The implementation of Mask-Ed: Reflections of academic participants

This paper profiles the findings from a study that explored the perspectives and experiences of nurse educators who implemented a novel simulation approach termed Mask-Ed. The technique involves the educator wearing a silicone mask and or body parts and transforming into a character. The premise of this approach is that the masked educator has domain specific knowledge related to the simulation scenario and can transmit this to learners in a way that is engaging, realistic, spontaneous and humanistic.Nurse educators charged with the responsibility of implementing Mask-Ed in three universities were invited to participate in the study by attending an introductory workshop, implementing the technique and then journaling their experiences, insights and perspectives over a 12 month period. The journal entries were then thematically analysed. Key themes were categorised under the headings of Preparation, Implementation and Impact; Reflexivity and Responsiveness; Student Engagement and Ownership; and Teaching and Learning.Mask-Ed is a simulation approach which allows students to interact with the ‘characters’ in humanistic ways that promote person-centred care and therapeutic communication. This simulation approach holds previously untapped potential for a range of learning experiences, however, to be effective, adequate resourcing, training, preparation and practice is required.     

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.     

HI I CARE: A mnemonic device to frame safe patient encounters and support simulation experiences for novice nursing students

BackgroundRemembering the many safety behaviors and patient care activities expected during a patient encounter can be difficult for novice nursing students. The HI I CARE mnemonic device was created to assist novice nursing students to remember and organize key safety behaviors and patient care activities. Subsequently, the mnemonic device was drafted into a checklist to be used as a performance support tool for students’ first simulation experience.MethodsA survey was designed and administered to beginning nursing students to explore their perception if the HI I CARE mnemonic device helped to (1) reduce anxiety prior to simulation experiences; (2) plan, organize, and deliver care; and (3) integrate classroom learning into the simulated patient encounter.ResultsOverwhelmingly, participants agreed or strongly agreed that the HI I CARE mnemonic helped to achieve these goals.ConclusionThe HI I CARE mnemonic device and correlating checklists are effective performance support tools that can be used to help novice nursing students to recall key safety behaviors and organize patient care activities in the nursing skills laboratory and the simulation setting. This mnemonic device, as a performance support tool, offers associate degree nursing students the opportunity to develop optimal habits that exemplify the safe patient encounter.     

Using simulation to improve the capability of undergraduate nursing students in mental health care

IntroductionMental health care is an increasing component of acute patient care and yet mental health care education can be limited in undergraduate nursing programs. The aim of this study was to establish if simulation learning can be an effective method of improving undergraduate nurses' capability in mental health care in an acute care environment.InterventionUndergraduate nursing students at an Australian university were exposed to several high-fidelity high-technology simulation activities that incorporated elements of acute emergency nursing practice and acute mental health intervention, scaffolded by theories of learning. This approach provided a safe environment for students to experience clinical practice, and develop their skills for dealing with complex clinical challenges.MethodsUsing a mixed method approach, the primary domains of interest in this study were student confidence, knowledge and ability. These were self-reported and assessed before and after the simulation activities (intervention) using a pre-validated survey, to gauge the self-rated capacity of students to initiate and complete effective care episodes. Focus group interviews were subsequently held with students who attended placement in the emergency department to explore the impact of the intervention on student performance in this clinical setting.ResultsStudents who participated in the simulation activity identified and reported significantly increased confidence, knowledge and ability in mental health care post-intervention. They identified key features of the intervention included the impact of its realism on the quality of learning. There is some evidence to suggest that the intervention had an impact on the performance and reflection of students in the clinical setting.DiscussionThis study provides evidence to support the use of simulation to enhance student nurses' clinical capabilities in providing mental health care in acute care environments. Nursing curriculum development should be based on best-evidence to ensure that future nursing graduates have the skills and capability to provide high-quality, holistic care.     

Student-LED interprofessional sequential simulation improves communication and teamwork

BackgroundAlthough simulation is a well-established learning method in Finland, sequential simulations are still uncommon. The objective of this project was to pilot interprofessional, sequential simulation demonstrating acute clinical pathways. The learning objectives were communication and collaboration.MethodsTwo groups consisting of nursing and emergency care students planned the simulation exercises. Other participants in the simulation were medical students, biomedical science students and radiography students.ResultsParticipants considered the sequential simulation were a good learning method particularly for skills in communication, patient encounters and working in an interprofessional setting.ConclusionsAn interprofessional, sequential simulation of a clinical pathway is a good method to practice non-technical skills. Sequential simulation also helps students understand the whole health care system.     

Second-year undergraduate nursing students’ experiences with clinical simulation training in mental health clinical practice: A focus group study

AimThe aim of this focus group study was to investigate second-year undergraduate nursing students’ experiences with clinical simulation training as part of their clinical practice in acute mental health care.BackgroundThe quality of bachelor programmes in nursing has been criticised for lacking theoretical and experiential learning in the mental health modules. Novice nurses feel unprepared to care for patients with mental health challenges and graduate nurses are reported to lack the necessary knowledge and skills to manage patients with mental health issues confidently and competently. Clinical simulation training can facilitate the teaching of clinical and non-clinical skills simultaneously and is a highly suitable method within mental health care for addressing gaps in knowledge and skills in communicating with patients. Clinical simulation training may enhance nursing students' competence and thereby reduce the risk of adverse events and increase safety. However, we know little about undergraduate nursing students’ experiences with clinical simulation training as an integrated part of nursing students’ clinical practice in acute mental health wards.DesignExplorative qualitative focus group study.MethodThree focus group interviews were conducted using a semi-structured interview guide with second-year undergraduate nursing students from a university in Norway during spring 2020. In total, 14 students who had experienced clinical simulation training as part of their mental health clinical practice participated in the study. The collected data were analysed using systematic text condensation.ResultsClinical simulation training as part of the clinical practice increased the students’ preparedness, coping and self-awareness. Most of the participants had positive perceptions of the use of high-fidelity simulation-based learning. Furthermore, they highlighted three elements that increased the value of the training. First, the simulation felt authentic and increased their professional skills. Second, the standardised patient had clinical qualifications, which made the simulation feel authentic and close to realistic situations. Third, not having a former relationship with the person acting as the standardised patient enhanced authenticity.ConclusionClinical simulation training as part of clinical practice contributed to increasing the students’ self-awareness and in-depth reflection and to broadening their nursing competence. The present study lays the groundwork for future studies on clinical simulation training in mental health clinical practice for nursing students.     

Modelo de aprendizaje de cuidados paliativos basado en la teoría de aprendizaje transformacional de cuidados paliativos de los estudiantes de enfermería en Indonesia

IntroductionPalliative care competence is one of the competencies that must be possessed by generalist nurses. For this reason, strategies for developing palliative care learning models need to be carried out to ensure nursing students have palliative care competencies. Therefore, this study was structured to develop a transformation theory-based palliative care learning model that prioritizes the active participation of students to deal with palliative care in future practice.MethodsThis study was a cross-sectional study involving 189 nursing students as participants. The proposed model involves six variables, namely student characteristics, educator characteristics, learning media, palliative care competencies, transformative learning theory (TLT)-based palliative learning, and competency achievement. Data were collected using a questionnaire that was tested using the Structural Equation Modeling (SEM) technique.ResultsSEM analysis showed that the R² value of TLT-based palliative care learning was 0.707 or 70.7%. These results indicate that the diversity of TLT-based palliative care learning variables can be explained by the variables of students, educators, palliative competencies, and learning media by 70.7%. Each construct has a value of Q2 > 0, which means the model is satisfactory. The path coefficient value of 0.627 indicates that the characteristics of educators have the most significant contribution to the TLT-based palliative care learning model.ConclusionIt can be concluded that the teaching-learning process based on TLT is a promising strategy to support nursing students to achieve palliative care competence.     

Simulation helps equip nursing students to care for patients with dementia

BackgroundTeaching undergraduate students about older adults with dementia remains an area of acute interest in academia. Identifying optimal simulation methodologies to inform dementia education is essential to prepare nursing students to provide care to this population.MethodsSchool of nursing faculty completed a quality improvement project to evaluate the effectiveness of simulation to teach geriatric nursing knowledge and clinical judgment to nursing students. A retrospective review of student journal reflections occurred. The thematic analysis approach was used to analyze the qualitative data collected from narrative journals submitted by nursing students (n = 263).ResultsThree major themes of Consciousness of Self, Consciousness of Time, and Consciousness of Communication were identified.ConclusionFindings have the potential to transform how nursing students view the care needs of geriatric patients. This article provides a resource for nursing educators seeking to integrate simulation-based education to teach concepts of care related to dementia.     

Effectiveness of using a simulation combined with online learning approach to develop discharge teaching skills

BackgroundDespite evidence of the impact of discharge teaching on patient outcomes, nursing students are poorly prepared in the pedagogical skills necessary for their role as patient and family educators in clinical practice. This study evaluated the effectiveness of simulation combined with online learning to improve nursing students’ discharge teaching skills.MethodsThe module included simulations before and after an online module on patient/family teaching for hospital discharge. Evaluation measures were student and independent rater evaluations using the Quality of Discharge Teaching Scale- Evaluation form (QDTS-E).ResultsStudents (n = 153) improved their performance on both content and delivery subscales of the QDTS-E by 20% (student self-evaluations) and 18% (independent raters). However, correlations between student and rater scores were low (r = 0.08-0.22).ConclusionUse of simulation with online learning in a discharge teaching module can help students build patient education skills to improve post-discharge patient outcomes, contributing to national health priorities to reduce hospital readmissions. With further refinement and testing, the learning module and QDTS-E evaluation form may also be useful for evaluation and continuing education of clinical nursing staff.     

Demonstration of caring and motivational interviewing in online simulation: A cross-sectional observational study

AimThe purpose of this paper is to describe an innovative educational approach for pre-licensure nursing students to learn and practice motivational interviewing skills in a telehealth simulation with standardized patients portraying pregnant women with substance use disorder.BackgroundGiven the ongoing need for online delivery of both nursing education and clinical practice, providers must continue to find approaches to facilitate the provision of empathetic and personalized care to achieve optimal patient outcomes. Motivational interviewing integrates a person-centered approach with specific communication strategies to encourage and support patients' commitment to change. Motivational interviewing skills can be implemented across a wide variety of patient situations, including mental health and primary nursing care.DesignThe study followed a pre-/post-test cross-sectional observational design.MethodsAfter completing an online training course to learn motivational interviewing skills, students participated in an online simulation with a standardized patient portraying a woman with substance use disorder during pregnancy. Prior to the simulation, students completed the Caring Behaviors Inventory-24 and the Opening Minds Scale for Health Care Providers. After the simulation, students and standardized patients completed the Simulated Clinical Interview Rating Scale and a 5-item version of the Caring Behaviors Inventory-6.ResultsOf the 252 students in the course, 85 (34%) participated in the study. Twenty-six student participants completed both pre- and post-simulation questionnaires; 40 completed only pre-simulation questionnaires; and 19 completed only post-simulation questionnaires. Prior to the simulated patient encounter, students rated themselves most favorably on ability to demonstrate assurance behaviors. After the training and simulation, students and standardized patients reported successful student demonstration of motivational interviewing skills and caring behaviors consistent with fundamental therapeutic communication and motivational interviewing knowledge. There was no statistically significant difference between self-reported student performance and the standardized patients’ observations.ConclusionsStudents attained and applied motivational skills and demonstrated caring behaviors in a virtual setting with standardized patients.     

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.     

The impact of student learning styles on interviewing skills and academic performance

Background: Many U.S. medical schools struggle to identify how to teach students the content and skills needed to communicate effectively with patients. Some schools have developed predoctoral curricula emphasizing both biomedical and psychosocial dimensions of patient care. It is important to identify whether this approach has a measurable impact on doctor‐patient communication.

Purpose: This study examined the impact of learning styles on 200 Ist‐year medical students’ academic performance and interviewing skills.

Methods: Analysis of variance were conducted comparing academic performance and interviewing skills across 4 learning styles in Kolb ‘s Learning Style Inventory.

Results: Findings revealed statistically significant differences in academic performance (p < .05) and interviewing skills (p < .05) by students’ learning styles.

Conclusions: Students possess different learning styles that influence their success in medical school. Educators can vary their teaching methods to ensure that students, regardless of learning style, perform optimally in every aspect of patient care.     

Nursing students’ experiences with patient death and palliative and end-of-life care: A systematic review and meta-synthesis

AimTo synthesise the experiences of nursing students encountering patient death and caring for patients under palliative care or at end-of-life and their families in clinical settingsBackgroundNurses are pivotal in caring for dying patients and families. It has been reported that nursing students feel unprepared in caring for dying patients and handling patient death. Understanding their experiences would better inform how palliative care education can be improved and how students can be better supported in clinical settings.DesignA qualitative systematic review and meta-synthesisMethodsPubMed, Embase, CINAHL, PsycINFO, ProQuest and Google Scholar were searched for peer-reviewed articles and theses/dissertations published between 1 January 2012–25 Feb 2023. Qualitative studies of any design reporting nursing students’ experiences of patient death, caring for patients under palliative care, at end-of-life, or with time-limiting diseases in clinical settings in English were included. Study quality was evaluated using the Critical Appraisal Skills Programme tool. Data were synthesised using Sandelowski and Barroso’s 2-step framework through a meta-summary using thematic analysis, which were then integrated into meta-syntheses using an event timeline.ResultsThe review included 71 studies from 26 countries (n = 1586 nursing students). The meta-summary contained 8 themes and 23 subthemes: (1) Communication experience with patients and families, (2) Satisfaction with care provided to patients and families, (3) Impact of the COVID-19 pandemic on death and dying, (4) Perceptions of death and dying, (5) Impact of death, (6) Nursing education on palliative end-of-life care, (7) Support systems and coping methods, (8) Learning outcomes. The meta-synthesis depicted nursing students' experiences before, during and after encountering dying patients, families and patient death. Suggestions for nursing faculty and clinical staff on how they could equip students with necessary skills and knowledge and support them in clinical settings were also provided.ConclusionsWhile caring for dying patients and families was beneficial to nursing students' learning and professional development, they encountered many challenges. Governments, clinical and academic nursing leaders must prioritise the integration of palliative care content into the curricula across nursing schools in face of increasing palliative and end-of-life care needs in patients. Nursing schools should ensure that students are adequately prepared by designing culturally and socioeconomically relevant curricula, integrating theoretical and experiential learning and offering students a thorough understanding of palliative and end-of-life care. Clinical staff and nursing instructors should support students emotionally and guide them in patient care.     

Using standardized patients to improve the hygiene care skills of first-year nursing students: A randomized controlled trial

Background

Standardized patient was useful for knowledge acquirement, communication skills, self-efficacy, learning motivation and clinical skill acquirement in the literature.

Effects of weight bias training on student nurse empathy: A quasiexperimental study

AimThis study aimed to identify the efficacy of weight bias training on the empathy skills of student nurses when working with a person with obesity.BackgroundWeight bias with nurses harboring negative attitudes towards patients with obesity results in inferior care and patients' reluctance to seek medical care. Empathy is a communication skill used in nursing to build trust and rapport with patients to provide optimal patient-centered care.MethodsThis study used a quasi-experimental design with 121 undergraduate nursing students in their first semester of the nursing program. The students completed learning activities on weight bias, including reading an article on weight bias, watching a video showing an individual with obesity's experiences in the healthcare setting and participating in a group discussion and reflection on the article and video. In addition, students completed the Jefferson Scale of Empathy-Health Professions Students’ version before and after the learning activities. Following the learning activities, students participated in a simulation activity with a standardized patient wearing an obesity suit. The standardized patient completed the Jefferson Scale of Patient Perceptions of Nurse Empathy to rate the patient's perception of the nursing student's level of empathy based on their interactions in the simulation scenario.ResultsA comparison of the scores on the Jefferson Scale of Empathy-HPS showed there was not a significant difference in the scores before learning activities (M = 15.45, SD = 12.7) and post-learning activities (M = 15.94, SD = 11.5); t(120) = 0.476, p = .635. Data analysis identified significant changes in empathy scores on the Jefferson Scale of Empathy-HPS in the accelerated second-degree cohort with differences in scores before learning activities (M = 113.7, SD = 10.5) and post-learning activities (M = 116.5, SD = 13.4); t(50) = 2.02, p = .049. The traditional cohort did not have a significant change in empathy scores. Empathy scores and the patient's perception of empathy scores showed no relationship. Most (79 %) of the patient's perception of empathy scores was moderate. Student comments in this study support the findings that some nursing students harbor weight bias towards individuals with obesity.ConclusionThere is a need to identify learning activities that eliminate weight bias in the nursing student population and result in the student's ability to demonstrate appropriate communication skills and nursing behaviors in a nondiscriminatory manner to the patient with obesity. To improve empathy behaviors, students should practice communication skills throughout the nursing curriculum.     

Virtual gaming to develop students' pediatric nursing skills: A usability test

BackgroundAs competition for specialty clinical placements increases, there is an urgent need to create safe, stimulating, alternative learning environments for students.ObjectiveTo address that clinical gap, our team developed a virtual game-based simulation to help nursing students develop their pediatric nursing skills.DesignA usability study was conducted using the Technology Acceptance Model as a research framework.Setting and ParticipantsThe study was conducted at a community college and included nursing students, nursing faculty/clinicians and two gaming experts.MethodsThe two experts evaluated the game using a heuristic checklist after playing the game. Participants engaged in a think-aloud activity while playing the game and completed a survey and interview based on the Technology Acceptance Model to explore ease of use and utility of the game.ResultsWe found a high degree of user satisfaction with the game. Students reported that they had learned about pediatric care, they had become immersed in the game and they were keen to keep playing. Several design changes were recommended.ConclusionUsability testing is critical in the early stages of simulation development and the study provided useful direction for the development team in the next stage of game development.     

Role-play simulation to teach nursing students how to provide culturally sensitive care to transgender patients

ObjectiveIncrease student knowledge and comfort with caring for a transgender individual and confronting colleagues when exhibiting poor cultural intelligence.BackgroundTransgender patients often experience health care inequities, including heteronormative microaggressions in communication and policies. Simulation has been a successful means of providing students with the education, tools, and experience necessary to combat systemic injustice in health care. Simulation is an interactive pedagogy that allows nursing students to practice assessment, patient care, and difficult conversations in a controlled, risk-free environment.Design/ MethodsPrelicensure nursing students role-played a simulation created as an interactive learning strategy to promote culturally sensitive assessment of a transgender patient and their caregiver, including assessing for pronouns and providing patient-centered care. The simulation included preforming a difficult conversation between nurses to cultivate an environment of being an upstander. The simulation demonstrated holistic methods of assessing and supporting unique patient needs for the patient who is transgender.ResultsNursing students reported they felt that their comfort with advocacy and ability to communicate with transgender patients, as well as with their families, and health care team members was enhanced after completing the simulation.ConclusionSimulation has the ability to reduce discomfort and discrimination in health care for transgender patients by equipping students with culturally sensitive and inclusive communication tools and providing them with risk-free environment where they can learn to provide care for this vulnerable population in preparation for successful future encounters.