Impact of bed height on the biomechanics of healthcare professionals during chest compressions on the neonate: a descriptive pilot study.

OBJECTIVES: The biomechanics of the healthcare professionals (HCPs) performing the life-saving intervention of chest compressions in the neonatal population is poorly understood. The aim of this pilot study was to describe the variations in body position at a self-selected and a predetermined bed height during neonatal chest compressions. Measures of joint angles, time to postural sway and number of postural adjustments were chosen as indices for the stability of the HCP's position. SETTING: Data were collected at a simulation-based research centre in which the patient care environment was replicated. PARTICIPANTS: HCPs with varying roles working in the neonatal intensive care unit and holding a current Neonatal Resuscitation Program Provider certification were recruited for this study. INTERVENTIONS: Fifteen HCPs performed two trials of chest compressions, each lasting 2 min, at a predetermined bed height and a self-selected bed height. Trials were video recorded, capturing upper and lower body movements. Videos were analysed for time to postural sway and number of postural adjustments. Joint angles were measured at the start and end of each trial. RESULTS: A statistically significant difference was found between the two bed height conditions for number of postural adjustments (p=0.02). While not statistically significant, time postural sway was increased in the choice bed height condition (85 s) compared with the predetermined bed height (45 s). After 30 s of chest compressions, mean shoulder and knee angles were smaller for choice bed height (p=0.03, 95% CI Lower=-12.14, Upper=-0.68 and p=0.05, 95% CI Lower=3.43, Upper=0.01, respectively). After 1 min and 45 s of chest compressions, mean wrist angles were smaller in the choice bed height condition (p=0.01, 95% CI Lower=-9.20, Upper=-1.22), stride length decreased between the 30 s and 1 min 45 s marks of the chest compressions in the predetermined height condition (p=0.02).

Identifying strengths and weaknesses in the utilization of Objective Structured Clinical Examination (OSCE) in a nursing program.

Objective Structured Clinical Examination (OSCE) is used in nursing to assess students' transfer of classroom and laboratory learning experiences into simulated clinical practice. OSCE is a performance-based exam in which students are observed demonstrating a multitude of clinical behaviors. The purpose of this study was to identify strengths and weaknesses in the utilization of OSCE in this nursing program with 60 full-time students ages 21 to 23. An evaluation methodology was used for this study. Interviews were conducted with two groups: faculty facilitators of OSCE and standardized patients (SPs). Areas of focus were: data collection of students' performance, SP selection and training, and modification of the Nursing Interview Interaction Scale (NIIS). It was found that with appropriate SP selection and training, utilization of appropriate tools, and good data collection, OSCE can offer a valid and reliable means of testing nursing students' clinical competencies.

Developing a successful nursing Objective Structured Clinical Examination.

The evaluation of nursing students' clinical competencies is essential to the educational process. The Objective Structured Clinical Examination (OSCE) program was designed to assess students in a variety of health topics that may not be experienced during the assigned clinical rotation. Building on prior work, the purpose of this study was to examine specific aspects of the nursing OSCE toward developing a reliable and valid tool for evaluating selected students' clinical competencies.The following areas were investigated using an assessment design: the development of case scenarios and updates, the role and training of the standardized patient, and students' perceptions of the nursing OSCE experience. Recommendations are made for the variety of case scenarios, frequency of updates, methods by which standardized patients should be trained, remediation, and program requirements. Students were overwhelmingly favorable to perceived benefits of participation in OSCEs during their nursing education.

Evaluation of undergraduate students using Objective Structured Clinical Evaluation.

This study proposed to develop an Objective Structured Clinical Evaluation (OSCE) for senior undergraduate nursing students. This evaluation process uses a simulated and standardized format to measure synthesis of knowledge and clinical skills. The benefit of OSCE is that it provides a formative evaluation for both students and the educational institute. The study included developing case studies, identifying or developing assessment tools, hiring and training standardized patients, obtaining a testing site, and analyzing data. A total of 49 students were assessed on three of six patient simulation stations and one of two nonpatient stationary stations. Both formative and summative evalu-