Developing Formative Strategies to Support Undergraduate Nursing Student's Learning in the Lab.

BACKGROUND: Undergraduate nursing education consists of supporting students' learning about psychomotor skills. There is variation in strategies used to facilitate learning in the lab setting because there is no single accepted or preferred educational approach. METHOD: Formative learning strategies were integrated into lab courses throughout a nursing curriculum for undergraduate students at a Canadian university. These strategies included developing and implementing guidelines, a rubric, and an addendum. RESULTS: Students enrolled in lab courses that used these strategies received ongoing verbal and written feedback from their instructor and were provided with an opportunity to engage in reflective practice and refine clinical judgment skills. CONCLUSION: Using consistent and effective formative strategies to support students' learning in the lab requires further empirical exploration and consideration. [J Nurs Educ. 2024;63(X):XXX-XXX.].

Scaffolding safety in nursing simulation: A grounded theory.

BACKGROUND: Simulation-based learning is a teaching technique that allows learners to apply theoretical knowledge to enhance patient safety. Despite limited evidence about the relationship between simulation and patient safety outcomes, nursing programs continue using simulation to improve student competencies. PURPOSE: To explore the processes driving the actions of nursing students while providing care for a rapidly deteriorating patient during a simulation-based experience. METHOD: Following the constructivist grounded theory method, the study recruited 32 undergraduate nursing students to explore their experiences during simulation-based experiences. Data were collected using semi-structured interviews over 12 months. Interviews were recorded, transcribed and analyzed using constant comparison and simultaneous data collection, coding, and analysis. RESULTS: Two theoretical categories emerged from the data to explain the processes driving the students' actions during simulation-based experiences: Nurturing and contextualizing safety. The themes revolved around a core category of "Scaffolding Safety" in simulation. CONCLUSION: Simulation facilitators can use the findings to build effective and targeted simulation scenarios. Scaffolding safety steers students' thinking and contextualizes patients' safety. It can be utilized as a lens to guide students and assist them with transferring skills from simulation to the clinical practice setting. Nurse educators should consider deliberately integrating the concepts of scaffolding safety into simulation-based experiences to connect theory and practice.

Exploring the meaning of critical incident stress experienced by undergraduate nursing students: A hermeneutic study.

AIM: To better understand the meaning of clinical related critical incident stress experienced by undergraduate nursing students. BACKGROUND: Undergraduate nursing students who engage in learning in the clinical practice setting may experience critical incidents. DESIGN: Gadamer's philosophical hermeneutics (1960/2013) was used to explore the meaning of clinical related critical incident stress experienced by undergraduate nursing students. METHODS: A purposive sample was used to recruit 11 students who were enrolled in a Canadian university baccalaureate nursing program. Data collection involved conducting semi-structured interviews over 10 months in 2020-2021. The interviews were recorded and transcribed verbatim and the data were analyzed using the interpretive method of hermeneutics. RESULTS: Findings from this research revealed that the student-teacher relationship was influenced by students' experiences of critical incident stress. Students' navigating uncertainty and the need to maintain the optic of perfection had a potential impact on the response to critical incidents. CONCLUSION: This study highlighted that critical incident stress may lead to distress associated with students' altered perception of nursing as a discipline and profession as well as created opportunity for new insights and possibilities.

Clinical related critical incidents in undergraduate nursing students: A scoping review.

AIM: The purpose of this scoping review was to map clinical-related critical incidents and their implications on undergraduate nursing students. BACKGROUND: The unpredictability inherent in the clinical learning environment places nursing students at risk of a critical incident that may lead to long-term consequences. DESIGN: A scoping review was conducted using the Joanna Briggs Institute framework. METHOD: A search for primary research sources and dissertations was conducted using the CINAHL, PubMed, Dissertation and Thesis Global, and MEDLINE databases. Eligibility criteria included primary research related to undergraduate nursing students who had experienced critical incidents in the clinical setting. RESULTS: From a total of 66 identified articles, only one met the inclusion criteria. Overall, it was identified that the term "stress" was inconsistently defined. Researchers have primarily focused on general stress from academic and experiential learning rather than sudden and unexpected critical incidents underpinned by clinical experiences. CONCLUSION: The scoping review results identify a significant gap in the research relative to clinical-related critical incidents and the associated implications experienced by undergraduate nursing students. RELEVANCE TO CLINICAL PRACTICE: Further research is needed so that crisis interventions can be prioritized and strategies to enhance resilience can be addressed before graduation.

Antihypertensive therapy in patients with moderate to severe aortic stenosis.

ABSTRACT: Patients with aortic stenosis are at risk for developing hypertension. The selection of antihypertensives is a topic of debate due to a lack of consensus regarding their safety. This article provides an overview of antihypertensives used in patients with aortic stenosis, focusing on renin-angiotensin system inhibitors, beta-blockers, diuretics, and vasodilators.

Exploring the meaning of critical incident stress experienced by intensive care unit nurses.

The complexity of registered nurses' work in the intensive care unit places them at risk of experiencing critical incident stress. Gadamer's philosophical hermeneutics (1960/2013) was used to expand the meanings of work-related critical incident stress for registered nurses working with adults in the intensive care unit. Nine intensive care unit registered nurses participated in unstructured interviews. The interpretations emphasized that morally distressing experiences may lead to critical incident stress. Critical incident stress was influenced by the perception of judgment from co-workers and the organizational culture. Nurses in this study attempted to cope with critical incident stress by functioning in 'autopilot', temporarily altering their ability to critically think and to conceal emotions. Participants emphasized the importance of timely crisis interventions tailored to support their needs. This study highlighted that critical incident stress was transformative in how intensive care unit nurses practiced, potentially altering their professional self-identity. Work-related critical incident stress has implications for nurses, the discipline, and the health care system.

Connecting Theory to Practice: Using Guided Questions to Standardize Clinical Postconference.

BACKGROUND: Assisting nursing students with the integration of theoretical knowledge in the practice setting can be a challenge for clinical instructors. Clinical instructors using planned questions to guide discussion among students during postconference is one method that can be used to achieve this goal. Open-ended guided questions that deliberately address and synthesize classroom knowledge during postconference discussions are advantageous to both students and clinical instructors. METHOD: The purpose of this article is to describe the process of standardizing the weekly postconference by deliberately integrating questions within a second-year nursing clinical course at a Canadian university. RESULTS: In this course, the guided questions provided clinical instructors who facilitated the postconferences with an opportunity to enhance their own level of comprehension and currency in various subject areas, as well as evaluate students' critical thinking and knowledge gaps. CONCLUSION: Understanding the nursing curriculum and providing clinical instructors with the appropriate skills to facilitate postconference discussions were paramount to the success of these standardized postconferences.