Effect of Virtual Simulation on Nurse Residents' Prioritization and Delegation Skills: A Pilot Study.

Data indicate a widening academic-practice gap. Utilizing a single-group pre-post interventional design, the purpose of this project was to determine if repeated participation in Sentinel U Patient Management and Delegation virtual simulations influenced new graduate nurses' prioritization and delegation. Increased confidence in ability to complete patient care assignments on time and transferability of learning outcomes to practice were identified. There may be value in nurses receiving virtual simulations within their residency program to close the academic-practice gap.

Integrative Literature Review on Cognitive Science to Reconsider Failure to Rescue in Nursing: A Call to Action.

BACKGROUND: When current workload demands exceed the cognitive capacity of nurses, tasks that are critical to early detection of clinical deterioration may be omitted. In many high-risk industries that require vigilance over sustained periods, such as the military, the cognitive resource theory of vigilance heavily guides systematic approaches. Yet, in research and policy on nursing failure to rescue, that same application of a cognitive science framework has been overlooked. METHOD: The nursing literature on failure to rescue was reviewed through the lens of the cognitive resource theory of vigilance. Fifteen articles met the inclusion criteria. RESULTS: Four themes emerged: relationship between clinical judgment and failure to rescue, implicit reference to the cognitive resource theory of vigilance, benefits of simulation-based education, and caregiver fatigue. CONCLUSION: The use of cognitive science to target advancement of patient management strategies has the potential to lead to a decrease in failure to rescue and an increase in nursing cognitive task efficiency. [J Contin Educ Nurs. 2023;54(6):253-260.].

A Scoping Review of Nurse Educator Competencies: Mind the Gap.

BACKGROUND: Unclear guidance continues faculty role preparation for promoting students' successful transition to practice. OBJECTIVES: To examine nurse educator competencies and their role in students' transition to practice. DESIGN: This study utilized Arksey and O'Malley's methodological framework for conducting a scoping review. The review is reported using the Preferred Reporting Items for Systematic Reviews Extension for Scoping Reviews (PRISMA-ScR), including the PRISMA-ScR checklist. METHODS: A comprehensive systematic search of MEDLINE, EMBASE, PsycINFO, ERIC, and CINAHL was performed for nurse educator competency. For the original search, no limitations were placed on dates. Two authors independently assessed eligibility via abstract review. The reference lists of the included studies were also examined. RESULTS: Eleven articles were included in the review dating from 1992 to 2021. Three themes in the literature were identified by the authors: (1) the need for appropriate mentorship, (2) lack of preparation of educators who transition directly from clinical practice, and (3) lack of use and/or vague operationalization of the National League for Nursing nurse educator competencies. CONCLUSION: Evidence regarding requisite competencies of nurse educators is limited. Further research on the competencies required for nurse educators to facilitate successful student transitions to practice is needed.

Role Clarity and Interprofessional Colleagues in Psychological Safety: A Faculty Reflection.

SUMMARY STATEMENT: Psychological safety in high-fidelity simulation-based experiences ensures that learners feel safe with new experiences in the service of learning. This article is a faculty reflection on breaches in the psychological safety among nursing students in 2 independent, high-fidelity simulation-based experience studies that were conducted in 2019. Demonstrated breaches in psychological safety included fear and anxiety in the sole provider role in multiple-patient simulations and incivility directed toward nursing students in a primary nurse role in interprofessional simulations. This article adds to the growing literature on psychological safety by sharing important lessons learned regarding role clarity and interprofessional colleagues, proposing recommendations, and providing suggestions for future research on psychological safety.

ISBARR Huddle: First-Year Medical Students Managing Critical Hypoglycemia as an Interprofessional Team.

Introduction: Recognizing a patient requiring urgent or emergent care and initiating evaluation and management must include elements that support teams working and thinking together. Although team communication strategies exist, a standardized approach for communicating about patients with urgent or emergent conditions is lacking. This simulation was designed to provide first-semester medical students with the opportunity to deliberately practice the foundational teamwork skills required to think as a team while caring for a patient with critical hypoglycemia. Methods: Students were introduced to a team huddle that was structured using ISBARR (identify, situation, background, assessment, recommend, recap) to assist in synthesizing gathered information and arriving at a diagnosis and associated care plan. Students practiced in small groups with faculty coaches and then applied the skills learned to two cases of a patient with critical hypoglycemia followed by debriefing. Results: Two hundred eight first-semester medical students participated in the simulation course across three campuses. We surveyed a single campus subset of 172 students. One hundred thirty-three students completed a postevent survey. The majority felt that the difficulty of the simulation was appropriate for their educational level (94%) and that the training would be applicable to real-life clinical events (76%) and would improve the quality and safety of care (100%). Survey comments highlighted teamwork and the use of the ISBARR huddle communication tool. Discussion: The course provided first-semester medical students with standardized practice of a team-based approach using huddle communication to advance patient care.

The Design and Validation of Three Interprofessional Simulations: A Feasibility Study.

ABSTRACT: This article provides pragmatic guidance on how to operationalize the INACSL Standards of Best Practice: SimulationSM. The purpose of this feasibility study was to determine content validity and intervention fidelity of three interprofessional simulations where clinical judgment is required to provide care to simulated patients. The process met all 11 criteria of the INACSL standards. The mean item-content validity indices for the scenarios ranged from .98 to 1. The scale-content validity indices ranged from .86 to 1. These findings advance the science of simulation design as an exemplar of the integration of best practices in simulation.

Nurse Educators' Guide to Clinical Judgment: A Review of Conceptualization, Measurement, and Development.

AIM: The purpose of this article is to define clinical judgment, examine valid and reliable instruments to measure the construct, review established strategies by which to develop it, and propose key future nursing education research priorities in clinical judgment. BACKGROUND: A pressing interest in prelicensure nursing students' clinical judgment development has emerged in response to the National Council of State Boards of Nursing project Next Generation NCLEX. METHOD: Sequential literature reviews uncovered six instruments that measure clinical judgment and 24 studies that demonstrate the effects of high-fidelity simulation on clinical judgment in prelicensure learners. RESULTS: Six themes emerged: number of simulation-based experience exposures, specific nursing specialty simulations, debriefing and its effect on clinical judgment, assessment, clinical decision-making, and reflection. CONCLUSION: Based on these results, key future research priorities investigating the effects of interprofessional simulation and simulation in the classroom were identified.

High-Fidelity Simulation in the Classroom for Clinical Judgment Development in Third-Year Baccalaureate Nursing Students.

High-fidelity simulation-based experience (HFSBE) in the laboratory setting is an evidence-based teaching strategy that engenders clinical judgment among students. There is very little literature on the use of HFSBE as a teaching strategy in the traditional classroom setting. This article describes an innovative approach using a prerecorded HFSBE and debriefing with third-year, baccalaureate, undergraduate students. Results of this strategy were positive, including student feedback such as, "Any way to visually integrate pathophysiology in the clinical setting is the best form of teaching yet."