RESUMO
BACKGROUND: Self-Regulated Learning (SRL) is key in developing healthcare professionals and lifelong learner. iCARE (internalization of Critical thinking, Assessment, Reflection to Empower learning) model was designed to enhance nursing students' SRL. AIM: This study investigated the effects of iCARE on nursing students' reflective practice, SRL, self-efficacy and skill performance as compared to conventional group reflection. METHOD: A quasi-experimental exploratory study was employed on 49 final-year nursing students in a tertiary acute hospital. The iCARE group (n = 24) received guided daily reflective journal with weekly feedback while the group reflection group (n = 25) received group reflection. Both were facilitated by clinical instructors. Participants' SRL score, self-efficacy level and skill performance were measured pre- and post- training. End of posting reflective journal between group was compared. Their experience and perception on both facilitation methods were obtained using questionnaires. Quantitative data were summarised and analysed using Chi-Square test and t-test. Theme coding and content analysis were used to analyse the qualitative responses. RESULTS: Compared to group reflection group, the iCARE group reported a statistically significant improvement in SRL score, reflective practice, skill performance and self-efficacy in skill performance after a four-week clinical posting. Participants from both groups perceived that reflection helped them learn from peers and experience, enhanced their performance and motivated them to learn. Three unique themes emerged only from the iCARE group: iCARE helped to developed SRL; application of assessment, planning, implementation and evaluation (APIE) improved clinical reasoning; iCARE improved the use of feedback. CONCLUSION: The findings demonstrated the effect of the iCARE model in enhancing the development of nursing students' reflective practice, SRL and clinical learning outcomes. The design of iCARE model that embeds SRL instructions, APIE framework and SRL focused feedback can promote cognitive and metacognitive development as well as skill performance.
RESUMO
BACKGROUND: Large-scale quarantine facilities staffed with non-healthcare workers (NHCW) were instrumental in preventing community spread of COVID-19 (coronavirus disease of 2019). The objective of this study was to determine the effectiveness of a newly developed procedural skills training framework in ensuring personal protective equipment (PPE) compliance of PPE-naïve NHCWs. METHODS: We developed a PPE procedural skills training framework for NHCWs using the Learn, See, Practice, Prove, Do, and Maintain (LSPPDM) framework and international guidelines on PPE for healthcare workers. The NHCWs underwent PPE training using this framework, conducted by a team of Infection Prevention nurses, prior to being stationed within the CCF. Effectiveness of the LSPPDM PPE training framework was assessed using: 1) competency assessment scores for NHCWs, 2) PPE compliance rates from daily audit findings, and, 3) healthcare-associated COVID-19 infection rates of NHCWs. RESULTS: A total of 883 NHCWs had completed the PPE training and demonstrated competency in PPE compliance, fulfilling 100% of the checklist requirements. Mean PPE compliance of all NHCWs during the 11-week study period was noted to be >96%. The post-implementation improvement was statistically significant when the compliance was expressed in 3-days blocks) and in bed management staff (P = < 0.05). None of the 883 NHCWs who underwent PPE training via the LSPPDM framework were diagnosed with healthcare-associated COVID-19 infection. CONCLUSION: An evidence-based skills training framework is effective in PPE training of large numbers of NHCWs, resulting in high compliance of appropriate PPE use and prevention of healthcare-associated COVID-19 infection.