Tool or Tyrant: Guiding and Guarding Generative Artificial Intelligence Use in Nursing Education.

As artificial intelligence (AI) continues to evolve rapidly, its integration into nursing education is inevitable. This article presents a narrative exploring the implementation of generative AI in nursing education and offers a guide for its strategic use. The exploration begins with an examination of the broader societal impact and uses of artificial intelligence, recognizing its pervasive presence and the potential it holds. Thematic analysis of strengths, weaknesses, opportunities, and threats collected from nurse educators across the southeastern United States in this case-based descriptive study used four codes: time, innovation, critical thinking, and routine tasks. Findings from the qualitative analysis revealed the overarching themes that AI can serve as both a tool and a tyrant, offering opportunities for efficiency and innovation while posing challenges of transparency, ethical use, and AI literacy. By establishing ethical guidelines, fostering AI literacy, and promoting responsible implementation in nursing education with a clear articulation of expectations, nurse educators can guide and guard the use of generative AI. Despite the concerns, the transformative potential of generative AI to enhance teaching methodologies and prepare students for the interprofessional health-care workforce provides a multitude of innovative opportunities for teaching and learning.

Engagement Across Professions: A Mixed Methods Study of Debriefing After Interprofessional Team Training.

INTRODUCTION: Simulation is an ideal tool for interprofessional (IP) team training. Debriefing after simulation is key to IP learning, although engagement and participation may be adversely influenced by cultural and hierarchical barriers. This mixed-methods study explored factors influencing learner engagement and participation in IP debriefing and the experience of "silent but apparently engaged" participants. METHODS: Semistructured profession-specific focus groups were conducted with participants from a weekly IP pediatric simulation program. Focus groups were recorded, transcribed, and thematically analyzed. Eligible participants were assigned to "silent" or "verbal" groups according to observed behavior and received a questionnaire. Participants' self-rated engagement scores were compared using a t test. RESULTS: Thirty-six of 81 eligible participants were included, 13 completed a questionnaire, and 23 (8 physicians, 10 nursing staff, 4 pharmacists, 1 respiratory therapist) participated in 13 focus groups. Twenty-two subthemes were grouped into 6 themes: psychological safety, realism, distractors, stress, group characteristics, and facilitator behavior, with differences in perspective according to profession. Of the 36 respondents, 18 were "silent" and 18 "verbal." Self-rated engagement scores differed between groups (3.65 vs. 4.17, P = 0.06); however, "silent" participants described themselves as engaged. CONCLUSIONS: Themes identified that influenced learner engagement in debriefing included aspects of prebriefing and the simulation. Some aligned with general simulation best practices, such as psychological safety, prebriefing, and facilitator behavior. Findings unique to IP simulation included importance of realism to nonphysician professions, protecting time for training, group composition, and direct probing by cofacilitators to decrease physician bias and emphasize IP contributions. Silent participants reported engagement.

Online Graduate Student Retention: Integrative Review With a Theoretically Framed Case Exemplar.

BACKGROUND: Retention of online nursing students in graduate education is essential as the need for nurses exceeds the current supply. METHOD: The factors contributing to student attrition are reviewed, and a real-world case exemplar is presented to demonstrate the theoretical design and implementation of an orientation to support retention. RESULTS: Knowles' theory of adult learning and Cooper's PECS (purpose, expectations, connections, and support) model for an evidence-based orientation framework guided the design of the orientation. Knowles' theory was aligned with the PECS model to further describe how student and environmental factors can be addressed in an orientation framework and provide strategies for implementation. Additionally, these PECS definitions were applied to specific activities within a conceptual, theoretical, and empirical framework for development of orientations. CONCLUSION: This case exemplar demonstrated an orientation framework for a feasible application of theory and evidence-based strategies for graduate online nursing programs. [J Nurs Educ. 2022;61(6):314-321.].

Student-Centered Reading Using PDF Software as an Innovative Teaching Strategy in Graduate Nursing Education.

ABSTRACT: Student engagement in scholarly reading and critical thinking contributes to nursing science. However, graduate students often lack the skills and experience needed to read and analyze scholarly writings in depth. This case example describes use of portable document format technology with reading prompts to improve student scholarship in a master of science in nursing program. Theory and research guided development of the visible reading innovation. Student work with this pilot assignment sequence indicates an increase in student engagement with the text, as evidenced by student comment content, comment spacing throughout the text, and text integration into a summative writing assignment.

Printing a Pacinian Corpuscle: Modeling and Performance.

The Pacinian corpuscle is a highly sensitive mammalian sensor cell that exhibits a unique band-pass sensitivity to vibrations. The cell achieves this band-pass response through the use of 20 to 70 elastic layers entrapping layers of viscous fluid. This paper develops and explores a scalable mechanical model of the Pacinian corpuscle and uses the model to predict the response of synthetic corpuscles, which could be the basis for future vibration sensors. The -3dB point of the biological cell is accurately mimicked using the geometries and materials available with off-the-shelf 3D printers. The artificial corpuscles here are constructed using uncured photoresist within structures printed in a commercial stereolithography (SLA) 3D printer, allowing the creation of trapped fluid layers analogous to the biological cell. Multi-layer artificial Pacinian corpuscles are vibration tested over the range of 20-3000 Hz and the response is in good agreement with the model.

Preparing Nurse Educators: The Current Landscape.

There is an urgent need to address the nursing faculty shortage and evaluate current enrollment in nurse educator programs across the country. In this article, we describe a nationwide review of graduate nursing programs focusing on the nursing education shortage; program, faculty, and student demographics; methodological approaches; concentrations, content and practice areas; and future directions for graduate program development.

Electronic Dissemination of a Web-Based Video Promotes PrEP Contemplation and Conversation Among US Women Engaged in Care at Planned Parenthood.

We evaluated the acceptability and impact of a web-based PrEP educational video among women (n = 126) by comparing two Planned Parenthood centers: one assigned to a Web Video Condition and one to a Standard Condition. Most women reported the video helped them better understand what PrEP is (92%), how PrEP works (93%), and how to take PrEP (92%). One month post-intervention, more women in the Web Video Condition reported a high level of comfort discussing PrEP with a provider (82% vs. 48%) and commonly thinking about PrEP (36% vs. 4%). No women with linked medical records initiated PrEP during 1-year follow-up.

Managing the Forgetful Patient: Best Practice for Cognitive Impairment.

The primary care physician is well positioned to identify and treat patients with cognitive impairment (CI). Simple, validated tools can screen for CI in the office. Identifying the type of dementia and stage of the disease helps to guide care. A thorough history, medication review, physical examination, laboratory workup, and imaging studies can help identify specific causes contributing to memory loss. A patient-centered, multidisciplinary team approach includes nonpharmacological and pharmacologic treatments. Patient safety and preservation of functional status should be at the forefront of caring for the forgetful patient.

Resilience Education for Health-Care Professionals.

BACKGROUND: Burnout among health-care professionals is a growing problem having a sizeable impact on patient safety and health care as a whole. High levels of resilience in health-care professionals have been associated with safer care environments, improved health outcomes, higher quality care, and improved caregiver well-being and mental health. Resilience education can improve personal and professional resilience. OBJECTIVE: The goal of this project was to evaluate a resilience education program to improve measures of burnout and resilience in health-care professionals. DESIGN: A quantitative cross-sectional pretest/posttest design was used. SETTING: The resilience education program was implemented in a large, not-for-profit health-care system in the southeastern United States. METHODS: Participants completed the Copenhagen Burnout Inventory (CBI) and The Connor-Davidson Resilience Scale-25 (CD-RISC-25) immediately before the workshop and 2 weeks afterward. Participants also completed an evaluation survey one day after the education. RESULTS: Scores on the CD-RISC-25 showed statistically significant increases in resilience qualities after the education. Although not statistically significant, burnout as measure by CBI scores decreased following the workshop. CONCLUSION: A relatively short educational program can positively impact resilience and burnout levels in health-care professionals. Positive outcomes included successful learning outcomes and increased resilience qualities.

Using the Jigsaw Teaching Method to Enhance Internal Medicine Residents' Knowledge and Attitudes in Managing Geriatric Women's Health.

Introduction: Although studies surveying internal medicine (IM) residency program directors identify geriatric women's health as an essential curriculum topic, there are limited published women's health curricula for IM residents. Our IM residency program performed a needs assessment, which revealed that the majority of residents were unsatisfied with our current curricula and most were not confident managing geriatric women's health. We developed and assessed a structured curriculum to improve IM residents' knowledge and confidence in addressing geriatric women's health. Methods: This 2-hour interactive workshop used the jigsaw teaching method (a cooperative learning strategy where peers deliver specific content in teams) to teach 84 categorical IM residents of all PGY levels about the diagnosis and management of menopause, osteoporosis, urinary incontinence, and abnormal uterine bleeding. Participants completed a pretest and immediate posttest to assess knowledge and confidence about the targeted topics. We compared baseline and postworkshop responses using chi-square and Wilcoxon signed rank tests. Results: Seventy-four (88%) IM residents completed the pretest, and 62 (74%) completed the posttest. Mean knowledge scores improved from 51% to 69% (p < .0001). Residents who reported feeling somewhat confident or confident in addressing women's health topics increased from 14% to 44% (p < .0001). The majority were satisfied or very satisfied with the workshop (94%) and requested additional women's health education (92%). Discussion: Our results suggest that workshops using the jigsaw teaching method can effectively increase IM resident knowledge and confidence in managing geriatric women's health.

AAIM Recommendations for the 2020-2021 Internal Medicine Residency Application Cycle in Response to the COVID-19 Pandemic.

This statement was released in June 2020 by the Alliance for Academic Internal Medicine to provide guidance for the 2020-2021 residency application cycle in light of the COVID-19 pandemic. While many of the recommendations are specific to this cycle, others, such as the Department Summary Letter of Evaluation, are meant to be an enduring change to the internal medicine residency application process. AAIM realizes that some schools may not yet have the tools or resources to implement the template fully this cycle and look toward collaboration within the internal medicine education community to facilitate adoption in the cycles to come.

Understanding roles in health care through interprofessional educational experiences.

BACKGROUND: Students can find interacting within a healthcare team challenging. It is important for students to understand their role and respect those of other healthcare team members. Interprofessional education (IPE) is a strategy for exploring the roles of self and others within the team. AIM: The purpose of this study was to evaluate nursing students' perceptions of roles and responsibilities following an IPE experience. METHODS: Students in an undergraduate baccalaureate degree nursing programme participated in a two-day IPE event with students in the physician's assistant's (PA) programme, pharmacy programme, and physical therapy (PT) programme. FINDINGS: Self-perception and the perception of others were two main themes that emerged. The results suggested that roles and responsibilities are often misunderstood. CONCLUSION: Educators must be committed to educating our future healthcare workforce on role expectations and responsibilities within an individual's own profession and that of others. This education should start in the foundation stages of each discipline's educational curricula.

Vibration sensing the mammalian way: an artificial Pacinian corpuscle.

A vibration sensor is presented mimicking the structure of the Pacinian corpuscle. A multi-step casting process is used to create a 5 mm diameter sensor with a liquid metal core, elastomer dielectric, and graphite counter electrode creating a spherical capacitive sensing element with sensitivities on the order of 10 Δ pF/mm-1. A model for the capacitance change of the spherical capacitor as it is formed is developed and its findings support the sensitivities observed. Various elastomer dielectric compositions with integrated barium titanate nanoparticles are tested to increase the dielectric constant. The biological acoustic filter within the corpuscle is mimicked using alternating cast layers of oligomers and elastomers around the spherical sensor element. Vibration sensing is characterized over the low frequency range of 10-300 Hz and the minimum detectable sensitivity is found to be 1 µm with a low power requirement of 7 mW. The artificial Pacinian corpuscle has potential applications in tactile sensing and seismic monitoring devices.

Role expectations and workplace relations experienced by men in nursing: A qualitative study through an interpretive description lens.

AIMS: The aim of this study was to investigate the lived experiences of male nurses in today's healthcare environment to understand the persistently low numbers of men in nursing. DESIGN: This study used interpretive description methodology, which aligns with nursing's approach to knowledge discovery by acknowledging the evolution and complexity of shared and individual experiences. METHODS: Participants, (N = 11), were recruited through the American Association for Men in Nursing using purposive sampling. Focused interviews were conducted between May 2018 - June 2018. Interviews were semi-structured, guided by open-ended questions and video and audio recorded. Data were analysed according to study design with categories and themes extracted using reliability measures. RESULTS: This study's findings reflected the unique experiences of each participant in a primarily female dominated work environment in clinical and academic settings. Our study identified thematic categories of role expectations and workplace relations for the men in the study. Role expectations were influenced by sociocultural views, professional acceptance and patient/family perceptions. Workplace relations were associated with being male, social cliques and peer support. CONCLUSION: Participants shared similar and distinctly individual experiences. Findings from this study indicate there has been progress toward improving male presence in nursing but additional efforts are needed to increase inclusivity. Findings can be used to make recommendations for professional change in nursing, strengthen diversity by refining ways to recruit more men, enhance patients' experiences and improve experiences for future male nurses. IMPACT: This study addressed low numbers of men in nursing. Main findings included role expectations and workplace relations and how they are experienced by men in nursing. Findings from this research have a multidisciplinary impact in the workplace, and affect care of patients and their families.

Differences in Medical Mistrust Between Black and White Women: Implications for Patient-Provider Communication About PrEP.

Pre-exposure prophylaxis (PrEP) is an effective biomedical HIV prevention method. PrEP uptake has been persistently low among US women, particularly Black women, who account for 61% of new HIV diagnoses among women. Further understanding of barriers to Black women accessing PrEP is needed. This 2017 cross-sectional survey study explored race-based differences in PrEP interest and intention among women and the indirect association between race and comfort discussing PrEP with a healthcare provider through medical mistrust. The sample consisted of 501 adult women (241 Black; 260 White) who were HIV-negative, PrEP-inexperienced, and heterosexually active. Black women reported greater PrEP interest and intention than White women. However, Black women expressed higher levels of medical mistrust, which, in turn, was associated with lower comfort discussing PrEP with a provider. Medical mistrust may operate as a unique barrier to PrEP access among Black women who are interested in and could benefit from PrEP.

Effectiveness of an interprofessional patient safety team-based learning simulation experience on healthcare professional trainees.

BACKGROUND: Although the American Council of Graduate Medical Education (ACGME) mandates formal education in patient safety, there is a lack of standardized educational practice on how to conduct patient safety training. Traditionally, patient safety is taught utilizing instructional strategies that promote passive learning such as self-directed online learning modules or didactic lectures that result in suboptimal learning and satisfaction. METHODS: During the summer of 2015, 76 trainees consisting of internal medicine interns and senior-level nursing students participated in an interactive patient safety workshop that used a flipped classroom approach integrating team based learning (TBL) and interprofessional simulated application exercises. RESULTS: Workshop trainees demonstrated an increase in knowledge specifically related to patient safety core concepts on the Team Readiness Assurance Test (TRAT) compared to the Individual Readiness Assurance Test (IRAT) (p = 0.001). Completion rates on the simulation application exercises checklists were high except for a few critical action items such as hand-washing, identifying barriers to care, and making efforts to clarify code status with patient. The Readiness for Interprofessional Learning Scale (RIPLS) subscale scores for Teamwork and Collaboration and Professional Identity were higher on the post-workshop survey compared to the pre-workshop survey, however only the difference in the Positive Professional Identity subscale was statistically significant (p = 0.03). A majority (90%) of the trainees either agreed that the safety concepts they learned would likely improve the quality of care they provide to future patients. CONCLUSIONS: This novel approach to safety training expanded teaching outside of the classroom and integrated simulation and engagement in error reduction strategies. Next steps include direct observation of trainees in the clinical setting for team-based competency when it comes to patient safety and recognition of system errors.

Proposed Performance-Based Metrics for the Future Funding of Graduate Medical Education: Starting the Conversation.

Graduate medical education (GME) in the United States is financed by contributions from both federal and state entities that total over $15 billion annually. Within institutions, these funds are distributed with limited transparency to achieve ill-defined outcomes. To address this, the Institute of Medicine convened a committee on the governance and financing of GME to recommend finance reform that would promote a physician training system that meets society's current and future needs. The resulting report provided several recommendations regarding the oversight and mechanisms of GME funding, including implementation of performance-based GME payments, but did not provide specific details about the content and development of metrics for these payments. To initiate a national conversation about performance-based GME funding, the authors asked: What should GME be held accountable for in exchange for public funding? In answer to this question, the authors propose 17 potential performance-based metrics for GME funding that could inform future funding decisions. Eight of the metrics are described as exemplars to add context and to help readers obtain a deeper understanding of the inherent complexities of performance-based GME funding. The authors also describe considerations and precautions for metric implementation.