (ICU) and ward nurses working in delirium care. STUDY DESIGN: This cross-sectional descriptive study included 71 ICU nurses and 149 ward nurses at one university hospital. Nurses' self-reported knowledge, barriers, importance, and performance of delirium care were surveyed. Data were analysed using descriptive statistics, chi-squared test or Fisher's exact test, Wilcoxon signed-rank tests, Mann-Whitney U tests, and the importance-performance analysis matrix. RESULTS: Compared to ward nurses, ICU nurses reported lower overall knowledge level (57.1% vs 60.7%, z = -2.005, P = .045) but higher overall gap between the importance and performance of delirium care (0.5 vs 0.2, z = -4.008, P < .001). The level of overall barriers to delirium care was similar between the two groups (3.8 vs 3.8, z = -1.190, P = .234). The highest training priority, showing high importance but low performance in the importance-performance matrix, was "family involvement and education" for ICU nurses and "non-pharmacological management" for ward nurses. CONCLUSIONS: The highest training priority for delirium care was different between ICU and ward nurses. To enhance the delirium care competency of hospital nurses, the nurse educator should develop training programs that target knowledge deficits, perceived barriers, and training priorities. RELEVANCE TO CLINICAL PRACTICE: Acute cognitive disturbances are common in patients hospitalized in wards and ICUs and can lead to adverse patient outcomes if not properly assessed and managed. Nurse educators need to develop and implement a training program based on the needs assessment and priorities identified in this study so that ICU and ward nurses can obtain the optimal level of delirium care competency.

Psychometric Evaluation of the Nurses' Cancer Pain Management Competency Scale.

BACKGROUND: There is lack of instruments for assessing nurses' comprehensive pain management competency. AIM: This study aimed to assess the psychometric properties of the Nurses' Cancer Pain Management Competency Scale and to conduct a cursory survey of the pain management educational needs/resources of nurses caring for patients with cancer pain. METHOD: A convenience sample of 230 Korean nurses who met the eligibility criteria completed the researcher developed the Nurses' Cancer Pain Management Competency Scale and a pain management educational needs/resources survey. The Nurses' Cancer Pain Management Competency Scale was based on the pain management core competencies identified by Fishman et al (2013). Internal consistency was assessed using Cronbach's alpha, and construct validity was examined using exploratory factor analysis with varimax rotation. RESULTS: Cronbach's alpha of the scale was 0.89. Nurse cancer pain management competency includes four factors, which accounted for 68.44% of the variance: the context of pain management, pain assessment and measurement, management of pain, and multidimensional nature of pain. Approximately 42% of nurses had no available protocols related to cancer pain management. Nurses preferred multi-component educational modalities, including simulation-based learning. CONCLUSIONS: Findings support internal consistency reliability and content and construct validity of the Nurses' Cancer Pain Management Competency Scale that can help examine pain management competency of nurses. Adopting an evidence-based clinical cancer pain management-related protocol and multi-component training programs are needed to achieve optimal cancer pain management competency in nurses.

Effects of a multifaceted neurological assessment educational program in nursing students: A randomized crossover study.

AIM: This study aimed to verify the effects of a multifaceted neurological assessment educational program on neurological assessment-related knowledge, skills, communication ability and self-efficacy in nursing students. BACKGROUND: Nurses should be equipped with optimal neurological assessment competency to ensure quality care for patients with neurological symptoms. DESIGN: This study involved a waitlist control group with a randomized crossover design. METHODS: Fourth-year nursing students were randomly assigned to an intervention group (n = 28) or a waitlist control group (n = 27). Pre- and post-intervention differences in neurological assessment knowledge, skills, communication ability and self-efficacy between the intervention and the waitlist control group were analyzed using generalized estimated equations. RESULTS: The nursing students in the intervention group showed significantly improved knowledge, skills, communication ability and self-efficacy scores compared with those in the waitlist control group. Scores related to knowledge, skills and communication ability were maintained and self-efficacy scores had further increased at 2 weeks after the educational program in the intervention group. CONCLUSIONS: Our multifaceted neurological assessment educational program is useful for improving nursing students' knowledge, skills, communication ability and self-efficacy.

Gender Differences in Psychological Safety, Academic Safety, Cognitive Load, and Debriefing Satisfaction in Simulation-Based Learning.

BACKGROUND: As there is an increasing trend in the number of male-identifying learners in undergraduate nursing education, a need exists to identify the gender differences in learners' perceptions regarding simulation-based learning. PURPOSE: This study aimed to identify the gender differences in psychological safety, academic safety, cognitive load, and debriefing satisfaction in simulation-based nursing education. METHODS: A cross-sectional descriptive survey was implemented with 97 female and 95 male nursing students. Data were analyzed using Mann-Whitney U tests or independent-samples t tests. RESULTS: Female nursing students reported a lower academic safety and higher intrinsic load than male nursing students. Male nursing students perceived a higher germane load than female nursing students. CONCLUSIONS: The significance of the present study was the identification of gender differences in participant perception of the simulation learning experience for effective simulation design.

The association of professionalism and systems thinking on patient safety competency: A structural equation model.

AIMS: The aim of this study is to identify how professionalism and systems thinking contribute to patient safety competency among Iranian nurses. BACKGROUND: Professionalism, systems thinking and patient safety competency play important roles in the quality of care. Strategies to enhance the patient safety competency of nurses must be devised by identifying the relationships between these variables. METHODS: A cross-sectional, descriptive survey study was conducted in 10 teaching hospitals in Tabriz, Iran. A total of 358 nursing staff with at least 12 months of experience in nursing were enrolled. Data were collected using the Professionalism scale, Systems Thinking Scale and Patient Safety Competency Self-Evaluation tool. Structural equation modelling analysis was performed to test the relationship between variables. RESULTS: The final model illustrated a good fit (χ2 /df = 2.329, goodness-of-fit index = 0.990, Tucker-Lewis index = 0.906 and root mean square error of approximation = 0.068). Professionalism directly influenced patient safety competency (ß = 0.59, p < 0.001) and indirectly influenced systems thinking (ß = 0.29, p < 0.001). Systems thinking directly influenced patient safety competency (ß = 0.46, p < 0.001). Results indicated that 91% of the variance in patient safety competency was explained by professionalism while 40.1% of the variance in the systems thinking was explained by professionalism. CONCLUSIONS: The professionalism and systems thinking of hospital nurses play a pivotal role as predictors in patient safety competency. Training opportunities, mentorship and nursing managers' leadership are needed to assist hospital nurses in their perceptions of professionalism and systems thinking. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing educators and managers should implement patient safety training strategies and improve the professionalism and systems thinking of hospital nurses to promote patient safety and quality care.

Effects of a tiered competence-based simulation educator development program.

AIM: This study aimed to develop and identify the effects of a tiered competence-based simulation educator development program on knowledge, competence and attitudes. BACKGROUND: Competence and educational needs-based training is required to improve nursing simulation educators' learning outcomes. DESIGN: This study used a one-group pretest-posttest design. Methods A convenience sample of 65 nursing simulation educators completed a self-administered questionnaire. Three levels of training programs were implemented: basic, intermediate and advanced courses. The pretest-posttest differences in knowledge, competence and attitude scores were analyzed using the paired t-test. The main variable scores for the three programs were compared using one-way ANOVA and the Scheffé post hoc test. RESULTS: Posttest levels of knowledge, competence and attitudes were higher than the pretest measures. Simulation educators in the basic course reported greater improvements in perceived competence when compared with participants in the intermediate course. CONCLUSIONS: The tiered competence-based simulation educator development program improved nursing simulation educators' knowledge, competence and attitudes across all course levels.

Effects of peer learning on nursing students' learning outcomes in electrocardiogram education.

BACKGROUND: Nurses should have the ability to interpret electrocardiograms (ECGs) quickly and accurately, but their ECG interpretation skills may be suboptimal. The best evidence for effective teaching methods is lacking. OBJECTIVES: This study aimed to compare the effects of peer and self-directed individual learning methods on nursing students' learning flow, interpretation skills, and self-confidence in web-based ECG education. DESIGN: This study employed a nonequivalent control group with a pretest-posttest design. SETTINGS: This study was conducted at two colleges of nursing in the Republic of Korea. PARTICIPANTS: Nursing students were conveniently assigned to either a peer learning group (n = 45) or a self-directed individual learning group (n = 51). METHODS: A self-administered questionnaire was used to measure the nursing students' learning flow and self-confidence in ECG rhythm interpretation. ECG interpretation skills were measured using a web-based interpretation skills test. Data were analyzed using a paired t-test and a two-sample t-test. RESULTS: Nursing students in both groups showed improved learning flow, interpretation skills, and self-confidence after ECG education compared with before learning. However, there were no significant pretest-posttest differences in learning flow, interpretation skills, or self-confidence between the two groups. CONCLUSIONS: Peer learning was as effective as self-directed individual learning in improving nursing students' learning flow, interpretations skills, and self-confidence in web-based education. Nurse educators should educate nursing students to have optimal ECG interpretation abilities, and web-based peer or individual learning are effective education methods.

Chloride Diffusion by Build Orientation of Cementitious Material-Based Binder Jetting 3D Printing Mortar.

Binder jetting 3D printing (BJ3DP) is used to create geometrical and topology-optimized building structures via architectural geometric design owing to its high degree of freedom in geometry implementation. However, building structures require high mechanical and durability performance. Because of the recent trend of using 3D printing concrete as a structural component in reinforcing bars, its durability with respect to chloride penetration needs to be reviewed. Therefore, in this study, the compressive strength and durability of the chloride diffusion of cement-based 3D-printed output were evaluated. In addition, to confirm the performance difference based on the build orientation, the compressive strength and chloride diffusion were evaluated with respect to the build direction and transverse direction. The experimental results show that the compressive strength was approximately 22.1-26.5% lower in the transverse direction than in the build direction and that the chloride diffusion coefficient was approximately 186.1-407.1% higher in the transverse direction. Consequently, when a structure that requires long-term durability is produced using BJ3DP, it is necessary to examine the design and manufacturing methods in relation to the build orientation in advance.

Psychometric testing of the Iranian version of the TeamSTEPPS teamwork perception questionnaire: a cross-cultural validation study.

BACKGROUND: The use of validated questionnaires to assess the perception of teamwork can be an early step in improving team training activities. Team-STEPPS® Teamwork Perception Questionnaire (T-TPQ) has been adapted and validated for hospital setting use in several countries. Due to linguistic and cultural differences, there is need to test the psychometrics of the adapted versions. However, no research have not yet assessed the psychometric properties of the Persian T-TPQ. Therefore, this study aims to assess the internal consistency reliability and construct validity of an Iranian version of the Team-STEPPS® Teamwork Perception Questionnaire (IR-T-TPQ). METHODS: To conduct this study, we undertook a cross-sectional survey approach between May 2020 and January 2021. In total, 404 nurses were recruited by convenience sampling technique from 10 teaching hospitals in Tabriz, Iran. Internal consistency reliability was analyzed using Cronbach's alpha coefficient. Confirmatory factor analysis was performed to test the construct validity of the instrument. RESULTS: Cronbach's alpha coefficients for each subscale were acceptable, ranging from 0.84 to 0.92, as well as for the total IR-T-TPQ (α = 0.96). The confirmatory factor analysis demonstrated a five-factor model, all of whose fit indices were acceptable, except for the goodness-of-fit index and normed fit index (χ2 (df) 1332 (550), p < 0.001, Normed chi-square (χ2/df) = 2.423, RMSEA = 0.059, TLI = 0.897, CFI = 0.904, AGFI = 0.814). CONCLUSIONS: The psychometric properties of the IR-T-TPQ resulted in acceptable levels of internal consistency reliability and construct validity, respectively, in Iranian hospital nurses. Further study is needed to compare the teamwork level of nurses in various settings or to evaluate the effectiveness of the teamwork intervention using this validated and reliable tool.

A Validation Study of the Korean Version of the Nurses' Patient Education Questionnaire.

This study aimed to investigate the internal consistency reliability and construct validity of the Korean version of the Nurses' Patient Education Questionnaire. An accurate assessment of nurses' perceived patient education competency is required, and these needs assessment results can provide the evidence for designing a continuing education to empower and equip nurses with optimal competency for patient education. A cross-sectional study was used to which a convenience sample of 262 hemodialysis unit nurses in the Republic of Korea. In the exploratory factor analysis, the questionnaire consisted of 26 items belonging to seven factors: (1) nurse belief and knowledge; (2) documentation of patient education activities; (3) collegial teamwork; (4) educational environment; (5) interdisciplinary cooperation; (6) education foundation; and (7) health care organization, all of which accounted for 70.2% of the variance. The internal consistency reliability was 0.91 for the overall scale and each factor at 0.70 to 0.77. The questionnaire provides a valid and reliable instrument to assess nurses' patient education competency.

Effects of a Debriefing Workshop for Simulation Educators in Nursing.

Simulation educators play an essential role in debriefing to induce learning outcomes following a simulation activity. Training programs are needed to ensure and maintain the simulation educator's debriefing competency. This study aimed to identify the effects of a 4-hour debriefing workshop on knowledge, debriefing competency, and satisfaction. A one-group pretest-posttest design was used. The debriefing workshop consisted of a lecture, a practicum for debriefing competency rating (peer evaluation, learner evaluation), a presentation, and a group discussion. A convenience sample of 22 simulation educators completed a self-administered questionnaire. The pretest-posttest difference in knowledge and debriefing competency was analyzed using a paired t test. The results indicated that simulation educators had a higher posttest than pretest knowledge score. Training also significantly improved the overall elements of the perceived simulation educator debriefing competency. The simulation educators were generally satisfied with the debriefing workshop. The debriefing workshop positively affected the simulation educators' knowledge, debriefing competency, and satisfaction. Further study is needed to identify the translational effects of a faculty development program regarding debriefing on learner outcomes.