Development and Effectiveness of a Rapid Cycle Deliberate Practice Neonatal Resuscitation Simulation Program: A Quasi-Experimental Study.

The Rapid Cycle Deliberate Practice (RCDP) simulation during neonatal resuscitation program (NRP) training provides in-event feedback for each simulation step, repeats the simulation from the beginning, and undergoes a continuous improvement process. It also offers after-event debriefing that involves follow-up discussion and reflection after completing simulations. These two methods differ in the timing and frequency of feedback application, and there may be differences in the effectiveness of neonatal resuscitation training. A quasi-experimental simulation study with a pre- and post-test design was used; the experimental group received RCDP simulation NRP training, based on the self-determination theory, while the control group received an after-event debriefing, following the NRP scenario. The experimental group displayed significantly improved clinical decision-making skills compared with the control group. When responding to emergencies involving high-risk newborns, we found that RCDP simulation during NRP training and better preparation for neonatal resuscitation among nursing students improved outcomes for newborns.

Video-Assisted Versus Traditional Problem-Based Learning: A Quasi-Experimental Study Among Pediatric Nursing Students.

BACKGROUND: The text-assisted problem-based, methods traditionally used to teach nursing students cannot adequately simulate holistic clinical situations and patient symptoms. Although video-assisted, problem-based learning methods combined with text have shown positive results in terms of improving comprehension and cognitive abilities, some studies have shown these methods to be inferior to text-assisted methods in terms of promoting deep critical thinking in medical students. PURPOSE: This study was designed to assess the benefits in nursing education of video-assisted, problem-based learning using online multimedia technologies compared with text-assisted, problem-based learning using traditional face-to-face classes. METHODS: A quasi-experimental, nonequivalent control group, preintervention-and-postintervention design was used. The experimental group ( n = 31) received video-assisted, problem-based learning materials with multimedia technologies (video scenarios, Google Docs worksheets, Google slides, Zoom cloud meetings, and e-learning management system) and weekly online lectures (100 minutes) for 4 weeks. The control group ( n = 35) received text-assisted, problem-based learning materials with traditional face-to-face classes and weekly lectures (100 minutes) for 4 weeks. The study data were analyzed using chi-square, Fisher's exact, and independent t tests as well as analysis of variance. RESULTS: At posttest, learning motivation ( t = 3.25, p = .002), academic self-efficacy ( t = 2.41, p = .019), and self-directed learning ( t = 3.08, p = .003) were significantly higher in the experimental group than in the control group. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Video-assisted, problem-based learning using multimedia technologies was shown to be effective in increasing learning motivation, academic self-efficacy, and self-directed learning in nursing students. These findings have implications for the development and planning of contactless classes in response to the coronavirus pandemic. Notably, no intergroup differences were found in terms of problem-solving skills. Future studies should include in-depth reviews and assessments of the difficulties faced in producing problem scenarios as well as the methods of instruction.

The effects of neonatal resuscitation gamification program using immersive virtual reality: A quasi-experimental study.

BACKGROUND: Clinical practice in neonatal intensive care units for nursing college students has been restricted due to the COVID-19 pandemic outbreak; thus, the gamification program has emerged as an alternative learning method. Consequently, there is a need to examine the effectiveness of such alternative learning methods to enhance the response to high-risk newborn emergencies. OBJECTIVES: To examine the effects (neonatal resuscitation nursing knowledge, problem-solving and clinical reasoning ability, self-confidence in practical performance, degree of anxiety, and learning motivation) of a neonatal resuscitation gamification program using immersive virtual reality based on Keller's ARCS model. DESIGN: A non-randomized controlled simulation study with a pretest-posttest design. SETTING: Lab and lecture rooms of two universities in South Korea, from June to November 2021. PARTICIPANTS: Prelicensure nursing students. METHODS: The virtual reality group (n = 29) underwent a neonatal resuscitation gamification program using virtual reality based on Keller's ARCS model. The simulation group (n = 28) received high-fidelity neonatal resuscitation simulations and online neonatal resuscitation program lectures. The control group (n = 26) only received online neonatal resuscitation program lectures. Changes in scores among these groups were compared using analysis of variance and analysis of covariance with SPSS for Windows version 27.0. RESULTS: Post intervention, neonatal resuscitation knowledge [F(2) = 3.83, p = .004] and learning motivation [F(2) = 1.79, p = .025] were significantly higher in the virtual reality and simulation groups than in the control group, whereas problem-solving ability [F(2) = 2.07, p = .038] and self-confidence [F(2) = 6.53, p < .001] were significantly higher in the virtual reality group than in the simulation and control groups. Anxiety [F(2) = 16.14, p < .001] was significantly lower in the simulation group than in the virtual reality and control groups. CONCLUSIONS: The neonatal resuscitation gamification program using immersive virtual reality was found to be effective in increasing neonatal resuscitation knowledge, problem-solving ability, self-confidence, and learning motivation of the nursing students who participated in the trial application process.

Individualized education focusing on self-management improved the knowledge and self-management behaviour of elderly people with atrial fibrillation: A randomized controlled trial.

AIM: This study examined the effect of an individualized educational intervention on the knowledge, attitudes and self-management ability after 12 weeks for outpatients with atrial fibrillation. METHODS: A randomized control-group pretest-post-test experimental design was used. Elderly outpatients with atrial fibrillation aged over 65 years were recruited from a university hospital in Korea. The experimental group received a 50-min individualized education on self-management, one telephone counselling after 8 weeks and maintenance of a self-management diary for 12 weeks. Data were collected from November 2017 to April 2018 and analysed using SPSS 22.0 for descriptive statistics and hypothesis testing. RESULTS: The participants' mean age was 71.9 (4.6) years. Compared to the control group (n = 29), the experimental group (n = 31) showed a significantly greater improvement in knowledge regarding atrial fibrillation and stroke prevention (t = -2.27, p = .027) and self-management behaviours (t = -8.02, p < .001). There were no significant group differences in attitudes towards atrial fibrillation. CONCLUSION: The findings suggest that education for elderly people with atrial fibrillation should be individualized, focusing on self-management in daily life to prevent cardiovascular complications. Future research is needed to confirm the long-term effects of such education programmes.

Effects of a simulated emergency airway management education program on the self-efficacy and clinical performance of intensive care unit nurses.

AIM: To examine the effects of a simulated emergency airway management education program on the self-efficacy and clinical performance among nurses in intensive care units. METHODS: A one-group, pre- and post-test design was used. Thirty-five nurses who were working in adult intensive care units participated in this study. The simulation education program included lectures, skill demonstration, skill training, team-based practice, and debriefing. Self-efficacy and clinical performance questionnaires were completed before the program and 1 week after its completion. The data were analyzed by using descriptive statistics and the paired t-test to compare the mean differences between the pre-test and post-test. The scores before and after education were compared. RESULTS: After education, there was a significant improvement in the nurses' self-efficacy and clinical performance in emergency airway management situations. CONCLUSION: Simulation education effectively improved the self-efficacy and clinical performance of the nurses who were working in intensive care units. Based on the program for clinical nurses within a hospital, it will provide information that might advance clinical nursing education.

[Validity and Reliability of the Peer Group Caring Interaction Scale-Korean Version].

PURPOSE: This paper was conducted to validate the Korean version of the Peer Group Caring Interaction Scale (PGCIS-K) that measures caring behaviors as experienced by nursing students. METHODS: Translation of the PGCIS-K was validated through forward-backward translation methods. Survey data were collected from 218 nursing students in a nursing school. Construct validity and criterion-related validity were evaluated. Internal consistency and the Guttman split-half coefficient were calculated to assess reliability. RESULTS: The PGIS-K showed reliability except for 4 items (Cronbach's α=.91, Guttman split-half coefficient=.85), which were low (<.30) or negatively correlated with the total scale. A 12-item reduced form of the PGCIS-K was developed by item-analysis and construct validity evidence. Factor loading for the 12 items on 2 factors ranged from .47~.82, which explained 58.4% of the total variance. Two factors were named 'modeling and assistance (Cronbach's α=.87)' and 'communication and sharing (Cronbach's α=.82)'. Convergent validity, discriminant validity, and criterion validity were supported according to the correlation coefficients of the 2 factors with other measure. CONCLUSION: The findings suggest preliminary evidence that the 12-item PGCIS-K can be used to measure nursing students' peer group caring interactions in Korea. Additional studies are recommended to continue the psychometric evaluation of this scale. Also, it can be extended to measure graduate nursing students or staff nurses' peer group caring interaction.

Spontaneous echo-contrast in the internal jugular veins of patients with ischemic stroke.

PURPOSE: Spontaneous echo-contrast (SEC) appears on B-mode images as moving curls of smoke in the lumen of veins. The aims of this study were to investigate the prevalence and characteristics of internal jugular vein SEC among patients with stroke, in comparison with control subjects. METHODS: We enrolled 97 Korean patients with acute ischemic stroke and 50 controls. Both internal jugular veins were examined for the presence and severity of SEC and measurement of flow velocity. Venous samples were obtained for laboratory evaluation of hematologic factors. RESULTS: In 294 internal jugular veins, the prevalence of SEC was 81% in stroke patients and 68% in controls (odds ratio, 2.0; 95% confidence interval, 1.1-3.6; p = 0.013). Stroke patients were more likely to have SEC on the left (p = 0.025) than on the right (p = 0.184) internal jugular vein. Overall, the association between stroke and SEC remained significant after adjustment for other variables (odds ratio, 4.3; 95% confidence interval, 1.7-10.8; p = 0.002). CONCLUSIONS: Internal jugular vein SEC was found more frequently in stroke patients than in controls. However, local as well as systemic factors must be considered in the interpretation of this finding.

The Characteristics of Cultural Conditions for the Mycelial Growth of Macrolepiota procera.

Macrolepiota procera, one of edible mushrooms belongs to Agaricaceae of Basidiomycota, has a good taste and good medicinal value. As a preliminary study for the development of artificial cultivation method of edible mushroom, cultural characteristics of M. procera was investigated on various culture media under different environmental conditions. Mycelial growth was compared on culture media composed of various carbon and nitrogen sources, and C/N ratios. The optimal conditions for the mycelial growth were 30℃ and pH 7. M. procera showed the rapid mycelial growth in the PDA media. The optimal carbon and nitrogen sources were maltose and glycine, respectively. The optimum C/N ratio was about 10 : 1 in case that 1% glucose was supplemented to the basal media as carbon source.

Culture Conditions Affecting the Optimal Mycelial Growth of Cystoderma amianthinum.

Cystoderma amianthinum, one of edible fungi belongs to Agaricaceae of Basidiomycota, has a good taste and flavor. This study was carried out to obtain the basic informations for the optimum mycelial growth of C. amianthinum. The optimal conditions for the mycelial growth were 25℃ and pH 5 in potato dextrose agar (PDA). C. amianthinum showed the favorable growth in the PDA and yeast malt extract agar (YMA). The favorable carbon and nitrogen sources promoting mycelial growth were fructose and histidine, respectively. The optimum C/N ratio was about 30 : 1 in case that 1% glucose was supplemented to the basal medium as a carbon source.

The conserved cis-Pro39 residue plays a crucial role in the proper positioning of the catalytic base Asp38 in ketosteroid isomerase from Comamonas testosteroni.

KSI (ketosteroid isomerase) from Comamonas testosteroni is a homodimeric enzyme that catalyses the allylic isomerization of Delta5-3-ketosteroids to their conjugated Delta4-isomers at a reaction rate equivalent to the diffusion-controlled limit. Based on the structural analysis of KSI at a high resolution, the conserved cis-Pro39 residue was proposed to be involved in the proper positioning of Asp38, a critical catalytic residue, since the residue was found not only to be structurally associated with Asp38, but also to confer a structural rigidity on the local active-site geometry consisting of Asp38, Pro39, Val40, Gly41 and Ser42 at the flexible loop between b-strands B1 and B2. In order to investigate the structural role of the conserved cis-Pro39 residue near the active site of KSI, Pro39 was replaced with alanine or glycine. The free energy of activation for the P39A and P39G mutants increased by 10.5 and 16.7 kJ/mol (2.5 and 4.0 kcal/mol) respectively, while DG(U)H2O (the free-energy change for unfolding in the absence of urea at 25.00+/-0.02 degrees C) decreased by 31.0 and 35.6 kJ/mol (7.4 and 8.5 kcal/mol) respectively, compared with the wild-type enzyme. The crystal structure of the P39A mutant in complex with d-equilenin [d-1,3,5(10),6,8-estrapentaen-3-ol-17-one], a reaction intermediate analogue, determined at 2.3 A (0.23 nm) resolution revealed that the P39A mutation significantly disrupted the proper orientations of both d-equilenin and Asp38, as well as the local active-site geometry near Asp38, which resulted in substantial decreases in the activity and stability of KSI. Upon binding 1-anilinonaphthalene-8-sulphonic acid, the fluorescence intensities of the P39A and P39G mutants were increased drastically, with maximum wavelengths blue-shifted upon binding, indicating that the mutations might alter the hydrophobic active site of KSI. Taken together, our results demonstrate that the conserved cis-Pro39 residue plays a crucial role in the proper positioning of the critical catalytic base Asp38 and in the structural integrity of the active site in KSI.