Expert patient illness narratives as a teaching methodology: A mixed method study of student nurses satisfaction

ObjectiveTo evaluate nursing students' satisfaction with Expert Patient Illness Narratives as a teaching and learning methodology based on patient involvement.Methods and DesignMixed methods were used in this study: online survey with quantitative and qualitative items designed by researchers.Settings and ParticipantsSixty-four nursing students of the Universitat Autònoma de Barcelona, attending a Medical Anthropology elective course.ResultsWomen more frequently considered that the new learning methodology was useful in developing the competency “to reason to reason the presence of the triad Health-Illness-Care in all the groups, societies and historical moments” (p-value = 0.02) and in that it was consolidated as a learning outcome (p-value = 0.022). On the other hand, men considered that this methodology facilitated the development of critical thinking (p = 0.01) and the ability to identify normalized or deviant care situations (p = 0.007). Students recognized the value of Expert Patient Illness Narratives in their nursing training as a way to acquire new nursing skills and broaden previously acquired knowledge. This educational innovation improved nursing skills and provided a different and richer perspective of humanization of care.ConclusionsThe results of the present study demonstrate that nursing students found Expert Patient Illness Narratives satisfactory as a learning and teaching methodology, and reported improvement in different areas of their training and also the integration of new knowledge, meaning, theory applicability, as well las critical and reflective thinking. Involvement of patients as storytellers also provides a new humanizing perspective of care. Nonetheless, further studies of Expert Patient Illness Narratives are needed in order to improve its benefits as a teaching and learning methodology.     

Impact of Chemical, Biological, Radiation, and Nuclear Personal Protective Equipment on the performance of low- and high-dexterity airway and vascular access skills

BackgroundFollowing CBRN incidents health care professionals will be required to care for critically ill patients within the warm zone, prior to decontamination, whilst wearing CBRN-PPE. The loss of fine-motor skills may adversely affect delivery of medical care.Methods64 clinicians were recruited to perform, intubation, LMA placement, insertion of an IV cannula and IO needle whilst wearing CBRN-PPE. A fractional factorial design was employed, in which each of the 64 clinicians had two attempts at performing each skill whilst wearing CBRN-PPE and once unsuited according to a pre-specified sequence.AnalysisThe unsuited and suit data were analysed independently with the primary outcome being time taken to complete each skill whilst suited. Analysis was undertaken using STATA (V9.2).ResultsMean times differ considerably by skill (p < 0.001). Overall, times to completion on attempt 2 were shorter than attempt 1 (p = 0.045), though the reduction in time differed significantly by skill (p = 0.004). LMA placement was on average completed nearly 45 s faster than intubation, and IO cannulation was nearly 90 s faster than IV cannulation. Whilst suited, 8% of intubation and 12% of intra-venous cannulation attempts were unsuccessful. Previous familiarity with CBRN-PPE did not improve performance (p = 0.23). Professional groups differed significantly (p = 0.009) with anaesthetists performing all skills faster than the other clinicians.ConclusionThis study supports the concept of instigating airway and vascular access skills whilst wearing CBRN-PPE but challenges the sole reliance on ‘high-dexterity skills’. Intubation is feasible but must be considered within the context of the incident as the LMA may offer a viable alternative. Intra-venous access prior to casualty decontamination is arguably a pointless skill and should be replaced with IO access.     

“Rolling Refreshers”: A novel approach to maintain CPR psychomotor skill competence

ObjectivesHigh quality CPR skill retention is poor. We hypothesized that “just-in-time” and “just-in-place” training programs would be effective and well-accepted to maintain CPR skills among PICU staff.Methods“Rolling Refreshers”, a portable manikin/defibrillator system with chest compression sensor providing automated corrective feedback to optimize CPR skills, were conducted daily in the PICU with multidisciplinary healthcare providers. Providers practiced CPR until skill success was attained, prospectively defined as <3 corrective prompts within 30 s targeting chest compression (CC) rate 90–120/min, CC depth >38 mm during continuous CPR. Providers completing ≥2 refreshers/month (Frequent Refreshers [FR]) were compared to providers completing <2 refreshers/month (Infrequent Refreshers [IR]) for time to achieve CPR skill success. Univariate analysis performed using non-parametric methods. Following actual cardiac arrests, CPR providers were surveyed for subjective feedback on training approach efficacy (5-point Likert scale; 1 = poor to 5 = excellent).ResultsOver 15 weeks, 420 PICU staff were “refreshed”: 340 nurses, 34 physicians, 46 respiratory therapists. A consecutive sample of 20 PICU staff was assessed before subsequent refresher sessions (FREQ n = 10, INFREQ n = 10). Time to achieve CPR skill success was significantly less in FREQ (median 21 s, IQR: 15.75–30 s) than in INFREQ (median 67 s, IQR: 41.5–84 s; p < 0.001). Following actual resuscitations, CPR providers (n = 9) rated “Rolling Refresher” training as effective (mean = 4.2; Likert scale 1–5; standard deviation 0.67).ConclusionsA novel “Rolling Refresher” CPR skill training approach using “just-in-time” and “just-in-place” simulation is effective and well received by PICU staff. More frequent refreshers resulted in significantly shorter times to achieve proficient CPR skills.     

An overview of the Families Improving Together (FIT) for weight loss randomized controlled trial in African American families

BackgroundThe Families Improving Together (FIT) randomized controlled trial tests the efficacy of integrating cultural tailoring, positive parenting, and motivational strategies into a comprehensive curriculum for weight loss in African American adolescents. The overall goal of the FIT trial is to test the effects of an integrated intervention curriculum and the added effects of a tailored web-based intervention on reducing z-BMI in overweight African American adolescents.Design and settingThe FIT trial is a randomized group cohort design the will involve 520 African American families with an overweight adolescent between the ages of 11–16 years. The trial tests the efficacy of an 8-week face-to-face group randomized program comparing M + FWL (Motivational Plus Family Weight Loss) to a comprehensive health education program (CHE) and re-randomizes participants to either an 8-week on-line tailored intervention or control on-line program resulting in a 2 (M + FWL vs. CHE group) × 2 (on-line intervention vs. control on-line program) factorial design to test the effects of the intervention on reducing z-BMI at post-treatment and at 6-month follow-up.InterventionThe interventions for this trial are based on a theoretical framework that is novel and integrates elements from cultural tailoring, Family Systems Theory, Self-Determination Theory and Social Cognitive Theory. The intervention targets positive parenting skills (parenting style, monitoring, communication); cultural values; teaching parents to increase youth motivation by encouraging youth to have input and choice (autonomy-support); and provides a framework for building skills and self-efficacy through developing weight loss action plans that target goal setting, monitoring, and positive feedback.     

New models to support the professional education of health visitors: A qualitative study of the role of space and place in creating ‘community of learning hubs’

BackgroundIn response to a policy-driven workforce expansion in England new models of preparing health visitors for practice have been implemented. ‘Community of Learning hubs’ (COLHs) are one such model, involving different possible approaches to student support in clinical practice placements (for example, ‘long arm mentoring’ or ‘action learning set’ sessions). Such models present opportunities for studying the possible effects of spatiality on the learning experiences of students and newly qualified health visitors, and on team relationships more broadly.ObjectivesTo explore a ‘community of learning hub’ model in health visitor education and reflect on the role of space and place in the learning experience and professional identity development of student health visitors.DesignQualitative research conducted during first year of implementation.SettingsThree ‘community of learning hub’ projects based in two NHS community Trusts in London during the period 2013–2015.ParticipantsManagers and leads (n = 7), practice teachers and mentors (n = 6) and newly qualified and student health visitors (n = 16).MethodsSemi-structured, audio-recorded interviews analysed thematically.ResultsParticipants had differing views as to what constituted a ‘hub’ in their projects. Two themes emerged around the spaces that shape the learning experience of student and newly qualified health visitors. Firstly, a generalised need for a ‘quiet place’ which allows pause for reflection but also for sharing experiences and relieving common anxieties. Secondly, the role of physical arrangements in open-plan spaces to promote access to support from more experienced practitioners.ConclusionsAttention to spatiality can shed light on important aspects of teaching and learning practices, and on the professional identities these practices shape and support. New configurations of time and space as part of educational initiatives can surface new insights into existing practices and learning models.     

Objective concurrent feedback on force parameters improves performance of lumbar mobilisation, but skill retention declines rapidly

ObjectiveTo determine the optimum practice for students to apply lumbar mobilisations with force parameters consistent with an experienced therapist.DesignThirty physiotherapy students attended three practice sessions over two weeks where they performed lumbar mobilisations on a fellow student. Students viewed feedback on their applied forces (measured using an instrumented treatment table) in real-time on a computer screen. Performance was tested before and after feedback at each practice session and at follow up sessions one week and three months later.Outcome measuresA greater accuracy in manual force application was defined as a smaller difference between each student-applied force parameter (mean peak force (N), force amplitude (N), and oscillation frequency (Hz)), and that previously applied by an expert. Test data from each session was analysed using Friedman's and Wilcoxon signed rank tests to determine student learning and retention.ResultsStudents were more accurate after feedback at Session 1 (median difference between student and expert force parameters 7.7 N, IQR 3.2–15.3) than before feedback (median 17.5, IQR 7.3–33.6, P < 0.001). Increased practice improved performance, with the greatest accuracy after feedback at Session 3 (median 7.0, IQR 3.5–11.9, P < 0.01). Retention however was poor, with performance at follow-up sessions no different to baseline.ConclusionsStudents apply more consistent and accurate mean peak force, force amplitude and oscillation frequency after practising with objective, concurrent feedback. Additional practice sessions further improve performance, however retention is poor.     

Diabetes knowledge and perceptions among nursing students,and curriculum differences in Japan and Australia: A cross-sectional study

ObjectivesTo investigate the associations between knowledge and perceptions of diabetes mellitus (DM) among nursing students from Japan and Australia; and to compare curriculum differences.Research Design and MethodsCross-sectional study. Convenience sample of students from Japan (N = 78) and Australia (N = 85) in their final year were surveyed. Students reported demographic details, and perceptions towards caring for patients with DM. The 23-item Michigan Diabetes Knowledge Test (MDKT) was used to assess general knowledge, and seven additional questions were used to assess DM-related clinical knowledge (CDKT). Multivariate logistic regression models were used to determine the associations between knowledge and perceptions. The curricula of the two universities were compared through a review of teaching hours on DM, teaching methods, class sizes and self-reported number of DM patients cared for during clinical placement.ResultsAustralian students were more likely to be aware of DM and identified caring for more patients on clinical placement during the course. They also performed better on the CDKT in comparison to the Japanese students (71.43% versus 65.02%). When teaching models were compared, the Japanese curriculum dedicated more hours to didactic classroom teaching on DM and had a smaller teacher to student ratio. While both groups felt they received enough classroom education on DM, the Japanese students self-reported lower perceived competency, self-confidence, and felt less prepared to care for DM patients. However Japanese students performed slightly better on the MDKT than Australian students (74.25% versus 70.03%). Being from Japan was a predictor for high MDKT score (> 73.91%), while perceived preparedness was a predictor for high CDKT score (> 71.43%).ConclusionsStatistically significant differences in DM knowledge (CDKT score) between students were found. There remains room for improvement, particularly a need for increased teaching hours at University and greater clinical practice time caring for patients with DM, to further improve knowledge and skills.     

The hidden curriculum in near-peer learning: An exploratory qualitative study

BackgroundNear-peer learning involving students from the same course, but at different levels, has gained prominence in health professional education over recent years. At the authors' university, nursing and paramedic students engage in near-peer learning in clinical skills laboratories where junior students learn specific skills from senior students. Our observations indicated that beyond the skills teaching, unintended learning occurred repeatedly.ObjectivesThe aim of this study was to examine near-peer learner and teacher experiences of participating in near-peer learning and to explore students' engagement beyond the skill being learnt.MethodsSeparate focus group interviews were conducted with groups of peer learners and peer teachers from nursing and paramedics following near-peer teaching and learning sessions. In total, 26 students participated in one of four audio-recorded focus groups.ResultsData were analysed thematically. A range of unintended learning experiences became evident, indicating the operation of hidden curriculum additional to that intended within the formal curriculum. Four main areas emerged and were focussed on junior students: identifying with their peers, the course and related expectations, clinical placements and managing difficult situations.ConclusionsNear-peer learning and teaching has been reported as having a range of positive outcomes, particularly for those engaged in the teaching. However, this study has highlighted that can also provide a range of benefits unique to junior students. More research is warranted to further examine this phenomena and ways to harness and extend such learning opportunities, as well as the nature of social and cognitive congruence.     

The effect of music listening on the anxiety of nursing students during their first blood draw experience

BackgroundNursing education is a process aimed both at theoretical knowledge and skill development. The Fundamentals of Nursing is a course that furnishes students with professional knowledge, concepts and technical skills, and, also, is the keystone of nursing education in our country. Students experience a great deal of anxiety as they face basic nursing practices for the first time. Studies have revealed the effectiveness of music in relieving anxiety in many patient groups. However, no previous studies were found where music was used with the intent to lower the anxiety that students experience over the course of skill learning. The experimental study is aimed at determining the effect of music in decreasing anxiety during the first nursing practices of students in a laboratory setting.MethodsThe experimental study was conducted on nursing students of Akdeniz University attending Fundamentals of Nursing, a freshman course, during the 2013–2014 academic year. A total of 73 students, of which 34 were assigned to the experimental group and 39 to the control group, participated in the study. Data collection was carried out using (a) the student identification form prepared by the authors, (b) skill control lists and (c) the Situational Anxiety Scale. The students in the experimental group listened to music during blood draw skill practice in a laboratory environment. The students were assessed with respect to their performance of blood drawing through skill control lists using the statements “True”, “False” and “Forgotten”. The anxiety levels and vital signs of students were assessed before and after the practice.ResultsThe mean age of the students was 19.08. 64.7% of the experimental group and 82.1% of the control group were female. The age group of 64.7% of the students in the experimental group was female. The age group of 82.1% of the students in the control group was female. After music listening, the mean anxiety score of the students was 38.70 ± 3.83 in the experimental group and 39.76 ± 4.72 in the control group. The difference between the mean anxiety scores of the two groups was statistically significant (p < 0.05). The evaluation made before and after the blood draw revealed a statistically significant difference in diastolic blood pressure values in the experimental group that listened to music(p < 0.05).ConclusionsThe results of the study showed that listening to music decreased the anxiety levels of nursing students during their first blood draw experience.     

Use of the learning conversation improves instructor confidence in life support training: An open randomised controlled cross-over trial comparing teaching feedback mechanisms

AimsFeedback is vital for the effective delivery of skills-based education. We sought to compare the sandwich technique and learning conversation structured methods of feedback delivery in competency-based basic life support (BLS) training.MethodsOpen randomised crossover study undertaken between October 2014 and March 2015 at the University of Birmingham, United Kingdom. Six-hundred and forty healthcare students undertaking a European Resuscitation Council (ERC) BLS course were enrolled, each of whom was randomised to receive teaching using either the sandwich technique or the learning conversation. Fifty-eight instructors were randomised to initially teach using either the learning conversation or sandwich technique, prior to crossing-over and teaching with the alternative technique after a pre-defined time period. Outcome measures included skill acquisition as measured by an end-of-course competency assessment, instructors’ perception of teaching with each feedback technique and candidates’ perception of the feedback they were provided with.ResultsScores assigned to use of the learning conversation by instructors were significantly more favourable than for the sandwich technique across all but two assessed domains relating to instructor perception of the feedback technique, including all skills-based domains. No difference was seen in either assessment pass rates (80.9% sandwich technique vs. 77.2% learning conversation; OR 1.2, 95% CI 0.85–1.84; p = 0.29) or any domain relating to candidates’ perception of their teaching technique.Conclusions & relevanceThis is the first direct comparison of two feedback techniques in clinical medical education using both quantitative and qualitative methodology. The learning conversation is preferred by instructors providing competency-based life support training and is perceived to favour skills acquisition.     

A smartphone application to educate undergraduate nursing students about providing care for infant airway obstruction

PurposeThis study had two aims: (a) to develop a smartphone-based application and (b) to evaluate the effectiveness of the application by measuring nursing students' knowledge, skills, and confidence in simulated performance when providing that care.DesignWe conducted a randomized trial using a pre- and post-test design at a university in Korea. Seventy-three junior nursing students participated.MethodsA smartphone-based app using a video was developed for the experimental group and one time lecture-based education was designed for the control group. We provided the app and information about its use to the experimental group, and we encouraged its use. We provided classroom instruction to the control group. Then, learning outcomes were evaluated. Results: The smartphone-based education group showed significantly higher scores on skills (t = 4.774, p < 0.001) and confidence in performance (t = 2.888, p = 0.005) than the control group. The scores on knowledge (t = 0.886, p = 0.379) and satisfaction with the learning method (t = 0.168, p = 0.867) for the experimental group were higher than for the control group, but the differences were not statistically significant.ConclusionThis study suggests that smartphone-based education may be an effective method to use in nursing education related to teaching infant airway obstruction.     

Evaluation of the Scrub Practitioners' List of Intraoperative Non-Technical Skills system

BackgroundThe Scrub Practitioners’ List of Intraoperative Non-Technical Skills (SPLINTS) system is a new tool for training and assessing scrub practitioner (nurse, technician) behaviours during surgical operations.ObjectivesThe aim of the study was to test the psychometric properties including inter-rater reliability of the prototype SPLINTS behavioural rating system.MethodsExperienced scrub practitioners (n = 34) attended a one-day session where they received background training in human factors and non-technical skills and were also trained to use the SPLINTS system. They then used SPLINTS to rate the scrub practitioners’ non-technical skill performance in seven standardized simulated, surgical scenarios.ResultsReliability, measured by within-group agreement (r_wg) for the three skill categories and six out of nine elements, was acceptable (r_wg > 0.7). Participants were within one scale point of expert ratings in >90% of skill categories and elements, and could use SPLINTS to score performance with a reasonable level of accuracy. There was good internal consistency of the system: absolute mean difference was M < 0.2 of a scale point for all three categories. Participants were surveyed and they indicated that the system was complete and usable as an assessment tool.ConclusionThe reliability of the SPLINTS system was deemed to be adequate for assessing scrub practitioners’ non-technical skills in simulated, standardized, video scenarios. On the basis of these results, the system can now move on to usability testing in the real operating theatre.     

Midwifery students' experiences of simulation- and skills training

BackgroundIn Sweden, simulation- and skills training are implemented in midwifery education in order to prepare students for clinical practice. Research regarding the use of both low to high levels of fidelity in simulation in midwifery programme is limited.AimThe aim of this study was to explore midwifery students' experiences of simulation- and skills training.MethodsMidwifery students (n = 61), at advanced level, were interviewed in 13 group interviews from 2011 to 2105. A semi-structured interview guide was used, and data were analysed by content analysis.ResultsThe results are presented in four main categories: develops hands on skills and communication, power of collaborative learning, highly valued learning environment and facilitates clinical practice. The majority of students felt that the simulation- and skills training were necessary to become familiar with hands on skills. Having repetitive practices in a safe and secure environment was viewed as important, and students highly valued that mistakes could be made without fear of comprising patient safety. Student's collaboration, reflections and critical thinking increased learning ability. Simulation- and skills training created links between theory and practice, and the lecturer had an important role in providing instructions and feedback. Students felt prepared and confident before their clinical practice, and simulation- and skills training increased safety for all involved, resulting in students being more confident, as patients in clinical practice became less exposed. Furthermore, mentors were satisfied with students' basic skills.ConclusionSimulation- and skills training support the development of midwifery skills. It creates links between theory and practice, which facilitates students' learning ability. Training needs to include reflections and critical thinking in order to develop their learning. The lecturer has an important role in encouraging time for reflections and creating safe environment during the skills and simulation training.     

Teaching research methods in nursing using Aronson's Jigsaw Technique. A cross-sectional survey of student satisfaction

BackgroundTo adapt nursing studies to the European Higher Education Area, new teaching methods have been included that assign maximum importance to student-centered learning and collaborative work. The Jigsaw Technique is based on collaborative learning and everyone in the group must play their part because each student's mark depends on the other students. Home group members are given the responsibility to become experts in a specific area of knowledge. Experts meet together to reach an agreement and improve skills. Finally, experts return to their home groups to share all their findings.Objective.The aim of this study was to evaluate nursing student satisfaction with the Jigsaw Technique used in the context of a compulsory course in research methods for nursing.MethodsA cross-sectional study was conducted using a self-administered anonymous questionnaire administered to students who completed the Research Methods course during the 2012–13 and 2013–14 academic years. The questionnaire was developed taking into account the learning objectives, competencies and skills that should be acquired by students, as described in the course syllabus. The responses were compared by age group (younger or older than 22 years).ResultsA total of 89.6% of nursing students under 22 years believed that this methodology helped them to develop teamwork, while this figure was 79.6% in older students. Nursing students also believed it helped them to work independently, with differences according to age, 79.7% and 58% respectively (p = 0.010). Students disagreed with the statement “The Jigsaw Technique involves little workload”, with percentages of 88.5% in the group under 22 years and 80% in older students. Most believed that this method should not be employed in upcoming courses, although there were differences by age, with 44.3% of the younger group being against and 62% of the older group (p = 0.037).ConclusionThe method was not highly valued by students, mainly by those older than 22 years, who concluded that they did not learn more with it than with other traditional techniques. The results of this study question whether this form of learning meets students' learning needs and its compatibility with individual and group realities.     

Handling of hazardous drugs – Effect of an innovative teaching session for nursing students

BackgroundImparting knowledge and practical skills in hazardous drug handling in nursing students' education is essential to prevent hazardous exposure and to preserve nurses' health.ObjectivesThis study aimed at comparing routine nursing education with an additional innovative teaching session.DesignA prospective controlled study in nursing students was conducted in two study periods: (i) a status-quo period (routine education on handling hazardous drugs) followed by (ii) an intervention period (additional innovative teaching session on handling hazardous drugs).Settings/ParticipantsNursing students at a vocational school were invited to participate voluntarily.MethodsIn both study periods (i) and (ii), the following factors were analysed: (a) knowledge of hazardous drug handling by questionnaire, (b) practical skills in hazardous drug handling (e.g. cleaning) by a simulated handling scenario, (c) contamination with drug residuals on the work surface by fluorescent imaging.ResultsFifty-three nursing students were enrolled. (a) Median knowledge improved from status-quo (39% right answers) to intervention (65%, p < 0.001), (b) practical skills improved from status-quo (53% of all participants cleaned the work surface) to intervention (92%, p < 0.001). (c) Median number of particles/m² decreased from status-quo to intervention (932/97, p < 0.001).ConclusionsCompared with routine education, knowledge and practical skills in hazardous drug handling were significantly improved after an innovative teaching session. Additionally, the amount of residuals on the work surface decreased. This indicates a lower risk for hazardous drug exposure.     

The effects of using high-fidelity simulators and standardized patients on the thorax,lung, and cardiac examination skills of undergraduate nursing students

BackgroundExisting research literature indicates that the use of various simulation techniques in the training of physical examination skills develops students' cognitive and psychomotor abilities in a realistic learning environment while improving patient safety.ObjectivesThe study aimed to compare the effects of the use of a high-fidelity simulator and standardized patients on the knowledge and skills of students conducting thorax-lungs and cardiac examinations, and to explore the students' views and learning experiences.DesignA mixed-method explanatory sequential design.SettingsThe study was conducted in the Simulation Laboratory of a Nursing School, the Training Center at the Faculty of Medicine, and in the inpatient clinics of the Education and Research Hospital.ParticipantsFifty-two fourth-year nursing students.MethodsStudents were randomly assigned to Group I and Group II. The students in Group 1 attended the thorax-lungs and cardiac examination training using a high-fidelity simulator, while the students in Group 2 using standardized patients. After the training sessions, all students practiced their skills on real patients in the clinical setting under the supervision of the investigator.ResultsKnowledge and performance scores of all students increased following the simulation activities; however, the students that worked with standardized patients achieved significantly higher knowledge scores than those that worked with the high-fidelity simulator; however, there was no significant difference in performance scores between the groups. The mean performance scores of students on real patients were significantly higher compared to the post-simulation assessment scores (p < 0.001).ConclusionsResults of this study revealed that use of standardized patients was more effective than the use of a high-fidelity simulator in increasing the knowledge scores of students on thorax-lungs and cardiac examinations; however, practice on real patients increased performance scores of all students without any significant difference in two groups.     

Online intravenous pump emulator: As effective as face-to-face simulation for training nursing students

BackgroundThe expansion of online education for nursing students has created the challenge of finding innovative ways to teach clinical skills. An online intravenous pump emulator (IVPE) modelled on actual IV pumps used in clinical healthcare settings was developed to facilitate online education delivery.ObjectivesThe objectives of the study were to implement the online IVPE and evaluate student learning outcomes and perceptions of device use.DesignA mixed method, quasi-experimental design was used.SettingThe study was conducted in the School of Nursing and Midwifery at a regional university in Queensland, Australia.ParticipantsParticipants were 179 first year nursing students enrolled in a medications course, ranging in age from 18 to 44 years, of whom 150 were female.MethodsParticipants were assigned to one of three groups and trained in the use of IV infusion pumps. Group 1 (n = 57) were trained online using the IVPE (ONL); Group 2 (n = 73) were trained on-campus using an actual IV pump (ONC); Group 3 (n = 49) were trained both on-campus using the actual IV pump and online using the IVPE (ONL + ONC). Competence in using the actual IV pump was assessed for all participants at the conclusion of the training period.ResultsNo significant differences in learning outcomes, measured by assessment scores out of 80 points, were found between the ONL (M = 65.5 ± 9.2) and ONC (M = 62.0 ± 14.8; p > .05) groups. Significantly better learning outcomes were evident for the ONL + ONC group (M = 68.7 ± 4.9) compared to the ONC group (p < .01).ConclusionsThis study highlights that the nursing students became more competent in the skill of preparing and administrating IV infusions when face-to-face and online learning were combined.     

Interprofessional training enhances collaboration between nursing and medical students: A pilot study

BackgroundEffective collaboration among healthcare providers is an essential component of high-quality patient care. Interprofessional education is foundational to ensuring that students are prepared to engage in optimal collaboration once they enter clinical practice particularly in the care of complex geriatric patients undergoing surgery.Study DesignTo enhance interprofessional education between nursing students and medical students in a clinical environment, we modeled the desired behavior and skills needed for interprofessional preoperative geriatric assessment for students, then provided an opportunity for students to practice skills in nurse/physician pairs on standardized patients. This experience culminated with students performing skills independently in a clinic setting.ResultsNine nursing students and six medical students completed the pilot project. At baseline and after the final clinic visit we administered a ten question geriatric assessment test. Post-test scores (M = 90.33, SD = 11.09) were significantly higher than pre-test scores (M = 72.33, SD = 12.66, t(14) = − 4.50, p < 0.001. Nursing student post-test scores improved a mean of 22.0 points and medical students a mean of 11.7 points over pre-test scores.Analysis of observational notes provided evidence of interprofessional education skills in the themes of shared problem solving, conflict resolution, recognition of patient needs, shared decision making, knowledge and development of one's professional role, communication, transfer of interprofessional learning, and identification of learning needs.ConclusionsHaving nursing and medical students “learn about, from and with each other” while conducting a preoperative geriatric assessment offered a unique collaborative educational experience for students that better prepares them to integrate into interdisciplinary clinic teams.     

An experimental investigation into the extent social evaluation anxiety impairs performance in simulation-based learning environments amongst final-year undergraduate nursing students

BackgroundWhile numerous theoretical and conceptual models suggest social evaluation anxiety would likely influence performance in simulation-based learning environments, there has been surprisingly little research to investigate the extent to which this is true.MethodsFinal-year Bachelor of Science (Nursing) students (N = 70) were randomly assigned to complete one of three clinically identical simulation-based scenarios designed to elicit varying levels of social evaluation anxiety by manipulating the number of other people present with the student during the simulation (1, 2 or 3 others). Rises in acute stress were measured via continuous heart-rate and salivary cortisol. Performance scores were derived from the average of two independent raters' using a structured clinical checklist (/16).ResultsStatistically different increases were found within the first minute of the simulation between those students with one versus three other people in the room (+ 4.13 vs. + 14.01 beats-per-minute respectively, p = 0.01) and salivary cortisol measures suggested significantly different changes in anxiety between these groups (− 0.05 vs. + 0.11 μg/dL respectively, p = 0.02). Independent assessments suggested students with only one other person accompanying them in the simulation significantly outperformed those accompanied by three others (12.95 vs. 10.67 respectively, p = 0.03).DiscussionStudents accompanied by greater numbers during simulations experienced measurably greater anxiety and measurably poorer performances. These results demonstrate the ability to manipulate social evaluation anxiety within high-fidelity simulation training of undergraduates in order to help students better acclimatise to stressful events prior to practising in real clinical settings.