Using complex adaptive systems theory to guide the transition to DNP nurse anesthesia education

The opportunities and challenges when transitioning from a master's to DNP in nurse anesthesia education are complemented by using a complex adaptive system (CAS) theory to guide the curricula modifications.Major functional changes included reorganizing the curriculum to incorporate AACN DNP Essentials, COA competencies and integrating the scholarly work of a DNP improvement project. These changes were infused while balancing the intensive clinical requirements of a nurse anesthesia curriculum.Highlights in the DNP curriculum included the driving theory of complex systems, ethical values, leadership development, evidence-based practice and adaptation to emergent situations found in nurse anesthesia practice. Goals were to produce a DNP graduate that is more reliant on strategy and vision rather than only tasks or operations.Using the CAS framework enabled our program to transition and prepare DNP graduates to contribute to improved organizational effectiveness and understand the importance of leading change to positively impact patient outcomes.     

Resident and fellow training in transfusion medicine

This article focuses on the design of transfusion medicine residency and fellowship training programs in the context of the Accreditation Commission for Graduate Medical Education (ACGME) competencies. Transfusion-specific examples of the six ACGME competencies are discussed, a transfusion medicine curriculum with designated training stages for specific curriculum elements is proposed, and examples of training activities are given. The authors also discuss transfusion service rotation design and how to build in graduated responsibility as training proceeds. Finally, methods for assessing the competency of transfusion medicine trainees and the effectiveness of the training program and teaching faculty are described. It is hoped that this article will provide a blueprint for how to design and implement a successful transfusion medicine residency and fellowship training program.     

Characteristics of students in occupational therapy educational programs

This study used data from self-administered questionnaires to compare technical- and professional-level students from four occupational therapy educational programs in Illinois. Examination of the similarities and differences in biographic characteristics indicate that registered occupational therapy and certified occupational therapy assistant students come from different backgrounds. The reasons why students chose their levels of education, and the amount and character of contact with occupational therapy that they had prior to entering the program provide useful information for counselors, recruiters, and designers of informational materials. The students' intended roles, desired career goals, and work values furnish suggestions for curriculum developers.     

Drivers for renewal and reform of contemporary nursing curricula: a blueprint for change

The creation of a curriculum blueprint appropriate to the development of a professional nurse who is practice-ready for the current and future context of health service delivery must take account of the extant context as well as an unpredictable and sometimes ambiguous future. The curriculum renewal process itself ought to challenge existing long held ideals, practices, and sacred cows within the health and higher education sectors. There is much to consider and importantly curriculum developers need to be mindful of reform within the health sector and health workforce education, as well as the concomitant vision and requirements of the nursing profession. Curriculum must develop more than discipline knowledge and skills: it must provide an infrastructure for generic abilities both social and intellectual in order to better prepare students for the registered nurse role. This paper discusses a number of forces that are essential to consider in curriculum development in undergraduate nursing education.     

Nursing informatics and undergraduate nursing curricula: A scoping review protocol

AimThis scoping review aims to review contemporary published literature on Nursing Informatics education in undergraduate nursing education.IntroductionNursing is the largest workforce in health care and nurses are increasingly required to work with digital information systems. The need for nurses to understand and embrace information technology is closely linked with the ability to function in the contemporary healthcare workplace. However, despite the early adoption of Nursing Informatics in Australia in the 1980 s, there remain barriers to Nursing Informatics engagement and proficiency, including poor computer literacy, limited professional development and a lack of undergraduate informatics education.DesignThis scoping review will be developed in adherence with the JBI Manual for Evidence Synthesis: Scoping Reviews and the PRISMA-ScR Checklist.MethodsTo be included in this scoping review, papers need to include Nursing Informatics education for undergraduate nursing students in a Bachelor of Nursing program. Undergraduate nursing students are defined as individuals enrolled in a recognised nursing program leading to registration as a Nurse. To meet the requirements for registration as a Registered Nurse, in Australia, individuals are required to complete a Bachelor of Nursing program at a university (Australian Qualifications Framework Level 7) For the purpose of this scoping review, undergraduate nursing students are defined as those individuals undertaking a three year Bachelor of Nursing program at a university. Equivalent international definitions will be also used in the scoping review procedure. Sources of information will be included if they were published between 2015 and 2022 and describe curriculum recommendations (including barriers to implementing Nursing Informatics education). The purpose of the identified timespan is to reflect the rapidly evolving nature of health informatics and digital technologies. The requirement for curriculum recommendations is to reflect the purpose of the scoping review as the basis for a Delphi study, where Nursing Informatics and its integration into Bachelor of Nursing curricula will be explored and described in collaboration with domain experts.Ethics and disseminationEthics approval has been obtained for this scoping review (Project ID: 2156) from the Flinders University’s Human Research Ethics Committee and has been determined to be low risk.     

护理全日制专本贯通定向培养模式下的急危重症护理床旁教学课程的构建

目的构建具体、可操作的急危重症护理床旁教学课程,以期为护理专业全日制专本贯通定向培养模式下的课程设置提供参考。方法依据泰勒课程设置基本框架,结合急危重症护理学实践要求,在文献回顾和专家小组访谈的基础上初步构建急危重症护理场旁教学课程,采用德尔菲法对23名专家进行2轮问卷咨询。结果 23名专家函询的平均积极系数分别为83.33%和92.00%,权威系数为0.903,专家协调系数0.401(P0.001),确定"护理专本贯通定向培养(急危重症方向)床旁教学课程",包括5个一级指标,19个二级指标,57个三级指标。结论形成的急危重症方向护理专本贯通班的床旁教学课程,构建过程科学,结果较为具体实用、可操作,为护理专业专本贯通课程的进一步探索提供借鉴与参考。     

Predictors of NCLEX-RN success in a baccalaureate nursing program as a foundation for remediation

This study evaluated students' demographic and nursing program variables and standardized test scores to determine whether significant differences existed between students who successfully completed the National Council Licensure Examination for Registered Nurses (NCLEX-RN) and those who were unsuccessful. In addition, the predictive accuracy of two standardized examinations, the Mosby AssessTest and the Health Education Systems, Incorporated (HESI) Exit Examination were compared. Two cohorts of graduating senior nursing students were studied (1999 cohort N = 121; 2000 cohort N = 103). Demographic and nursing program variables were obtained from student records. The Undergraduate Studies Committee provided standardized test scores (Mosby AssessTest in 1999; HESI Exit Examination in 2000). Only two program variables were consistently associated with success on the NCLEX-RN--final course grade for a didactic, senior-level medical-surgical nursing course and cumulative program grade point average. Scores on both standardized tests were significantly different in students who were successful on the NCLEX-RN and those who were not. The HESI Exit Examination demonstrated greater sensitivity, specificity, positive and negative predictive value, and test efficiency, compared with the Mosby AssessTest. Use of program variables and students' standardized test scores may allow faculty to identify students at risk for failing the NCLEX-RN and to provide structured remediation so these students may be successful on the licensing examination and begin their nursing careers.     

Impacting Faculty Teaching and Student Performance: Nine Years' Experience With the Objective Structured Clinical Examination

Background: The impetus for administering the 2nd-year Objective Structured Clinical Examination (OSCE) came from the great variability in student performance observed by 3rd-year clerkship directors. Purpose: To document the effects of the OSCE on faculty teaching, student performance, and the curriculum over 9 years of administration of the examinations to more than 1,000 second-year medical students. Method: A 20-station OSCE was administered to all medical students at the end of their 2nd year. Using predetermined criteria, clinical faculty served as evaluators in each station. A mix of 1st-, 3rd-, and 4th-year medical students were recruited to serve as simulated patients. Faculty evaluators and examinees completed a questionnaire evaluating their experience with the OSCE. Students received a report card of their performance. Small-group leaders of the Introduction to Clinical Medicine course received feedback on their group's performance on each station compared to the class mean. Summative data on class performance was reported to the curriculum committee. The academic status committee received data on students who performed unsatisfactorily. Results: Faculty and examinee ratings of the OSCE experience were very positive. Over the 9-year period, student performance improved showing less variability and significantly fewer failed stations. Conclusion: The OSCE has proven to be a technically feasible, authentic evaluation method yielding valuable information for decisions regarding student performance, faculty teaching, and curriculum planning.     

The cognitive style of nursing students: educational implications for teaching and learning

As cognitive and kinesthetic demands on nursing students increase, so does the need for optimal learning environments. Witkin's empirically supported measure of field dependent/independent cognitive style assesses the manner in which students perceive and process information and classifies them along a continuum of field dependence to field independence. Witkin's Groups Embedded Figures Test (GEFT) was administered to 876 students enrolled in 10 health care programs. Statistically significant differences in the GEFT mean scores of students enrolled in the different programs were discovered. The effect size was moderate. Undergraduate nursing students scored higher on the GEFT than did graduate or RN-to-BSN nursing students. However, nursing students were classified as more field dependent than students in other health-related disciplines. Due to their cognitive processing requirements, field-dependent nursing students may be at risk for academic failure. Therefore, instructional strategies tailored to students' needs should be incorporated into the nursing curriculum.     

Looking at the past to change the future: a retrospective study of associate degree in nursing graduates' National Council Licensure Examination scores

This is a retrospective study comparing academic records and demographic data of students in an associate degree in nursing program who failed the National Council Licensure Examination for Registered Nurses (NCLEX-RN) with students who passed the NCLEX-RN. The sample was obtained from the population of graduates from courses spanning one academic calendar year. The study examined the relationship between multiple variables and success on the NCLEX-RN. The dependent variable was passing NCLEX-RN. Several independent variables include entering cumulative grade point average (GPA), entering nursing curriculum GPA, preadmission examination score, terminal grades in each of the five clinical nursing courses, National League for Nursing examination scores taken in various program courses, graduating GPA, and Health Education Systems, Inc. (HESI), examination score taken at the end of the program. Standardized test results and the pass/fail rate in the nursing courses taught in the curriculum appear to be the most significant variables identified in profiling the student most likely to fail NCLEX-RN. Males and minorities (Black, Hispanic, and Asian) had a lower pass rate than their White counterparts.     

Curriculum as environment: a focus group study

Curricula development is critical for the advancement and evolution of holistic nursing education. Although the American Holistic Nurses Association offers advanced practice board certification for graduate nurses, there is a scarcity of available graduate holistic nursing courses and curricula. The researchers developed a curriculum for an advanced holistic nursing program at a university college of nursing in South Florida. The curriculum and process of development were presented at a workshop during a national holistic nursing conference. A portion of the workshop included an opportunity for attendees to voluntarily participate in a focus group research study. The specific aim of the research was to determine the best approaches for the development of curricula for the promotion of graduate holistic nurse education based on the insights of holistic nurses, nurse educators, nurse practitioners, and scholars. A content analysis identified 3 themes that addressed holistic nursing curriculum: (1) consider curriculum as an evolving blueprint for personal and professional growth; (2) embrace the uniqueness of students; and (3) encourage faculty to co-create the learning environment.     

Predicting Success for Associate Degree Nursing Students in a Concept-Based Curriculum

The study objective was to assess critical thinking scores, National Council Licensure Examination for Registered Nurses (NCLEX-RN) prediction scores, and NCLEX-RN pass rates for associate degree nursing (ADN) students educated with a concept-based curriculum. Results suggested that a concept-based curriculum can assist in developing critical thinking among ADN students, and critical thinking and probability of pass scores may be used as predictors for first-time NCLEX-RN passage for ADN students in a concept-based curriculum.     

Nursing students' level of autonomy: a study from Turkey

Nursing curriculum programs developed to train future professional nurses, methods of teaching and learning and practice can either prepare or be an obstacle to the students' thinking and acting like independent professionals. This study was conducted for the purpose of determining the level of autonomy of nursing students in the baccalaureate degree program at Cumhuriyet University School of Nursing. The research was conducted with a total of 326 students. Two forms were used for data collection in the research. The first was a 15-question personal information form. The second was the 30 item autonomy subscale from the Sociotropy/Autonomy Scale (SAS). The research data were entered into the Statistical Package for Social Sciences (SPSS) version 11.0 and frequency distribution, arithmetic mean, variance analysis (One-Way ANOVA) and Independent Samples t-test were used in the analysis of data. According to the General Autonomy (GA) score mean from the SAS administered in this study the nursing students' GA score mean was 83.03+/-14.51 and the highest level of autonomy was found to be in the 1st year students (84.87+/-14.44), followed consecutively by 2nd year (83.18+/-15.09), 3rd year (82.72+/-15.80) and 4th year (81.47+/-12.81) students. The conclusion of the study is that the autonomy levels of the students who regarded the professional qualities given them by the nursing education as enough have been remarkably high. This suggests that the nursing curriculum program being used is not adequately supporting the development of autonomy in students.     

The NCLEX-RN examination: charting the course of nursing practice

The author describes the changes in the 2004 NCLEX-RN(R) Test Plan and provides information about the alternate item formats that are being developed for the NCLEX examination. Nursing educators will learn details about the new test plan and review sample alternate items. Information from this article can be used for curriculum review and to prepare students to take the NCLEX examination.     

Unsafe student clinical performance calls for a systematic approach

Patient safety is the responsibility of both the system and the individual practitioner. Unsafe incidents are a very real possibility when nursing students are preparing for their profession. The curriculum committee of the Nursing Education Program of Saskatchewan (NEPS) identified the need for a unified and consistent process related to students who demonstrate unsafe clinical performance. Many clinical teachers experience difficulty in identifying and making decisions related to students' unsafe performance. The authors describe the development of a systematic approach that was adopted by NEPS in June 2005 and is being used across all program years and sites. The approach provides students with a fair and just process and reflects the responsibility of the educational program to prepare graduates who will provide safe, competent care.     

中美注册护士考试的比较与启示

通过中美注册护士考试的比较总结两国该方面的差异，为完善我国护士执业资格考试提供借鉴。美国注册护士考试体系形成了较成熟的技术操作方案，能较好地满足执业准人考试的要求。我国护士执业资格考试在考试形式、考试内容、考试题型及合格标准等方面还存在不足。美国注册护士考试体系为我国护士执业考试的改革提供了经验。我国应该完善考试的组织管理系统和相关制度规定，实现计算机化考试形式，改革考试设计和合格标准，探索操作技能考查办法。     

Evaluation of critical thinking outcomes of a BSN program

Following a curriculum revision, which emphasized critical thinking, a school of nursing selected the California Critical Thinking Skills Test (CCTST) as a standardized outcomes measure for its bachelor's of science in nursing (BSN) program. Students in three tracks of the program were administered the CCTST on entry into the nursing curriculum and again on exit. Paired t tests for dependent samples were used to analyze pretest-posttest differences of all students (N = 136) in the program. Results for students in each of the three tracks demonstrated significantly improved (P < or = .05) CCTST scores on all subscales and total scores, with one exception. RN to BSN students' scores on the Analysis subscale approached but did not reach significance (P = .058). Implications for evaluation are discussed.