Comparison of gamification and role-playing education on nursing students' cardiopulmonary resuscitation self-efficacy.

BACKGROUND: Cardiopulmonary resuscitation (CPR) is one of the most fundamental skills a nursing student should be trained in. Gamification in education involves using game elements to increase motivation, engagement, and personalization of the learning process. The gamification method creates competition among students using various methods, comparing to the role-playing method which is a teaching method that allows individuals to actively engage in simulated scenarios. Therefore, this research aimed to compare the effect of CPR education using gamification and role-playing on the self-efficacy of nursing students. METHODS: This research was a quasi-experimental intervention type with three groups. A total of 154 nursing students participated in this study and were divided into intervention with role-playing (n = 53), gamification (n = 60) and conventional (lecture) (n = 41) groups. In the conventional method, CPR skills were taught to students using practical exercises. In the role-playing method, after training with moulages, a scenario was presented, and students were assigned roles. In the gamification method, after training with moulages, a scenario was presented, and after that, Kahoot software was used to create a sense of competition and excitement in the game. Self-efficacy scores were measured before and after interventions. Self-efficacy in CPR, knowledge, and skills of nursing students in CPR were assessed in each of the three groups using The Basic Resuscitation Skills Self- Efficacy Scale. RESULTS: In the present study, 154 nursing students, including 92 females and 62 males, participated. There was a statistically significant difference in the mean self-efficacy scores before and after training in both the gamification and role-playing groups (P < 0.05). There was a statistically significant difference in the mean self-efficacy scores among the three groups (gamification, role-playing, and lecture) (P < 0.05). CONCLUSION: Based on results it can be concluded that the teaching method used in CPR training affects the self-efficacy of CPR. Active methods, have a greater impact on CPR self-efficacy.

Evaluation of the effect of reinforced education on the satisfaction of patients undergoing colonoscopy: A randomized controlled trial.

INTRODUCTION: Fourteen million colonoscopies are performed annually in the United States, with the results dependent on bowel preparation before the procedure. However, suitable preparation is neglected in 20-25% of cases, resulting in increased loss of time, failure to diagnose, procedure repetition, and decreased patient satisfaction. Consequently, the current study was performed to evaluate the effect of reinforced education (RE) on the satisfaction of patients undergoing colonoscopy. METHODS: This study employed an experimental research method. Participants included 83 patients referred to Ayatollah Taleghani Medical Educational Center for colonoscopy, who were divided into control and intervention groups. The control group received standard education, whereas the intervention group received instruction via media and virtually, and preparation was followed up on the day before the colonoscopy. The research tool was a demographic and satisfaction questionnaire developed by the researcher. Analyses were conducted using IBM SPSS software (v. 20). RESULTS: Eighty-three patients, including 47 men and 36 women with an average age of 49.19 years, participated in the study. Mean (standard deviation) patient satisfaction was 11.78 (4.65) in the intervention group and 9.04 (2.95) in the control group; the independent t-test revealed a significant difference between the two groups (P<0.001). CONCLUSIONS: The study suggests that reinforced education using media and virtual means is effective in the satisfaction of patients undergoing colonoscopy.

Is there any relationship between nurses' perceived organizational justice, moral sensitivity, moral courage, moral distress and burnout?

AIM: The present study is an attempt to investigate the relationship between Corley's model variables in mental health nurses. BACKGROUND: Based on Corley's model, burnout and moral distress in nurses are, in retrospect, the consequences of the interplay of organizational and individual factors such as perceived organizational justice, moral sensitivity, and moral courage. The relationship between two variables or three variables of Corley's moral distress model has been investigated, but the test of Corley's moral distress model with more variables has not been done. Therefore, this research was proposed with the aim of investigating the relationship between the variables of moral courage and moral sensitivity (as characteristics of nurses), perceived organizational justice (as an antecedent), moral distress, and job burnout (as consequences of moral distress). METHODS: The study was conducted as a descriptive correlational study involving 500 nurses working in the mental health wards of hospitals. Data collection was conducted using perceived organizational justice scale, moral sensitivity scale, moral courage scale, moral distress scale, and burnout inventory. RESULTS: The results showed a significant relationship between perceived organizational justice, moral sensitivity, moral courage, and moral distress (< 0.05). Moreover, perceived organizational justice and moral distress had an inverse relationship. Moral sensitivity and moral courage had a direct relationship with moral distress (< 0.05). Furthermore, the results showed inadequate model fitness. CONCLUSIONS: This study adds to the existing knowledge about the experiences of mental health nurses and their interactions with both organizational and individual factors. It highlights that the connections between perceived organizational justice, moral sensitivity, moral courage, moral distress, and burnout are intricate and multifaceted. As we deepen our understanding of these relationships, it opens the door for the development of interventions and strategies to enhance nurses' well-being and the quality of care they deliver in mental health settings. Moreover, future research and ongoing refinement and expansion of Corley's model will be crucial in addressing the complex challenges within the healthcare sector.

Patient safety improvement in the gastroenterology department: An action research.

BACKGROUND: Patient safety is a global concern. Safe and effective care can shorten hospital stays and prevent or minimize unintentional harm to patients. Therefore, it is necessary to continuously monitor and improve patient safety in all medical environments. This study is aimed at improving patient safety in gastroenterology departments. METHODS: The study was carried out as action research. The participants were patients, nurses and doctors of the gastroenterology department of Ayatollah Taleghani Hospital in Tehran in 2021-2022. Data were collected using questionnaires (medication adherence tool, patient education effectiveness evaluation checklist, and medication evidence-based checklist), individual interviews and focus groups. The quantitative data analysis was done using SPSS (v.20) and qualitative data analysis was done through content analysis method using MAXQDA analytic pro 2022 software. RESULTS: The majority of errors were related to medication and the patient's fault due to their lack of education and prevention strategy were active supervision, modification of clinical processes, improvement of patient education, and promotion of error reporting culture. The findings of the research showed that the presence of an active supervisor led to the identification and prevention of more errors (P<0.01). Regarding the improvement of clinical processes, elimination of reworks can increase satisfaction in nurses (P<0.01). In terms of patient education, the difference was not statistically significant (P>0.01); however, the mean medication adherence score was significantly different (P<0.01). CONCLUSION: The improvement strategies of patient safety in Gastroenterology department included the modification of ward monitoring processes, improving/modification clinical processes, improvement of patient education, and development of error reporting culture. Identifying inappropriate processes and adjusting them based on the opinion of the stakeholders, proper patient education regarding self-care, careful monitoring using appropriate checklists, and presence of a supervisor in the departments can be effective in reducing the incidence rate. A comprehensive error reporting program provides an opportunity for employees to report errors.

Coping strategy with coronavirus disease-2019 health anxiety in nursing students.

BACKGROUND: The high prevalence of coronavirus disease-2019 (COVID-19) has a lot of stress on medical students. This study was conducted to investigating the adaptation strategy with COVID-19 health anxiety in nursing students. MATERIALS AND METHODS: This study was designed as a cross-sectional study. Participants of the study were 431 students of the Nursing and Midwifery Faculty of Shahid Beheshti University of Medical Sciences. Inclusion criteria were studying at the time of the outbreak of COVID-19 and willingness to participate in the study. Data collection tools included participated in the study. Data collection tools included a demographic questionnaire, Health Anxiety and Coping Inventory for Stressful Situations (Short Form). Reliability of tools was assessed and confirmed with Cronbach's alpha coefficient. Cronbach's alpha coefficient of health anxiety was 0.76 and Cronbach's alpha coefficient of Coping Inventory for Stressful Situations was 0.79. Data were collected between July 2020 and September 2020. Pearson's correlation coefficient was used to examine the relationship between the data. Data were analyzed with SPSS 26. RESULTS: Findings indicated that most of the participants were female, single, 22-28 years old, and undergraduate students. The mean of COVID-19 health anxiety was 5.59 ± 17.04. Results showed that 19.58 ± 5.05 of the participants used avoidance-focused adaptation strategies, 25.12 ± 3.88 problem-focused adaptation strategies, and 19.32 ± 5.13 emotion-focused adaptation strategies. CONCLUSION: The COVID-19 health anxiety was higher in female, young, and married students. The problem-focused adaptation strategy should be further taught so that students can better coping with COVID-19 health anxiety.

The effects of teaching methods on academic motivation in nursing students: A systematic review.

Motivation is one of the key factors in educational achievement. Like any other field of study, motivation in nursing is highly critical. The instructor's knowledge about the teaching methods that are effective in academic motivation of students enables them to adopt proper measures to improve the teaching efficiency. The present paper is a systemic review of the efficiency of instructional interventions in improvement of academic motivation in nursing students. The published papers related to the study from 2000 to February 2020 were searched at different databases such as PubMed, Scopus, Web of Science, PsycInfo, and ERIC. To examine the quality of the articles, critical appraisal instrument for reports of educational interventions was used. Totally, 18 articles entered the study for structured review. The majority of the articles reported that educational interventions improved academic motivation in nursing students. The effective teaching methods described in the reviewed articles that led to an improvement in academic motivation were simulation, case-based learning, cooperative learning, learning contract, peer assessment, and self-assessment using video typing. As the findings showed, implementation of applied and participatory methods in teaching process improved the academic motivation of nursing students. Therefore, using such methods, nursing instructors can improve the academic motivation of their students.

Psychometrics of the moral distress scale in Iranian mental health nurses.

BACKGROUND: One of the challenges that nurses often face in ethical decision-making situations is moral distress. Moral distress is caused by the conflict between professional and individual values in decision-making situations. Despite its importance, there is no reliable scale in Persian to measure it. Therefore, this study was conducted to validate the moral distress scale in mental health nurses in Iranian culture and Persian language. METHODS: This study was conducted in two parts: Translation and cross-cultural adaptation and psychometric analysis. The translation and cross-cultural adaptation process was conducted based on the Polit approach. Next, face validity (qualitative), content validity (quantitative and qualitative), and construct validity were examined. This part of the study was a cross-sectional study. In this step, a demographic questionnaire and the Moral Distress Scale were sent to 500 nurses working in selected educational and medical centers in Iran via online questionnaires. Then, the construct validity of the "Moral Distress Scale" was confirmed by confirmatory factor analysis and the reliability of the instrument was examined by studying the internal consistency with Cronbach's alpha and the internal correlation of the AIC. RESULTS: The confirmatory factor analysis showed an acceptable ratio of the expressions in 15 items in three factors: Acquiescence to patients' rights violations (6 items), Unethical conduct by caregivers (5 items), and low staffing (4 items) in the scale. The internal consistency of the instrument with Cronbach's alpha was higher than 7.0. CONCLUSION: The Persian version of moral distress with 15 items of the three factors had validity and reliability. According to the present findings, this scale can be used to study moral distress among nurses working in psychiatric wards. Moral distress leads to burnout, increases risks to patient safety and reduces quality of care. Nurses need to be able to assess and manage moral distress. Therefore, considering the side effects, it is necessary to have a reliable and valid scale that can be studied. Considering that culture has an impact on nurses' moral distress, it is suggested that this instrument be studied in and tested in other languages and cultures.

Translation and validation of caring behaviors inventory among nurses in Iran.

BACKGROUND AND OBJECTIVES: Nurses' caring behaviors, professional activities, and behaviors for the benefit of patients, influence patients' perception of care and satisfaction with the quality of care provided. Caring behaviors of nurses are contextual and various factors such as patients' social structure, lifestyle, culture, and interests, as well as their biographical, social, and physiological characteristics, can influence perceptions of caring behaviors of nurses, as caring behaviors are an interactive and mental process between patients and nurses. This study was conducted to provide a transcultural translation and psychometric analysis of Caring Behaviors Inventory (CBI) among nurses in Iran. METHODOLOGY: Transcultural translation of the 16-item CBI was performed. Then, face validity (qualitative), content validity (quantitative and qualitative), and construct validity were examined in a cross-sectional study of 509 patients. A demographic questionnaire and the 16-item CBI were sent to enrolled patients via online questionnaires. The reliability of the instrument was assessed by internal consistency using Cronbach's alpha. Then, construct validity of the single factor CBI was assessed using Confirmatory Factor Analysis (CFA). Since one factor CBI was not confirmed, construct validity was examined using Exploratory Factor Analysis (EFA). The final number of factors was confirmed using CFA. RESULTS: The internal consistency of the instrument was good with Cronbach's alpha 0.89. Based on EFA, the CBI were loaded on two factors, eigenvalues >1, no item was removed. The emergent factors were named "Communicating respectfully" and "Professional knowledge and skill". These two factors explained 50.197% of the total variance. Then, CFA showed an acceptable fit for the two factors CBI. CONCLUSION: The results showed that the Persian version of the 16-item CBI had adequate validity and reliability. Accordingly, this instrument can be used to study nurses' caring behaviors.

Essential dimensions of professional competency examination in Iran from academic and clinical nurses' perspective: A mixed-method study.

BACKGROUND: Planning for the issuance of professional competency examination has been put on the agenda of professional policymakers, but the ways of evaluating and conducting examinations and its dimensions are the main challenges. The present study aimed to explain the essential dimensions of professional competency examination in Iran from academic and clinical nurses' perspective. MATERIALS AND METHODS: The present mixed-method study was performed at three stages, systematic review, qualitative, and quantitative stages. At the first stage, 56 articles and texts were collected from PubMed, CINHAL, Ovid, and ProQuest databases, by using the keywords, namely professional competency examination and assessment. Base on the inclusion criteria and eligibility assessment of article, six articles and one text on regulation were selected. At the second stage, the results of the literature review were approved by 20 nursing experts. Direct content analysis was used for data analysis. The results were prepared in the form of a questionnaire. At the last stage, the questionnaire was given to 2209 clinical, academic, nurse managers, and nurses. RESULTS: Based on findings of the review literature, essential dimensions of the professional competency examination included a central theme of the client's needs with four categories. At the second stage, the Professional Competency Examination dimensions were approved by experts. At the third stage, a comparison of findings indicated that clinical nurses emphasized more on cardiopulmonary resuscitation, client safety, and implementation of procedures, while academic nurses emphasized on the client's needs, client education, and clients' physiological integrity. CONCLUSION: The client's need is the most important dimension in the professional competency examination. The nurses will be successful in providing care if they can identify the clients' needs and provide care plans based on client needs and priorities.

Comparison of complications in percutaneous dilatational tracheostomy versus surgical tracheostomy.

BACKGROUND: Tracheostomy facilitates respiratory care and the process of weaning from mechanical ventilatory support. AIMS: To compare the complications found in percutaneous dilatational tracheostomy (PDT) and surgical tracheostomy (ST) techniques. METHODS: This was a prospective randomized study to evaluate the complications of PDT and ST procedures in patients admitted to ICU unit of a teaching hospital during 2008 to 2011. We studied 40 patients in each group. PDTs were performed with blue rhino technique at the bedside by a skilled clinician and all cases of STs performed by Charles G Durbin technique in operating room under general anesthesia. Bronchoscopic examination through tracheostomy tube was performed to ensure the correct position of tracheostomy tube in the trachea lumen. The duration of procedures and pre- and post-interventional complications were recorded. RESULTS: The most common complications observed in the PDT group were minor bleeding (n=4), hypoxemia, and cardiac dysrhythmias (n=3) whereas in the ST group, the most frequent complications were minor bleeding (n=5) and endotracheal tube puncture (n=3). The difference in overall complications between the two groups was insignificant (P=0.12). CONCLUSION: PDT with blue rhino technique is a safe, quick, and effective method while the overall complications in both groups were comparable.