Evaluating Virtual Simulation to Augment Undergraduate Nurses' Clinical Practice.

BACKGROUND: Due to the lack of clinical placements during the pandemic, virtual simulation was used to augment student practice experiences. METHOD: Using Kirkpatrick's evaluation model, a program evaluation study using a mixed-methods design was implemented to assess student and faculty satisfaction and usefulness of virtual simulation, the effectiveness of meeting learning needs, and the effects of the virtual simulation resource on the development of clinical judgment (n = 70). RESULTS: Virtual simulation was rated as moderately useful with an overall mean of 1.7 (SD = 0.66, range 1 to 3). Only 21% to 49% of the students found online simulation either met or well met the various areas of learning needs. Qualitative data highlighted the benefits of this strategy as well as implementation factors that affected students' experience. CONCLUSION: Virtual simulation can be used in clinical courses to augment learning when implemented in a way that addresses students' needs. [J Nurs Educ. 2024;63(7):470-477.].

Conceptualizing Student Experiences of Psychological Safety in Simulation: A Grounded Theory Study.

BACKGROUND: Simulation-based learning activities have become more prevalent in prelicensure nursing curricula. When following the Simulation Standards of Best Practice, optimal learning conditions can be achieved, including the creation of a psychologically safe learning environment. Yet, the process of how students come to feel psychologically safe during a simulation experience remains unknown. METHOD: A grounded theory approach was used to conceptualize the basic social process by which nursing students feel psychologically safe during a simulation learning experience. RESULTS: Six categories emerged from the data: (1) being nervous; (2) having a good instructor; (3) learning; (4) coming together; (5) being in debriefing; and (6) leaving on a positive note. The core category of putting myself out there emerged as the basic social process. CONCLUSION: The social process of psychological safety in simulation develops within nursing students as the result of interplay among several dimensions of the learning experience. [J Nurs Educ. 2024;63(7):427-433.].

Peer Collaborative Clinical Decision Making in Nursing Simulation: A Theoretical Framework.

BACKGROUND: Collaboration and decision making among nursing students are essential competencies in nursing education. However, how students collaborate and make decisions in simulation is a complex phenomenon and not well understood. This study aimed to develop a framework that describes peer collaborative clinical decision making (PCCDM) among nursing students in simulation. METHOD: Charmaz's constructivist grounded theory method was used. The sample included 32 participants (16 dyads) from two nursing programs. RESULTS: The PCCDM framework described three interrelated functional domains (cognition, behavior, and emotion) experienced through three interrelated processes (awareness, communication, and regulation), alternating between individual and collaborative spaces and changing across time according to the simulation's acuity levels. CONCLUSION: The PCCDM framework provides a model that reflects how these processes unfold over time in simulations, which can be applied in nursing simulation, classroom, and clinical settings that require students to make collaborative decisions. [J Nurs Educ. 2024;63(7):435-443.].

Teaching Psychomotor Skills in Undergraduate Nursing Education: An Integrative Review.

BACKGROUND: Psychomotor skills, a cognitive and fine motor process, are an essential component to undergraduate nursing education. Currently, no national guidelines exist to guide nursing programs on the best way to educate students to ensure competent and safe practice of psycho-motor skills in the clinical setting. This review sought to determine what methods of education, training, and practice of psychomotor skills enhanced psychomotor skill competency in undergraduate nursing students. METHOD: An integrative review was conducted to determine teaching and practice strategies to support psychomotor skill competence. RESULTS: Four significant categories were identified and included (1) simulation; (2) technology; (3) deliberate practice; and (4) theoretical and collaborative instruction. Overall, simulation and technology were found to be the most effective in psychomotor skill competence. CONCLUSION: Additional research is needed to identify which teaching strategies best support nursing students' long-term knowledge acquisition and competency as they transition into professional practice. [J Nurs Educ. 2024;63(7):421-426.].

Understanding Resilience Among Generation Z Baccalaureate Nursing Students: A Hermeneutical Phenomenology Study.

BACKGROUND: Supporting resilience for nursing student success is critical to future health care. This study explored the meaning and process of resilience among Generation Z traditional baccalaureate nursing students. METHOD: Using a qualitative hermeneutical phenomenology approach, 13 Generation Z nursing students with the lived experience of resilience were surveyed and interviewed. Results were analyzed interpretively. RESULTS: Themes of resilience among Generation Z nursing students were identified relative to study questions. Identified themes included "Maneuvering the Murky Water" and "This Can Either Ruin Me or I Can Keep Moving With It," as well as a resilience process within the context of nursing education. Open-response data provided further reflective insights on resilience and recommendations for resilience in nursing education programs. CONCLUSION: Supporting resilience begins with understanding students' individual and generational perspective. Future nursing education research should include innovative interventions wherein the perspectives of Generation Z students are central to design. [J Nurs Educ. 2024;63(7):460-469.].

Supporting nursing faculty to teach veteran's care: a mixed method, multi-intervention study.

OBJECTIVES: This study aimed to (a) describe nurse educators' attitudes towards veterans after workshop participation, (b) evaluate the effectiveness of the workshop and timed digital interventions (TDI) on nurse educators' integration of veteran-centered content into their courses and curricula, and (c) describe nurse educators' experiences with transferring learning from the workshop to teaching practice. METHODS: A longitudinal multi-intervention, multi-method pilot study was conducted using pre- and post-workshop surveys and interviews. RESULTS: Twenty-six nurse faculty reported a neutral attitude toward working with veterans during the pre-workshop survey period. TDIs kept veteran-centered content fresh on faculty minds, yielding evidence of integration into nursing courses. CONCLUSIONS: Nursing faculty preparation and development is crucial to effectively integrate specific veteran care content into nursing education to ensure a competent and culturally sensitive workforce. Integrating TDIs using widely accessible technologies is a cost-effective way of increasing engagement with new information and bridge implementation gaps associated with traditional professional development activities.

Crisis Response in Nursing Education: An Integrative Review of Nursing Program Adaptation to COVID-19.

PURPOSE: This integrative review sought to systematically examine and synthesize published research on crisis response to identify ways in which undergraduate nursing education programs in various countries adapted to the coronavirus disease 2019 (COVID-19) pandemic. METHOD: A computerized search of CINAHL, Science Direct, and Web of Science databases was performed. The literature search, review, and data extraction process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) format of identification, screening, eligibility, and inclusion. RESULTS: Digital learning technology platforms were used in undergraduate nursing education in various ways to adapt to the teaching and learning challenges of the COVID-19 pandemic. CONCLUSION: Teaching and learning methodologies identified included online lectures and webinars; interactive virtual learning experiences, such as videos, presentations, quizzes, games, and other web-based interactive forms of multimedia files and textual content; and virtual simulations for nursing skills and tele-health experience. [J Nurs Educ. 2024;63(7):445-451.].

A Tool to Teach and Assess Clinical Nurse Specialist Student Prescribing Competency: A Pilot Study.

PURPOSE/AIMS: The purpose of this study was to assess the usefulness of a tool designed to develop and evaluate clinical nurse specialist (CNS) student competency and confidence in prescribing therapeutic agents. Specifically, the aims were to identify students' perceptions of the tool's (1) helpfulness in learning to prescribe, (2) impact on confidence as a prescriber, and (3) recommended use in CNS education. DESIGN: An exploratory design was used. METHODS: Students used the tool in patient care with a supervising mentor during clinical rotations. Students completed surveys after using the tool at 2 points in time. Data were analyzed using descriptive statistics. RESULTS: Of the 18 students, 5 students completed the survey at time 1 and 6 students at time 2. The aims were met in that students perceived the tool to be helpful during CNS prescribing activities, felt confident about prescribing after using the tool, and agreed the tool should be used in CNS education. CONCLUSION: Replication of the study with larger samples of CNS students and psychometric analyses of the tool is recommended by the study's findings to support its use in CNS education beyond the study site.

Simulation design - peer-to-peer training as preparation for full-scale scenarios.

OBJECTIVES: Design of simulation training can have important implications for learning outcomes. This paper describes a pilot simulation training program for baccalaureate nursing students that includes intensive preparations, peer-to-peer skills training (P2P), prior to full-scale scenario training. METHODS: A quality improvement analysis of a large scale experimental, mixed methods study. The project describes the design, analysis, and potential effects of a simulation education program containing P2P for third year nursing students (163 in treatment; 148 in control, n=311). RESULTS: The intervention group was found to be significantly more confident in both technical and non-technical nursing skills. Results suggest that the addition of P2P training may have a direct positive impact and increase the impact on full-scale simulations and debriefing. CONCLUSIONS: Enhanced focus on preparation activities prior to full-scale scenarios, including the use of P2P training methods are advocated.

Development of clinical decision-making among undergraduate nursing students: the effect of unfolding case-based learning.

OBJECTIVES: This prospective cohort study evaluated the effect of unfolding case-based learning on undergraduate nursing students' self-perceived clinical decision-making ability. METHODS: Students' self-reported responses to Jenkins's Clinical Decision Making in Nursing Scale were compared between the unfolding case-based learning cohort (n=140) and the comparison cohort (n=126) at a school of nursing in the United States. RESULTS: The results revealed similar students' responses between the two study cohorts. However, unfolding case-based learning significantly increased students' perceived proficiency in "search for information and unbiased assimilation of new information". CONCLUSIONS: Findings from the present study highlight possibilities presented by unfolding case-based learning in undergraduate nursing education. The study supports that unfolding case studies can be introduced early on, and then nurtured throughout the undergraduate program to influence the development of nursing students' clinical decision-making skills.

Educational Outcomes in Undergraduate Nursing: A Systematic Review.

BACKGROUND: Baccalaureate nursing education has experienced tremendous challenges requiring new flexibility of moving among traditional classroom, online education, and other teaching modalities to improve student outcomes, combined with the pressing need for determining which educational methods deliver quality instruction while having a positive effect on outcomes. This systematic review explored different teaching modalities and measurable educational student outcomes in undergraduate baccalaureate education. METHOD: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: Of the 20 articles included in this systematic review, simulation, face-to-face, asynchronous, problem-based learning, gaming, flipped classrooms, reflective writing, tweets, and podcasts were represented. Three distinct educational outcomes that were identified included competence, confidence, and communication. CONCLUSION: A variety of educational methodologies drives positive outcomes in educating the next generation of nurses to have increased competence, confidence, and improved communication. [J Nurs Educ. 2024;63(6):380-386.].

OWIED System to Facilitate the Entrustment Decision in EPA Implementation.

BACKGROUND: Entrustable professional activities (EPAs) are gaining attention as an approach for adequate implementation of a competency-based evaluation framework in nursing education. This study sought to develop an Online Web-assessment Interface for Entrustment Decision (OWIED) to facilitate the entrustment decision in EPA implementation. METHOD: A participatory qualitative action research design consisting of two phases was used for this study. The exploration phase was conducted in close collaboration with stakeholders. Following the exploration phase, the primary researcher and a team of subject-matter experts in academic and information technology developed the OWIED system according to the exploration phase results. RESULTS: The necessary features that met the expectations of the stakeholders were identified and assisted in developing the OWIED system. CONCLUSION: OWIED may provide a valid tool to track and validate nursing student acquisition of core competencies and assist in making entrustment decisions as students fulfill their training requirements in their academic program. [J Nurs Educ. 2024;63(6):356-365.].

Integrative Review of Sources of Baccalaureate Nursing Students' Clinical Practice Anxiety.

BACKGROUND: Nursing education research and anecdotal literature has revealed that undergraduate nursing students report anxiety related to clinical practice. Most published studies have focused on the effectiveness of interventions to reduce anxiety; only a few identify specific sources of clinical practice anxiety. METHOD: We conducted an integrative literature review to understand the sources of nursing students' practice-related anxiety and how this anxiety has been measured. RESULTS: We classified sources of practice-related anxiety into nine themes grouped into five categories: consequences of making a mistake; fear of the unknown; incivility of staff members or teachers; threat to self-concept, image, or health; and theory-practice gap. Practice-related anxiety was measured quantitatively with various surveys and qualitatively using semistructured individual or group interviews and students' journal entries. CONCLUSION: Different sources of practice-related anxiety likely require distinct interventions. Further research is recommended to identify effective interventions to reduce anxiety related to each of the identified themes. [J Nurs Educ. 2024;63(6):349-355.].

Self-Care in Nursing Education.

BACKGROUND: The mental health of students and faculty has become a growing issue in academia. Faculty need to provide role-modeling early in nursing programs to enhance psychological well-being for future nurses that will have lasting effects throughout their careers. METHOD: A total of 29 faculty members participated in a descriptive study investigating types of self-care goals and how they could be achieved by College of Nursing faculty during their annual performance appraisal. RESULTS: Seventy-three percent of respondents reported they anticipated that achieving these self-care goals would enhance their faculty role. Further, the respondents associated achievement of self-care goals as a way to improve their faculty performance. CONCLUSION: Since every individual has a unique perspective of the world, a self-care approach that works for one person might not work for another. Self-care goals should therefore be tailored to the unique needs and perspectives of each person. [J Nurs Educ. 2024;63(6):394-398.].

Evaluating the Effectiveness of Empathy-Based Education in Undergraduate Nursing: A Scoping Review.

BACKGROUND: Empathy is an essential trait in nursing practice that improves the quality of patient care. Nursing curricula that incorporate empathy-based experiential learning (i.e., hands-on educational experiences and reflections designed to foster and develop emotional intelligence) promote students' self-awareness and confidence when providing care to patients. This scoping review examined studies that explored the effects of educational interventions on the development of empathy in undergraduate nursing students. METHOD: Searches were conducted in MEDLINE using keywords related to nursing education and translated into CINAHL, EMBASE, and ERIC databases. RESULTS: A total of 6,238 studies were identified. After duplicate and unrelated articles were excluded, 18 publications were considered for this review. Sixteen studies concluded empathy interventions were effective, five indicated the need for further research, and two implicated a need for standardization in empathy-evaluation tools. CONCLUSION: This review endorses the effectiveness of educational interventions and supports their implementation to promote empathy in undergraduate nursing students. [J Nurs Educ. 2024;63(6):367-371.].

Interventions to Increase the Diversity of Nursing Programs: An Integrative Review.

BACKGROUND: In 2011, the Institute of Medicine's The Future of Nursing: Leading Change, Advancing Health report declared the need to increase diversity in nursing. The National League for Nursing stated that nursing pipeline programs would be essential to create increased diversity. However, no details regarding the definition, construction, or implementation of a nursing pipeline were available within the position statement. METHOD: An inclusive integrative literature review was conducted. The aim was to examine interventions targeted toward increasing diversity in nursing education programs. RESULTS: Twelve articles were included in the review. Similar interventions were used by nursing education programs; these included strategies to raise awareness about nursing to prospective students, preen-try preparation, holistic admissions, scholarships, tutoring, mentoring, and targeted advising. CONCLUSION: Evidence indicates interventions aimed at the retention of at-risk individuals are successful. Additional research is needed to develop effective recruitment strategies for diverse populations. [J Nurs Educ. 2024;63(6):387-393.].