The Effects of a Deliberate Practice Debriefing During a Response to Rescue Patient Simulation With Undergraduate Nursing Students.

ABSTRACT: The purpose of this multisite, randomized, pretest/posttest quasi-experimental study was to compare student nurse competency, learning retention, and perceived student support after exposure to a deliberate practice debriefing versus standardized debriefing. Fifty undergraduate students participated in the complex response to rescue simulation. The intervention group had significantly higher total mean and three subscale scores on the competency tool than the comparison group, although differences in learning retention and student support were not significant. This study provides preliminary support for the effectiveness of deliberate practice debriefing to enhance students' mastery of skills and behaviors in complex simulations.

Technology Use and Technological Self-Efficacy Among Undergraduate Nursing Faculty.

AIM: This study explored faculty responses to a survey about using technology to teach undergraduate nursing students. BACKGROUND: Little is known regarding faculty confidence, technology use, or supports for integrating technology into nursing education. METHOD: A descriptive correlational design was utilized to explore the relationship between technology use and technological self-efficacy in faculty (N = 272) who teach at Commission on Collegiate Nursing Education-accredited nursing programs. Instruments used were a sociodemographic questionnaire, the Roney Technology Use Scale, and the Technology Self-Efficacy Scale. RESULTS: Participants who taught didactic content had moderate technology use as compared to those teaching didactic and clinical/laboratory who reported high levels of technology use. A weak relationship between age and technological self-efficacy (ρ = .127, p < .05) was also found. CONLUSION: This research was an initial step in understanding levels of technology use and responses to this challenge by undergraduate nursing faculty.

After the Gap Analysis: Education and Practice Changes to Prepare Nurses of the Future.

AIM: The purpose of the study was to describe the Connecticut Nursing Collaborative-Action Coalition's work in identifying and addressing gaps between nursing education and practice based on the Institute of Medicine's Future of Nursing report. BACKGROUND: Massachusetts Nurse of the Future (NOF) Competencies highlight the knowledge, skills, and attitudes/behaviors required for professional nurses. Integrating these concepts into the educational system will prepare the nursing workforce to respond to current/future health care needs and population health issues. METHOD: Education and practice partners in four regions conducted a gap analysis of the education to practice transition for new graduate nurses using NOF as a framework for assessment. RESULTS: Gaps in competencies were similar across regions. However, each organization uniquely addressed curricular gaps to best prepare nurses of the future. CONCLUSION: Curriculum improvements will provide students the advantage of being prepared for the rapid changes happening in health care.

Humanizing Substance Abuse: A Theory-Based Educational Intervention for Undergraduate Nursing Students.

BACKGROUND: Healthcare providers, as well as healthcare students, have been found to harbor negative attitudes toward individuals with substance abuse disorders, impacting the care they give and subsequently creating poor patient outcomes. PURPOSE: This study seeks to determine the effectiveness of an educational intervention, grounded in theory, toward changing nursing student attitudes regarding patients with a substance abuse disorder. METHODS: Nursing students participated in a teaching intervention, developed using the experiential learning theory, that utilizes modalities for each kind of learner aimed at reducing bias toward this population. The Medical Condition Regard Scale was used pre/post intervention to determine regard toward patients with the diagnosis of substance abuse. RESULTS: Student nurses maintained the least favorable attitudes toward individuals who abuse substances in comparison with patients with the diagnoses of pneumonia or gastroesophageal reflux disease; there were significant differences in attitudes toward patients who abused substances before and after participation in the educational intervention, with postparticipation attitudes being significantly more positive than attitudes before participation. Students found the educational intervention and debriefing highly satisfactory. IMPLICATIONS: This educational intervention can provide a cost-effective, easy-to-replicate, time-efficient learning activity that could be added to undergraduate nursing curriculum.

Assessment of nursing student's learning outcomes and employment choice after the implementation of a senior capstone course.

Many undergraduate baccalaureate nursing programs incorporate clinical emersion courses at the end of the program. Nursing capstone courses have become increasingly important in facilitating student transition into practice. However, little is known regarding the overall effectiveness of this teaching model for students, nursing programs, and clinical agencies. Previous studies revealed conflicting results about the benefits of a senior level precepted clinical experience. In this multi-method study, the authors examined student learning outcomes, perceptions, employment choice and retention following implementation of a new capstone nursing course. Results of this study indicated that a capstone course does not necessarily significantly improve scores on achievement exams or NCLEX RN first time pass rates. Nevertheless, qualitative content analysis revealed the following themes: integration, autonomy, confidence, authority, and advocacy consistent with a perceived enhanced competence in the nursing role. Data indicated that graduates often seek employment and remain at their capstone site or within their capstone specialty.

Evaluation of the McMahon Competence Assessment Instrument for Use with Midwifery Students During a Simulated Shoulder Dystocia.

INTRODUCTION: Intrapartum emergencies occur infrequently but require a prompt and competent response from the midwife to prevent morbidity and mortality of the woman, fetus, and newborn. Simulation provides the opportunity for student midwives to develop competence in a safe environment. The purpose of this study was to determine the inter-rater reliability of the McMahon Competence Assessment Instrument (MCAI) for use with student midwives during a simulated shoulder dystocia scenario. METHODS: A pilot study using a nonprobability convenience sample was used to evaluate the MCAI. Content validity indices were calculated for the individual items and the overall instrument using data from a panel of expert reviewers. Fourteen student midwives consented to be video recorded while participating in a simulated shoulder dystocia scenario. Three faculty raters used the MCAI to evaluate the student performance. These quantitative data were used to determine the inter-rater reliability of the MCAI. RESULTS: The intraclass correlation coefficient (ICC) was used to assess the inter-rater reliability of MCAI scores between 2 or more raters. The ICC was 0.86 (95% confidence interval, 0.60-0.96). Fleiss's kappa was calculated to determine the inter-rater reliability for individual items. Twenty-three of the 42 items corresponded to excellent strength of agreement. DISCUSSION: This study demonstrates a method to determine the inter-rater reliability of a competence assessment instrument to be used with student midwives. Data produced by this study were used to revise and improve the instrument. Additional research will further document the inter-rater reliability and can be used to determine changes in student competence. Valid and reliable methods of assessment will encourage the use of simulation to efficiently develop the competence of student midwives.

Enhancing evidence bases for interventions in a baccalaureate program.

Modifying the sequence, objectives, and research-based content for a nursing interventions course in a baccalaureate curriculum resulted in improved outcomes including enhancement of the evidence bases for nursing interventions. A mixed methods research study demonstrated better student preparation for clinical experiences and improved satisfaction with course content, consistency, and sequencing. Faculty reported improved integration of theory, research, and practice. Although grades were slightly lower in the new course, the positive outcomes greatly outweighed this expected finding. A foundation for improving the evidence bases for future nursing practice is guided by the curricular modifications described in this article.

Antibiotic-taking experiences of undergraduate college students.

PURPOSE: The purpose of this qualitative descriptive study was to explore the medication-taking experiences of undergraduate college students prescribed short-term antibiotic therapies and to describe factors influencing their adherence. DATA SOURCES: Thirty-four undergraduate students prescribed antibiotics for treatment of an acute infectious illness at a large university health center were recruited to participate in this study. Semistructured telephone interviews were conducted after students finished their course of treatment. Qualitative descriptive content analysis was used to analyze the transcripts typed from the audio-taped phone interviews. CONCLUSIONS: The main theme that emerged from the data was antibiotic-taking self-management. Most participants were able to adapt medication regimens into their daily routines, and used events in their day and specific reminder strategies to help them to remember to take their medications. This occurred despite an ever-changing class and work schedule and being prescribed complex, lengthy antibiotic regimens. Most dosing errors occurred during times when schedules changed or students were off campus during weekends or college breaks. A small number of students discontinued therapy early because of side effects or forgetfulness. IMPLICATIONS FOR PRACTICE: By understanding factors that influence antibiotic adherence from a college student perspective, healthcare providers can suggest strategies to promote adherence that are tailored to the specific needs of this unique population.

Care of the adult patient with cystic fibrosis.

Recently published consensus statements and conference proceedings from the Cystic Fibrosis Foundation provide new direction with regard to the etiology, diagnosis, and treatment of the adult patient with cystic fibrosis (CF). Survival has improved through early diagnosis and improved treatment, and aggressive management of complications. The current state of knowledge, the most recent evidence-based treatment options, and essentials of nursing care for the adult patient with CF are outlined.