Nursing students' preparedness for the digitalised clinical environment in Australia: An integrative review.

AIM: The aim of this integtrative review is to examine the literature on nursing students preparedness for the digitalised clinical setting. BACKGROUND: Digital literacy skills ensure nursing students can provide quality and safe care to patients in a digitalised clinical setting. DESIGN: Integrative review of the literature. METHODS: The integrative review of the literature incorporated Whittemore and Knafl's (2005) framework and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2021 statement. A review of the literature comprised of a search of the following databases: ERIC, Scopus, CINAHL, Medline, Cochrane Library and Google Scholar from 2010-2022. Data were critically appraised using the Critical Appraisal Skills Programme (CASP), the Mixed Method Tool (MMAT) and Joanna Biggs Institute (JBI). RESULTS: The literature reported on nine studies from 2010 to 2022. The four themes identified using Braun and Clarke's thematic analysis were curriculum design, education and training, digital literacy level and professional digital literacy competency standard framework. Major findings include the need for the development and integration of a professional digital literacy competency standard framework embedded into nursing curricula to equip nursing students with appropriate digital literacy skills to navigate digitalised healthcare settings. CONCLUSION: Current registered nurses and preregistration nurses are required to be upskilled with the understanding and knowledge of health informatics and its role in the clinical setting. This will enable future registered nurses to keep up with the rapidly evolving technological clinical environment.

First year undergraduate nursing students' perceptions of the effectiveness of blended learning approaches for nursing numeracy.

The ability to safely calculate and administer medications are indispensable, core nursing skills in nursing education and practice. Therefore, it is imperative that nursing students are adequately prepared with the necessary numeracy skills during their undergraduate nursing studies. The focus of this study, conducted at a single multi-campus university in the western Sydney region of Australia, was to determine the effectiveness of a suite of blended learning approaches on numeracy self-efficacy from the students' perspective. Surveys were administered as part of the study and included open-ended questions. 525 students provided open-ended responses that were analysed by the research team. Four main themes were identified from the open-ended responses: (i) Self-realisation; (ii) Practice, practice, practice; (iii) Boosting confidence; and (iv) Wanting more. The themes captured students' perceptions of the benefits of having a rigorous learning design in blended learning approaches. The study showed that a structured pedagogical approach to nursing numeracy in undergraduate programs improved students' self-reported self-efficacy with mathematics and assisted students in realising the importance of learning and applying these skills as nursing clinicians.

Contextualising numeracy skill development and assessment in a first year undergraduate nursing subject: A mixed methods research study.

BACKGROUND: Undergraduate nursing students continue to perform poorly on clinically-related numeracy tasks, making errors that betray fundamental misconceptions about the underlying mathematics. Graduate nurses are also prone to error in this area but they have the benefit of performing their calculations in a real-world setting with the assistance of colleague nurses if required. These conditions are difficult to simulate in a classroom environment, but when effort is made in this direction the effects can be rewarding for students and educators. OBJECTIVES: To investigate the effect on undergraduate nursing students' learning experience and test performance of a practical, clinically contextualised numeracy workshop featuring individual and collaborative modes of assessment. DESIGN: A mixed methods study using pre and post tests and a survey. SETTINGS: Clinical practice classrooms at an Australian university. PARTICIPANTS: First year undergraduate nursing students undertaking a subject whose curriculum features medication safety and clinically-related numeracy. METHODS: Administration of individual and collaborative short-answer pre and post tests, a survey, and facilitation of team-based, clinically-related numeracy activities over a 1.5 h workshop. All test marking, data collection and analysis were performed by the authors. RESULTS: Positive responses to survey questions probing students' judgement of the effect of contextualised learning on their confidence, engagement and proficiency in nursing numeracy, as well as the value of working in a clinical setting. Significant improvement in students' performance in pre/post tests. CONCLUSIONS: Contextualised, practical and collaborative learning and assessment of nursing numeracy is valued by students and has a positive effect on their experience and performance in the content area.

The influence of mathematics self-efficacy on numeracy performance in first-year nursing students: A quasi-experimental study.

AIM AND OBJECTIVES: To examine the factors that influence nursing students' mathematics self-efficacy, the effect of numeracy instruction on self-efficacy, and the association between self-efficacy and numeracy test performance. BACKGROUND: Medication administration errors, including administering incorrect dosages or infusion rates, can result in serious harm to patients. Hence, it is essential that nursing students are adequately prepared with the necessary numeracy skills during their nursing program. DESIGN: This quasi-experimental cohort study used a pre- and post-test survey design. The study complied with the STROBE checklist for cohort research. METHODS: In total, n = 715 undergraduate first year nursing students participated in the study from June to October 2017 at a single multi-campus university in the Western Sydney region of Australia. Data were collected at three time-points: (a) baseline, including assessing pre-instruction mathematics self-efficacy (NSE-Math scale); (b) 6-week follow-up; including assessing post-instruction mathematics self-efficacy; and (c) numeracy test performance was collected at 7-week follow-up. FINDINGS: At baseline, those with high NSE-Math scale scores were more likely to be male and have at least high school advanced mathematics level education. Following structured numeracy instruction, NSE-Math scale scores increased significantly, and those who obtained a satisfactory grade in their numeracy assessment were more likely to have high NSE-Math scale scores and high academic performance in the previous semester. CONCLUSION: The study shows that structured numeracy instruction improved mathematics self-efficacy, which in turn influenced numeracy test performance. RELEVANCE TO CLINICAL PRACTICE: Using a structured medication numeracy pedagogical approach, to teach skills in nursing undergraduate programs, provides students with the foundations to improve mathematics self-efficacy and to be successful and safe with medication numeracy calculations and administration in clinical practice.

The effectiveness of short answers test papers in evaluating academic nursing programs: A review of the literature.

Short answer tests (SAT) are an assessment that examines nursing students' knowledge and can be used to evaluate expectations for student educational success. The purpose of this literature review is to combine the best available evidence as to whether short answer test papers meet nursing facility curricula learning outcomes. A literature review was performed consisting of data bases which included; ERIC, SCOPUS, CINAHL MEDLINE, COCHRANE LIBRARY and JOHANNA BIGGS INSTITUTE (JBI). The following keywords were used: Short answer test, written assessment, quiz, organisations, university, higher degree education, tertiary education, nursing, perceptions, attitude, opinions, thoughts, feeling and belief. The majority of studies demonstrated that short answer tests equip nursing students with the knowledge and critical thinking skills for the clinical setting. Three major themes were identified: the effects of increasing class sizes; authenticity and the validity of short answer tests. Short answer tests are commonly used in undergraduate nursing programs to evaluate students' level of knowledge which consists of their ability to critically analyse and problem solve. To maintain authenticity and validity of an assessment, there is a need for an evidence-based approach to their design to meet the core learning objectives within the curriculum.

The importance of academic literacy for undergraduate nursing students and its relationship to future professional clinical practice: A systematic review.

OBJECTIVES: This systematic review was designed to assess the importance of academic literacy for undergraduate nursing students and its relationship to future professional clinical practice. It aimed to explore the link between academic literacy and writing in an undergraduate nursing degree and the development of critical thinking skills for their future professional clinical practice. DESIGN: A systematic review of qualitative studies and expert opinion publications. DATA SOURCES: A systematic literature search was undertaken of the following databases: ERIC, PubMed, CINAHL, MEDLINE and Scopus. All papers reviewed were from 2000 to 2016 and were written in English. REVIEW METHODS: We identified 981 studies and expert opinion papers from the selected databases. After reviewing key words and abstracts for the inclusion and exclusion criteria, 48 papers were selected for review. These were read and reread, with 22 papers, including one thesis, selected for quality appraisal. One paper was discarded due to the exclusion criteria. RESULTS: Three major themes were evident from this study. First, students need assistance to develop tertiary level academic literacy skills when they commence their undergraduate nursing degree. Second, that teaching practices need to be consistent in both designing assessments and in giving feedback to students, in order to assist improvement of academic literacy skills. And finally, academic literacy can facilitate critical thinking when students are assessed using discipline specific genres that relate to their future professional nursing practice. CONCLUSIONS: This review highlights the importance of critical thinking in clinical nursing practice and its strong relationship with academic writing skills. It has shown critical thinking is discipline specific and nursing students need to be taught discipline specific literacy genres in undergraduate nursing degrees. Nursing has a diverse educational and cultural mix of students, and educators should not assume academic literacy skills upon commencement of an undergraduate nursing programme.

Tools to reduce first year nursing students' anxiety levels prior to undergoing objective structured clinical assessment (OSCA) and how this impacts on the student's experience of their first clinical placement.

BACKGROUND: One form of assessment that tests students' theoretical skills and confidence in their clinical practice is known as the Objective Structured Clinical Assessment (OSCA). Traditionally it was first launched from medical education, and is now being incorporated by other disciplines, such as nursing. OBJECTIVES: This review seeks to present the best available evidence into strategies that help reduce first year nursing students' anxiety levels prior to undergoing OSCA and clinical placement. SEARCH STRATEGY: A systematic literature search was performed using Medline and CINAHL. SELECTION CRITERIA: This review considered any English language original research published between 2005 and 2013. RESULTS: A literature search located 117 articles. Eight articles were identified as meeting the inclusion in criteria. Majority of studies reported simulation session prior to the OSCA increased students confidence and reduced their anxiety levels. This resulted in students' reporting that they valued the OSCA as a worthwhile assessment. However there were four major themes: that students were anxious about attending the OSCA; that adequate preparation was seen as a coping strategy; that simulation was a further cause for anxiety; and that the simulation experience could also be used as an OSCA tool. CONCLUSIONS: Students who have been exposed to simulation scenarios before the OSCA are able to cope much better during the OSCA. Therefore, it is highly recommended to incorporate simulation scenarios into the nursing curricula for first year nursing students' clinical units to help reduce their anxiety levels prior to OCSA.