Nursing students' readiness towards the 'new normal' in clinical practice: a distributed cognition qualitative perspective.

BACKGROUND: Clinical practicums are a core component of baccalaureate nursing education. Following the coronavirus pandemic, there have been extensive changes in the workforce environment that may potentially affect nursing students' experience and readiness for clinical practicums. METHODS: A qualitative study was conducted to explore final-year nursing students' experiences and readiness for their final clinical practicum before becoming a registered nurse. A purposive sample of 24 final-year baccalaureate nursing students was included in this study. Individual semi-structured interviews were conducted face-to-face via Zoom. The data was analysed using an inductive thematic analysis approach. RESULTS: Three themes depicting students' experiences and clinical readiness were elucidated. The themes included: (1) Experiencing multiple concerns, (2) requiring a network of support, and (3) easing the transition to professional practice. Students considered the final clinical practicum as challenging and demanding which evoked numerous concerns. CONCLUSIONS: Considering the stress that final-year nursing students experience, it will be important to devise strategies ranging from personal, relational, and environmental protective factors to enable their successful transition and completion of clinical practice.

A Qualitative Description of CRNA Clinical Coordinators' and Student Registered Nurse Anesthetists' Perceptions of Clinical Readiness.

The transition from classroom academic environment to clinical patient-focused learning is a celebrated milestone, yet it is a source of stress and anxiety for student registered nurse anesthetists (SRNAs). In nurse anesthesia education, limited information exists on perceptions of clinical readiness, either from the certified registered nurse anesthetist (CRNA) clinical educators' or the SRNAs' experiences. The purpose of this study was to explore the perceptions of CRNA clinical coordinators and SRNAs regarding clinical readiness as the students transition from classroom to clinical training. A qualitative descriptive design from a postpositivist philosophical mindset was utilized and a semistructured interview guide and content analysis methodology described by Graneheim and Lundman was used. Seventeen participants were interviewed. Four themes emerged from the analysis of the CRNA clinical coordinators' perceptions: 1) going in with good attitudes and professionalism, 2) the expectation of clinical readiness, 3) mental preparedness, and 4) solid simulation experiences. Additionally, four themes emerged from the content analysis of students' perception: 1) expectations of readiness is higher than anticipated, 2) transitional orientation/adjuncts for preparedness, 3) sound didactic training, and 4) simulation and the effects of COVID-19. While prioritization is different, educators and SRNAs value knowledge, skills (including simulated), and positive attitudes as measures of clinical readiness.

Resident Readiness for Senior Level Decision Making: Identifying the Domains for Formative Assessment and Feedback.

OBJECTIVE: To establish expert consensus regarding the domains and topics for senior surgery residents (PGY-4) to make critical decisions and assume senior-level responsibilities, and to develop the formative American College of Surgeons Senior Resident Readiness Assessment (ACS SRRA) Program. DESIGN: The American College of Surgeons (ACS) education leadership team conducted a focus group with surgical experts to identify the content for an assessment tool to evaluate senior residents' readiness for their increased levels of responsibility. After the focus group, national experts were recruited to develop consensus on the topics through three rounds of surveys using Delphi methodology. The Delphi participants rated topics using Likert-type scales and their comments were incorporated into subsequent rounds. Consensus was defined as ≥ 80% agreement with internal-consistency reliability (Cronbach's alpha) ≥ 0.8. In a stepwise fashion, topics that did not achieve consensus for inclusion were removed from subsequent survey rounds. SETTING: The surveys were administered via an online questionnaire. PARTICIPANTS: Twelve program directors and assistant program directors made up the focus group. The 39 Delphi participants represented seven different surgical subspecialties and were from diverse practice settings. The median length of experience in general surgery resident education was 20 years (IQR 14.3-30.0) with 64% of the experts being either current or past general surgery residency program directors. RESULTS: The response rate was 100% and Cronbach's alpha was ≥ 0.9 for each round. The Delphi participants contributed a large number of comments. Of the 201 topics that were evaluated initially, 120 topics in 25 core clinical areas were included to create the final domains of ACS SRRA. CONCLUSIONS: National consensus on the domain of the ACS SRRA has been achieved via the modified Delphi method among expert surgeon educators. ACS SRRA will identify clinical topics and areas in which each senior resident needs improvement and provide data to residents and residency programs to develop individualized learning plans. This would help in preparing the senior residents to assume their responsibilities and support their readiness for future fellowship training or surgical practice.

A novel maturity index for assessing medical device startups.

Background: Startup companies in the healthcare sector often fail because they lack sufficient entrepreneurial, regulatory, and business development expertise. Maturity models provide useful frameworks to assess the state of business elements more systematically than heuristic assessments. However, previous models were developed primarily to characterize the business state of larger nonmedical companies. A maturity index designed specifically for startup companies in the medical product sector could help to identify areas in which targeted interventions could assist business development. Methods: A novel MedTech Startup Maturity Index (SMI) was developed by a collaborative team of academic and industry experts and refined through feedback from external stakeholders. Pediatric medical device startups associated with the West Coast Consortium for Technology & Innovation in Pediatrics (CTIP) were scored and ranked according to the SMI following semi-structured interviews. The CTIP executive team independently ranked the maturity of each company based on their extensive experiences with the same companies. Results: SMI scores for 16 companies ranged from 1.2 to 3.8 out of 4. These scores were well aligned with heuristic CTIP rankings for 14 out of 16 companies, reflected by strong correlations between the two datasets (Spearman's rho = 0.721, P = 0.002, and Kendall's tau-b = 0.526, P = 0.006). Conclusions: The SMI yields maturity scores that correlate well with expert rankings but can be assessed without prior company knowledge and can identify specific areas of concern more systematically. Further research is required to generalize and validate the SMI as a pre-/post-evaluation tool.