Healthcare Students' Experiences of Learner-Educator Cocreation of Virtual Simulations: A Phenomenographic Study.

INTRODUCTION: Cocreating virtual simulations with learners during a course is an innovative approach to improving student preparation for real-world practice while helping simulationists meet learner needs, support authentic assessment, and maximize the impact of simulation-based learning. This study explores differences in healthcare students' experiences of learner-educator cocreation of virtual simulations (LECoVSs) using phenomenographic methods. Identifying differences in perceptions of LECoVSs enables educators to make evidence-informed decisions about engaging in simulation cocreation as a tool to maximize learning. METHODS: Phenomenography focuses on identifying different ways that participants can experience the same phenomenon, in this case, LECoVSs. The setting was a collaborative interprofessional simulation assignment between navigation and nursing students. Participants completed a demographic survey then submitted reflective journals completed during the course and/or an open-ended survey. Data analysis occurred in iterative stages, from familiarization with the data to grouping and interpreting themes. RESULTS: Nineteen open-ended surveys and 13 reflective journals from navigation and nursing students who completed the simulation assignment between 2021 and 2023 were analyzed. Students experienced LECoVSs in 4 increasingly complex ways: (1) supporting consistent student progress, (2) amending course expectations, (3) sharing decision-making, and (4) fostering mutual growth. CONCLUSIONS: Simulationists may leverage cocreation to improve student learning, access, empowerment, and professional growth. However, for students to achieve higher learning outcomes, educators need to clearly communicate the full potential of cocreation, how it can occur, and why it can support learning. This study's findings may be used as a framework for explaining simulation cocreation to students to maximize their learning.

PROTOCOL: Learner-educator co-creation of student assessment in health professional education courses: A scoping review protocol.

This is a protocol for a Campbell Review following JBI scoping review methodology. The objectives are to answer the following questions: What has been reported in the literature about collaborative learner-educator design, implementation, or evaluation of learner assessment in health professional education? (1) Where is learner-educator co-creation of assessment occurring? (i.e., which disciplines, course types, level of learner, year of study). (2) What course assessment decisions are influenced or being made together? (i.e., assessment instructions and/or grades). (3) How much influence do learners have on decision-making? (i.e., where does it fall on Bovill and Bulley's ladder of participation). (4) How do learners and educators go about making decisions together? (i.e., discussion or voting, with a whole class or portion of the class). (5) What are the perceived benefits, disadvantages, barriers, and/or facilitators reported by the authors?

Development and evaluation of virtual simulation games to increase the confidence and self-efficacy of healthcare learners in vaccine communication, advocacy, and promotion.

BACKGROUND: Although healthcare providers (HCPs) are the most trusted source of vaccine information, there is a paucity of easily accessible, multidisciplinary educational tools on vaccine communication for them. Virtual simulation games (VSGs) are innovative yet accessible and effective tools in healthcare education. The objectives of our study were to develop VSGs to increase HCP confidence and self-efficacy in vaccine communication, advocacy, and promotion, and evaluate the VSGs' effectiveness using a pre-post self-assessment pilot study. METHODS: A multidisciplinary team of experts in medicine, nursing, pharmacy, and simulation development created three VSGs for HCP learners focused on addressing conversations with vaccine hesitant individuals. We evaluated the VSGs with 24 nursing students, 30 pharmacy students, and 18 medical residents who completed surveys and 6-point Likert scale pre-post self-assessments to measure changes in their confidence and self-efficacy. RESULTS: There were no significant differences in baseline confidence and self-efficacy across the three HCP disciplines, despite varied levels of education. Post-VSG confidence and self-efficacy (median: 5) were significantly higher than pre-VSG (median: 4-5) for all three HCP disciplines (P ≤ 0.0005), highlighting the effectiveness of the VSGs. Medical residents reported significantly lower post-VSG confidence and self-efficacy than nursing and pharmacy learners despite completing the most significant amount of education. CONCLUSIONS: Following the completion of the VSGs, learners in medicine, nursing, and pharmacy showed significant improvement in their self-assessed confidence and self-efficacy in holding vaccine conversations. The VSGs as an educational tool, in combination with existing clinical immunization training, can be used to increase HCP confidence and engagement in vaccine discussions with patients, which may ultimately lead to increased vaccine confidence among patients.

Shaping Social Justice Values Through Inclusive Assessment and Debriefing of eLearning Modules.

BACKGROUND: Nurses need to recognize how intersectionality shapes the experiences of individuals and families navigating complex health systems. Guided reflection on complex social justice issues serves as an approach to move beyond simply understanding social determinants of health toward shaping core professional values of developing nurses to promote lasting change. METHOD: Third-year Canadian undergraduate prelicensure nursing students co-created assignment expectations, completed online modules, and submitted initial reflections before class in a mandatory social justice course. In-class debriefing was based on students' reflections and cofacilitated by subject matter experts. Students completed a final reflection that focused on advocating for social change. RESULTS: Student feedback, reflections, and grades as well as faculty observations support the success of this interactive student-centered approach. CONCLUSION: A flexible approach to debriefing modular content informed by universal design for learning and simulation theory enables nurse educators to promote in-depth, meaningful, and lasting student learning. [J Nurs Educ. 2024;63(1):48-52.].

Using simulation to enhance primary care sexual health services for breast cancer survivors: a feasibility study.

PURPOSE: To evaluate the impact of a virtual simulation game (VSG) to improve primary care sexual health services for breast cancer survivors. METHODS: We developed a VSG to help primary care providers (PCPs) address sexual health disturbances among breast cancer survivors. We used a pretest-posttest design with a series of validated tools to assess the feasibility and perceived impact of the  VGS, including an open-ended question about participants' perceptions. Quantitative data was analyzed using descriptive and inferential statistics and qualitative data through an inductive content analysis approach. RESULTS: Of the 60 participants, the majority were nurse practitioner students (n = 26; 43.3%), female (n = 48; 80%), and worked full-time (n = 35; 58.3%). Participants perceived the VSG as feasible and potentially effective. The intervention elicited an improvement in PCPs' perception of knowledge between pretest and posttest surveys (z = - 1.998, p = 0.046). Professional background and previous exposure to sexual health training were predictors of knowledge perception. Participants described the intervention as an engaging educational strategy where they felt safe to make mistakes and learn from that. CONCLUSIONS: VSGs can be a potentially effective educational approach for PCPs. Our findings indicate that despite being an engaging interactive strategy, VSG interventions should be tailored for each professional group. IMPLICATIONS FOR CANCER SURVIVORS: This intervention has potential to improve the knowledge and practice of PCPs related to breast cancer follow-up care to support comprehensive care for survivors, resulting in a better quality of life and patient outcomes.

The use of clinical simulation in wound care education for nurses: a scoping review protocol.

Many nurse educators consider simulation a valuable tool to supplement and augment learning due to current shortages of clinical placements. Wound care is integral to nursing practice yet many students and practicing nurses experience difficulties in securing sufficient learning opportunities or experience at the undergraduate level to feel competent in providing it. Emerging evidence supports simulation as a promising intervention to facilitate student learning in wound care, building nurses' confidence and competence in providing evidence-based wound care. OBJECTIVE: To understand how clinical simulation is being used to educate nurses about wound assessment and management, and to explore the impact of clinical simulation on learning outcomes, including knowledge, attitudes, confidence, and skills related to wound care. INCLUSION CRITERIA: Inclusion criteria include studies of nursing students and nurses, simulation educational interventions, and learning outcomes related to wound care evaluated by any measures. Any studies that do not fit these criteria will be excluded. METHODS: Databases to be searched include PubMed/MEDLINE, CINAHL, ERIC, SciELO up to February 2022. Studies in English with a date limit of 2012 to 2022 will be included. Search results will be imported into Covidence and screened by two independent reviewers, first based on the title and abstract and then full text. Data will be extracted with a novel extraction tool developed by the reviewers and then synthesised and presented in narrative, tabular, and/or graphical forms. DISSEMINATION: The finished scoping review will be published in a scientific journal once analysis is completed.

Identifying the Professional Development Needs Among Early Career Doctorally Prepared Oncology Professionals.

This study aimed to identify the professional development needs of early career doctorally prepared professionals in psychosocial oncology. We used a cross-sectional descriptive survey design to assess professionally related skills deemed most important to participants' academic excellence and promotion, skills they felt most and least confident to engage in, and those they were most interested to learn more about. Seventeen participants completed the survey and were, on average, 39.3 years of age (range 29-55 years) and had completed doctoral or post-doctoral training 3.1 years previously (range 0-5 years). Participants identified seeking external funding as not only the most important skill to achieve their academic excellence and promotion, but also as the skill they felt least confident to engage in. They felt most confident to engage in career planning and getting published and were most interested to learn more about how to negotiate a career/position. Participants also expressed interest in having access to a forum wherein they could collaborate with others and receive mentorship from expert oncology professionals with doctoral degrees. The findings from this study point to the need for professional development opportunities for oncology professionals before and after they complete their doctoral or post-doctoral training. Study participants' perspectives offer insights about topics that may be enhanced in doctoral and post-doctoral mentorship programs.

"How to start that conversation?": Experiences of developing a virtual simulation about sexual health care for breast cancer survivors.

Virtual simulation (VS) is an innovative and engaging knowledge translation strategy that can improve healthcare providers' knowledge and skills. However, there is no known literature published related to the use of simulation to improve cancer survivorship care. In this paper, we describe our experience of developing a VS to educate primary healthcare professionals about sexual health disturbances among breast cancer survivors. Based on literature in other contexts, this VS may help increase health professionals' knowledge and skills needed to assist breast cancer survivors with sexual health concerns. Our VS development experience can be used to encourage and guide other researchers planning to develop similar interventions in the future.

Virtual clinical simulation to teach mental health concepts: a scoping review protocol.

OBJECTIVE: The objective of this review is to determine the extent of the literature on the use of virtual clinical simulation to teach health professional students about mental health. INTRODUCTION: Graduates of health professional programs need to be prepared to provide safe and effective care for persons with a mental illness in every practice context. Clinical placements in specialty areas are difficult to obtain and cannot ensure students will have opportunities to practice specific skills. Virtual simulation is a flexible and innovative tool that can be used in pre-registration health care education to effectively develop cognitive, communication, and psychomotor skills. Given the recent focus on virtual simulation usage, the literature will be mapped to determine what evidence exists regarding virtual clinical simulation to teach mental health concepts. INCLUSION CRITERIA: We will include reports that focus on pre-registration health professional students and use virtual simulation to teach mental health concepts. Reports that focus on health care workers, graduate students, patient viewpoints, or other uses will be excluded. METHOD: Four databases will be searched including MEDLINE, CINAHL, PsycINFO, and Web of Science. Reports with a focus on mental health virtual clinical simulation for health professional students will be mapped. Independent reviewers will screen titles and abstracts, then review the full texts of articles. Data from studies meeting the inclusion criteria will be presented in figures and tables, and described narratively. REVIEW REGISTRATION NUMBER: Open Science Framework https://osf.io/r8tqh.

Quality improvement tools to manage deceased organ donation processes: a scoping review.

OBJECTIVE: To collate and summarise the literature on the quality improvement tools that have been developed for deceased organ donation processes after circulatory determination of death and neurological determination of death. DESIGN: Scoping review using the Joanna Briggs Institute framework. DATA SOURCES: We searched for published (MEDLINE, Embase, PsycINFO, CINAHL, Web of Science) and unpublished literature (organ donation organisation websites worldwide). The search was initially conducted on 17 July 2021 and updated on 1 June 2022. Included articles discussed the creation and/or use of quality improvement tools to manage deceased organ donation processes. Two independent reviewers screened the references, extracted and analysed the data. RESULTS: 40 references were included in this review, and most records were written in English (n=38), originated in Canada (n=21), published between 2016 and 2022 (n=22), and were specific for donation after neurological determination of death (n=20). The tools identified included checklists, algorithms, flow charts, charts, pathways, decision tree maps and mobile apps. These tools were applied in the following phases of the organ donation process: (1) potential donor identification, (2) donor referral, (3) donor assessment and risk, (4) donor management, (5) withdrawal of life-sustaining measures, (6) death determination, (7) organ retrieval and (8) overall organ donation process. CONCLUSIONS: We conducted a thorough investigation of the available quality improvement tools for deceased organ donation processes. The existing evidence lacks details in the report of methods used for development, testing and impact of these tools, and we could not locate tools specific for some phases of the organ donation process. Lastly, by mapping existing tools, we aim to facilitate both clinician choices among available tools, as well as research work building on existing knowledge.

Developing simulation games to advance public health nursing competence in baccalaureate education.

We describe the development of an innovative baccalaureate nursing education strategy for public health nursing. Virtual simulation pedagogy is known to be effective for acute care nursing practice while less known for public health nursing. Three Canadian nursing schools, the Canadian Association of Schools of Nursing (CASN), and the Canadian Alliance of Nurse Educators using Simulation (CAN-Sim) partnered to develop three public health nursing virtual simulation games. Learners work through unfolding population health scenarios, simulating public health nursing practice focused on entry level public health nursing competencies. Each game fosters clinical reasoning and collaborative, community decision-making to respond to population health issues during community assessment, evidence-informed health promotion planning, and evaluation processes. A companion guide was developed to support best practices in implementing virtual simulation and promote optimum student learning using the public health nursing games.

Exploring the effect of neurofeedback on postcancer cognitive impairment and fatigue: A pilot feasibility study.

Purpose: Postcancer cognitive impairment (PCCI) and fatigue are adverse effects that often persist following cancer treatment, and impact quality of life. The study purpose was to evaluate feasibility and effect of neurofeedback on cognitive functioning and fatigue in cancer survivors. Specifically, we aimed to test feasibility of recruitment strategies and our study protocol including outcome measures. Design: This pilot feasibility study used a 10-week wait-list design. Participants served as their own controls and received neurofeedback training twice a week for 10 weeks. Participants: The sample consisted of breast cancer survivors from Kingston, Ontario (n = 16). Methods: Outcomes were assessed using validated, self-report scales and neuropsychological tests before, during, and after neurofeedback. Findings: The neurofeedback protocol was feasible and resulted in significant decreases in perceived cognitive deficits, fatigue, sleep, and psychological symptoms. Implications for psychosocial providers: Neurofeedback may be an effective, non-invasive complementary therapy for PCCI in breast cancer survivors.

Wolfgang's Story: A Virtual Simulation Supporting Effective and Supportive Communication With an Older Gay Adult.

Lesbian, gay, bisexual, transgender, queer, intersex, and Two-Spirit (LGBTQI2S) older adults face barriers to quality health care, often because practitioners misunderstand the unique health needs of this population. Education is essential to support nurses in maintaining culturally safe practice. Wolfgang's Story, a virtual simulation developed as an educational resource to address this need, focuses on an interaction between an older gay adult and a nurse during a health-care encounter, exploring the use of appropriate terminology, personal assumptions, biases, and key concepts related to heterosexism and to grief. The aim of the article is to report on the development, implementation, and evaluation of this project.

Feasibility of Virtual Simulation-Based Diabetes Foot Care Education in Patients with Diabetes in Ethiopia: Protocol for a Randomized Controlled Trial.

Introduction: Diabetes mellitus is a rapidly growing global public health problem; the number of adults with diabetes is expected to increase from 424.9 million in 2017 to 628.6 million in 2045. Approximately 80% of diabetic patients live in low- and middle-income countries where access to care may be limited. For example, in Ethiopia, diabetes care is often rudimentary, and formal, structured diabetes education is almost non-existent. One potential solution to the lack of diabetes management education for patients could be virtual simulation-based diabetes education incorporating the contextual realities of patients in Ethiopia. Despite its great potential to improve glycemic control, delay diabetes-related complications and reduce mortality associated with diabetes, the feasibility of virtual simulation-based diabetes self-management education has not been studied in low- and middle-income settings. Objective: The purpose of the current study is to evaluate the feasibility of a virtual simulation-based Diabetes Foot Care Education (DFCE) program among adult patients with diabetes in Ethiopia. Methods: A randomized controlled feasibility study including participants from University of Gondar Referral Hospital (UoGRH) will be conducted. A sample of 40 participants will be recruited, of which 20 participants will receive the virtual simulation-based education program, and the other 20 participants will continue with their usual diabetes care. After the education program, a questionnaire and structured interview will be used to explore the feasibility (acceptability, practicality) and the potential impact of virtual simulation-based DFCE intervention in patients with diabetes. Data will be analyzed using SPSS version 25 using descriptive statistics, independent t-tests, paired sample t-test, and factorial ANOVA at significance levels of less than 0.05. Discussion: Our study seeks to understand the perceived usefullness and usability of virtual simulation-based diabetes foot care education on behavioural (diabetes foot-care knowledge, foot self-care practices, and foot self-care efficacy). Furthermore, the study will provide insight to assist in the development of technologically assisted and contextually designed DFCE programs. Trial Registration Number: NCT04841291 (ClinicalTrials.gov Identifier).

Cultural Humility Toolkit.

BACKGROUND: Diversity, equity, and inclusion (DEI) are increasingly recognized as core values for nursing education and practice. PURPOSE: The purpose of this article is to offer teaching tools and strategies to integrate cultural humility within the nursing curriculum and create a more inclusive learning environment. APPROACH: Various teaching tools, methods, and strategies are presented. OUTCOMES: Use of ground rules, an environmental assessment, examination of the curriculum landscape and teaching materials, bias awareness activity, modified privilege walk, Modified Monopoly, simulation, low-income community experiences, study abroad, debriefing, and evaluation with valid and reliable tools are suggested. CONCLUSIONS: By threading cultural humility concepts throughout the curriculum, nurse educators have the potential to shape learner perspectives to better appreciate and value diversity.

Quality improvement tools to manage deceased organ donation processes: A scoping review protocol.

AIM: To collate and summarize the literature on what quality improvement tools have been developed on safety of deceased organ donation processes for donation after circulatory determination of death and neurological determination of death. BACKGROUND: The increasing organ shortage requires that organ donation organizations take preventive measures to improve their processes and maximize organ donation opportunities. Quality improvement tools can be used to facilitate daily activities, prevent errors and enhance organ donation processes. Still, there is a paucity of comprehensive evidence around the use of these strategies to manage organ donation processes. METHODS: Scoping review methodology according to the Joanna Briggs Institute framework. We will search MEDLINE, Embase, PsycINFO, CINAHL, Web of Science - Science Citation Index and Social Science Citation Index and Academic Search Complete. We will also conduct a web search of Google and request unpublished material (e.g., institutional protocols and quality improvement tools) from key stakeholders in the organ donation field worldwide and we will consider reports dated after 2000. Two independent reviewers will screen the literature against the inclusion criteria, extract data according to the data extraction tool and perform descriptive analysis. Results will be assembled, summarized and presented through tabular form accompanied by a narrative summary to answer the review question. EXPECTED RESULTS: Results from this scoping review will be used to develop and update quality improvement tools in decease organ donation, will be used to guide the second phase of a study aiming at developing a set of quality improvement tools to decease organ donation process, as well as these results can be used to inform future policy development in deceased organ donation.

Reviews of Literature in Nursing Research: Methodological Considerations and Defining Characteristics.

Despite the availability of guidelines about the different types of review literature, the identification of the best approach is not always clear for nursing researchers. Therefore, in this article, we provide a comprehensive guide to be used by health care and nursing scholars while choosing among 4 popular types of reviews (narrative, integrative, scoping, and systematic review), including a descriptive discussion, critical analysis, and decision map tree. Although some review methodologies are more rigorous, it would be inaccurate to say that one is preferable over the others. Instead, each methodology is adequate for a certain type of investigation, nursing methodology research, and research paradigm.

Redefining Cheating on Written Exams: A Shift Toward Authentic Assessment to Promote Universal Design for Learning in the Context of Critical Caring Pedagogy.

Educators who recognize the value of authentic written exams for promoting student critical thinking may struggle with concerns about cheating. In this article, we explore how educators may use open-web take-home exams to help students develop integrity and evidence-based practice skills. Lang's theory is used to explore why students may cheat. We discuss the importance of caring assessment practices by drawing on critical caring pedagogy and universal design for learning. Throughout the discussion, we illustrate how authentic questions and instruction that is focused on dialogue, collaboration, and resource use may reduce cheating possibilities while improving student learning.