Nursing students' self-reported experiences and attitudes regarding patient safety: A cross-sectional study comparing the classroom and clinical settings

BackgroundPatient safety education varies in nursing schools and therefore it is crucial to identify the educational needs of students by determining their skills, attitudes, and competencies regarding patient safety and medical errors.AimThis study was conducted to determine nursing students’ patient safety education competencies in the classroom and clinical settings, their attitudes towards medical errors, and the relationship between them.MethodsThis was a cross-sectional questionnaire study conducted with 204 nursing students. The participation rate was 96%. Data were collected using the Health Professional Education in Patient Safety Survey (H-PEPSS_TR), and the Medical Errors Attitude Scale (MEAS). A STROBE checklist was used to report findings.FindingsStudents’ patient safety knowledge and competence scores obtained from the H-PEPSS_TR were the highest for the ‘communicating effectively’ subscale in the classroom and for the ‘culture of safety’ subscale in the clinics while their ‘understanding human and environmental factors’ subscale scores were the lowest. The total H-PEPSS_TR scores in the classroom, ‘working in teams with other health professionals,’ ‘communicating effectively,’ ‘managing safety risks,’ and ‘understanding human and environmental factors’ subscales scores of the students who had positive attitudes according to MEAS were higher (p < 0.05).DiscussionStudents with positive attitudes towards medical errors had higher patient safety knowledge in the classroom; however, it did not affect patient safety competence in the clinical setting.ConclusionNursing students had positive attitudes towards medical errors. Their patient safety knowledge and competencies gained in the classroom were more than that developed in the clinical settings.     

Patient safety competence for final-year health professional students: Perceptions of effectiveness of an interprofessional education course

As final-year medical and nursing students will soon play key roles in frontline patient care, their preparedness for safe, reliable care provision is of special importance. We assessed patient safety competencies of final-year health profession students, and the effect of a 1-day patient safety education programme on these competencies. A cross-sectional survey was conducted with 233 students in three colleges of medicine, nursing, and traditional medicine in Seoul. A before-and-after study followed to evaluate the effectiveness of the curriculum. Patient safety competency was measured using the Health-Professional Education for Patients Safety Survey (H-PEPSS) and an objective patient safety knowledge test. The mean scores were 3.4 and 1.7 out of 5.0, respectively. The communication domain was rated the highest and the teamwork domain was rated the lowest. H-PEPSS scores significantly differed between the students from three colleges. The 1-day patient safety education curriculum significantly improved H-PEPSS and knowledge test scores. These results indicated that strengthening patient safety competencies, especially teamwork, of students is required in undergraduate healthcare curricula. A 1-day interprofessional patient safety education programme may be a promising strategy. The findings suggest that interprofessional patient safety education needs to be implemented as a core undergraduate course to improve students’ safety competence.     

Effectiveness of a nursing board games in psychiatric nursing course for undergraduate nursing students: An experimental design

AimTo examine the effectiveness of a psychiatric nursing board game in an undergraduate psychiatric nursing course.BackgroundDidactic teaching fails to assist students in deepening their understanding of abstract concepts in psychiatric nursing. The game-based learning of professional courses can address the demands of digital-age students, which may improve their learning outcomes.DesignA parallel two-arm experimental design was adopted in a nursing college in southern Taiwan.MethodsThe participants were fourth-year students enroled in a college nursing programme in southern Taiwan. Simple random sampling was used to divide the class into intervention and control groups. The former participated in an eight-week game-based intervention course, while the latter continued to receive traditional instruction. In addition to collecting the students’ demographic data, three structural questionnaires were developed to examine the variation in students’ nursing knowledge and attitudes toward psychiatric nursing, as well as their learning satisfaction before and after the intervention.ResultsThere were a total of 106 participants, with 53 in each group. After the intervention, the two groups were significantly different in terms of their psychiatric nursing knowledge, attitudes and self-reported learning satisfaction. The intervention group’s scores were significantly higher than those of the control group across all three dimensions. This suggests the positive effects of the board game intervention on students’ learning outcomes.ConclusionThe research outcome can be applied in formative and undergraduate nursing education in teaching psychiatric nursing globally. The game-based learning materials developed can be used to train psychiatric nursing teachers. Future studies should recruit a larger sample and increase the follow-up time for assessing students’ learning outcomes, as well as examine the similarities and differences in the learning outcomes of students from different educational systems.     

Effects of board game play on nursing students’ medication knowledge: A randomized controlled trial

AimThis study aimed to examine the effectiveness of an educational board game in improving nursing students’ medication knowledge.BackgroundMaintaining patient safety is a core practice for nurses. Medication management is a central principle of patient safety. Nurses acquire pharmacology knowledge and medication safety skills in the classroom training. Thus, solidifying and strengthening nursing students’ medication knowledge are crucial tasks for nursing faculty members. In recent years, board games, which offer both entertainment and competitive play, have been employed to educate students in a variety of disciplines and settings. Through board game play, students can learn in an enjoyable and fun atmosphere.DesignA randomized controlled trial design.MethodsA convenience sample of 69 nursing students was obtained from a university in Taiwan. Participants were randomly assigned either to an experimental (board game) group (n = 35) or a comparison group (n = 34) using block randomization. The experimental group engaged in board game play to learn about medications, whereas the comparison group attended a one-hour didactic lecture. Using questionnaires, data were collected before the intervention, immediately post intervention and one month post intervention.ResultsFollowing the intervention, regardless of the learning method, both groups showed significant improvements in their immediate recall of medication information. However, when retested after one month, the experimental group obtained significantly higher scores than the comparison group. Moreover, students in the experimental group reported more satisfaction with the learning method than those in the comparison group.ConclusionsThe study results suggest that learning through board games could enhance nursing students’ retention of knowledge. Students reported favorable reactions to using a board game learning method for increasing knowledge of medication. With respect to this finding, faculty members may consider employing board games as teaching tools in nursing and other health science courses. Moreover, the findings of this study can also provide additional information for nursing managers in hospital wards or long-term care facilities where nurses are trained to familiarize themselves with frequently administered medications.Tweetable abstractBoard game play can enhance nursing students’ retention of knowledge; students reported positive reactions to game-based learning for medication training.     

The impact of educational experiences on nursing students' knowledge and attitudes toward people with Alzheimer's disease: A mixed method study

BackgroundAs the population ages, the effects of Alzheimer's disease will be felt by all nurses. Providing proper care for people with Alzheimer's disease is difficult and requires specific skills, attitudes, and knowledge. Limited data exists regarding nursing students' attitudes and knowledge toward people with Alzheimer's disease, whether undergraduate education prepares students to care for this population, or the best methods to support students in learning in an innovative and interactive environment.ObjectivesThe aim of this study was to determine the effect of different educational experiences on nursing students' knowledge and attitudes toward people with Alzheimer's disease and to explore nursing students' knowledge and attitudes surrounding the care of people with Alzheimer's disease.DesignA convergent mixed method design. A three group (Alzheimer's disease clinical experience, online learning module, and no dementia-specific intervention), pretest and posttest design served as the quantitative arm of the study. A focus group discussion with themes extracted served as the qualitative piece of the study.SettingCollege of Nursing in North Texas.ParticipantsConvenience sample of 94 senior level nursing students enrolled in the undergraduate nursing program's Community Health course.MethodStudents completed pre and posttest surveys which included Alzheimer's Disease Knowledge Scale, Dementia Attitudes Scale, and demographic questionnaire. Content analysis was conducted on focus group responses to qualitative interview questions.ResultsThe Alzheimer's disease clinical group experienced increased knowledge and improved attitudes toward people with Alzheimer's disease compared with students who completed the online module or had no dementia-specific intervention. Four themes emerged from focus group data: Basic Alzheimer's disease knowledge, need for Alzheimer's disease experiential learning, negative feelings related to behaviors, and appropriate responses to behavioral and psychological symptoms of dementia.ConclusionExperiential learning in the form of clinical placements increased knowledge and improved attitudes about Alzheimer's disease compared with an online module and no dementia-specific intervention.     

在本科护生中开展患者安全教育的效果研究

目的研究开设患者安全教育课程对本科护生患者安全知识、态度和技能的影响。方法以皖南医学院2009级五年制本科护生为研究对象,选取82名大四上学期选修患者安全护理课程的护生为观察组,另以同年级未选修患者安全护理课程的359名护生为对照组,在大三上学期初和大四上学期课程结束后对两组护生进行患者安全知识、态度和技能的问卷调查。结果在"患者安全护理"选修课程结束后,观察组护生在"医疗差错相关知识"模块和"医疗差错发生后我应该怎么做"模块的得分均高于对照组护生,且差异具有统计学意义(P<0.05)。结论开设患者安全教育课程可明显提高本科护生的患者安全知识、态度和技能。     

The effects of applying an assessment form based on the health functional patterns on nursing student's attitude and skills in developing the nursing process

ObjectivesComprehensive nursing assessment, as the first step in the nursing process, involves the systematic and constant data gathering to facilitate the development of the patient-specific nursing process. The aim of this study is to determine the effects of applying an assessment form based on the health functional patterns on nursing student's attitude and skills in developing nursing process.MethodsA randomized controlling design was conducted. Of 84 undergraduate nursing students, 42 students were allocated to the intervention or control group. In clinical education, a patient assessment form based on Gordon's functional health patterns was applied to help students in the intervention group to develop nursing process, while the control group received traditional methods. The data were gathered using a demographic information questionnaire, skills in nursing process development checklist, and attitudes towards nursing process questionnaire.ResultsThe average scores for students’ attitude and skills in developing nursing process in the intervention group were greater than those of the control group.ConclusionApplying nursing assessment using the patient assessment form based on Gordon's functional health patterns can improve the students' learning in developing nursing process.     

Use of a flipped classroom in ophthalmology courses for nursing,dental and medical students: A quasi-experimental study using a mixed-methods approach

BackgroundTraditional teaching is associated with dilemmas, such as low motivation to learn and passive learning. In contrast, use of a flipped classroom with the proper learning design has the potential to promote accelerated learning, bolster transmission of competencies (i.e., critical thinking, communication and problem-solving skills) and improve teamwork capacity, all of which are of great significance in professional healthcare practice, including nursing, dentistry and medicine.ObjectiveThe aim of the study was to examine the effects of using a flipped classroom in ophthalmology courses for undergraduate nursing students, dental students and higher vocational medical students.DesignA quasi-experimental design was used with an intervention (n = 100) and a comparison group (n = 100), pre-/post-testing measures and a mixed-methods approach.SettingA university in China.ParticipantsA total of 200 students were included.MethodsStudents' self-rated learning ability was measured before and after the courses, and skill exams were performed after the courses. In addition, interviews were conducted with the clinical medical students concerning their experiences of the flipped classroom.ResultsStudents' self-rated learning ability improved significantly more in the intervention than in the comparison group, for the total scale and the three factors ‘learning goals’, ‘self-efficacy and social learning’ and ‘problem-solving’. Skill exam scores were statistically significantly better in the intervention than in the comparison group. On the whole, the clinical medicine students felt the flipped classroom had a positive impact and improved their learning ability as well as knowledge in ophthalmology.ConclusionsUse of a flipped classroom for nursing, dental and clinical medical students in ophthalmology courses shows promising results in the form of students' skill exam scores and self-rated learning ability.     

A spiritual education course to enhance nursing students’ spiritual competencies

The study aimed to determine the impact of an elective spiritual education course for nursing students on spiritual competencies. A convenience sample of nursing students (N = 92) was recruited from a baccalaureate school of nursing between February and July 2016. The intervention group (n = 45) was comprised of students enrolled in the elective spiritual education course which integrated non-Christian Eastern cultural beliefs; the control group was comprised of students not enrolled in the elective (n = 47). A quasi-experimental design examined pretest, posttest, and follow-up data from students' self-administered questionnaires. The intervention effect of the course was analyzed using generalized estimation equation. The results indicated posttest scores among nursing students in the intervention group were significantly better than the comparison group for spiritual health. Practicum stress and professional commitment were significantly better at follow-up. Spiritual care attitudes, caring behavior, and religious belief were significantly improved from pretest to posttest, and at follow-up for the intervention group compared with the control group. In conclusion, a spiritual education course should be considered as a regular course in the nursing curriculum, which could improve students’ spiritual competencies, individual spiritual growth, and the ability to care for patients.     

Simulation-based learning for patient safety: The development of the Tag Team Patient Safety Simulation methodology for nursing education

BackgroundSince the ground-breaking report ‘To Err is Human: Building a Safer Health Care System’ was published nearly two decades ago, patient safety has become an international healthcare priority. Universities are charged with the responsibility of preparing the future nursing workforce to practise in accordance with relevant patient safety standards. Consequently, simulation-based learning is increasingly used for developing the technical and non-technical skills graduates require to provide safe patient care.AimTag Team Patient Safety Simulation is a pragmatic group-based approach that enhances nursing students’ knowledge and skills in the provision of safe patient care. The aim of this paper is to describe the Tag Team Patient Safety Simulation methodology and illustrate its key features with reference to a medication safety scenario.MethodsInformed by the National Safety and Quality Health Service Standards and the Patient Safety Competency Framework for Nursing Students, Tag Team Patient Safety Simulation methodology actively engage large numbers of nursing students in critical conversations around every day clinical encounters which can compromise patient safety.ConclusionTag Team Patient Safety Simulation is a novel simulation methodology that enhances nursing students’ skills and knowledge, fosters critical conversations, and has the potential to enhance students’ resilience and capacity to speak up for safe patient care.     

The effects of high-fidelity simulation training on empathy and attitudes toward older people among undergraduate nursing students: A quasi-experimental study

AimTo evaluate the effects of high-fidelity simulation training on attitudes towards older people and empathy among undergraduate nursing students.BackgroundPeople worldwide are living longer and, consequently, the number of older people is increasing globally. Geriatric syndromes are highly prevalent and associated with increased morbidity and mortality in this population. Positive attitudes towards older people and high levels of empathy are necessary for the provision of high-quality nursing care, which will contribute towards improving the quality of life of older patients affected by these syndromes.MethodsA quasi-experimental study was conducted using a longitudinal design with a single group and a pre- and post-intervention evaluation. The development of attitudes towards older people and empathy skills were evaluated using high-fidelity simulation-based training, comparing the levels obtained in these skills at baseline and after the simulation experience. The simulated scenarios recreated the great geriatric syndromes in older patients: instability, immobility, intellectual impairment and incontinence.ResultsAfter the simulation sessions, nursing students significantly improved their total scores for both attitudes toward older people and empathy, moreover, improvements were found in the three subscales of empathy. The effect size was large for the total scores of both the attitudes towards older people and the empathy scales and the ‘perspective taking’ subscale. The obtained effect size was small for the ‘compassionate care’ subscale, whereas for the ‘standing in the patient’s shoes’ subscale, the obtained effect size was medium.ConclusionsOur high-fidelity simulation-based training allows undergraduate nursing students to improve their empathy levels and positive attitudes toward older people. The development of these skills may provide benefits directly related to high-quality care for older patients. Therefore, the inclusion of simulation training programs in geriatric nursing study plans is necessary to train nursing students in the care of older people and to prepare them for real clinical practice.     

Trauma-informed education: Creating and pilot testing a nursing curriculum on trauma-informed care

BackgroundTrauma is a significant contributor to morbidity and mortality. Trauma-informed care (TIC) provides a safe and supportive healthcare environment for patients who have experienced trauma. Educating healthcare providers improves knowledge, attitudes, and skills related to TIC. However, nursing programs do not systematically integrate TIC education.PurposeTo create, implement, and evaluate nursing content on TIC at the graduate and undergraduate levels at one university.MethodA pretest-posttest survey was utilized to assess changes in TIC knowledge, attitudes, and skills related to the delivery of content on trauma and TIC to students in three courses at one large Midwestern university in January 2019. Safety, acceptability, and transferability were also measured.FindingsThe content improved nursing students' knowledge and skills related to providing TIC. Further, content on TIC is acceptable to both undergraduate and graduate students and is transferrable to non-nursing students.DiscussionThe current study provides a trauma-informed nursing education model that is safe, appropriate, acceptable, and efficacious.     

Engaging students in a QI/QM presentation to enhance QSEN concept learning

The Quality and Safety Education for Nurses (QSEN) Initiative addresses goals to better prepare future nurses by proposing and defining 6 competencies addressing knowledge, skills, and attitudes (KSA) needed for undergraduate, pre-licensure nursing students to be successful, competent, and qualified registered nurses. Educators maintain the responsibility to bridge education and clinical preparation to enable nursing students to practice at a level that projects quality and safety. This article introduces and explains a guided Quality Indicator/Quality Measure (QI/QM) teaching-learning strategy aimed at the promotion of learning about QSEN competencies, in which students identify a clinical QI/QM issue, gather data, collaborate, apply research techniques, create a presentation, and report their findings. Specific QSEN competency sub-scores from an NCLEX test preparation strategy were used to measure students’ learning, and improvements on these sub-scores were observed. Introducing QSEN concepts sets the stage for competent nursing care in the future and this valuable teaching-learning strategy suggests how to infuse QSEN competencies into an undergraduate nursing curriculum.     

Can a clinical placement influence stigma? An analysis of measures of social distance

BackgroundThe way people who experience mental illness are perceived by health care professionals, which often includes stigmatising attitudes, can have a significant impact on treatment outcomes and on their quality of life.ObjectiveTo determine whether stigma towards people with mental illness varied for undergraduate nursing students who attended a non-traditional clinical placement called Recovery Camp compared to students who attended a ‘typical’ mental health clinical placement.DesignQuasi-experimental.ParticipantsSeventy-nine third-year nursing students were surveyed; n = 40 attended Recovery Camp (intervention), n = 39 (comparison group) attended a ‘typical’ mental health clinical placement.MethodsAll students completed the Social Distance Scale (SDS) pre- and post-placement and at three-month follow-up. Data analysis consisted of a one-way repeated measures analysis of variance (ANOVA) exploring parameter estimates between group scores across three time points. Two secondary repeated measures ANOVAs were performed to demonstrate the differences in SDS scores for each group across time. Pairwise comparisons demonstrated the differences between time intervals.ResultsA statistically significant difference in ratings of stigma between the intervention group and the comparison group existed. Parameter estimates revealed that stigma ratings for the intervention group were significantly reduced post-placement and remained consistently low at three-month follow-up. There was no significant difference in ratings of stigma for the comparison group over time.ConclusionsStudents who attended Recovery Camp reported significant decreases in stigma towards people with a mental illness over time, compared to the typical placement group. Findings suggest that a therapeutic recreation based clinical placement was more successful in reducing stigma regarding mental illness in undergraduate nursing students compared to those who attended typical mental health clinical placements.     

A cross-sectional survey of nursing students' patient safety knowledge

BackgroundKnowledge provides a foundation for safe and effective nursing practice. However, most previous studies have focused on exploring nursing students' self-reported perceptions of, or confidence in, their level of patient safety knowledge, rather than examining their actual levels of knowledge.ObjectiveThe overarching objective of this study was to examine final year nursing students' levels of knowledge about key patient safety concepts.DesignA cross-sectional design was used for this study. Data collection was undertaken during 2018 using a web-based patient safety quiz with 45 multiple choice questions informed by the Patient Safety Competency Framework for Nursing Students. A Modified Angoff approach was used to establish a pass mark or ‘cut score’ for the quiz.Setting and participantsNursing students enrolled in the final year of a pre-registration nursing program in Australia or New Zealand were invited to participate in the study.ResultsIn total, 2011 final year nursing students from 23 educational institutions completed the quiz. Mean quiz scores were 29.35/45 or 65.23% (SD 5.63). Participants achieved highest scores in the domains of person-centred care and therapeutic communication, and lowest scores for infection prevention and control and medication safety.Based on the pass mark of 67.3% determined by the Modified Angoff procedure, 44.7% of students (n = 899) demonstrated passing performance on the quiz. For eight of the institutions, less than half of their students achieved a passing mark.ConclusionsGiven the pivotal role that nurses play in maintaining patient safety, the results from this quiz raise important questions about the preparation of nursing students for safe and effective clinical practice. The institutional results also suggest the need for increased curricula attention to patient safety.     

The effect of a peer education program on combating violence against women: A randomized controlled study

BackgroundStudent nurses in Turkey need to be exposed to appropriate undergraduate training if they are to acquire the required knowledge, attitudes and skills that will help them to fight the issue of violence against women (VAW).ObjectivesThe aim of this research study was to assess the effect of a peer education program about combating VAW on the knowledge, attitudes and skills of nursing students.DesignThe study was designed as a randomized controlled trial.SettingsThe participants in the intervention group received peer education on combating VAW.Participants136 nursing students (intervention group: n = 63, control group: n = 73) were included in the study.ResultsParticipants in both the intervention and control groups were assessed at pre-training and at two months post-training. Pre-training and post-training knowledge and attitudes were significantly different in the intervention group (p < 0.001). Moreover, the intervention group displayed a statistically significant difference in their ability to explain the correct interventions in a case study about VAW (p < 0.001).ConclusionsOur results indicate that peer education should be used as a part of undergraduate nursing education on VAW.     

A scoping review of safety management during clinical placements of undergraduate nursing students

BackgroundThe abundant knowledge on nursing students’ competencies in clinical safety, and the multiple approaches adopted make it difficult to obtain an overview of the current status of this question.PurposeTo review the literature on undergraduate nursing students' safety competencies during their clinical placements.MethodA scoping review was carried out. Searches were executed in PubMed, CINAHL, WOS, MEDES, and websites of relevant organizations. The framework proposed by the Joanna Briggs Institute was adopted.FindingsA total of 43 studies were selected for the final sample. The review identified four major topics: the presence of adverse events in clinical placements, the acquisition of competencies in clinical safety, student experiences regarding clinical safety, and pedagogical approaches for clinical safety.DiscussionNursing students encounter adverse events and clinical safety incidents throughout their clinical training. Faculties should assign the highest priority to this question, due to its importance in the creation of a culture of safety.     

Innovations in interprofessional learning and teaching: providing opportunities to embed patient safety within the pre-registration physiotherapy curriculum. A Pilot Study

Abstract

Background: Despite recognition of the need to embed patient safety within undergraduate healthcare education, there are limited examples of how this has been achieved within physiotherapy. The purpose of this regional initiative was to develop a course and teaching resources to support Higher Education Institutions in the United Kingdom (UK) when embedding the World Health Organization (WHO) multiprofessional patient safety curriculum into undergraduate healthcare education.

Objectives: In this pilot study, researchers assessed the impact of the interprofessional simulation-based education (IPSE) course on students’ perceptions of interprofessional learning and patient safety post-course, and explored the participants’ perceived application of knowledge and skills 3 months later.

Methods: A sequential mixed-methods evaluation was conducted, including pre- and post-course Readiness for Interprofessional Learning Scale (RIPLS) questionnaires and two course evaluation questionnaires featuring open and closed items (administered immediately post-course and 3 months later). Participants included undergraduate physiotherapy, medical, nursing, and pharmacy students.

Results: The IPSE course enabled students to develop an appreciation of each other’s professional roles and particularly their individual and collaborative practices that may positively impact upon patient safety. Post-course students reported being able to influence patient safety through an increased application of their ability to identify errors and influence their colleagues’ practices, thus impacting directly upon patient safety.

Conclusion: This paper provides an evaluation of an innovative method of providing interprofessional patient safety learning and teaching opportunities within undergraduate healthcare curricula.