Just Another Patient? Student Reflections on Providing Mental Health Care to Transgender and Gender Expansive People During Simulated Encounters.

AIM: This study analyzed psychiatric-mental health nurse practitioner (PMHNP) students' reflections following a virtual simulated encounter with a patient who identified as transgender or gender expansive (TGE). BACKGROUND: To reduce mental health disparities, PMHNP students must be prepared to deliver affirming care. Engaging in and reflecting on simulated encounters with standardized patients can improve PMHNP students' affirming care competency. METHOD: A thematic analysis process was used to analyze student reflections during simulation debriefings. RESULTS: Five themes emerged: application of affirming care principles, recognizing minority stressors, treating all patients the same, desire to learn more, and valuing authentic practice. CONCLUSION: PMHNP students' reflections on the experience of providing care to a standardized patient who identified as TGE support the use of virtual simulations to prepare future providers to deliver affirming, person-centered care.

The Role of Technology in Health Professions Education During the COVID-19 Pandemic.

The COVID-19 pandemic has sparked radical shifts in the ways that both health care and health professions education are delivered. Before the pandemic, some degree programs were offered fully online or in a hybrid format, but in-person learning was considered essential to the education and training of health professionals. Similarly, even as the use of telehealth was slowly expanding, most health care visits were conducted in-person. The need to maintain a safe physical distance during the pandemic rapidly increased the online provision of health care and health professions education, accelerating technology adoption in both academic and professional health care settings. Many health care professionals, educators, and patients have had to adapt to new communication modalities, often with little or no preparation. Before the pandemic, the need for cost-effective, robust methodologies to enable teaching across distances electronically was recognized. During the pandemic, online learning and simulation became essential and were often the only means available for continuity of education and clinical training. This paper reviews the transition to online health professions education and delivery during the COVID-19 pandemic and provides recommendations for moving forward.

Interprofessional care of people with multiple chronic conditions: An open-access resource for nursing educators.

Nurses, nurse practitioners, and other healthcare professionals must be prepared to care for the growing population of patients with multiple chronic conditions, to promote patient engagement, patient self-management, and for interprofessional collaboration. Interprofessional Care of Individuals with Multiple Chronic Conditions is an open-access eLearning course designed to prepare students with these skills. The course features multimedia presentations, interactive exercises, and an immersive "day in the life of a patient-centered medical home" in which learners make decisions, receive feedback, and experience consequences in the context of real-world video scenarios. Three hundred thirty-four nurse practitioner students participated in the educational program. To evaluate the program, we conducted a paired-samples t-test to compare scores on pre and posttest evaluation surveys. There was a significant difference in the scores for applying the Chronic Care Model t (df) = 15.99; p < 0.001, coaching for self-management t (df) = 11.04; p < 0.001 and interprofessional collaboration t (df) = 3.86; p < 0.00. The majority of students were satisfied or very satisfied with the modules. Students found the immersive video scenarios to be the best feature of the course. The course is available to assist students in gaining the ability to care for patients with chronic illnesses within interprofessional practice settings.

Evaluating an Interactive Digital Intervention for College Weight Gain Prevention.

OBJECTIVE: Pilot a digital interactive intervention for weight gain prevention among college students. METHODS: One sample pre-post study reporting on initial usability and changes in theoretical constructs (ie, self-efficacy, behavioral capability, elaboration) and program acceptability. Twenty college freshmen (mean age, 18.25 ± 0.72 years) reviewed a digital program providing self-assessment and brief tailored feedback on 8 behaviors that relate to a healthy weight: physical activity, sedentary behavior, and consumption of sugary beverages, high fat snacks, breakfast, fried foods, fruits and vegetables, and pizza. RESULTS: At posttest, improvements in self-efficacy were found for 5 behaviors (ie, physical activity, high fat snacks, breakfast, fried foods, fruits and vegetables); improvements in behavioral capability were found for 3 behaviors (ie, high fat snacks, fried foods, and fruits and vegetables). Acceptability benchmarks included: positive impression (60%), relevance (95%), and ease of comprehension (75%). CONCLUSIONS AND IMPLICATIONS: This program demonstrates acceptability for a digital weight gain prevention intervention, with improvements in behavioral mediators of change. Suggestions to simplify messaging and allowing for user control may enhance acceptability and comprehension. There is a need for further testing with larger more diverse populations before broader implementation by universities to address student health.

Formative work to design a digital learning self-assessment and feedback tool to prevent weight gain among college students.

OBJECTIVE: While colleges have implemented brief, tailored interventions for health-risk areas such as alcohol prevention, theoretically-guided digital learning offerings for weight gain prevention have lagged behind in programming and implementation. Thus, the objective was to design and usability test a weight gain prevention digital learning platform for college students with modules targeting key nutrition and physical activity behaviors. METHODS: Development occurred in iterative phases: formative research, descriptive normative data collection, prototype development, and usability testing. Formative research consisted of background work and survey administration to incoming and current freshmen. Prototype development was guided by theories of behavior change and cognitive processing, and consisted of brief assessment and feedback using written text, graphs, and videos. Iterative usability testing was conducted. RESULTS: Current freshmen reported eating more quick order meals per week than incoming freshman, but fewer high-fat snacks and fewer sugary beverages. Current freshmen reported more sedentary time than incoming freshmen. Based on iterative testing results, eight behavioral targets were established: breakfast, high-fat snacks, fried foods, sugary beverages, fruit/vegetables, physical activity, pizza intake, and sedentary behavior. Initial usability testers indicated the modules were easy to understand, held their attention, and were somewhat novel. Analysis of qualitative feedback revealed themes related to content, layout, structure and suggested refinements to the modules. CONCLUSIONS: A gap exists for evidence-based obesity prevention programs targeted to adolescents as they transition into adulthood. Brief, tailored digital learning interventions show promise towards addressing key behavioral nutrition and physical activity targets among students during the transition to college.

Evaluating Transfer of Continuing Education to Nursing Practice.

BACKGROUND: The nursing profession needs solid evidence of the important contributions that continuing education (CE) makes to nursing practice change. We analyzed nurses' intent to change practice, actual practice change, and examples of practice change after completing CE courses of differing types, topics, and geographic locations. METHOD: A retrospective, mixed-methods study design was used to assess quantitative and qualitative survey data gathered upon completion and within 1 year following completion of 16 different CE courses. RESULTS: A large majority of nurses reported positive intent to change practice (88.6%) and actual practice change (89.1%) following participation in the CE courses. Qualitative analysis revealed four themes related to types of practice change, including Becoming Certified, Improved Leadership, Enhanced Role Performance, and Educating or Mentoring Others. CONCLUSION: CE can positively influence nursing practice change and lead to broader organizational improvements. [J Contin Educ Nurs. 2019;50(8):375-380.].

Geriatric education utilizing a palliative care framework.

The dramatic growth of persons older than age 65 and the increased incidence of multiple, chronic illness has resulted in the need for more comprehensive health care. Geriatrics and palliative care are medical specialties pertinent to individuals who are elderly, yet neither completely addresses the needs of older adults with chronic illness. Interprofessional faculty developed Geriatric Education Utilizing a Palliative Care Framework (GEPaC) to teach an integrated approach to care. Interactive online modules use a variety of instructional methods, including case-based interactive questions, audio-visual presentations, reflective questions, and scenario-based tests. Modules are designed for online education and/or traditional classroom and have been approved for Continuing Medical Education. Pre- and posttest scores showed significant improvements in knowledge, attitudes, and skills. Participants were highly satisfied with the coursework's relevance and usefulness for their practice and believed that GEPaC prepared them to address the needs of older adults for disease and symptom management, communicating goals of care, and supportive/compassionate care.

Transitioning a bachelor of science in nursing program to blended learning: Successes, challenges & outcomes.

To help address the challenges of providing undergraduate nursing education in an accelerated time frame, the Teaching and Transforming through Technology (T3) project was funded to transition a second-degree ABSN program to a blended learning format. The project has explored the use of blended learning to: enable flexible solutions to support teaching goals and address course challenges; provide students with new types of independent learning activities outside of the traditional classroom; increase opportunities for active learning in the classroom; and improve students' digital literacy and lifelong learning skills. Program evaluation included quality reviews of the redesigned courses, surveys of student perceptions, pre- and post-program assessment of students' digital literacy and interviews with faculty about their experiences with the new teaching methods. Adopting an established quality framework to guide course design and evaluation for quality contributed to the efficient and effective development of a high-quality undergraduate blended nursing program. Program outcomes and lessons learned are presented to inform future teaching innovation and research related to blended learning in undergraduate nursing education.

Preparing students for graduate study: an eLearning approach.

This paper describes the development and preliminary evaluation of an eLearning program intended to provide incoming nursing students with the basic knowledge, skills and abilities needed to succeed in graduate-level, online coursework. Using Mayer's principles (2008) for the effective design of multimedia instruction, an open-access, self-directed, online program was developed. The Graduate School Boot Camp includes five online modules focused on learning strategies and time management, academic writing, technology, research, and library skills. To motivate and engage learners, the program integrates a fun, graphical sports theme with audiovisual presentations, examples, demonstrations and practice exercises. Learners begin with a self-assessment based on the Motivated Strategies for Learning Questionnaire or MSLQ (Pintrich et al., 1993). To assess change in knowledge levels before and after completing the program, learners take a pre-test and post-test. Preliminary findings indicate that the students found the information relevant and useful. They enjoyed the self-paced, multimedia format, and liked the option to return to specific content later. This innovative program offers a way to prepare students proactively, and may prove useful in identifying students at risk and connecting them with the appropriate resources to facilitate successful program completion.

Using algorithmic practice maps to teach emergency preparedness skills to nurses.

In 2004, The George Washington University received funding from the U.S. Department of Homeland Security to develop a web-based emergency preparedness course for nurses. The purpose of the course was to provide training that would be accessible regardless of work setting or location. In designing the course, the development team used algorithmic decision making as a conceptual framework to transcend the linear, didactic focus of traditional online preparedness training to provide learners with a learning experience crafted around the decision-making process. This article describes the design of the algorithmic practice maps underlying this course and provides a replicable structure for those interested in developing similar offerings for nurses.

Online teaching strategies to improve collaboration among nursing students.

Collaborative problem-solving is an essential competency for nurses and all health professionals. This paper compares the design characteristics and educational benefits of three online-teaching strategies that nurse educators can use to build the critical thinking and social skills needed for effective collaboration: computer supported collaborative learning, case-based facilitated discussion, and cognitive flexibility hypermedia. These strategies support a critical instructional outcome required for effective collaboration: the ability to examine, assess, and synthesize multiple perspectives to resolve illstructured problems (i.e., problems for which there is no clear-cut solution). Descriptions, examples, and guidelines for implementing each strategy are provided. By integrating these strategies into their online courses, nurse educators can prepare nurses to work effectively with others to solve complex problems in clinical practice and the broader health-care system.

Online teaching strategies to improve collaboration among nursing students.

Collaborative problem-solving is an essential competency for nurses and all health professionals. This paper compares the design characteristics and educational benefits of three online-teaching strategies that nurse educators can use to build the critical thinking and social skills needed for effective collaboration: computer supported collaborative learning, case-based facilitated discussion, and cognitive flexibility hypermedia. These strategies support a critical instructional outcome required for effective collaboration: the ability to examine, assess, and synthesize multiple perspectives to resolve illstructured problems (i.e., problems for which there is no clear-cut solution). Descriptions, examples, and guidelines for implementing each strategy are provided. By integrating these strategies into their online courses, nurse educators can prepare nurses to work effectively with others to solve complex problems in clinical practice and the broader health-care system.