Traditional Clinical Outcomes in Prelicensure Nursing Education: An Empty Systematic Review.

BACKGROUND: Effectiveness of traditional apprenticeship models used in undergraduate nursing education has been questioned in the literature for over 50 years. This systematic review aimed to examine best evidence available upon which to base decisions regarding use of traditional clinical experience with prelicensure nursing students. METHOD: A systematic review was conducted following Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Nine electronic databases were searched. Full-text review was completed for 118 articles meeting inclusion criteria. RESULTS: No studies reported learning outcomes attributed to clinical education models, resulting in an empty review. Studies were commonly self-reports of perceptions and confidence, lacking quantitative outcomes. CONCLUSION: No sufficient evidence was found to support traditional clinical models. The scope of nursing practice and patient complexity requires higher order thinking skills, ability to prioritize, and leadership in interdisciplinary care environments. This review raises serious concerns about how nurse educators assess learning in traditional clinical environments. [J Nurs Educ. 2021;60(3):136-142.].

Closing the gap: a call for a common blueprint for remote distance telesimulation.

The physical requirements mandated by the COVID-19 pandemic have presented a challenge and an opportunity for simulation educators. Although there were already examples of simulation being delivered at a distance, the pandemic forced this technique into the mainstream. With any new discipline, it is important for the community to agree on vocabulary, methods and reporting guidelines. This editorial is a call to action for the simulation community to start this process so that we can best describe and use this technique.

Simulation as a Nursing Education Disrupter.

Simulation as an evidence-based pedagogy began emerging at a time when many constraints were being imposed on clinical experiences for nursing students. As research illuminated the advantages of simulation and standards were developed, educators began to recognize the limitations of the clinical setting, such as the inability to provide experiences in teamwork and delegation, and a focus on tasks. Simulations are crafted to provide an experience that matches content that is being taught in class, and debriefing techniques guide learners in a reflective process that promotes the development of clinical reasoning and judgment. The National Council of State Boards of Nursing study concluded that simulation could be substituted for 50% of clinical hours. Simulation-exposed gaps in the curriculum and its pedagogical principles are now extending to adaptations of its use in the classroom and in clinical postconferences. They are also shaping teacher-student conversations in the office and the hallways. Use of simulation for assessment is beginning to evolve. In a little more than 10 years, it has started a revolution that will continue to have a major impact on all aspects of nursing education in the future.

The Changing Landscape of Simulation-Based Education.

: Once considered solely as an educational tool in undergraduate education, simulation-based education (SBE) now has many uses. SBE is now embedded in both graduate and undergraduate nursing education programs and has become increasingly accepted practice in hospital orientation and transition-to-practice programs. Newer applications include ongoing professional education, just-in-time training, teamwork development, and systems testing. This article highlights the changing landscape of SBE and describes elements critical to its successful use, including facilitator competencies, the necessity of providing a psychologically safe environment to enable learning, and the importance of addressing other safety concerns, such as the possibility of accidentally introducing simulated equipment and medications into real patient care.

Designing and implementing asynchronous online deliberate practice to develop interprofessional communication competency.

Communicating with healthcare providers is a core tenant in the Quality and Safety Education for Nurses and Institute of Medicine teamwork and collaboration competency but remains a major concern for pre-licensure nursing students and novice nurses. Pre-licensure nursing students rarely have opportunities to practice interprofessional communication skills with other healthcare providers even though lack of this skill competency may lead to patient harm. This article explores the feasibility of using story-guided online deliberate practice sessions as an educational strategy to improve students' interprofessional critical communication competency. The design and testing of asynchronous online deliberate practice session prototypes is described and the implementation and evaluation of two online deliberate practice sessions into a nursing course is reported. The online format provided students with convenient opportunities to develop competency in critical communication skills using SBAR in a safe environment. Results from the prototype testing and student evaluation indicated that students had an overall positive experience. The online deliberate practice sessions provided a low-cost, flexible practice experience to develop critical communication skills and were evaluated as highly satisfactory and easy to navigate. The optimal number of practice sessions needed to attain competency, retain skills, and impact patient outcomes require further longitudinal study.

Findings from a nursing student CPR study: implications for staff development educators.

This article reports a secondary data analysis of a year-long study with 606 nursing students involving brief monthly CPR practice with voice-activated manikins versus no practice. Findings indicate that even with monthly practice and accurate voice-activated manikin feedback, some students could not perform CPR correctly. Implications of these findings for staff educators are discussed.

Conducting multisite research studies in nursing education: brief practice of CPR skills as an exemplar.

Few large, multisite studies have been conducted in nursing education, and literature pertaining to conducting those studies is lacking. We recently completed a randomized trial to examine the effects of brief practice on nursing students' retention of CPR psychomotor skills. The purpose of this article is to describe strategies for implementing a multisite study in nursing education, using our research as an exemplar. Strategies are presented for structuring a multisite study; selecting, preparing, and communicating with team members across sites; selecting sites; recruiting and retaining participants; managing the technical aspects of an intervention; and collecting and managing data. Ethical considerations also are explored.

The first Research Consensus Summit of the Society for Simulation in Healthcare: conduction and a synthesis of the results.

INTRODUCTION: In this article, we describe the preparation and execution of the first Research Consensus Summit (Summit) of the Society for Simulation in Healthcare (SSH) held in January 2011 in New Orleans, Louisiana. The goals of the Summit were to provide guidance for better simulation-related research, to broaden the scope of topics investigated, and to highlight the importance of simulation-related research. METHOD: An international Core Group (the authors of this article) worked with the SSH Research Committee to identify 10 topic areas relevant for future research that would be examined by the 10 Topic Groups composed of Topic Chairs and Topic Group Members. Each Topic Group prepared a monograph and slide presentation on their topic which was presented at the 2-day Summit. The audience provided feedback on each presentation. Based on this feedback, the Topic Groups revised their presentations and monographs for publication in this supplement to Simulation in Healthcare. The Core Group has synthesized an overview of the key Summit themes in this article. RESULTS: In some groups, the agreement was that there is currently no consensus about the state of the science in certain topic aspects. Some key themes emerged from the Topic Groups. The conceptual and theoretical bases of simulation-related research, as well as the methods used and their methodological foundations, need to be more explicitly described in future publications. Although no single method is inherently better, the mix of research methods chosen should match the goal of each study. The impact of simulation, whether direct or indirect, needs to be assessed across different levels of training, and larger, more complex contexts need to be taken into account. When interpreting simulation-related research, the ecological validity of the results needs to be taken into consideration. The scope of simulation-related research can be widened from having simulation as the focus of research (research about simulation), to using simulation to investigate other research questions (research with simulation). Simulation-related research can benefit from an improved understanding of structural differences and similarities with other domains. The development of simulation equipment and concepts will benefit from applying known and available science-based design frameworks. Overall, the context of simulation-related research needs to be better understood. The progress of research depends on building overarching and sustainable research programs that relate individual studies with each other. DISCUSSION: The Summit was successful in taking a snapshot of the state of the science. Future summits might explore these topics further, monitor progress, and address new topics.

Reporting inquiry in simulation.

The term "inquiry" covers the large spectrum of what people are currently doing in the nascent field of simulation. This monograph proposes appropriate means of dissemination for the many different levels of inquiry that may arise from the Summit or other sources of inspiration. We discuss various methods of inquiry and where they might fit in the hierarchy of reporting and dissemination. We provide guidance for deciding whether an inquiry has reached the level of development required for publication in a peer-reviewed journal and conclude with a discussion of what most journals view as inquiry acceptable for publication.

Diffusion of innovation: embedding simulation into nursing curricula.

Numerous articles have documented the benefits of using simulation as a teaching method for undergraduate nursing students. Simulation can enhance learning and provides a stimulating environment for technologically proficient students. Yet, there remain a large number of nursing programs and faculty members that are resistant toward implementing simulation as a learning tool. This article provides details on the efforts to embed simulation in an undergraduate program that started with a few interested faculty at a large, multi-site nursing program. The Diffusion of Innovation theory was used to guide the expansion of simulation to other faculty groups. The techniques used to embed simulation into the undergraduate curriculum were directed by past research. This process led to a successful integration of simulation which could provide some innovative suggestions for other programs facing similar barriers.