The Inter Face of Social Media Recruitment and Nursing Education Research.

This study describes using social media in recruiting a large and hard-to-reach national sample of family nurse practitioner students in the United States enrolled in their final clinical course and the impact on survey response targets. Social media recruitment was initiated when sample targets were not met using traditional, direct email invitations. A cross-sectional, observational, complex-samples survey design was used to collect data from students enrolled in accredited programs. When inviting participants via emails to schools of nursing and program administrators was only moderately successful, direct recruitment via social media sites was used. Targeted study advertisements were shown 602 389 times to 77 410 unique Facebook users over 14 months. In the final sample of 3940 study participants, 46% (n = 1811) were recruited through social media. Survey responses for health education research are typically 50% or less of the target. Using Facebook was successful for recruiting a large, geographically disperse and representative student sample necessary to ensure findings were representative and generalizable. This recruitment strategy could be effectively used for a myriad of research in areas where social media use exists to gain access to participants who might otherwise not be accessible.

Effectiveness of Screen-Based Simulation as a Strategy to Improve Nurse Practitioner Students' Access to Electronic Health Records in Clinical Education.

Learning to use electronic health records is essential for family nurse practitioner students to inform practice and clinical decision-making. Limited access to electronic health records during clinical training can lead to suboptimal use. Academic programs often rely on healthcare organizations to provide opportunities for students to learn electronic health record skills. However, clinical experiences are highly individualized, and students may not have access to electronic health records. Alternatives are needed to develop this critical competency. This study compared self-reported ratings regarding comfort and access to electronic health record documentation between students who participated in screen-based simulation and students who completed traditional clinical experiences with a preceptor during the last 70 hours of clinical training in one family nurse practitioner program. There was a significant difference in electronic health record access between students who participated in simulated versus traditional clinical experiences ( P = .002). There were no significant differences in ratings of comfort using electronic health records between groups. Both groups reported limited access to electronic health records in the first 500 hours of clinical experience. However, students who participated in screen-based simulation reported a quarter-fold increase in electronic health record access during their last 70 hours of clinical training.

The Impact of a Perioperative Elective on Practice Workforce Development: Content Analysis.

PURPOSE: Developing strategies to educate, employ, and retain newly graduated nurses in perioperative (periop) settings is paramount to addressing a succession crisis with unprecedented vacancy rates. The purpose of this study was to explore the impact of a prelicensure periop elective on the decision of participants to seek and accept a periop position upon graduation and to describe their transition to practice experience. DESIGN: This study used qualitative descriptive methodology. METHODS: Virtual semistructured interviews were conducted in 2021 with 20 recent graduates of an accelerated prelicensure nursing program who completed a periop elective course. Questions focused on if they did or did not seek and accept a periop position upon graduation and, for those who accepted, explored their transition to practice experience. Data were coded using conventional and directed content analyses. FINDINGS: Three themes emerged via conventional content analysis: the impact of a prelicensure periop elective, the periop environment, and recommendations for faculty and hiring managers. Concerning directed content analyses, participants used the coping factors of situation, self, support, and strategies to navigate career transitions. CONCLUSIONS: A periop elective course delivered through academic-practice partnerships appears to be a successful strategy to address the succession crisis. Graduates were prepared to make informed decisions about entering the periop specialty.

Learning Impact of Armed Forces Medical Background on Military Nursing Students in an Accelerated Bachelor of Science in Nursing Program.

ABSTRACT: The study examined differences between military students enrolled in an accelerated bachelor of science in nursing (BSN) program with and without medical experience and/or a previous bachelor's degree on graduation grade point average (GPA) and NCLEX®-RN first-time pass rates. Significant differences were found between groups with/without military medical experience on NCLEX-RN, but not graduation GPA. Significant differences were found between groups with/without prior degree on GPA, but not on NCLEX-RN. Having both medical experience and a prior degree did not make a difference on GPA or NCLEX-RN. Findings offer guidance on admission criteria to accelerated programs for this unique group of students.

An Innovative Distance-Based Mentorship Program for Nurse Practitioner Student-Alumni Pairs.

ABSTRACT: Little research exists on mentoring programs for nurse practitioner (NP) students. This pilot project aimed to develop, implement, and evaluate a distance program with NP alumni mentoring NP students across the United States. Mentor-mentee pairs (113) were hand-matched and surveyed at six months to collect program data. Most mentees wanted more job-hunting and resume-writing tips; mentors were interested in receiving strategies for mentoring and calendar reminders of important school events. Alumni were interested in helping prepare future NPs by serving as mentors but needed training. Distance mentorship programs may require additional structured guidelines and resources to facilitate success.

Faculty Perceptions in Facilitating Success for Accelerated BSN Student Veterans.

ABSTRACT: Student veterans enrolled in nursing programs often experience challenges transitioning to higher education environments. This study investigated faculty perspectives regarding the strengths and challenges of student veterans in an accelerated bachelor's of science in nursing program; faculty (N = 21) participated in focus groups. Four themes emerged: No Man Left Behind, Acclimating to the Higher Education Environment, Not Wanting to Be Different, and Professionalism/Maturity. Faculty perceived student veterans possess strengths and approaches to learning different from students without a military background. Integrating these strengths into the curriculum, with strategies such as team-based learning and group assignments, will leverage their skills and facilitate academic success.

Lack of pediatric mental health clinical experiences among FNP students.

BACKGROUND: Mental health disorders accounted for approximately 5% of outpatient child and adolescent visits between 2008 and 2011, and 34.8% of these children were seen by a primary care provider. As primary care providers, family nurse practitioners (FNP) are positioned to address mental health issues across the lifespan; however, they require appropriate training and experience. AIM: The study examined pediatric mental health assessment clinical experiences in a national survey of FNP students. METHODS: A secondary analysis was performed on a data set of FNP students (N = 3940). Frequencies and chi-square analyses were performed to examine pediatric mental health assessment clinical experiences. RESULTS: Nearly 30% (n = 1118) of FNP students reported experiencing two or fewer pediatric mental health assessments during their clinical rotations. More than half (53%) of these students were required to set up their own preceptors and clinical sites. CONCLUSION: Despite the growing need for mental health care in the U.S, students reported lacking pediatric mental health assessment clinical opportunities. Moreover, students who set up their own clinical sites and preceptors were even less likely to assess pediatric patients' mental health. FNP educators and programs are encouraged to provide students with the support and opportunity for adequate pediatric practice, including mental health assessment.

NLN Core Competencies for Nurse Educators: Are They Present in the Course Descriptions of Academic Nurse Educator Programs?

AIM: As an initial approach to determining representation of the NLN Core Competencies for Nurse Educators in Master's of Science in Nursing Education and Post-Master's Certificate programs, the study identified the presence of the competencies in course descriptions. BACKGROUND: The competencies are the gold standard to ensure academic nurse educators have the knowledge and skill to teach, assist learners, develop curricula, and implement effective evaluation methods. METHOD: A descriptive design that applied web scraping techniques was used to collect data from school web pages, including course descriptions, credit hours, practica information, distance accessibility, and Certified Nurse Educator exam preparation. RESULTS: Four competencies were well represented (≥85 percent), and four competencies were poorly represented (<50 percent) in a sample of 529 schools. CONCLUSION: Programs should review courses and course descriptions for inclusion of all competency areas that prepare nurse educators and make revisions to address poorly represented competencies.

Military nursing: A primer for new recruits.

This article offers an overview of military nursing and provides three examples that illustrate how nurses can advance their careers within each service.

Current State of International Clinical Experiences in US Prelicensure Nursing Programs.

AIM: The study purpose was to describe current international clinical experience (ICE) practices in RN prelicensure programs in the United States. BACKGROUND: There is interest in ICE to fulfill the goal of preparing global citizens; however, lack of evidence on developing, implementing, and evaluating best practices for ICE limits the enactment of this approach. METHOD: An electronic survey was completed by 900 deans and/or directors of diploma, associate, bachelor's, accelerated bachelor's, and master's-entry RN prelicensure programs. RESULTS: Respondents (n = 241, 27 percent) indicated their programs included ICE. Across programs, ICE occurred most often in community health courses. The predominant reason for offering ICE was alignment with the institutional mission and vision. CONCLUSION: Wide variability exists in methods used to implement ICE for credit toward the nursing major. There is a need to continue to assess and disseminate best practices in implementing ICE to accomplish the goal of global health engagement.

Training future clinicians: An interprofessional approach to treating tobacco use and dependence.

The high prevalence of smoking among persons with mental illness and co-occurring substance use disorders has not changed in the past decade despite a decline in smoking among the general population. Interprofessional collaborative care offers clinicians the opportunity to engage their patients in tobacco cessation treatment that is coordinated and comprehensive. Investigators applied a 1-group, pre/post-test design with qualitative and quantitative descriptive analyses to estimate the impact of an interprofessional tobacco education program on perceived self-efficacy and self-reported counseling abilities of graduate nursing, social work, and pharmacy (PharmD) students (N = 36; nursing, n = 13, n = 9 PharmD, n = 14 social work) to treat tobacco dependence among this subpopulation of smokers, and to assess their perceptions of interprofessional education. All participants completed a 2-h web-based module, a 3-h classroom training, a simulation with a standardized patient, and a group audio-recorded debriefing session with faculty. Emergent themes from qualitative analyses were valuing simulations, demystifying disciplines, reflecting on and critiquing practice, and lessons learned. Participants' perceived self-efficacy, self-rated counseling ability, intention to ask about tobacco use, and intention to provide counseling for tobacco cessation increased significantly. Teaching students an interprofessional team approach appears to be effective in enhancing counseling abilities and self-efficacy and may positively influence health professions students' perceptions of interprofessional education. Larger studies are recommended to validate the results of this pilot study.

'Asking' but Not 'Screening': Assessing Physicians' and Nurses' Substance-Related Clinical Behaviors.

BACKGROUND: Screening, brief intervention, and referral to treatment (SBIRT) is a promising public health approach for problematic substance use. A core component of SBIRT is the use of formal screening tools to categorize a patient's likely level of risk in order to provide an appropriately-matched service. Training in formal screening is included in many SBIRT training programs, but infrequently is emphasized. OBJECTIVES: To assess pre-training levels of SBIRT-related clinical behaviors, including screening, this study examined a secondary dataset collected from internal medicine residents and graduate nurse practitioner students. METHODS: Learners (n = 117) completed 13 self-report items assessing use of SBIRT-related behaviors. Researchers used exploratory factor analysis to identify underlying concepts in the questionnaire, then used mixed ANOVA to compare mean frequency of utilization of each factor (asking, screening, and intervening) by academic program. RESULTS: Learners reported asking about substance use frequently, intervening some of the time, and infrequently using formal screening tools. Interaction and between-academic-program effects were significant but small. CONCLUSIONS: Prior to SBIRT training, most clinical practitioners reported asking patients about substance use, but few reported regularly using formal substance use screening tools. This may have implications for the importance of SBIRT training as part of curricular work, and for the internal content foci of SBIRT curricula.

Students' Perceptions of a Tobacco Education Intervention.

Persons living with a mental illness represent an especially vulnerable and disadvantaged subgroup of smokers. Compared to those in the general population, they smoke more, die younger, and suffer disproportionately from cardiovascular disease, diabetes, stroke, and cancer, all diseases and conditions directly associated with, and exacerbated by, smoking. Despite strong evidence that tobacco cessation counseling by a health professional can approximately double patients' odds of quitting, clinicians across disciplines are reluctant to offer these individuals effective means by which to quit smoking. This disinclination is due, at least in part, to inadequate tobacco cessation training during degree education. The purpose of this qualitative study was to assess undergraduate nursing students' perceptions of a tobacco education intervention. Findings support the integration of tobacco education into undergraduate nursing curricula.

Evaluation of a theory-based education program to motivate nursing students to intervene with their seriously mentally ill clients who use tobacco.

Tobacco dependence is a major health problem for persons with a serious mental illness (SMI). Nurses working with psychiatric clients often lack the knowledge, ability, and confidence to offer their clients meaningful, effective help to quit smoking. The purpose of this study was to evaluate the effects of a tobacco education program on the perceived competence and motivation of baccalaureate nursing students (BSN) to intervene with SMI clients who use tobacco. The education program significantly improved the competence and motivation of BSN students to deliver cessation interventions to this vulnerable population of smokers.

Clinical education in nursing: rethinking learning in practice settings.

Clinical education is a time- and resource-intensive aspect of contemporary nursing programs. Despite widespread agreement in the discipline about the centrality of clinical experiences to learning nursing, little is known about if and how current clinical experiences contribute to students' learning and readiness for practice. Before large-scale studies testing specific educational interventionals can be conducted, it is important to understand what currently occurs during clinical experiences. This study, funded by the National Council of State Boards of Nursing, examined the nature of contemporary clinical education by describing students' and faculty's experiences at three geographically diverse universities in the United States. Findings suggest that teachers' and students' focus on task completion persists and often overshadows the more complex aspects of learning nursing practice.

Reflecting on diagnosis: The Metacognitive Diagnostic Reasoning Model©.

BACKGROUND: Diagnostic reasoning is a complex cognitive process that requires intuitive, heuristic processing from knowledge and experience, as well as deliberate and reflective thinking. Evidence on interventions to improve diagnostic reasoning is inconsistent, in part because different terms and models are used to guide research. PURPOSE: To present a model of the factors of diagnostic reasoning in Advanced Practice Registered Nurses (APRNs), based on a review of the literature supporting the Metacognitive Diagnostic Reasoning (MDR) Model©. METHODOLOGY: A review of the literature through systematic database search, historical articles, texts, and documents was conducted from inception through August 2023 (N = 41). RESULTS: The MDR model depicts the following concepts: (1) metacognition is viewed as the driving force of diagnostic reasoning; (2) dual cognitive processing and knowledge representations are used; (3) once a diagnosis, treatment plan, and evaluation are complete, APRNs use metacognition for the next patient encounter, using repetition for improvement of the process. CONCLUSIONS: The model combines key concepts of diagnostic reasoning, providing a framework for researchers to develop and test, and faculty to teach and evaluate this complex process in learners. IMPLICATIONS: The MDR model provides research opportunities to validate its usefulness and effectiveness and a framework to guide educational research, contributing to the body of evidence-based practice in nursing. In addition, it may foster ongoing education and training that could lead to more accurate diagnoses and treatment plans, ultimately improving patient care by reducing diagnostic errors.

The use of electronic health records in advanced practice nursing education: a scoping review.

Electronic health records are integral to the advanced practice registered nurse role, yet access and training during academic preparation are profoundly limited. Lack of exposure to electronic health records prevents students from becoming fully prepared for the responsibilities of clinical practice and potentially impacts quality of care, patient safety, and communication among patients and providers. This scoping review of 20 articles on electronic health record use in advanced practice registered nursing student education shows significant gaps in current research. Nine articles were classified as research. The remaining 11 were non-research reports of teaching innovations describing the use of simulated electronic health records in graduate nursing education or the use of an electronic health record in interprofessional education activities. Most of the limited research did not use valid and reliable instruments or robust designs, employed disparate approaches and tools to study the phenomenon, and measured low-level outcomes such as student navigation and confidence in using electronic health records. The non-research literature draws attention to the deficits in educational resources, including unaffordable electronic health records for academic use. Although rigorous evidence is lacking, a common theme throughout the reviewed literature was the benefit of simulation to develop electronic health record skills.

International programs in United States schools of nursing: driving forces, obstacles, and opportunities.

AIM/PURPOSE: To understand the development of international programs in United States schools of nursing from the perspective of driving forces, obstacles, and opportunities. BACKGROUND: Despite increasing philosophical support for international programs, significant obstacles to their development, integration, and sustainability exist in schools of nursing across the United States. METHOD: A National League for Nursing (NLN) survey collected information on the number and type of international programs being offered, with an emphasis on obstacles to integration. RESULTS/FINDINGS: Driving forces for international programs, identified by 487 responding institutions, included valued program outcomes, a global focus, and limited availability of clinical sites. Obstacles, such as cost, safety, and lack of credit toward a major, were identified. CONCLUSION: Suggestions for addressing and overcoming the obstacles are proposed, including the sharing of resources and utilization of the NLN Faculty Preparation for Global Experiences Toolkit. More research is needed to understand the implications for curricula, logistics, development, costs, and sustainability.