Evaluating the use of streaming video to support student learning in a first-year life sciences course for student nurses

Streaming video was used to support the learning of first year student nurses on a Life Sciences module, as one of many innovations designed to increase the range of resources and support available to students. This paper describes the background to this innovation, the procedures adopted and the results of extensive evaluation. The use of streaming video was evaluated in three applications in the module. A total of 656 students used online directed-learning sessions that incorporated streamed video. Just over half of these students actually viewed the video streams. Their feedback showed that 32% found access easy, 59% enjoyed using the resources, and 25% were very confident that they learned from them. Different types of video were used, and embedded in diverse ways, but the results were consistent across the three applications. They suggest that streamed video can contribute to useful resources to support learning by student nurses but, for a variety of reasons, it may not appeal or be adequately accessible to all students at present.     

Exploring the meaning of undergraduate nursing students' experiences and confidence in clinical skills using video

BackgroundStudents and health care faculty staff report a lack of confidence in graduating nurses' clinical skills practice. Traditional approaches to support nursing students' clinical skills development have relied on small group, face-to-face, practice-based learning in clinical laboratories. However, with changing curricula, increased numbers of students, and pressure on laboratory timetables and availability, alternate methods of delivery are necessary to ensure students gain confidence in the development of their clinical skills. Video podcasting is an innovative approach that is being used to stimulate active and ongoing learning of clinical skills.DesignA hermeneutic phenomenological approach.MethodData were collected through in-depth interviews with 10 second-year, undergraduate nursing students about their experiences using three clinical skills video podcasts and their perceptions of how this impacted on their learning of these clinical skills and confidence in practice.FindingsThree themes emerged from the data: ‘Accessibility for learning the skill’; ‘Preparation for learning and practice’; and ‘Student-directed learning’. These themes provided an insight into the students' engagement with video podcasts, demonstrating their sense of confidence was increased in clinical skills development.ConclusionThe findings of this study provide an insight into the students' engagement with video podcasts in relation to their confidence in clinical skills development, and indicate that undergraduate nursing students value the use of video podcasts in their learning of clinical skills. However, it was evident that students still value face-to-face delivery to guide their study, which suggests that video podcasts could be used as an adjunct to teaching to support learning.     

Integrating technology in skills lab: Using smartphones for urinary catheter validation

Nurse educators are challenged to promote student success in all learning environments. Historically, students had increased anxiety associated with poor outcomes for indwelling urinary catheter skill validation. Faculty were looking for alternative ways to reduce stress, improve learning, and achieve successful student skill validations.The purpose of this process change project was to implement and evaluate an innovative teaching strategy of a psychomotor skill. Specifically, the integration of smartphone technology, self-evaluation, and peer feedback on indwelling urinary catheter skill validation was implemented and student perceptions of this strategy were evaluated. Throughout two, four-hour skills lab sessions, 81 students in the second semester of a baccalaureate program in nursing participated in peer pairs where they used smartphones to video and refine their indwelling urinary catheter skills through self-reflection and peer feedback.Students reported the utilization of technology and peer feedback positively enhanced learning and “decreased anxiety”. However, students agreed integrating technology into a psychomotor skill validation was not without challenges. However, the benefits outweighed the challenges providing implications for nursing education to use smartphones to evaluate a psychomotor skill as a strategy to integrate technology, self-reflection, and peer feedback into a clinical skills lab environment.     

Using branching path simulations in critical thinking of pain management among nursing students: Experimental study

BackgroundNursing education has to promote nursing students' critical thinking skills especially those who are going to work with people with dementia suffering from pain. Therefore, nursing education needs to incorporate new and effective teaching methods in nursing curricula for critical thinking skills promotion. Branching path simulation is an interactive learning tool which helps students; (1) to make decisions about treatment options for patients and get feedback immediately and (2) to demonstrate and promote their critical thinking skills in a safe and supported environment before dealing with complex and real-life case scenarios.ObjectivesThe present study aimed to examine the effectiveness of branching path simulation in promoting the critical thinking skills of undergraduate nursing students.MethodsThis an equivalent control group pretest-posttest experimental study was done in 2019 on 102 undergraduate nursing students who had registered in both practical and theoretical courses of Advanced Adult Health Nursing. A pretest posttest experimental design with concurrent control group and random assignment to the treatment/nontreatment variable was used and a convenience sample of 102 nursing students was recruited in this study. The students were randomly assigned and divided into two equal intervention and control groups and each group attended different training sessions. The control group was trained by traditional lectures while the intervention group was trained by branching path simulation. The researcher used a demographic questionnaire and the Critical Thinking Self-Assessment Scale (CTSAS) for data collection.ResultsAfter the training sessions, the mean scores of the CTSAS and its subscales domain in the intervention group were significantly higher than the control group.ConclusionsBranching path simulation is an effective teaching method to promote students' critical thinking skills. Future studies are recommended to examine the effect of branching path simulation on other nursing students learning outcomes.     

Family nursing telesimulation: Teaching therapeutic communication in an authentic way

BackgroundA nurse's skill in establishing therapeutic communication is central to family nursing. Using a family-centered approach, nurses can facilitate relationship building with members of a family unit. Through authentic learning activities such as simulation, students can practice the competencies required to provide effective family nursing care.DesignOne hundred and one nursing students participated in a two-part family nursing telesimulation. Students were sent an online evaluation about their simulation experience immediately afterwards.ResultsFifty-six percent (n = 57) of the 101 students completed the online evaluation. Students overwhelmingly appreciated the opportunity to apply theory in a real-world manner, engaging in family nursing in an authentic way.ConclusionThe telesimulation strongly supported students’ ability to practice their clinical decision-making skills and respond to changing family needs. Telesimulation is a promising teaching strategy that allowed students to practice their therapeutic communication in the context of family nursing.     

Recognition of physical deterioration in patients with mental health problems: the role of simulation in knowledge and skill development

Recognition of physical deterioration in patients with mental health problems has been recognized as a significant problem. Areas of particular concern include rapid tranquilization, physical restraint, the consumption of alcohol and illicit drugs have the potential to result in sudden and catastrophic patient deterioration. Simulation sessions, using patient mannequins, are widely used to support the education of nurses but its use in mental health has been somewhat restricted. The aim of this study was to design and deliver simulation scenarios to develop the skills and knowledge of mental health nursing students in the recognition and management of physical deterioration. A series of three scenarios were developed and delivered to a group of final-year nursing students. Evaluation of the sessions was undertaken using analysis of video footage from the sessions and through two focus groups. The results show that simulation is a useful catalyst for discrepancy creation which in turn leads to the student focusing their future learning towards addressing any identified deficits in skills and knowledge identified. Authenticity of the simulation sessions also plays a role in ensuring student engagement and faculty support during sessions is vital to support the students in managing unfamiliar situations.     

Enhancing Motivational Interviewing Training in a Family Medicine Clerkship

Problem: Despite the prevalence of unhealthy behaviors among patients in the healthcare system, traditional medical training involves little or no exposure to effective behavior change techniques such as Motivational Interviewing. Intervention: An online learning community for enhanced training in Motivational Interviewing was developed for 3rd-year medical students. The website included educational materials about Motivational Interviewing as well as problematic health behaviors, a repository of exemplar videos and student videos with feedback, and a discussion board. Student participants were given the opportunity to record an encounter with a patient and to receive feedback on their use of Motivational Interviewing from a faculty member. Context: Student volunteers in the Family Medicine Clerkship at Georgetown University School of Medicine were randomized to enhanced training, which included the online learning community, or training as usual. All student volunteers completed a questionnaire assessing self-efficacy initially and at the end of the clerkship. Students also participated in an Observed Structured Clinical Exam, which was subsequently coded by a blinded rater for behavioral counts of Motivational Interviewing techniques, key steps in Motivational Interviewing, and overall Motivational Interviewing style. Outcome: Students in the enhanced training arm were rated as having significantly higher scores in Motivational Interviewing style in the Observed Structured Clinical Exam than training as usual students. A significant increase in self-efficacy from pre- to posttest in the overall sample was observed but between-group differences were not significant. Student feedback was particularly positive regarding video recorded practice sessions with patients and individualized feedback. Lessons Learned: The results of this study as well as student feedback suggest that future work should include patient practice sessions and individualized feedback in developing Motivational Interviewing curricula.     

Structured debriefing: What difference does it make?

Debriefing in simulation is a cornerstone of learning. However, in-depth studies examining simulation debriefing are scarce. This study explored four key debriefing attributes—feedback, reflection, knowledge development, and psychological safety—prior and subsequent to the implementation of a new pedagogical intervention in a pre-clinical scenario simulation course. The scenarios focused on patients with deteriorating conditions and took place at bachelor's nursing degree level. The new intervention for the debriefing sessions contained a detailed observation tool describing specific, correct nursing actions for deteriorating patients; video playback watched only by students acting as nurses, and debriefing organized into two sections. The study design was explorative. To generate data, 12 debriefing sessions were audio and video recorded in 2013 and 11 in 2014. Two student groups participated each year, comprising 16 and 10 students, respectively. Qualitative analysis was performed to examine the transcribed audio and video recordings. Relative to the 2013 cohort, the reflections of observers and the students acting as nurses were more assertive, and students' feedback was more specific and comprehensive in the 2014 cohort. Conducting in-depth studies examining debriefing is important to increase knowledge regarding the impact of pedagogical underpinnings on debriefing content and processes.     

Self-Observation and Peer Feedback as a Faculty Development Approach for Problem-Based Learning Tutors: A Program Evaluation

Problem: Good teaching requires spontaneous, immediate, and appropriate action in response to various situations. It is even more crucial in problem-based learning (PBL) tutorials, as the tutors, while directing students toward the identification and attainment of learning objectives, must stimulate them to contribute to the process and provide them with constructive feedback. PBL tutors in medicine lack opportunities to receive feedback from their peers on their teaching strategies. Moreover, as tutorials provide little or no time to stop and think, more could be learned by reflecting on the experience than from the experience itself. We designed and evaluated a faculty development approach to developing PBL tutors that combined self-reflection and peer feedback processes, both powerful techniques for improving performance in education. Intervention: We developed an observation instrument for PBL facilitation to be used both by tutors to self-observe and reflect on own teaching strategies and by peers to observe and provide feedback to tutors. Twenty PBL sessions were video-recorded. Tutors completed the instrument immediately after their PBL session and again while watching their video-recorded session (self-observation). A group of three observers completed the instrument while watching each recorded session and provided feedback to each tutor (peer observation and feedback). We investigated tutors' perceptions of the feasibility and acceptability of the approach and gathered data on its effectiveness in enhancing tutors' facilitation skills. Context: The preclinical medical curriculum at the University of Geneva is essentially taught by PBL. A new program of faculty development based on self-observation and peer feedback was offered to voluntary tutors and evaluated. Outcome: Our results suggest that self-observation and peer feedback, supported by an instrument, can be effective in enhancing tutors' facilitation skills. Reflection on self-observation raised teachers' awareness of the effectiveness of the strategies they used to foster student learning. This motivated a need to change their teaching practice. However, for the changes to become operative, peer feedback was required, providing the cues and strategies needed to improve the facilitation skills. Lessons Learned: Peer coaching was considered feasible and useful to improve tutors' facilitation skills. Evaluating the program made it possible to assess tutors' needs and the reasons underlying their difficulties, and this in turn provided the basis for advanced workshops. Nonetheless, aspects related to logistics and the time constraints of such an individualized approach, as well as the cultural appropriation of peer coaching, might be obstacles that need to be addressed.     

Teaching health assessment in the virtual classroom

Health assessment skills are vital to professional nursing practice. Health assessment has traditionally been taught using lecture, teacher-developed tests, practice and live demonstration, and interactive and computer-based learning materials. Rapid advances in information technology during the past decade have greatly expanded distance learning options in higher education. Although much nursing education now uses the Internet, there has been limited use of the Web to teach psychomotor and clinical skills. This article describes how online instruction can be integrated into a health assessment course to teach physical examination skills. The development of instructional videos that can be digitally streamed onto the Web for ready and repeated access can also enhance online learning of technical and clinical skills. Student evaluation of this Web-enhanced course revealed that online assignments enabled them to pace their learning, thereby promoting greater flexibility and independence. Students were able to master the technical skills of working online with minimal difficulty and reported that working online was no more stressful than attending class. The most helpful aspect of the online course was the instructor-developed video that was digitally streamed online.     

Simulation workshops with first year midwifery students

Simulated teaching methods enable a safe learning environment that are structured, constructive and reflective. We prepared a 2-day simulation project to help prepare students for their first clinical practice. A quasi-experimental pre-test – post-test design was conducted. Qualitative data from the open-ended survey questions were analysed using content analysis. Confidence intervals and p-values were calculated to demonstrate the changes in participants' levels of understanding/ability or confidence in clinical midwifery skills included in the simulation. 71 midwifery students participated. Students rated their understanding, confidence, and abilities as higher after the simulation workshop, and higher still after their clinical experience. There were five main themes arising from the qualitative data: having a learning experience, building confidence, identifying learning needs, developing communication skills and putting skills into practise. First year midwifery students felt well prepared for the clinical workplace following the simulation workshops. Self-rated understanding, confidence and abilities in clinical midwifery skills were significantly higher following consolidation during clinical placement. Longitudinal studies on the relationship between simulation activities and student's overall clinical experience, their intentions to remain in midwifery, and facility feedback, would be desirable.     

Transforming Magnetic Resonance Imaging Education through Simulation-Based Training

IntroductionClinical instructors are facing the challenge of limited clinical training sites as the opportunities to train on actual patients become less available. In addition, work regulations, productivity requirements, and patients’ awareness of trainees “practicing” on them has led to a decline in training opportunities. These factors reduced training experience into fewer direct patient encounters, and fewer opportunities to perform procedures. This study assesses the perception of students on the MRI simulation training for undergraduate medical imaging students.MethodsThis action research study used a triangulation method to integrate quantitative and qualitative data. After participation in six simulated MRI training sessions, students completed a questionnaire and focus group discussion to assess their perceptions. Percentage distributions were calculated for the questionnare and qualitative comments were summarized using thematic content analysis to identify recurrent themes.ResultsThe MRI simulation program was well received by students. Simulation proved to be an effective educational method, providing a comfortable learning environment for learning.The study confirmed the constructive role of simulation in MRI education and preparation for clinical practice as 69% endorsed using the learned skills during simulation in clinical practice. Simulation training also helped to identify areas for improvement in practice and learning from mistakes (60%).ConclusionsThe results of this study support the use of simulation in MRI education and demonstrate that MRI-simulated training sessions were well received by radiography students. Students perceived both educational and clinical benefits from this simulation training session.     

The application of reusable learning objects (RLOs) in preparation for a simulation laboratory in medication management: An evaluative study

To enhance the preparedness of undergraduate nursing and midwifery students to participate in the safe provision of medication administration on their clinical placements, an innovative blended learning strategy was designed and developed by the authors. The blended learning strategy included a suite of online reusable learning objects specific to medication management theoretical knowledge and psychomotor skills to prepare students for a 90-minute practical face to face simulation laboratory session. Students identified that the reusable learning objects had prepared them for the simulation laboratory session and was rated as a productive learning experience. The blended learning strategy implemented to teaching and learning medication management to undergraduate nursing and midwifery students can positively influence students’ acquisition of knowledge and psychomotor skills to safely administer medications prior to their practice placements in a clinical setting.     

Can interactive educational technologies support the link between ultrasound theory and practice via feedback mechanisms?

Linking theory to practice is an area of concern for ultrasound students, clinical mentors and academic staff. The link between theory and practice requires a robust clinical mentorship scheme in addition to careful curricula design considerations to improve student outcomes. The introduction of interactive technology in education provides ripe opportunity to improve feedback to students to support the link between theory and practice. A series of three interactive learning and teaching activities were designed and delivered to a PostGraduate Ultrasound cohort, after which, evaluation was performed to answer the research question: Which interactive technologies support the link between theory and practice through improved feedback mechanisms? An action research methodology was adopted involving an enquiry based literature review, planning, design and action process. Data were collected following action of three interactive teaching and learning sessions within the Medical Ultrasound cohort of 2013/2014 at Glasgow Caledonian University via a paper based questionnaire. A 100% response rate was achieved (n = 14). All three interactive learning and teaching sessions were considered with 100% highest point agreement to support the link between ultrasound theory and practice via feedback. Students found all three designed and facilitated sessions valuable and relevant to their learning, which in turn provided positive experiences which were perceived to support the link between theory and practice through feedback. These activities can be considered valuable in Postgraduate Ultrasound education.     

Supporting student mental health nurses in clinical placement through virtual in-practice support (VIPS): Innovation uptake and the ‘VIPS’ project

ObjectiveThe integration of technology in nurse education has become an essential element of academic practice. Yet innovation uptake between academic institutions across the four countries of the UK and their clinical practice partners has proved problematic, leading to a slow introduction of digitally enhanced teaching and learning innovations, particularly in the area of clinical decision making and leadership.ParticipantsThe Virtual in Practice Support (VIPS) project involved two academic institutions working with the same mental health care service partner aiming to maximise student clinical placement learning. Student nurses in their final year of training were invited to take part in testing the viability of distance e-tutoring (via computer access to academic nurse lecturers) for facilitated critical reflection.DesignAn evaluation of the use of video linked conference sessions, set up for students to undertake a group based online (i.e. virtual) group tutorial is presented.MethodsAll participants completed an evaluation data sheet using a five point Likert scale and free text evaluation feedback form completed at the end of each online tutorial session. Students were also invited to a focus group and all tutors were interviewed at the completion of the project.ResultsThe VIPS project findings highlight; i) the importance of a clear project vision for innovation uptake ii) consequences of working with innovation champions and iii) how technology can be used to maximise student learning across geographical distance through online facilitated group critical discussion.ConclusionVIPS' participants were able to articulate positive outcomes as a result of engaging in a multi-institutional project that capitalised on the richness of nursing clinical practice learning experience for both the students and the academics involved as innovation champions.