Challenges for Nurse Anesthetists Reentering Practice Following Substance Use Disorder Treatment.

Substance use disorder (SUD) is a persistent, relapsing condition that is present in approximately 10% of anesthesia providers, who, compared with other healthcare providers, face a greater risk of developing an SUD by virtue of constant access to medications. The ability of certified registered nurse anesthesiologists (CRNAs) to obtain or maintain employment after treatment for SUD treatment is not well documented. The purpose of this qualitative study was to explore challenges encountered by CRNAs in recovery as they attempt to reenter practice following SUD treatment. The phenomenon was explored through multiple-case study, using qualitative semistructured interviews with participants in four cases: CRNAs in recovery, CRNA colleagues, CRNA employers, and professional health program employees. Thirty-six participants conveyed their perspectives about challenges that CRNAs in recovery face upon reentry into practice following SUD treatment. The Worker Well-Being conceptual model was used to guide this study. The study revealed that more SUD education is a key facilitator for reentry, risk of relapse was a major concern, and stigma was the most significant barrier for CRNAs in recovery. Stigma persists as a considerable barrier in many facets of SUD, contributing to an increase in shame associated with having the disease.

What Would You Do?: Engaging Remote Learners Through Stop-Action Videos.

BACKGROUND: Engaging remote learners can be challenging for nurse educators. With an increase in virtual learning, nurse educators are seeking activities that support engagement and improve critical thinking. PROBLEM: Students in virtual classes need learning experiences that support critical thinking and involve appropriate case studies for knowledge application. APPROACH: Stop-action video vignettes as unfolding case studies employ technology that can facilitate critical thinking and active learning in a virtual setting. Stop-action video vignettes can be useful in enhancing student learning through 3 methods: video-based discussion, text-based discussion, and branching matrices. CONCLUSION: Stop-action video vignettes with unfolding case studies may provide effective and versatile activities to engage students and enhance learning.

The Power of Presence in Virtual Teaching and Practice Environments.

This article examines the concept of telepresence and the use of video chat platforms to facilitate family and nurse presence in hospital settings. Ethical, technical, and logistical challenges for using video chat platforms at the bedside are addressed. In addition, the Community of Inquiry model is used to explore how human presence is facilitated in distance-accessible nursing education. Special focus is on the use of technology to meet the challenges of presence during virtual nursing instruction.

Gamification and education: A pragmatic approach with two examples of implementation.

Leveraging elements of game design and theories of human motivation, gamification provides a variety of techniques to engage learners in novel ways. Our Clinical and Translational Science Award created the software platform (Kaizen-Education©) to deliver gamified educational content in 2012. Here, we explore two novel use cases of this platform to provide practical insights for leveraging these methods in educational settings: (1) national training in rigor, reproducibility, and transparency and (2) attainment of learner competency (n = 7) as a gauge of curricular effectiveness across Master of Public Health degree tracks (n = 5). Data were captured in real time during player interaction with Kaizen-Education© to provide descriptive analyses of player engagement in both implementation examples. We then assessed item analysis to assess knowledge gain and competency attainment. We have just begun to leverage the potential for gamification to engage learners, enhance knowledge acquisition, and document completion of training, across various learning environments. We encourage a systematic approach to gamification applying insights from self-determination theory to learners and learning environments, a methodical approach to game design and rigorous analysis after implementation to generate evidence-based insights to maximize educational return for time invested.

Addressing Gaps in Nurses' Knowledge of Sepsis: A Literature Review.

Sepsis is a dangerous and costly health care condition requiring prompt identification and emergency treatment. Bedside nurses have a crucial role in these early steps. Nurses should receive effective and timely education on identifying and treating sepsis in their patient populations. The purpose of this article is to review the literature and to identify how current sepsis education methods are addressing the gaps in nursing knowledge of sepsis. PubMed and CINAHL databases were used to search the literature. After inclusion and exclusion criteria were applied, nine articles were chosen for synthesis. Synthesis revealed three major themes: (a) assessing nurse sepsis knowledge, (b) using electronic learning methods for education, and (c) incorporating simulation into sepsis training. Gaps in the literature were also identified. [J Contin Educ Nurs. 2021;52(1):43-46.].

Physical Activity Promotion in a Safety-net Clinic: Does the Provider Make a Difference? A Pilot Study.

BACKGROUND: Despite the long-term health benefits of physical activity, many Americans across the lifespan do not meet the recommended levels. However, physical activity discussions in the clinic setting may hold promise. The purpose of this study aimed to understand health care providers' beliefs and practices about physical activity discussions being a part of patients' healthcare treatment. METHODS: Semi-structured, audiotaped interviews were conducted to elicit narratives from ten health care providers. Interview data were transcribed verbatim, then coded and analyzed by two qualitative researchers using NVivo12. RESULTS: Three major themes emerged: importance of regular PA counseling for vulnerable populations, patients' lack of regular physical activity, including subthemes of lack of time, current health conditions, and social determinants of health, and healthcare provider's reflections about their own physical activity. CONCLUSION: Healthcare providers have an important role when it comes to promoting good health. Having physical activity discussions with patients at every clinic visit is a great opportunity to encourage patients to engage in healthy lifestyle behaviors such as regular physical activity. From this pilot study, implications for practice may include increased awareness of the healthcare providers to discuss physical activity at every visit, which may lead to improved provider-patient communications related to the benefits of daily physical activity behaviors. These discussions may even have a secondary gain of encouraging the providers themselves to adopt the healthy behavior and thereby serve as a role model for their patients.

Applying Design Thinking in Health Care: Reflections of Nursing Honors Program Students.

Nursing faculty at the University of Alabama at Birmingham (UAB) incorporated design thinking (DT) into the curriculum of the UAB School of Nursing Honors Program as a framework for undergraduate students' immersion into research experiences. This article describes the experiences of students who participated in the first honors class that used DT and discusses how to incorporate DT into nursing research and quality improvement projects. Active learning strategies provided students various opportunities to conceptualize and apply the five-step DT process by identifying possible solutions to problems in clinical settings. Three major themes emerged from these reflections: trusting the process, cultivating empathy, and applying DT in the future. Students found that trusting the process of learning about DT facilitated their understanding of empathy's role in health care as they recognized DT's far-reaching applications beyond the honors program. A pragmatic, intuitive, and innovative approach to identifying problems and solutions, DT empowers nurses to creatively and confidently address issues they encounter to improve outcomes for their patients, health-care systems, and communities.

Coffee in the Collaboratory: A Collegial Club for Nursing Faculty.

Nurse educators frequently strive to collaborate and share innovative teaching ideas. Finding dedicated time to discuss ways to improve teaching by engaging students is often difficult. Faculty at one university discovered a way to use a new space in an addition to the school of nursing. Faculty meet monthly for "Coffee in the Collaboratory" to share, test, and develop teaching strategies for face-to-face and distance accessible courses. During the meetings, faculty embrace opportunities to practice using new technology. Icebreakers and student-centered learning activities are demonstrated and tested. Faculty take turns sharing how new ideas might be incorporated into both undergraduate and graduate programs. Discussions are spontaneous and fun in this relaxed and friendly environment. A "Coffee in the Collaboratory" meeting can be beneficial in both academic and clinical settings by providing time and space for nurse educators to get together and explore innovative teaching strategies. [J Contin Educ Nurs. 2020;51(8):387-388.].

Building Capacity for Nursing and Midwifery Education Through an Asynchronous Online Course.

BACKGROUND: Global organizations urge toward transformative, lifelong learning for nurses and midwives. Throughout Latin America and the Caribbean, strengthening the quality of nursing and midwifery education is top priority. A regional partnership of World Health Organization Collaborating Centers aimed to develop a user-friendly, culturally relevant, and adaptable educational quality improvement intervention. METHOD: Following the five-step ADDIE process, experts analyzed objectives and needs, designed activities and assessments, and determined optimum delivery of course content. A self-directed, asynchronous online course was developed, in line with regional needs and mandates. Three sequential online educational modules for English-speaking and Spanish-speaking nurse and midwife educators focused on (a) principles of teaching and learning, (b) instructional strategies, and (c) methods to evaluate students and courses. Content and design were externally reviewed and culturally adapted. CONCLUSION: Upon completion of pilot testing and evaluation, final course versions in both languages are expected to become freely accessible. [J Nurs Educ. 2020;59(1):38-41.].

Kaizen: Interactive Gaming for Diabetes Patient Education.

Objective: An estimated 100 million Americans have diabetes, undiagnosed diabetes, a high risk of being diagnosed with diabetes, or prediabetes. Many complications can arise if diabetes is poorly managed. Hence, the need for adequate knowledge, skills, and ability to care for oneself, known as diabetes self-care management, is needed to reduce complication rates. We used an interactive platform that incorporates principles of gamification to enhance user engagement to enhance diabetes knowledge. The purpose of this descriptive pilot study was to discover what adult patients with diabetes thought about this novel educational approach to diabetes education. Materials and Methods: We collected focus group data from participants at a diabetes clinic after they played an interactive diabetes trivia game, on our software platform (Kaizen Education). Transcripts were coded and common themes were identified. Results: We conducted 9 focus groups that included 33 adult (age >18) participants who had diabetes. An overarching theme of play/gaming as a form of learning was apparent, and after analyzing the coding several themes emerged, including preferences and desired environments (clinic and home) for learning, desired players (including family, significant others), and a good balance of question difficulty. Conclusions: Participants were overwhelmingly positive about gamified education and felt empowered to lead discussions with their health care providers about diabetes self-care education, in a sense "flipping" the traditional clinic patient education paradigm. These results suggested that a flipped clinic approach could be beneficial, empowering, and engaging for patients.

Accelerating Clinical Innovation in Biomedical Engineering Education by Using a Digital Portal for Collaboration.

The rapidly changing healthcare landscape requires continuous innovation by clinicians, yet generating ideas to improve patient care is often problematic. This paper describes the development of a digital tool used in an interprofessional program designed to enhance collaborations between clinicians, undergraduate, and graduate STEM students, particularly biomedical engineering (BME). The program founders began by connecting clinicians and students through a course portal in a learning management system (LMS). They eventually secured internal funding to create an open access tool for posting and viewing problems, allowing interprofessional teams to rally around healthcare challenges and create prototypes for solving them. Results after three years of the program's inception have been encouraging, as teams have created devices and processes that have led to intellectual property disclosures, provisional patents, grant funding, and other productive interprofessional relationships. The open access tool has given clinicians and STEM students an outlet for convenient team formation around unsolved clinical problems and allowed a fluid exchange of ideas between participants across a variety of clinical disciplines.

Driving Innovation in Health Care: Clinical Nurse Leader Role.

BACKGROUND: The clinical nurse leader (CNL) role was developed as a strategy for redesigning care delivery to address quality and safety gaps in health care. However, innovation competencies have never been assessed in this group. PURPOSE: The purpose of this study was to determine whether CNLs have different perceptions of innovation and their own competence to lead it, compared with other nurse leaders. METHODS: A web-enabled concurrent mixed-method survey design was used to compare self-reported innovation competencies between nurses in a leadership role and certified CNLs at a large academic medical center. RESULTS: A statistically significant difference between groups was found for only 1 competency, with non-CNLs rating themselves as more competent in the use of unconventional approaches than CNLs. Qualitative data showed wide variation in recognition of innovation and how it is defined. CONCLUSIONS: Replication of this study is needed with an increased sample size of CNLs to determine whether curriculum change is needed.

"Playing for Bragging Rights": A Qualitative Study of Students' Perceptions of Gamification.

BACKGROUND: Nursing faculty sought to promote students' engagement with course material and their peers by using Kaizen, an online educational game. The purpose of this qualitative study was to learn more about nursing students' perceptions of team competition in an educational game and whether the game promoted their engagement with educational material in one fundamental nursing course. METHOD: Qualitative data collection included focus groups, observations of students, documents showing leaderboards and game participation, and "status of competition" e-mails. Data were transcribed and coded to determine emerging themes. RESULTS: Four themes emerged from data analysis: learning in teams, motivators to play, learning course content, and suggestions for game improvement. CONCLUSION: Students were overwhelmingly positive about using a gamified platform for its educational rewards. They perceived that playing the game increased their knowledge retention, and they believed it helped them improve their test-taking skills. [J Nurs Educ. 2019;58(2):79-85.].

Educational Analytics: A New Frontier for Gamification?

To determine the effects of gamification on student education, researchers implemented "Kaizen," a software-based knowledge competition, among a first-year class of undergraduate nursing students. Multiple-choice questions were released weekly or biweekly during two rounds of play. Participation was voluntary, and students could play the game using any Web-enabled device. Analyses of data generated from the game included (1) descriptive, (2) logistic regression modeling of factors associated with user attrition, (3) generalized linear mixed model for retention of knowledge, and (4) analysis of variance of final examination performance by play styles. Researchers found a statistically significant increase in the odds of a correct response (odds ratio, 1.8; 95% confidence interval, 1.0-3.4) for a round 1 question repeated in round 2, suggesting retention of knowledge. They also found statistically significant differences in final examination performance among different play styles.To maximize the benefits of gamification, researchers must use the resulting data both to power educational analytics and to inform nurse educators how to enhance student engagement, knowledge retention, and academic performance.

If You Give a Nurse a Cookie: Sharing Teaching Strategies for Nurse Educator Development.

Nurse educators often do not have time or a space to discuss ideas about effective teaching. To address this issue, an instructor at one school of nursing initiated Cookie Swap, a bimonthly, school-wide e-mail featuring stories about teaching strategies and tools used in face-to-face, online, and clinical courses. J Contin Educ Nurs. 2017;48(1):12-13.

Benefits and Challenges of Teaching Nursing Online: Exploring Perspectives of Different Stakeholders.

BACKGROUND: Recruiting and retaining faculty to teach courses is crucial for online nursing programs to succeed. The purpose of this study was to gain a fuller understanding of the benefits and challenges of teaching nursing courses online by exploring the perspectives of faculty, administrators, and instructional designers at three schools of nursing in the southeastern United States. METHOD: This qualitative multiple case study explored perspectives of 21 participants from different stakeholder groups. Researchers used cross-case analysis and determined emerging themes in data collected from interviews, course demonstrations, and course documents. RESULTS: Data analysis revealed themes regarding benefits and challenges for nursing instructors in (a) teaching strategies, (b) instructor availability, (c) training and support, and (d) institutional issues. CONCLUSION: This study found gaps in perspectives between participant groups that indicated a need for institutions to address communication issues, training program objectives, and institutional policies and procedures regarding online course design and delivery to promote faculty success and satisfaction. [J Nurs Educ. 2016;55(8):433-440.].