[Applying Game-Based Learning in Nursing Education: Empathy Board Game Learning].

Attending lectures and reading are two common approaches to acquiring knowledge, while repetitive practice is a common approach to acquiring skills. Nurturing proper attitudes in students is one of the greatest challenges for educators. Health professionals must incorporate empathy into their practice. Creative teaching strategies may offer a feasible approach to enhancing empathy-related competence. The present article focuses on analyzing current, empathy-related curriculums in nursing education in Taiwan, exploring the concepts of empathy and game-based learning, presenting the development of an empathy board game as a teaching aid, and, finally, evaluating the developed education application. Based on the learner-centered principle, this aid was designed with peer learning, allowing learners to influence the learning process, to simulate the various roles of clients, and to develop diverse interpersonal dialogues. The continuous learning loops were formed using the gamification mechanism and transformation, enabling students to connect and practice the three elements of empathy ability: emotion, cognition and expression. Via the game elements of competition, interaction, storytelling, real-time responses, concretizing feedback, integrated peer learning, and equality between teachers and students, students who play patient roles are able to perceive different levels of comfort, which encourages the development of insight into the meaning of empathy. Thereby, the goals of the empathy lesson is achievable within a creative game-based learning environment.

[Reflection on the Differences and Similarities of Mental Health Care in Virginia and Taiwan: Geography, History, Culture, and Nurse Practitioners].

Sponsored by the pilot overseas internships project of the Ministry of Education, Taiwan, the authors and ten undergraduate students from Taiwan visited several mental health facilities in Virginia for one month. These facilities included the Catawba State Hospital, Salem Veteran Affairs Medical Center, Carilion Saint Albans Behavioral Health (New River Valley Medical Center), Warm Hearth Village, Adult & Child Family Counseling private outpatient clinic, the Free Clinic of the New River Valley, New Life Clubhouse, and Self-Government Program for Assertive Community Treatment. In-depth dialogue and participation in nursing care under the supervision of registered nurses facilitated the authors' reflection on mental health care and the roles and functions of Taiwanese nurse practitioners. The present article adopts a macro view in order to compare the related issues between Taiwan and Virginia, including: geographic features, history, culture of health-seeking behavior, healthcare insurance, and the relationships among various professionals. How these issues relate to social-cultural background and how the overall healthcare environment impacts upon the roles of nurse practitioners in Taiwan are rarely discussed in literature. We expect that this cross-cultural contrast and reflection will elicit a better understanding of how these factors have shaped and affected the roles of Taiwanese nurse practitioners. Further, suggestions about how to improve the nursing profession in Taiwan are presented.

A cooperative learning intervention for improving a simulation-based paediatric nursing course: A quasi-experimental study.

AIM: This study aimed to examine if a cooperative intervention improved outcomes for a simulation-based paediatric nursing course. BACKGROUND: Fostering cooperative learning can enhance student engagement and improve learning. Simulation-based courses provide nursing students an opportunity to practice and hone nursing skills when hands-on experiences are limited. Providing instruction in cooperative learning could improve course outcomes. DESIGN: A quasi-experimental study with pre-test/post-test assessments. METHODS: Third-year nursing students enrolled in an 18-week paediatric simulation-based nursing course were purposively recruited (N = 110). One class (n = 55) received a researcher-developed cooperative learning program, which encouraged student support during class activities and simulations. The second class (control) received usual class instruction and simulations. The efficacy of the intervention was assessed by comparing mean scores at class enrolment (pre-test) and completion (post-test) for self-perceived problem-solving attitude, cooperative learning experience and knowledge of paediatric nursing. Paired t-tests compared pre-test with post-test scores for the two groups. ANCOVA examined differences in mean scores between groups. Correlations between differences in mean pre-test and post-test subscale scores for problem-solving attitude and cooperative learning experience were also examined. RESULTS: There was no significant difference in age or gender between groups. Mean post-test scores on the final exam were significantly higher for students who received the intervention (85.26, 95 % CI 84.19, 86.33) compared with controls (83.61, 95 % CI 82.52, 84.69; F = 4.63, p = 0.034). There were no significant differences in total scores for problem-solving attitude or cooperative learning experience or between groups. For the intervention group, two problem solving subscales were correlated with two cooperative learning subscales: problem solving confidence with learning motivation, respectively (r = 0.302, p = 0.025) and personal control with classroom learning, respectively (r = 0.389, p = 0.003). For the control group, approach-avoidance problem solving was negatively correlated with cooperative learning efficacy (r = -0.343, p = 0.01). CONCLUSIONS: Compared with the control group, nursing students who received the cooperative learning intervention had higher scores for knowledge of paediatric nursing, as well as learning motivation and attitude and problem-solving confidence, suggesting that the researcher-designed intervention facilitated simulation-based learning as well as confidence in problem-solving. Nurse educators could easily integrate the intervention into simulation-based paediatric nursing courses to enhance students' problem-solving abilities.

Psychometric evaluation of Suicide Management Competency Scale for nursing students: A cross-sectional study.

Suicide management skills are essential for nursing students, as they are often the initial healthcare contact for individuals at risk of suicide. Recognising signs of suicidal ideation and behaviour is critical for initiating timely interventions. This study aimed to develop and access the psychometric evaluation of the Suicide Management Competency Scale (SMCS) for nursing students. A first draft of the SMCS was initially developed following literature and focus group, and a scale containing 28 items was constructed. We recruited 216 participants from two nursing schools. Construct validity was evaluated with exploratory factor analysis (EFA). Internal consistency reliability was determined with Cronbach's alpha, and test-retest reliability was examined with intra-class correlation. After four rounds of EFA and item analysis, we reduced the number of items to 16. We deleted 12 items, including 4 items for communalities less than 0.40, 3 items for cross-loading, 3 items for factor loading less than 0.40, and 2 items for low corrected item-total correlation. The final 16-item SMCS resulted in three subscales, which explained 55.813% of the total variance: emotional challenges in suicide risk assessment, delivering suicide interventions, and suicide risk nursing competence and confidence. Cronbach's alpha was 0.854 for the total score and 0.748 to 0.847 for the subscales. The newly developed SMCS was found to have good reliability and validity, suggesting that this scale could be used to evaluate nursing students' perceived competency in managing suicide, which might help cultivate competence in nurses' ability to effectively manage and prevent suicide, thus contributing to saving lives.

Exploring the Zen meditation experiences of patients with generalized anxiety disorder: a focus-group approach.

BACKGROUND: Most of the many studies on the efficacy of meditation on anxiety disorders over the past half century have been quantitatively studied and lacked consensus. Studies into the experiences of meditation practitioners are lacking. Taiwan has a high prevalence of generalized anxiety disorders (GAD), and Zen meditation is popular. PURPOSE: This study provides a deeper understanding of Zen meditation practice experience among patients with GAD in Taiwan. METHODS: The study site was a psychiatric outpatient department in a general hospital in Taiwan. Two groups of adult patients with GAD (n = 9) and without any kind of meditation experience (n = 12) enrolled in and attended a Zen meditation program. Heidegger's phenomenology was the core framework used to guide data interpretation. Researchers used six-session focus groups, diaries, and field notes to collect data. To boost trustworthiness, researchers applied investigator triangulation, data triangulation, prolonged engagement, persistent observation, and group debriefing (feedback). RESULTS: A major theme, "The process of Zen meditation," emerged. It was underpinned by the three categories: "struggling to reach a state of calm," "signs of improvement," and "an individual process." Signs of improvement included "finding a personal way to enter a state of calm," "changing the sense of time," and "adjusting Zen meditation practice goals." CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The there-being state (dasein) of participants shaped their understanding of Zen meditation practice. Findings revealed the diverse "phenomena-featuring process" aspect of Zen meditation practice. Findings provide a better understanding of essential elements of Zen meditation complementing quantitative studies and may be used by professionals who intend to apply Zen meditation as an alternative therapy for patients with GAD.