The impact of covid-19 on the regulation of nursing practice and education.

To adapt to the environment resulting from a worldwide pandemic, states across the country enacted regulation changes impacting nursing education, entry into practice, and licensure. In this manuscript, the authors collected state board of nursing data from sources including websites and letters from the State Boards to deans, directors, and chairs. Information obtained reflected changes to regulation of practice and regulation of education. As the pandemic continues, associate degree educators will need to continue to stay abreast of nursing regulation changes made to meet healthcare workforce needs while also ensuring public safety.

Development of a Scale to Measure Synergy: A Tool to Evaluate Team-Based Learning in Nursing.

AIM: The purpose of this study was to develop and pilot an instrument to assess group synergy and team-based learning among nursing students. BACKGROUND: Little is known on how to evaluate soft nursing skills such as synergy. METHOD: Nurse faculty were recruited through purposive and snowball sampling to serve on an expert panel. Using the DeVillis framework, three rounds of data were collected using semistructured online surveys. The resulting scale of 34 items was piloted with teams of undergraduate nursing students taking part in a simulation experience. RESULTS: Item-content validity index ranged from .8 to 1.0 for each item. Scale-content validity index average was .93; scale-content validity index universal was .62. Exploratory factor analysis identified three factors. CONCLUSION: This study suggests that synergy is multifactorial and can be assessed by faculty. However, further testing of the scale is needed.

Evaluation of two simulation methods for teaching a disaster skill.

Introduction: With increasing use of virtual reality simulation (VRS) in nursing education, there is a paucity of research exploring learning outcomes following training with VRS as compared with traditional mannequin-based simulation. Given the resource intensive nature of mannequin-based simulation, especially for disaster education, understanding outcomes from newer technologies like VRS are needed. Methods: A quasi-experimental design was used to examine the differences in learning outcomes for the disaster skill of decontamination, based on type of simulation. The study was framed by the National Leage for Nursing (NLN) Jeffries Simulation Theory, with participant outcomes identified by the framework (satisfaction, self-confidence and performance). Outcomes were measured using the NLN Student Satisfaction and Self- Confidence in Learning scale and a Decontamination Checklist. Senior nursing students in the final semester of a baccalaureate nursing programme were recruited to participate during one of their scheduled laboratory days. Following a didactic presentation, students were randomly assigned to one of two treatment groups (VRS or mannequin-based simulation training) to learn the skill of decontamination. Results: A total of 121 participants took part in the study. No statistically significant results were noted for any of the study outcomes: performance (accuracy and time), satisfaction and self-efficacy. Results of the study demonstrate that VRS is as effective as mannequin-based simulation in training participants for the skill of decontamination. Conclusions: Simulation-based education experiences must be matched to learning outcomes and evaluated for effectiveness. As evidence emerges regarding use of newer technologies, like VRS, educators will have more options for providing students with opportunities that best match available resources.

Comparative Cost of Virtual Reality Training and Live Exercises for Training Hospital Workers for Evacuation.

Adoption of virtual reality technology may be delayed due to high up-front costs with unknown returns on that investment. In this article, we present a cost analysis of using virtual reality as a training tool. Virtual reality was used to train neonatal intensive care workers in hospital evacuation. A live disaster exercise with mannequins was also conducted that approximated the virtual experience. Comparative costs are presented for the planning, development, and implementation of both interventions. Initially, virtual reality is more expensive, with a cost of $229.79 per participant (total cost $18 617.54 per exercise) for the live drill versus $327.78 (total cost $106 951.14) for virtual reality. When development costs are extrapolated to repeated training over 3 years, however, the virtual exercise becomes less expensive with a cost of $115.43 per participant, while the cost of live exercises remains fixed. The larger initial investment in virtual reality can be spread across a large number of trainees and a longer time period with little additional cost, while each live drill requires additional costs that scale with the number of participants.

Anxiety and Stress in Live Disaster Exercises.

INTRODUCTION: Nurses play critical roles in disaster response, often preparing through simulated exercises. According to The NLN Jeffries Simulation Theory, simulations can lead to anxiety in participants that affects learning. The objective of this research was to measure and describe anxiety and stress levels of participants in a live disaster-training exercise. METHODS: A quasiexperimental/descriptive design using quantitative methods (amylase, cortisol levels) and qualitative methods (survey, focus groups) was used with a convenience sample of senior nursing students taking part in a disaster exercise. Participants completed self-reports of anxiety before and after the exercise using the State-Trait Anxiety Inventory (pre/post). Following the training, participants provided saliva samples for analysis of cortisol and amylase levels to measure physiological stress levels. Participants were also invited to take part in a focus group after exercise participation. RESULTS: A total of 22 participants were recruited. Significant elevation of self-reported anxiety levels was found on the State-Anxiety Inventory comparing pre- with post-training, but no Trait-Anxiety changes were noted. Amylase and cortisol levels were within normal ranges. Themes emerging from qualitative analysis include preparation, uncertainty, teamwork, realism, and decision making. DISCUSSION: Disaster training may be anxiety provoking and stressful. ED nurses should consider how to include best practice approaches for simulation in design of exercises to prepare for the increasing number of multicasualty events.

Effectiveness of Two Varying Levels of Virtual Reality Simulation.

AIM: The aim of the study was to assess two levels of immersive virtual reality simulation (VRS) to teach the skill of decontamination. BACKGROUND: Little is known about the use of VRS in providing disaster education, including retention. METHOD: Quasiexperimental design with repeated measures, supplemented by qualitative data, using a convenience sample of senior baccalaureate nursing students (n = 197) from four Midwest campuses was used. Students were randomly assigned to a group (two levels of immersive VRS and a control group) to learn the skill of decontamination. Cognitive learning, performance, and performance time were measured pre/post and at six months. RESULTS: Outcome measures were significant with immediate postintervention improvements and lower retention scores at six months. No significant differences were noted between groups. Students were satisfied with the VRS but found immersive VRS more interactive. CONCLUSION: VRS provides another alternative for simulated learning experiences; best practice approaches for its use still need to be explored.

The Student Experience With Varying Immersion Levels of Virtual Reality Simulation.

With increasing use of virtual reality simulation (VRS) in nursing education and given the vast array of technologies available, a variety of levels of immersion and experiences can be provided to students. This study explored two different levels of immersive VRS capability. Study participants included baccalaureate nursing students from three universities across four campuses. Students were trained in the skill of decontamination using traditional methods or with VRS options of mouse and keyboard or head-mounted display technology. Results of focus group interviews reflect the student experience and satisfaction with two different immersive levels of VRS.

National Disaster Health Consortium: Competency-Based Training and a Report on the American Nurses Credentialing Center Disaster Certification Development.

As the largest profession of health care providers, nurses are an integral component of disaster response. Having clearly delineated competencies and developing training to acquire those competencies are needed to ensure nurses are ready when disasters occur. This article provides a review of nursing and interprofessional disaster competencies and development of a new interprofessional disaster certification. An overview of a standardized disaster training program, the National Disaster Health Consortium, is provided as an exemplar of a competency-based interprofessional disaster education program.

Learning Outcome Measurement in Nurse Participants After Disaster Training.

OBJECTIVE: The National Disaster Health Consortium is an interprofessional disaster training program. Using the Hierarchical Learning Framework of Competency Sets in Disaster Medicine and Public Health, this program educates nurses and other professionals to provide competent care and leadership within the interprofessional team. This study examined outcomes of this training. METHODS: Training consisted of a combination of online and on-site training. Learning outcomes were measured by using the Emergency Preparedness Information Questionnaire (EPIQ) pre/post training and participant performance during live functional exercises with the use of rubrics based on Homeland Security Exercise and Evaluation principles. RESULTS: A total of 64 participants completed the EPIQ before and after training. The mean EPIQ pre-training score of 154 and mean post-training score of 81 (reverse-scored) was found to be statistically significant by paired t-test (P<0.001). Performance was evaluated in the areas of triage, re-triage, surge response, and sheltering. Greater than 90% of the exercise criteria were either met or partially met. Participants successfully achieved overall objectives in all scenarios. CONCLUSIONS: Disaster response requires nurses and other providers to function in interprofessional teams. Educational projects, like the National Disaster Health Consortium program, offer the potential to address the need for a standardized, interprofessional disaster training curriculum to promote positive outcomes. (Disaster Med Public Health Preparedness. 2016;page 1 of 6).

Virtual reality disaster training: translation to practice.

Disaster training is crucial to the mitigation of both mortality and morbidity associated with disasters. Just as clinical practice needs to be grounded in evidence, effective disaster education is dependent upon the development and use of andragogic and pedagogic evidence. Educational research findings must be transformed into useable education strategies. Virtual reality simulation is a teaching methodology that has the potential to be a powerful educational tool. The purpose of this article is to translate research findings related to the use of virtual reality simulation in disaster training into education practice. The Ace Star Model serves as a valuable framework to translate the VRS teaching methodology and improve disaster training of healthcare professionals. Using the Ace Star Model as a framework to put evidence into practice, strategies for implementing a virtual reality simulation are addressed. Practice guidelines, implementation recommendations, integration to practice and evaluation are discussed. It is imperative that health educators provide more exemplars of how research evidence can be moved through the various stages of the model to advance practice and sustain learning outcomes.

A workplace violence educational program: a repeated measures study.

Violence against healthcare employees is a profound problem in the emergency department worldwide. One strategy to reduce the risk of violence is prevention focused education. The purpose of this paper was to report the learning outcomes of a workplace violence educational prevention program tailored to the needs of emergency department employees. A quasi-experimental design was used to determine the knowledge retention of program content following a hybrid (online and classroom) educational intervention. One hundred twenty emergency department employees that completed the workplace violence prevention program participated in the study. A repeated-measures analysis of variance was conducted to determine if individual test scores increased significantly between baseline, posttest, and six month posttest periods. The results indicated a significant time effect, Wilk's Λ = .390, F (2, 118) = 26.554, p < .001, η2 = .310. Follow-up polynomial contrasts indicated a significant linear effect with means increasing over time, F (1, 119) = 53.454, p < .001, η2 = .310, while individual test scores became significantly higher over time. It was concluded that the use of a hybrid modality increases the probability that significant learning outcomes and retention will be achieved.