Evaluating the Effectiveness of Empathy-Based Education in Undergraduate Nursing: A Scoping Review.

BACKGROUND: Empathy is an essential trait in nursing practice that improves the quality of patient care. Nursing curricula that incorporate empathy-based experiential learning (i.e., hands-on educational experiences and reflections designed to foster and develop emotional intelligence) promote students' self-awareness and confidence when providing care to patients. This scoping review examined studies that explored the effects of educational interventions on the development of empathy in undergraduate nursing students. METHOD: Searches were conducted in MEDLINE using keywords related to nursing education and translated into CINAHL, EMBASE, and ERIC databases. RESULTS: A total of 6,238 studies were identified. After duplicate and unrelated articles were excluded, 18 publications were considered for this review. Sixteen studies concluded empathy interventions were effective, five indicated the need for further research, and two implicated a need for standardization in empathy-evaluation tools. CONCLUSION: This review endorses the effectiveness of educational interventions and supports their implementation to promote empathy in undergraduate nursing students. [J Nurs Educ. 2024;63(6):367-371.].

Interventions to Increase the Diversity of Nursing Programs: An Integrative Review.

BACKGROUND: In 2011, the Institute of Medicine's The Future of Nursing: Leading Change, Advancing Health report declared the need to increase diversity in nursing. The National League for Nursing stated that nursing pipeline programs would be essential to create increased diversity. However, no details regarding the definition, construction, or implementation of a nursing pipeline were available within the position statement. METHOD: An inclusive integrative literature review was conducted. The aim was to examine interventions targeted toward increasing diversity in nursing education programs. RESULTS: Twelve articles were included in the review. Similar interventions were used by nursing education programs; these included strategies to raise awareness about nursing to prospective students, preen-try preparation, holistic admissions, scholarships, tutoring, mentoring, and targeted advising. CONCLUSION: Evidence indicates interventions aimed at the retention of at-risk individuals are successful. Additional research is needed to develop effective recruitment strategies for diverse populations. [J Nurs Educ. 2024;63(6):387-393.].

A Tool to Teach and Assess Clinical Nurse Specialist Student Prescribing Competency: A Pilot Study.

PURPOSE/AIMS: The purpose of this study was to assess the usefulness of a tool designed to develop and evaluate clinical nurse specialist (CNS) student competency and confidence in prescribing therapeutic agents. Specifically, the aims were to identify students' perceptions of the tool's (1) helpfulness in learning to prescribe, (2) impact on confidence as a prescriber, and (3) recommended use in CNS education. DESIGN: An exploratory design was used. METHODS: Students used the tool in patient care with a supervising mentor during clinical rotations. Students completed surveys after using the tool at 2 points in time. Data were analyzed using descriptive statistics. RESULTS: Of the 18 students, 5 students completed the survey at time 1 and 6 students at time 2. The aims were met in that students perceived the tool to be helpful during CNS prescribing activities, felt confident about prescribing after using the tool, and agreed the tool should be used in CNS education. CONCLUSION: Replication of the study with larger samples of CNS students and psychometric analyses of the tool is recommended by the study's findings to support its use in CNS education beyond the study site.

Educational Outcomes in Undergraduate Nursing: A Systematic Review.

BACKGROUND: Baccalaureate nursing education has experienced tremendous challenges requiring new flexibility of moving among traditional classroom, online education, and other teaching modalities to improve student outcomes, combined with the pressing need for determining which educational methods deliver quality instruction while having a positive effect on outcomes. This systematic review explored different teaching modalities and measurable educational student outcomes in undergraduate baccalaureate education. METHOD: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: Of the 20 articles included in this systematic review, simulation, face-to-face, asynchronous, problem-based learning, gaming, flipped classrooms, reflective writing, tweets, and podcasts were represented. Three distinct educational outcomes that were identified included competence, confidence, and communication. CONCLUSION: A variety of educational methodologies drives positive outcomes in educating the next generation of nurses to have increased competence, confidence, and improved communication. [J Nurs Educ. 2024;63(6):380-386.].

OWIED System to Facilitate the Entrustment Decision in EPA Implementation.

BACKGROUND: Entrustable professional activities (EPAs) are gaining attention as an approach for adequate implementation of a competency-based evaluation framework in nursing education. This study sought to develop an Online Web-assessment Interface for Entrustment Decision (OWIED) to facilitate the entrustment decision in EPA implementation. METHOD: A participatory qualitative action research design consisting of two phases was used for this study. The exploration phase was conducted in close collaboration with stakeholders. Following the exploration phase, the primary researcher and a team of subject-matter experts in academic and information technology developed the OWIED system according to the exploration phase results. RESULTS: The necessary features that met the expectations of the stakeholders were identified and assisted in developing the OWIED system. CONCLUSION: OWIED may provide a valid tool to track and validate nursing student acquisition of core competencies and assist in making entrustment decisions as students fulfill their training requirements in their academic program. [J Nurs Educ. 2024;63(6):356-365.].

Integrative Review of Sources of Baccalaureate Nursing Students' Clinical Practice Anxiety.

BACKGROUND: Nursing education research and anecdotal literature has revealed that undergraduate nursing students report anxiety related to clinical practice. Most published studies have focused on the effectiveness of interventions to reduce anxiety; only a few identify specific sources of clinical practice anxiety. METHOD: We conducted an integrative literature review to understand the sources of nursing students' practice-related anxiety and how this anxiety has been measured. RESULTS: We classified sources of practice-related anxiety into nine themes grouped into five categories: consequences of making a mistake; fear of the unknown; incivility of staff members or teachers; threat to self-concept, image, or health; and theory-practice gap. Practice-related anxiety was measured quantitatively with various surveys and qualitatively using semistructured individual or group interviews and students' journal entries. CONCLUSION: Different sources of practice-related anxiety likely require distinct interventions. Further research is recommended to identify effective interventions to reduce anxiety related to each of the identified themes. [J Nurs Educ. 2024;63(6):349-355.].

Self-Care in Nursing Education.

BACKGROUND: The mental health of students and faculty has become a growing issue in academia. Faculty need to provide role-modeling early in nursing programs to enhance psychological well-being for future nurses that will have lasting effects throughout their careers. METHOD: A total of 29 faculty members participated in a descriptive study investigating types of self-care goals and how they could be achieved by College of Nursing faculty during their annual performance appraisal. RESULTS: Seventy-three percent of respondents reported they anticipated that achieving these self-care goals would enhance their faculty role. Further, the respondents associated achievement of self-care goals as a way to improve their faculty performance. CONCLUSION: Since every individual has a unique perspective of the world, a self-care approach that works for one person might not work for another. Self-care goals should therefore be tailored to the unique needs and perspectives of each person. [J Nurs Educ. 2024;63(6):394-398.].

Development of clinical decision-making among undergraduate nursing students: the effect of unfolding case-based learning.

OBJECTIVES: This prospective cohort study evaluated the effect of unfolding case-based learning on undergraduate nursing students' self-perceived clinical decision-making ability. METHODS: Students' self-reported responses to Jenkins's Clinical Decision Making in Nursing Scale were compared between the unfolding case-based learning cohort (n=140) and the comparison cohort (n=126) at a school of nursing in the United States. RESULTS: The results revealed similar students' responses between the two study cohorts. However, unfolding case-based learning significantly increased students' perceived proficiency in "search for information and unbiased assimilation of new information". CONCLUSIONS: Findings from the present study highlight possibilities presented by unfolding case-based learning in undergraduate nursing education. The study supports that unfolding case studies can be introduced early on, and then nurtured throughout the undergraduate program to influence the development of nursing students' clinical decision-making skills.

Simulation design - peer-to-peer training as preparation for full-scale scenarios.

OBJECTIVES: Design of simulation training can have important implications for learning outcomes. This paper describes a pilot simulation training program for baccalaureate nursing students that includes intensive preparations, peer-to-peer skills training (P2P), prior to full-scale scenario training. METHODS: A quality improvement analysis of a large scale experimental, mixed methods study. The project describes the design, analysis, and potential effects of a simulation education program containing P2P for third year nursing students (163 in treatment; 148 in control, n=311). RESULTS: The intervention group was found to be significantly more confident in both technical and non-technical nursing skills. Results suggest that the addition of P2P training may have a direct positive impact and increase the impact on full-scale simulations and debriefing. CONCLUSIONS: Enhanced focus on preparation activities prior to full-scale scenarios, including the use of P2P training methods are advocated.

Changing the delivery of continuing professional education: An action research approach.

AIM: A participatory action research project was used to change the design and delivery of continuing professional education in a large Irish academic teaching hospital. BACKGROUND: Participation in continuing professional education, designed as a short course, is often a method to maintain competence for many nurses. Structured short education courses are often used to orientate and upskill new staff to specialist clinical areas. Traditionally many courses relied on face-to-face delivery over a period of weeks which is challenging for one clinical area to release staff to attend theoretical days in person. DESIGN: A six-stage participatory action research cycle over a 3-year period in a large Irish academic teaching hospital. METHODS: Multiple methods were used in the cyclical process of participatory action research. Constructive alignment theory and instructional design principles were used to redesign the educational framework. Data collection included audits of courses, questionnaires and focus groups with key participants. RESULTS: Analysis of the focus group themes included 1) underestimated time 2) the process of change 3) teaching and learning styles and 4) acceptance and integration. 20 learners completed the evaluation and reported a positive synergy between e-learning and clinical workshops. E-learning was reported as time-consuming. 75 % of learners reported they were motivated to learn. 90 % of the learners reported they gained new knowledge and skills, 84 % reported the clinical area benefited from the education and 80 % identified a direct improvement in their clinical skills in the specialist area. CONCLUSIONS: Participatory action research supports organisational change in continuing professional education. Constructive alignment theory supports the value of outcomes-based learning. In this context it resulted in successfully blending theory and clinical skills for nurses working in specialist areas. The redesigned continuing professional education framework was positively evaluated across nurses in the organisation.

Competency-Based Medication Administration and Error Reporting.

BACKGROUND: Accuracy is needed with medication administration, a skill that involves rule-based habits and clinical reasoning. This pilot study investigated the use of an evidence-based checklist for accuracy with oral medication administration and error reporting among prelicensure nursing students. Checklist items were anchored in the mnemonic C-MATCH-REASON© (Client, Medication, ADRs, Time, Client History, Route, Expiration date, Amount, Site, Outcomes, Notation). METHOD: Nineteen participants randomly assigned to crossover sequence AB or BA (A: checklist; B: no checklist) practiced simulation scenarios with embedded errors. Nursing faculty used an observation form to track error data. RESULTS: Using the C-MATCH-REASON© checklist compared with not using the checklist supported rule adherence (p = .005), knowledge-based error reduction (p = .011), and total error reduction (p = .010). The null hypothesis was not rejected for errors found (p = .061) nor reported (p = .144), possibly due to sample size. CONCLUSION: C-MATCH-REASON© was effective for error reduction. Study replication with a larger sample is warranted. [J Nurs Educ. 2024;63(5):320-327.].

Design and Implementation of a Nursing Capstone Across a Multisite Health System.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic created profound effects in nursing education. Using a robust academic-practice partnership, a college of nursing and a health care organization collaborated to launch Jefferson Capstone Experience (JCE), an education delivery model that included a one-to-one, 108-hour clinical preceptorship between an experienced RN and an undergraduate nursing student. METHOD: The expedited design, implementation, and evaluation of JCE is described. The mixed-method program evaluation included surveys, interviews, and focus groups with students, faculty, and preceptors. RESULTS: Students and preceptors reported high levels of satisfaction with JCE. All parties emphasized the importance of clear and timely communication, academic practice collaboration, and organization. A significant number of capstone graduates accepted a position with a capstone clinical partner. CONCLUSION: Although the logistics of planning and implementation were challenging, an immersive and largely positive experience was created for undergraduate students, which created a robust hiring pipeline of new-to-practice nurses. [J Nurs Educ. 2024;63(5):292-297.].

Community, Public, and Population Health Content in Nursing Curricula: National Survey Results.

BACKGROUND: Policy, societal, and system changes are prompting nursing programs to expand population health content in curricula. This study examined the current state of community, public, and population health (CPPH) education in nursing curricula throughout the United States. METHOD: This descriptive study examined CPPH education in nursing programs nationally. A survey was developed and distributed to nursing programs from January to May 2021. RESULTS: CPPH content integration occurred across all program levels, and the majority of the participants were involved in the development of CPPH-specific curriculum. Programs experienced reductions in CPPH curriculum due to coronavirus disease 2019 (COVID-19), lack of experienced faculty, budget constraints, and an emphasis on acute care. CONCLUSION: The continuation of CPPH education in current nursing curricula is critical. National and academic nursing organizations must continue to monitor CPPH content in nursing curricula to assure a competent CPPH nursing workforce. [J Nurs Educ. 2024;63(5):282-291.].