Promotion of Student Engagement Through the Application of Good Practices in Nursing Online Education.

The purpose of this article is to review Chickering and Gamson's principles of good practice in teaching and to illustrate their applicability to nursing online education delivery. An additional purpose is to present examples of teaching methods used by faculty to promote engagement in online education courses during the pandemic. The original 7 best practices in education, including ( a ) encourages contact between students and faculty, ( b ) develops reciprocity and cooperation among students, ( c ) uses active learning techniques, ( d ) gives prompt feedback, ( e ) emphasizes time on task, ( f ) communicates high expectations, and ( g ) respects diverse talents and ways of learning, remain evidence-based guidelines today. The authors recommend the addition of 2 new best practices: ( a ) incorporating assignment flexibility to meet student learning preferences; and ( b ) applying learning to real-life situations. Having evidence-based guidelines for supporting the role of a teacher in the online learning setting is of paramount importance.

Nursing Faculty Resilience During a Time of Disruption and Change.

ABSTRACT: Assessing the resilience level of nursing faculty during a time of unprecedented change in nursing education was the focus of this study. A descriptive cross-sectional survey that incorporated demographic data and the 10-item Connor-Davidson Resilience Scale was used. Participants ( n = 78) had an average resilience score of 32.6. No correlation was found between resilience and demographic variables such as age, years of teaching experience, and type of nursing program. Resilience is important because it helps faculty assimilate various protective factors and persist during times of rapid change.

Xenoprotein engineering via synthetic libraries.

Chemical methods have enabled the total synthesis of protein molecules of ever-increasing size and complexity. However, methods to engineer synthetic proteins comprising noncanonical amino acids have not kept pace, even though this capability would be a distinct advantage of the total synthesis approach to protein science. In this work, we report a platform for protein engineering based on the screening of synthetic one-bead one-compound protein libraries. Screening throughput approaching that of cell surface display was achieved by a combination of magnetic bead enrichment, flow cytometry analysis of on-bead screens, and high-throughput MS/MS-based sequencing of identified active compounds. Direct screening of a synthetic protein library by these methods resulted in the de novo discovery of mirror-image miniprotein-based binders to a ∼150-kDa protein target, a task that would be difficult or impossible by other means.

Diffusiophoresis in Multivalent Electrolytes.

Diffusiophoresis is the spontaneous movement of colloidal particles in a concentration gradient of solutes. As a small-scale phenomenon that harnesses energy from concentration gradients, diffusiophoresis may prove useful for passively manipulating particles in lab-on-a-chip applications as well as configurations involving interfaces. Though naturally occurring ions are often multivalent, experimental studies of diffusiophoresis have been mostly limited to monovalent electrolytes. In this work, we investigate the motion of negatively charged polystyrene particles in one-dimensional salt gradients for a variety of multivalent electrolytes. We develop a one-dimensional model and obtain good agreement between our experimental and modeling results with no fitting parameters. Our results indicate that the ambipolar diffusivity, which is dependent on the valence combination of cations and anions, dictates the speed of the diffusiophoretic motion of the particles by controlling the time scale at which the electrolyte concentration evolves. In addition, the ion valences also modify the electrophoretic and chemiphoretic contributions to the diffusiophoretic mobility of the particles. Our results are applicable to systems where the chemical concentration gradient is comprised of multivalent ions, and motivate future research to manipulate particles by exploiting ion valence.

Peripartum Cardiomyopathy.

Audience: This simulation is appropriate for emergency medicine (EM) residents of all levels. Introduction: Peripartum cardiomyopathy (PPCM) is a rare, idiopathic condition that occurs in the mother around the time of childbirth. Heart failure with reduced ejection fraction and/or reduced systolic function diagnosed in patients during the last month of pregnancy or up to five months following delivery defines PCCM.1 Another broader definition from the European Society of Cardiology defines PPCM as heart failure that occurs "towards the end of pregnancy or in the months following delivery, where no other cause of heart failure is found."2 Though PPCM occurs worldwide, most data is extracted from the United States (incidence 1:900 to 1:4000 live births), Nigeria, Haiti, and South Africa.3,4Risk factors for PPCM include pre-eclampsia, multiparity, and advanced maternal age. Unfortunately, the complete pathophysiology of PPCM remains unclear. However, it is important for emergency physicians to be aware of this rare diagnosis because though 50-80% of women with PPCM may eventually recover normal left ventricle systolic function,5 positive outcomes depend on timely recognition of PPCM as a disease and the appropriate management of heart failure. Symptomatic PPCM is an emergent condition that requires an attentive and knowledgeable emergency medicine physician for rapid recognition and treatment. A simulation of this rare condition can give residents the experience of identifying and managing this disease that they might not otherwise see personally during their training. Educational Objectives: By the end of this simulation session, learners will be able to: 1) initiate a workup of a pregnant patient who presents with syncope, 2) accurately diagnose peripartum cardiomyopathy, 3) demonstrate care of a gravid patient in respiratory distress due to peripartum cardiomyopathy, 4) appropriately manage cardiogenic shock due to peripartum cardiomyopathy. Educational Methods: This simulation was conducted as a high-fidelity medical simulation case followed by a debriefing. It could potentially be adapted for use as a low-fidelity case or an oral boards exam case. Research Methods: The educational content and clinical applicability of this simulation was evaluated by oral and written feedback from participant groups at a large three-year emergency medicine residency training program. Each participant completed the case and the facilitated debriefing afterwards. Case facilitators also provided their personal observations on the implementation of the simulation. Results: The participants gave the simulation positive feedback (n=18). Seventeen EM residents and one pediatric emergency medicine (PEM) fellow participated in the feedback survey. Learners overall agreed (18.75%) or strongly agreed (81.25%) that participating in this simulation would improve their performance in a live clinical setting. Discussion: Peripartum cardiomyopathy is a low frequency, high acuity illness that requires a synthesis of the learner's knowledge of complex physiology, navigation of logistical and systems-based challenges, and advanced communication and leadership skills to ensure the best possible patient outcome. All EM physicians will be expected to expertly manage this illness after completion of an EM training program, yet not every EM resident will encounter this type of patient during training. Supplementing the EM resident's standard training with this simulation experience provides a psychologically and educationally safe space to learn and possibly make mistakes without causing patient harm. Practically all residents were able to correctly diagnose the patient with a cardiomyopathy even if they were not familiar with the diagnosis of "peripartum cardiomyopathy." The residents particularly enjoyed the case to explore concepts of benefits and risks of medical therapeutics (ie, positive pressure ventilation, vasopressors/inotropes) and safe practice for the gravid patient. This case and the associated high yield debriefing session were effective teaching tools for emergency medicine residents about PPCM. Topics: Medical simulation, peripartum cardiomyopathy, pregnancy, respiratory failure, cardiogenic shock, emergent cesarian section.

Experiential Learning in Patient Safety: A Multi-Center Study Examining Emergency Medicine Residents' Situational Awareness of Hazards via Simulation.

Introduction The 2016 Clinical Learning Environment Review established that experiential patient safety curricula for residents are uncommon. Moreover, these curricula do not incorporate non-technical skills linked to safety, such as situational awareness (SA). We developed an in-situ patient safety simulation exercise incorporating core SA concepts and subsequently assessed exercise feasibility and acceptability, and measured residents' safety SA. Methods A simulation scenario and mock chart were designed, incorporating 16 patient safety hazards. Residents at two institutions reviewed the chart and had 10 minutes in an emergency department room with the simulated scenario to document identified hazards, followed by a facilitated debriefing. Pre- and post-exercise surveys were completed. We used regression analyses to compare exercise performance and survey responses by training year, and measures of proportional difference and association for survey responses. Results This study included 76 of 104 eligible residents (73.1%). Around 56.5% initially reported being comfortable identifying hazards. During the exercise, hazards requiring higher SA were identified less frequently. Senior residents identified more hazards (OR 2.26; 95%CI 1.56-3.28) (mean 8.28, SD1.45); 93.4% expressed satisfaction with the session, and residents reporting comfort increased significantly (89.5%, p<0.001). Conclusion In-situ simulation incorporating SA concepts feasibly provides experiential safety education and enhances resident comfort with safety issues. Visible hazards were often identified; those requiring information synthesis were usually missed, suggesting a need for developing more robust resident SA. While interns demonstrated the poorest performance, senior residents only identified 50% of errors, indicating that patient safety education enhancing SA should begin early and continue longitudinally.

Genetic testing likelihood: the impact of abortion views and quality of life information on women's decisions.

Little is known about factors predicting the likelihood of choosing genetic testing in college aged women versus older women, including knowledge of quality of life (QOL) associated with a disorder. Using vignettes with female college students (Experiment 1: n=257, mean age=19.70 yrs) and female faculty/staff/alumni (Experiment 2: n (nulliparous)=83, mean age=30.20 yrs; n (mothers)=53, mean age=33.77 yrs), we examined the contribution of multiple factors to predicting genetic testing likelihood for cystic fibrosis. We investigated malleable situational factors (style of genetic risk presentation and providing QOL information including physical and social aspects) and stable dispositional factors (abortion views). Parity (i.e., prior births) was more influential in women's genetic testing likelihood than was age. Greater acceptability of abortion for oneself and self-assessed knowledge following QOL information were predictors of higher testing likelihood for college students. Greater acceptability of abortion for another person was a predictor for nulliparous women. Abortion views moderated the effect of predictors for nulliparous women and mothers. Findings encourage genetic counselors to utilize QOL information to promote informed decision making through genetic testing.

A Multicenter Study of Student Engagement and Satisfaction in Online Programs.

BACKGROUND: Students who are more satisfied and engaged in online courses have better learning experiences and outcomes. METHOD: Survey data were collected during a 4-month period in 2019. The research team created a survey to collect demographic information and assess student satisfaction. Student engagement was measured using the 19-item Online Student Engagement Scale. RESULTS: Overall student engagement and satisfaction scores in online programs were moderately high. Generation Z participants and students from PhD programs were the most satisfied and engaged in their programs. CONCLUSION: Students who are more engaged in online coursework are more satisfied and thus are more likely to remain and successfully complete their respective programs. [J Nurs Educ. 2021;60(5):259-264.].

Transitioning to Teaching Online During the COVID-19 Pandemic.

BACKGROUND: During the COVID-19 pandemic many nursing educators have been required to abruptly convert to an online delivery model. Faculty need resources and support to transition face to face courses into an online format. PURPOSE: The purpose of this article is to highlight nursing faculty perceptions of the effectiveness of resources, support, and methodologies for online teaching during the COVID-19 Pandemic. METHODS: A cross-sectional descriptive survey design was used to collect data about nursing faculty resources, support and methodologies used to transition at least one undergraduate or graduate degree nursing course to an online format during the COVID-19 pandemic. RESULTS: Eighty-four faculty who taught in ten university colleges of nursing used varied teaching methodologies in online courses, but included some consistent methods such as websites and web based tools. The student engagement strategies that faculty were most satisfied with were journal writing and projects. Most faculty reported having information technology support and access to instructional design resources. CONCLUSION: Nursing faculty were resourceful, adaptive, and willing to use both novel and existing resources and methodologies to meet their teaching objectives and engage students. They were also, overall, satisfied with the administrative support they received from their respective institutions. Many of these resources, methodologies, and supports will continue to be used by faculty as likely more programs and courses will continue to be managed online.

Perception of online teacher self-efficacy: A multi-state study of nursing faculty pivoting courses during COVID 19.

BACKGROUND: COVID-19 forced many colleges and schools of nursing to abruptly pivot face-to-face learning to online formats. Online teaching is not new, but some faculty have not taught in a virtual environment and rapidly transitioning courses online was challenging. It is not known if teacher self-efficacy was impacted by these circumstances. OBJECTIVES: We aimed to assess online teacher self-efficacy of nursing faculty who transitioned at least one-face-to face course to an online format. We hypothesized that faculty with previous online teaching experience and greater self-rated instructional support would demonstrate higher online teacher self-efficacy scores compared to faculty who had little or no online teaching experience or reported less satisfaction with instructional support. DESIGN: A cross-sectional, descriptive design was used. SETTING: Faculty from ten universities across the United States were recruited. PARTICIPANTS: Nursing faculty (N = 84) who transitioned at least one face-to-face course to an online format during COVID-19 were included in the study. METHODS: Participants completed the 32-item Michigan Nurse Educators Sense of Efficacy for Online Teaching (MNESEOT) instrument and a demographic questionnaire which included items about prior online teaching experience and instructional support. RESULTS: Participants scored overall teacher self-efficacy high (75th percentile). "Computer skills" were scored highest while "student engagement" scored lowest. Prior online teaching was a predictor of higher online teacher self-efficacy; however, instructional support was not a predictor of higher online teacher self-efficacy. CONCLUSION: Nursing faculty reported a high level of online teacher self-efficacy during an abrupt pivot from face-to-face teaching to a virtual format. Pre-emptive opportunities to teach online can build self-efficacy for novice faculty. Faculty and students will benefit from improving student engagement skills, especially during isolating and overwhelming events such as the COVID-19 pandemic.

A Multicenter Study About Resilience of Nursing Students and Faculty in Online Courses.

BACKGROUND: Resilience is the process of adapting well in adverse situations. Due to the challenges of teaching in online programs and the adaptations needed by students, it is important that faculty and students maintain a high level of resilience. PURPOSE: The purpose of this study was to assess the resilience level of undergraduate and graduate nursing students and faculty who interact in an online environment and to determine factors that impact resilience. METHODS: This study employed a descriptive cross-sectional study design using a convenience sample of undergraduate and graduate students and faculty at six accredited universities in the United States. Faculty and student resilience were measured using the Connor Davidson 10 Resilience scale instrument. RESULTS: The sample included 92 faculty who taught at least one online course and 200 students who were enrolled in at least one online course. There was no difference in faculty or student resilience by generation or program. Overall resilience scores were at the moderate level for both students and faculty. CONCLUSION: Resilience has multiple benefits for both students and faculty, and is a critical concept for focus in nursing education at all levels.

Characteristics of RN to BSN students in online programs.

BACKGROUND: Registered nurse to baccalaureate in nursing (RN-BSN) programs has rapidly moved to online formats to increase the ability of working nurses to earn their BSN degree. Nursing faculty are tasked with designing programs to meet the needs of the nursing workforce using best practices for online learning. OBJECTIVES: Describe RN-BSN student perceptions of their online programs, including clinical experiences. Specific aims were: 1) evaluate student satisfaction in online courses, 2) describe experiences students were required to have to meet clinical objectives, 3) determine generational differences in satisfaction with online learning 4) determine the students' perception of the value of course content in online program 5) examine life responsibilities impacting student program participation. DESIGN: A descriptive cross-sectional design with convenience sampling was used. SETTING: Participants included 43 RN-BSN students currently enrolled in at least one online course at one of six accredited nursing programs across the United States. METHODS: Survey data were collected over 4 months in the summer of 2019. The research team created a 9-item online survey, including investigator-initiated questions and demographic information. RESULTS: Overall satisfaction in online programs was high. Technology, nursing informatics, computer classes, research and evidence-based practice, public health, pathophysiology, pharmacology, leadership, reading text books, assessment, brushing up on skills, and emotional intelligence were most valued content. Least valued content included discussion boards and group projects. Clinical requirements and setting varied across programs. Life responsibilities impacted students' participation in online programs. CONCLUSIONS: Overall, students were satisfied and found value in their online RN-BSN coursework. Clinical experiences varied between RN-BSN programs and participation in online courses was impacted by extracurricular obligations. Based on this study, more data regarding what could be counted as clinical hours is needed. Faculty need to consider alternative ways to achieve learning outcomes. This study's outcomes may help guide faculty in developing RN-BSN programs and student-centered courses.

Diabetes and pre-eclampsia affecting pregnancy: a retrospective cross-sectional study.

The interaction between pre-eclampsia and diabetes mellitus (DM) is far from being completely understood. In this study, we compared normal pregnancies with those complicated with pre-eclampsia, gestational DM, and/or pre-existing diabetes to assess the effects of hyperglycemia on placental development. AnInstitutional Review Board (IRB) approved retrospective cross-sectional study with 621 subjects was performed. Statistical analysis was performed using Duncan's post hoc test and analysis of variance. Regardless of diabetes status, patients with pre-eclampsia delivered prematurely. Patients in the group with pre-eclampsia and pregestational diabetes delivered much earlier, at 35.0±0.4 weeks, when compared with the patients that had pre-eclampsia with gestational diabetes and pre-eclampsia with no diabetes (*P<0.05 for each). Additionally, patients with pre-existing diabetes who developed pre-eclampsia delivered smaller babies than those with pre-existing diabetes without pre-eclampsia (1.00±0.03, P<0.05 for each). Pre-existing diabetes with added insult of pre-eclampsia led to fetal growth restriction. This outcome validates the understanding that elevated glucose earlier in pregnancy alters placentogenesis and leads to fetal growth restriction.