The effect of flipped learning on blood pressure knowledge and self-directed learning skills of first-year nursing students: A randomized controlled trial

AimThis study investigated the effect of flipped learning on first-year nursing students’ blood pressure knowledge levels and self-directed learning skills.BackgroundFlipped learning is an innovative approach that helps nursing students learn about blood pressure and how to measure how to measure blood pressure accurately. Flipped learning also promotes active and student-centered learning settings and encourages nursing students to develop self-directed skills.DesignThis study adopted a pretest-posttest open-label randomized controlled trial.MethodThe sample consisted of 94 first-year nursing students randomized into experimental (n = 48) and control groups (n = 46). The experimental group participants were trained using the flipped learning model. Data were collected using a personal information form, the Blood Pressure Knowledge Test (BPKT) and the Self-Directed Learning Skills Scale (SDLSS).ResultsThere was no significant difference in pretest BPKT scores between the experimental and control groups. However, there was a significant difference in posttest BPKT scores between the experimental and control groups (p = 0.011). Moreover, there was a significant difference between the experimental group's mean pretest, posttest and follow-up SDLSS scores (p = 0.009).ConclusionThe experimental group had a significantly higher mean posttest BPKT score than the pretest score. They had significantly higher mean posttest SDLSS total and “self-monitoring,” “motivation,” and “self-confidence” subscale scores than the pretest score.     

First-year nursing students’ attitudes towards artificial intelligence: Cross-sectional multi-center study

AimTo assess the attitudes of nursing students toward artificial intelligence.BackgroundPossible applications of artificial intelligence-powered systems in nursing cover all aspects of nursing care, from patient care to risk management. Although the final acceptance of artificial intelligence in practice will depend on positive 'nurses' attitudes toward artificial intelligence, those attitudes have gained little attention so far.DesignA cross-sectional multicenter study.MethodsThe study was performed at nursing schools of four Croatian universities, surveying a total of 336 first-year nursing students (response rate 69.7%) enrolled in 2021. A validated instrument, the General Attitudes towards Artificial Intelligence Scale, consisting of 20 Likert-type items, was chosen for the study. Where applicable, the items were contextualized for nursing. Four sub-scales were identified based on the outcomes of the factor analysis.ResultsThe average attitude score was (mean ± standard deviation) 64.5 ± 11.7, out of a maximum of 100, which was significantly higher than the neutral score of 60.0 (p < 0.001). The attitude towards AI did not differ across the universities and was not associated with students’ age. Male students scored slightly higher than their female colleagues. Scores on subscales “Benefits of artificial intelligence in nursing”, “Willingness to use artificial intelligence in nursing practice”, and “Dangers of artificial intelligence” were favorable of artificial intelligence-based solutions. However, scores on the subscale “Practical advantages of artificial intelligence” were somewhat unfavorable.ConclusionsFirst-year nursing students had slightly positive attitudes towards artificial intelligence in nursing, which should make it easier for the new generations of nurses to embrace and implement artificial intelligence systems. Reservations about artificial intelligence in daily nursing practice indicate that nursing students might benefit from education focused specifically on applications of artificial intelligence in nursing.     

Hand hygiene education of Greek medical and nursing students: A cross-sectional study

AimTo investigate medical and nursing students’ education on hand hygiene, their attitude on hand hygiene education and how this education influences their hand hygiene knowledge and practices.BackgroundHospital-acquired infections are associated with prolonged hospitalisation and mortality. The most effective measure for their control is healthcare workers’ hand hygiene compliance. Since medical and nursing students constitute the future healthcare workers, our study focuses on them.DesignCross-sectional studyMethodsThis study was conducted during the academic year 2016–2017, using a modified World Health Organisation questionnaire. Our sample consisted of 132 medical and 111 nursing students from National and Kapodistrian University of Athens, Greece. In data analysis, the Mann-Whitney and Fisher’s exact tests were applied to compare differences in continuous variables and proportions in categorical variables, respectively. Knowledge and practices overall scores were calculated per student group. Multiple linear regression analyses were performed to assess the influence of potential confounders on these scores.ResultsWe found that 73.1% of medical and 98.2% of nursing students had received relevant education, which was reported as “only theoretical” by 77.4% of the former and as “hands-on and theoretical” by 88.1% of the latter group. Besides the risk of infection, knowledge acquired in lectures and trainer’s behaviour were also considered very influential factors shaping hand hygiene attitude in both groups. Overall, medical students reported better hand hygiene practices than nursing ones (69.9% and 59.7%, respectively; p < 0.001). The opposite finding was observed regarding their overall knowledge on hand hygiene (57.2% of medical versus 60.4% of nursing students, p = 0.04). The majority of students (86.6% of all participants; p < 0.001) supported the inclusion of compulsory hand hygiene education in their curriculum. Compulsory education and seminars were assessed as the most effective measures to increase hand hygiene compliance (71.4% of all students).ConclusionIn our study, medical students scored better in practices questions than nursing students; this did not apply for the knowledge score. The majority of students supported the inclusion of compulsory education on hand hygiene principles in their Departments’ curricula, highlighting compulsory education and seminars as the most effective measures to increase compliance with hand hygiene.     

Problematic mobile phone use,nomophobia and decision-making in nursing students mobile and decision-making in nursing students

The objective of this study was to determine the influence of nomophobia and/or problematic mobile phone use on decision-making in nursing students. A cross-sectional study was carried out. The sample consisted of 124 nursing students. The Nomophobia Questionnaire, Mobile Phone Problematic Use Scale and Melbourne Decision Making Questionnaire were used for data collection. Regarding the results, the average total score of the Nomophobia Questionnaire was 69.50 ± 21.08, and the average total score of the Mobile Phone Problematic Use Scale was 83.60 ± 19.90 points. Positive correlations were found between the dimensions of nomophobia and the Mobile Phone Problematic Use Scale. Additionally, positive correlations were found between nomophobia and the dimensions of “buck-passing” (rs = 0.263; p = 0.017), procrastination (rs = 0.307; p = 0.011) and hypervigilance (rs = 0.284; p = 0.002) in regards to decision-making. As for the Mobile Phone Problematic Use Scale, a positive correlation was found between this scale and the procrastination dimension (rs = 0.128; p = 0.015). Problematic mobile phone use and/or nomophobia may have an influence on decision-making in nursing students. Levels of procrastination, hypervigilance and “buck-passing” in nursing students are affected by mobile phone use throughout their training. These factors may affect their academic performance, as well as their relationships with patients and other colleagues.     

Stress levels and coping strategies among undergraduate nursing students in Greece during economic recession: a cross-sectional study

AimTo identify factors contributing to Greek nursing students’ stress and the coping strategies used.BackgroundStress experienced by nursing students in the context of ongoing economic recession is as yet unexplored.DesignA cross-sectional study .MethodologyUndergraduate nursing students (n = 424) completed the Student Nurse Stress Index (short version) and the Brief COPE questionnaires during the year 2017.ResultsMost of the participants stated that their current financial status (81.7%) contributed towards their experience of stress, and they had higher scores on the interface worries subscale (p < 0.001). Female gender (p < 0.001) seniority (p = 0.005) and stress of transportation from home to university (p = 0.019) significantly increased the SNSI total score as well as most of the stress subscales scores. As far as coping subscales were concerned, higher means were shown in active/positive coping (mean 2.95), seeking support (mean 2.84), expression of negative feelings (mean 2.71) and avoidance (2.47). However, the use of higher maladaptive coping strategies was noted in cases presenting higher SNSI Total score, interface worries and personal problems.ConclusionThe introduction of stress management training and conflict management skills ought to be considered. Fund raising initiatives should be considered to provide financial assistance to those in need.     

Blood donation attitudes and knowledge in Spanish undergraduates with roles in health-education

BackgroundRecent investigations highlight how important it is to identify the key factors involved in the design of strategies to promote blood donation among undergraduates as a public health concern. The study aims to investigate attitudes and knowledge towards blood donation in university students with health education roles and examine the way sociodemographic and educational characteristics play a part in it.Materials and methodsA cross-sectional and multi-center design was used. A structured questionnaire was answered by 1128 Spanish university students (Schools of Health Sciences and Education Sciences).ResultsThe knowledge test indicated a low score (M = 4.2 out of 10), being Me = 3.00 in the case of Education Sciences and Me = 5.00 in Health Sciences students. The greatest degree of importance is found in the “external incentives” dimension (M = 3.7 out of 5). Health science students and participants with relatives who needed a donation showed fewer “fears” (p ≤ 0.001) and “pretexts” (p ≤ 0.01).ConclusionsThe low knowledge score stresses the need to develop valuable health education-related strategies in the curriculum of studies related with health education; showing room for improvement particularly in Education Science students. Health education interventions aimed at increasing donors in the university environment should be designed while considering differences among undergraduates. Based on their better attitudes, health science students might play a relevant role in promoting blood donation.     

Nursing degree students’ clinical placement experiences in Australia: A survey design

AimThis study aimed to evaluate Australian nursing students’ views of placements at seven tertiary education institutions with the use of the Placement Evaluation Tool (PET).BackgroundClinical placements are a core element of healthcare education programs around the world (Chuan and Barnett, 2012) with undergraduate nursing students required to complete a prescribed number of hours as part of their degree. The quality of nursing clinical placements varies with a range of positive and negative learning experiences.DesignA survey design was used with a contemporary survey tool– the Placement Evaluation Tool (PET). Using Qualtrics software (Qualtrics, 2005) the on-line survey was distributed to approximately 6265 undergraduate nursing students at six Australian universities and one Technical and Further Education (TAFE) college where Bachelor of Nursing degree students were enrolled. Three Australian States were covered. Sites were selected where a project team member was employed.MethodsA total of 1263 nursing students completed the Placement Evaluation Tool (PET) − 19 items (rated 1–5), one global rating (rated 1–10) − following placement in three Australian States (July 2019−February 2020). Most - 618 (48.9%) completed a placement in acute care with placements positively rated overall.ResultsThe total PET mean score was 78.3% with 29.8% being ‘extremely satisfied’ (10 out of 10 – Item 20). However, 11.0% were dissatisfied with global ratings of four or less, whilst ratings between States differed significantly (p = <0.001). One third of respondents answered a free text statement relating to placement experiences, with significantly more comments from older students (p = <0.001) and from those with ratings in the lower range (p = <0.001). Three core themes emerged: 1. Staff Attitudes to Students, 2. Environment and 3. Lifestyle.ConclusionsWhilst students’ clinical experiences in Australia tend to be positive a minority reported exposure to negative staff attitudes, in unsafe environments, with lifestyle detriments. Further work is required to understand and enhance student experiences.     

EMG activity of the serratus anterior and trapezius muscles during elevation and PUSH UP exercises

BackgroundElevation and push up (Pu) exercises are considered to be beneficial for the rehabilitation of shoulder complex pathology. Despite their clinical utility, there is a lack of evidence comparing scapulothoracic muscles recruitment during these exercises.ObjectiveTo evaluate the EMG activity of upper trapezius (UT), Lower Trapezius (LT), Upper Serratus anterior (USa) and Lower Serratus anterior (LSa) muscles during a variety of elevation and Pu exercises.MethodsThirteen healthy participants (non, athlete, male, mean ± standard deviation; age: 21.1 ± 1.8 years; height: 1.80 m ± 0.04; weight: 79 ± 12 kg) were assessed. EMG data was collected during Scaption, wall slide and elevation with external rotation (EleEr) with and without load. Pu classic, Pu plus (PuP) on stable/unstable surfaces and Pu with shoulder internal rotation were also assessed.ResultsUT had a significant higher activity during ‘Scaption load’ (p < .05) and LT in ‘EleEr load’ and ‘Scaption load’ (p < .05). USa and LSa had a significant higher activity on ‘PuP unstable surface’ and ‘PuP internal rotation’ compared to elevation exercises (p < .05). Scaption had greater activity ratio compared to the other exercises on UT/LT (p < .05). Pu variations had lower results in UT/USa and UT/LSa ratios compared to shoulder elevation exercises (p < .05).ConclusionsElevation exercises produce significant effects on upper and lower trapezius activation while Pu exercises on Sa muscles. Wall slide exercise notes the lowest activation in all muscles. A descending order of muscle activity during different variations of elevation and Pu exercises is provided in order to guide exercise selection in everyday clinical practice.     

Effects of blended versus offline case-centred learning on the academic performance and critical thinking ability of undergraduate nursing students: A cluster randomised controlled trial

ObjectiveThis study aimed to compare the effect of blended and offline case-centred learning on medical nursing education for undergraduate nursing students.BackgroundTechnological advancements are rapidly changing nursing education in higher educational settings. Educational reform, especially regarding methods of teaching, has been the focus of nursing educators in recent years.DesignThe research was conducted between September 2018 and July 2019 in China.MethodsSecond-year undergraduate nursing students in two classes were enrolled for this study by cluster sampling. The study outcomes were academic performance and critical thinking ability, measured using the Critical Thinking Disposition Inventory-Chinese Version.ResultsStudents in the experimental class showed significantly higher improvements in academic performance than those in the control class. Compared with the control class, the pre-post difference in competency in critical thinking self-confidence in the experimental class was significantly greater (p = 0.037). In the experimental class, there was a significant improvement over the baseline in the dimension of critical thinking self-confidence (p = 0.022). In the control class, there was a significant improvement over the baseline in the total score (p = 0.029) and two of the seven dimensions: truth-seeking (p = 0.016) and systematicity (p = 0.005).ConclusionsThe use of blended case-centred learning showed promising results in improving students’ academic performance. Both blended and offline case-centred learning were indicated to be effective educational approaches to improve the critical thinking ability of undergraduate nursing students and could be implemented for other nursing subjects in the future.     

Personality traits affect critical care nursing competence: A multicentre cross-sectional study

ObjectiveTo investigate the relationship between personality traits and critical care nursing competence among critical care nurses.Research methodology/designMulticentre cross-sectional survey using a self-report questionnaire and path modelling, from August 2017 to December 2018.SettingSix intensive care units in Japan.Main outcome measuresWe assessed relationships among the Big Five personality traits and four critical care nursing competencies in nurses.FindingsWe included 211 nurses (77.7% women, 59.2% in their 20 s); 62.6% had 1–5 years’ critical care nursing experience. Among the four competencies, principles of nursing care had a direct positive effect on decision-making (0.77, p < 0.001); decision-making had a direct positive effect on collaboration (0.74, p < 0.001) and nursing interventions (0.77, p < 0.001). The personality traits openness to experience, agreeableness, and extraversion had a significantly positive effect (0.17, p < 0.05; 0.43, p < 0.001; 0.29, p < 0.01; respectively) on principles of nursing care, the key competency. The personality trait neuroticism had a direct or indirect negative effect on all four nursing competencies.ConclusionNursing competence in the critical care setting is affected by personality traits. Our findings can be applied in nursing education to improve competence based on individual personality traits.     

A web-based clinical pedagogy program to promote professional development for nurse preceptors: A quasi-experimental study

ObjectiveTo examine the effectiveness of a web-based clinical pedagogy program on nurse preceptors’ clinical teaching competency, self-efficacy, and attitudes toward web-based learning in comparison to face-to-face course.BackgroundPreceptorship is a dynamic educational process that requires designing, and implementing various teaching strategies, evaluation, assessment and feedback. Web-based learning has been recognized as an effective learning approach for nursing professional development.DesignA prospective quasi-experimental approach with two-group pre-test and post-test repeated measures was adopted.MethodsThe web-based clinical pedagogy program was provided to the preceptors in the experimental group, while control group received the face-to-face preceptorship course. Clinical Teaching Competence Inventory (CTCI), Preceptor Self-efficacy Assessment Instrument (PSEQ), and Attitudes toward Web-based Continuing Learning Survey (AWCLS) were used to evaluate preceptors’ learning outcomes. Data were collected at three time points – before, immediately after the learning program, and after 6 months of the clinical teaching experience.ResultsA total of 150 nurses (75 participants/group) were recruited from a tertiary hospital in Singapore from July 2018 to June 2020. The results from the repeated measures analysis of covariance showed that there was a significant interaction effect (group x time) on the overall CTCI score after adjusting for covariate (F = 5.390, p = 0.005). However, there were no significant interaction effect (group x time) on PSEQ (F = 2.693, p = 0.070) and overall AWCLS score (F = 1.341, p = 0.264) between the two groups across the three time points.ConclusionThe web-based clinical pedagogy program produced outcomes comparable to the face-to-face program in terms of preceptors’ clinical teaching competence and self-efficacy. The innovative and cost-effective web-based clinical pedagogy program provided professional development and the flexibility to accommodate preceptors’ busy work schedules. Online learning has become increasingly popular during the COVID-19 pandemic and the web-based clinical pedagogy program was implemented when face-to-face workshop was not feasible.     

Emergency department nurses’ perceptions of caring behaviors toward individuals with mental illness: A secondary analysis

AimThe aim of this study was to determine emergency department (ED) nurses’ caring behaviors toward individuals with mental illness; and the influence of stigma on their caring behaviors.MethodThis is a secondary analysis of a cross-sectional study with (n = 813) ED nurses working in the United States from March 2021 to April 2021. The Caring Behaviors Inventory-24 item (CBI-24) and the Mental Illness: Clinicians’ Attitudes Scale-4 (MICA v4) were used to collect data.ResultsThe mean CBI-24 score was 4.6 (SD = 0.8). The MICA v4 had an overall sum of 53.4 (SD = 9.2). Caring behaviors and stigma were found to have significant weak inverse relationship (r = - 0.23, p <.001). Age and level of education had a significant inverse relationship with caring behaviors (r = - 0.12; r = -. 19, p <.01 respectively).ConclusionThe results of this study may contribute to the quality, equity, and safety of the emergency nursing care of individuals with mental illness, thereby improving health outcomes. It is recommended that the diversity of nurses and the characteristics of the ED be taken into consideration when designing trainings, providing leadership support, and managing resources to support the care of individuals with mental illness.