Effect of a clinical skills refresher course on the clinical performance,anxiety and self-efficacy of the final year undergraduate nursing students

Although the final year of nursing undergraduate programs that focus on clinical education are planned to prepare nursing students to better transition to the real world of health care service; evidence has shown that this program is not sufficient to reach this end goal. This controlled trial study was to investigate the effectiveness of a basic clinical skills refresher course for nursing students before entering the internship program. The sample consisted of 160 undergraduate nursing students assigned into two groups. The intervention was a three-day refresher course directed by nurse instructors for intervention group focused on 10 basic nursing procedures in the clinical skill lab. The control group did not receive any intervention. The students' anxiety, clinical self- efficacy and clinical skills practice were measured before and after intervention in both groups. The results indicated that the students who took part in the refresher course experienced lower anxiety levels, higher levels of clinical self-efficacy, and have better clinical skills during their internships. The undergraduate nursing curriculum can be strengthened by the basic clinical skills refresher course. This refresher course can bridge the theory - practice gap and provide a better transition from the student to nurse role.     

Competence: A concept analysis

Twenty years ago, the National League for Nursing pushed for major reform in nursing curriculum. It was their intent to revitalize nursing education and help prepare the next generation of nursing students for the increasingly complex nursing challenges of the future. Benefits of this change were to provide better prepared nurses, increased nursing satisfaction, and decreased nursing attrition. Unfortunately, many nursing schools have not changed their curriculum in a substantive way to meet this challenge. To meet this challenge, nurse educators need to look at new ways to help students develop critical-thinking skills to be able to competently problem solve in today's challenging health care environment. This article explores the concept of competence as it relates to nursing practice. Through examination and understanding of this concept, nurse educators are challenged to redefine and rebuild nursing curriculum to help develop competent nurses and make the profession stronger.     

Primary health care theory to practice: experience of first-year nursing students in Hong Kong

In the past, nursing education in Hong Kong has focused on acute illness care, and institutions providing nursing education have been slow to modify the illness-focused curriculum to a health-based curriculum. The nursing curriculum at the University of Hong Kong is unique in that it focuses on primary health care, and these concepts are introduced in both theory and practice in the first year of the baccalaureate program. In the second semester of the first year, students are required to develop and implement a primary health care project in a community setting. This article outlines the process and outcomes of the experience of 8 first-year nursing students who developed and implemented a primary health care project with older adults in a Hong Kong community. The Generalized Model for Program Development (McKenzie & Smeltzer) was used to guide the students in their practicum activities. The students demonstrated a high degree of competency in relation to health assessment skills; analysis of individual and community needs; development of appropriate health promotion sessions in relation to coronary artery disease, diabetes mellitus, and arthritis; and evaluation strategies to demonstrate effectiveness of the intervention. This experience early in the program provided a strong foundation for the students in primary heath care and grounded their nursing practice in scientific-based evidence.     

Critical thinking in clinical nurse education: Application of Paul’s model of critical thinking

Nurse educators recognize that many nursing students have difficulty in making decisions in clinical practice. The ability to make effective, informed decisions in clinical practice requires that nursing students know and apply the processes of critical thinking. Critical thinking is a skill that develops over time and requires the conscious application of this process. There are a number of models in the nursing literature to assist students in the critical thinking process; however, these models tend to focus solely on decision making in hospital settings and are often complex to actualize. In this paper, Paul’s Model of Critical Thinking is examined for its application to nursing education. I will demonstrate how the model can be used by clinical nurse educators to assist students to develop critical thinking skills in all health care settings in a way that makes critical thinking skills accessible to students.     

Implementing competency recommendations into pre-registration nursing curricula: effects upon levels of confidence in clinical skills

The competency based pre-registration nursing curriculum was introduced to address concerns about levels of confidence and competence in skills of newly qualified Project 2000 educated nurses [Department of Health, 1999. Making a Difference: Strengthening the Nursing, Midwifery and Health Visiting Contribution to Health and Healthcare. The Stationary Office, London]. This study sought to examine whether the implementation of the competency recommendations has led to improvements in the confidence of nursing students in their clinical skills. A self-administered questionnaire examining ratings of confidence in areas of nursing practice and core competencies as specified by the Nursing and Midwifery Council (NMC) [UKCC, 2001. Requirements for Pre-registration Nursing Programmes. UKCC, London] was administered to 139 final year adult nursing students who were studying with the Project 2000 or competency curriculum. The response rate was 53%, results indicating that the students studying the competency curriculum have higher levels of confidence in all areas of their practice targeted by the competency recommendations than students studying in the Project 2000 curriculum. The positive effect that the competency recommendations had upon levels of confidence in nursing practice, and the implications of such changes to curricula are discussed.     

The missing link: information literacy and evidence-based practice as a new challenge for nurse educators

The evolution of nursing as a profession requires the development of evidence-based practice based on outcomes and the ability by nurses to access and evaluate professional literature, both in print and on the Internet. To educate nurses to apply current research outcomes to nursing practice, an information literacy program was designed and implemented for first-semester associate degree nursing students in conjunction with a foundations in nursing course. The effectiveness of the program was evaluated using a 22-item questionnaire, both prior to the course and immediately after. A control group, students who did not receive the intervention, was also tested at both time points. Data analysis revealed that the information literacy program had both a positive effect on students' literacy skills and a negative effect on their attitudes toward the need for using these skills in nursing practice.     

Critical thinking dispositions and skills of senior nursing students in associate, baccalaureate, and RN-to-BSN programs

This study investigated the critical thinking dispositions and skills of senior nursing students. Study participants were students enrolled in associate (n = 137), baccalaureate (n = 102), and RN-to-BSN (n = 66) programs accredited by the Korean Ministry of Education. The California Critical Thinking Disposition Inventory (CCTDI) and California Critical Thinking Skills Test (CCTST) were used. A comparison of the CCTDI scores revealed a statistically significant difference between the students enrolled in different programs (F = 4.159, p = 0.017), as did a comparison of the CCTST scores (F = 24.205, p < 0.0001). Within the total sample (n = 305), the relationship between CCTDI and CCTST scores was significant (r = 0.305, p = 0.000). Developments in medical technology, the growing number of older adults and patients with chronic illnesses, and the demand for high-quality nursing care have led to various, increasingly complex, professional, legal, and educational issues within the nursing workplace. Therefore, nurses need creativity and critical thinking skills to make the decisions required of them in their nursing practice. In line with this, when conducting a survey of the effectiveness of nursing education, the necessity of critical thinking skills cannot be overlooked. In fact, the National League for Nursing Accrediting Commission (NLNAC) (1999) and American Association of Colleges of Nursing (AACN) (1998) require the concept of critical thinking be included as one of the core elements of curricula and that it be measured as an outcome when evaluating nursing education. In 1998, during the evaluation of colleges of nursing conducted by the South Korean Council for University Education, several universities presented the fostering of critical thinking as one of the terminal learning goals of nursing education based on the idea that critical thinking is important not only in the nursing workplace, but also in nursing education. To evaluate the effectiveness of Korea's current nursing education curriculum, focus was placed on current students in South Korea's three systems of nursing education. Each curriculum's effectiveness can be evaluated by indexing critical thinking dispositions and skills. This article intends to offer insight into the first steps necessary in reorganizing nursing education by comparing these evaluations of each of the three systems. To this end, we conducted a comparative study of the critical thinking dispositions and skills of students in 3-year associate degree (ADN), 4-year baccalaureate (BSN), and 5-year RN-to-BSN programs. The RN-to-BSN program requires students to finish a separate 2-year program after the initial 3-year ADN program.     

Finnish nurses' and nursing students' mathematical skills

The health care environment requires that practitioners have sufficient mathematical skills to perform accurate, safe and effective medication administration. This is a highly responsible and nursing task, which is performed daily. In this study 364 nurses and 282 graduating nursing students in Finland completed the Medication Calculation Skills Test (MCS Test). According to the findings students lacked accurate mathematical skills, while nurses attained higher scores in the test. Nurses with an upper secondary school education managed better with the calculation problems than nurses with a lower basic education. Students who had an excellent mark (9-10) in mathematics, had studied mathematics longer at high school and were more satisfied with the amount of medication calculation instructions and scored higher in the MCS Test than others. The differences between the nurses' and students' mathematical skills were significant. The MCS Test could be used to measure one's own skills and to give information of the mathematical skill level for constructing a nursing curriculum or additional training for clinical practice.     

Planning quality patient care in today's marketplace

New skills and perspectives are essential for nursing to meet the demands of shrinking resources without co-opting professional standards. Planning patient care in a definitive, value-based framework that ensures a balance among cost, work time, and quality outcomes for the consumer is the new work of nursing. Translating current practice into a value-based model requires an orientation to the content of our care, the context in which it is provided, and the effectiveness of our collaborative skills.     

How baccalaureate nursing programs teach writing

BACKGROUND. Written communication skills are critical for nursing practice. However, nursing faculty often find students unprepared to communicate clearly and effectively in writing. This integrative review identifies and discusses specific approaches used in baccalaureate programs to teach writing skills to prelicensure nursing students. METHODS. Electronic databases PubMed, CINALHL, and ERIC were used. Nine articles were found describing programs that taught writing skills to prelicensure nursing students in baccalaureate programs. All articles were published since 1990 and met inclusion and exclusion criteria. Writing programs were divided into two categories: stand‐alone programs and programs integrated across a nursing curriculum. Instructional strategies were analyzed to identify common elements. FINDINGS AND DISCUSSION. Five common elements of such programs were identified: short writing assignments, faculty training, sequential writing assignments, giving students examples of successful writing or explaining grading rubrics, and revision after faculty or peer feedback. Across‐curriculum programs appeared to include these components more often than stand‐alone programs. CONCLUSION. Writing programs implemented across a nursing curriculum may be more likely to include certain common components than are stand‐alone programs. There is a critical need to measure both short‐ and long‐term outcomes of these writing programs.     

Use of videotaping to assess competencies and course outcomes

A constant challenge in nursing education is effectively teaching competencies and allowing students to safely practice essential nursing skills. Faculty members must develop sound methods of instruction to achieve program outcomes, which determine program effectiveness, assure professional readiness, and meet accreditation standards. To this end, the use of videotaping is suggested. Videotaping offers a safe way for students to practice skills and develop confidence prior to actual performance. This article reviews the literature on videotaping and discusses videotaping as used at Central Missouri State University baccalaureate school of nursing. Videotaping is a teaching-learning strategy used to help students develop effective communication, physical assessment, and selected psychomotor skills. Videotaping also provides students with a mechanism for detailed instructor feedback to improve performance.     

Teaching and learning activities to educate nursing students for interprofessional collaboration: A scoping review

To prepare new graduates with the knowledge, skills, and attitudes to engage in effective interprofessional collaboration (IPC) in practice, healthcare professional programmes need to ensure their curriculum provides opportunities for interprofessional education (IPE) and IPC. To strengthen IPE within an undergraduate curriculum and meet the professional requirements set out by regulatory bodies to prepare new graduate nurses to achieve IPC competencies, a curriculum initiative was developed to expand IPE across the four years of the Baccalaureate of Science in Nursing (BSN) programme. The purpose of this scoping review was to identify published teaching-learning activities in undergraduate nursing programmes to inform the development and integration of IPE curricula. The literature included was identified by searching the following electronic databases: EMBASE and EBSCO (CINAHL, Medline, Education Research Complete, ERIC). The search was limited to articles with abstracts published between 2008 and 2016 in the English language. All ten studies that met inclusion criteria reported students’ perceived interprofessional education as valuable in facilitating their achievement of IPC competencies. Interprofessional education is an approach for preparing nursing students with knowledge, skills, and attitudes to achieve IPC competencies and therefore, urgently needs to become more prevalent in nursing curricula. Educators can use a variety of IPE teaching-learning activities to support students’ achievement of IPC competencies in order to prepare new practitioners to engage in effective IPC in a variety of healthcare milieus. Nurse educators are encouraged to intentionally integrate learning opportunities into current and future undergraduate nursing education to prepare collaborative ready graduate nurses.     

Reflection: a casualty of modularisation?

INTRODUCTION: The use of reflection in nursing and midwifery is well-established and reflective skills are taught on both pre- and post-registration courses as a way of integrating theory and practice, and of developing students' critical and analytical skills. Reflection is generally regarded positively with an assumption that reflective skills benefit both practitioners and patients. The aim of this study was to identify the educational strategies used to develop reflective skills in one pre-registration diploma in nursing curriculum. METHODS: The survey was cross-sectional in design. A questionnaire was designed for the study to explore perceptions of both students and lecturers in one educational establishment. Curriculum documentation was analysed to examine where in the curriculum the development of reflective skills was prominent. The sample consisted of two student cohorts from the adult branch and all senior lecturers within the Institute who taught on the pre-registration programme. RESULTS: The findings revealed a complex picture of students' and lecturers' views of the teaching and learning strategies used to develop reflective skills. Lectures and group work were the strategies cited most commonly by the students, whereas the lecturers felt the strategies used most often were personal tutorials, group work and case scenarios. The documentary analysis revealed that out of the 13 modules, there was explicit reference in only three modules to reflective practice. Furthermore, it was evident that the majority of lecturers were not clear where in the curriculum reflective skills were taught which suggested that an overview of the whole curriculum is not always evident. CONCLUSIONS: Modularisation may have contributed to a fragmentation in the way in which some key health practitioner skills are developed and built upon throughout a curriculum. There needs to be agreement on the nature of the skills which are central to the development of reflective practitioners and clear thinking on how these are developed and assessed within a curriculum.     

Integration of clinical judgment in the nursing curriculum: challenges and perspectives

The purpose of this qualitative, multiple-case study design was to better understand the influence of the nursing curriculum on clinical judgment development in baccalaureate nursing students and the capacity to provide safe nursing practice in health care settings. A sample of 20 preceptors for new graduate nurses were selected from three hospitals in Lebanon, and curriculum documents of three nursing programs provided data to determine the influence of curriculum on clinical judgment development. The preceptors' responses and curriculum data were triangulated, resulting in identification of strengths and weaknesses in the development of the clinical judgment ability of nursing students. The findings provide specific information regarding the influence of the nursing curriculum on the development of clinical judgment abilities, as well as implications for integration of new graduates into professional nursing practice. Strategies are described that can be used globally as baccalaureate nursing programs embrace and strengthen the partnership with service.     

Extended immersive simulation to develop nontechnical skills: Content analysis of students' views

BackgroundThe purpose of undergraduate nursing education is the preparation of graduates for clinical practice. Despite this focus, graduates are often unprepared for independent practice, particularly in the use of skills such as time management, delegation and critical thinking in clinical situations. This paper reports on students’ views of using extended, immersive simulation to consolidate the use of both technical and nontechnical skills in preparing them for independent nursing practice.AimTo investigate students’ views on the value of extended, immersive simulation in preparing them for independent practice as registered nurses.MethodsCross-sectional research involving content analysis of open-ended survey questions. The study involved comments from 287 final year nursing students conducted at a university in Western Australia.FindingsThemes related to critical thinking, the role of the registered nurse, communication, time management, teamwork and leadership were identified through the content analysis. Students believed exposure to extended simulation facilitated development of the essential skills required to practise independently and helped them prepare for the role of a registered nurse. Many expressed the wish for this type of simulation to be included throughout all years of the nursing curriculum.DiscussionStudents need experience in clinical situations where they are challenged to use multiple skills simultaneously to develop the expertise required of registered nurses. The ability to practise independently, and take responsibility for decisions made in complex ward conditions, is not currently required of students on clinical placements. Simulation is a way to fill this void in nursing education to enable students to experience the full role of a registered nurse.ConclusionBased on our findings nursing students believed that extended, immersive simulation was an effective method of supporting students as they undertake the full responsibilities of registered nurses to enable them to be safe and effective practitioners on commencement of the registered nurse role.     

基于PBL教学法的护理学理论实践一体化教学模式的介绍

改革传统的护理教学中理论、技能和实践之间脱节的教学方法,将PBL学习法和理论实践一体化教学法相结合,融入护理综合能力训练的教学中,通过PBL病案再现临床情景,以护理问题为线索,以护理程序为方法,按时间推进,模拟临床护理工作。激发学生的学习兴趣,锻炼学生的临床思维能力及自主学习、信息管理、团队协作、评判性思维、人际沟通、法律意识等能力。     

Clinical education in managed care for advanced practice nurses: A case example

Managed care is a major component in the current practice environment of advanced practice nurses (APNs). Professional nursing organizations are incorporating managed care concepts into their requirements for nursing curriculum. Partnerships for Quality Education (PQE) was developed to foster partnerships designed to incorporate managed care skills into clinician education. This paper describes how one PQE-funded nurse practitioner project joined with a federally qualified community health center (FQCHC) to provide a foundation in managed care theory and practice to nursing students, clinicians, and other support staff.     

A protocol for a scoping review of the use of mental simulation and full-scale simulation in practising healthcare decision-making skills of undergraduate nursing students

AimThis scoping review aims to explore the effect of FSS and mental simulation on the decision-making skills of nursing students.BackgroundFull-scale simulation (FSS) has been the most used simulation modality in nursing education due to its applicability to enhance both technical and non-technical skills. However, FSS can be excessively costly and other factors such as technophobia and lack of trained staff and support make FSS less accessible, especially for nursing education. Therefore, a novel mental simulation that is interactive and supported by visual elements can be a substitute for FSS, at least for some of the skills, such as clinical decision-making. Reviews comparing the effectiveness of FSS and mental simulation on decision-making skills in nursing students are lacking. Further knowledge on the effectiveness of these two modalities on decision-making skills for nursing students is needed to inform the nursing education curriculum and to decide between the two modalities.DesignThis protocol adheres to the guidelines outlined in the PRISMA extension for scoping reviews (PRISMA-scr) checklist.MethodThe methodological framework for scoping reviews will be followed for this scoping review. Scopus, EBSCOhost the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE and for the grey literature ERIC and BASE will be searched for related studies. The search will be limited to January 2008 and April 2023 (up-to-date) and English. A detailed search strategy was developed with an experienced research information manager and this strategy will be adapted to each database. A single screening will be performed by an author who will screen all abstracts and titles and full-text publications. After the study selection step of the framework, the data from the included studies will be charted using a data extraction form. The data will be synthesised by comparing the effect of FSS and mental simulation on decision-making skills.ConclusionA synopsis of the publication on FSS and mental simulation on nurse students’ decision-making skills will be useful for stakeholders when choosing between two modalities to deliver decision-making skills to nursing students and also help to inform the nursing education and simulation practice.Scoping Review RegistrationProtocols.io (doi: 10.17504/protocols.io.e6nvw57y7vmk/v1)     

Inquiry in baccalaureate nursing education: fostering evidence-based practice

With the increasing emphasis on evidence-based nursing practice, nurse educators need to more fully implement teaching strategies that help students gain critical thinking skills related to inquiry and understand the importance of evidence-based nursing practice. Research and scholarship emphases in one baccalaureate nursing program, student-identified benefits, and challenges associated with incorporating inquiry across the curriculum are described in this article. In clinical journal entries, students described the following benefits associated with curricular emphasis on inquiry: increased interest in evidence-based nursing practice and participating in the generation of research; enhanced critical thinking skills through the development of knowledge, experience, and competencies; increased motivation to continue professional growth and development by participating in lifelong learning; the desire to become better consumers of research findings; better understanding of the "real world" of clinical research; and increased desire to pursue graduate studies in nursing. The challenge to promote student growth toward competence in the application of evidence-based principles in clinical practice is ongoing.