Motivation: bringing up the rear in nursing education. Motivational elements in simulation. The participants' perspective

Learning Environments in Undergraduate Nursing Education During COVID-19: A Scoping Review

BACKGROUND

The COVID-19 pandemic radically changed nursing education.

PURPOSE

To map the existing literature on learning environments (LEs) in undergraduate nursing education during COVID-19 and identify the LE elements based on the 4 domains of Gruppen's conceptual framework: personal, social, organizational, and physical and virtual spaces.

METHOD

Eligible articles were reviewed using the Joanna Briggs framework.

RESULTS

The search retrieved 5003 articles, of which 80 met the inclusion criteria. Most studies were cross-sectional and conducted in the United States. Of the studies included, 68 studies focused on the personal component of students, 67 investigated physical and virtual space components, 19 examined the social domain, and 15 examined organizational aspects.

CONCLUSIONS

The COVID-19 pandemic significantly influenced the LE of nursing students. Based on the current review of LE in nursing education, nurse educators and researchers can develop interventions to maintain the quality and accessibility of nursing education in future crises.

"A Certainty for you Does Not Mean That it is a Certainty for Science": A Phenomenological Analysis of Experiences of Uncertainty in Clinical Reasoning of Nurses in the Postanesthesia Care Unit

PURPOSE

To explore the experiences of uncertainty in the clinical reasoning of nurses in the postanesthesia care unit (PACU).

DESIGN

A phenomenological descriptive design, following Colaizzi's analysis.

METHODS

Semistructured interviews were conducted with 14 nurses from a PACU on their experience of uncertainty in clinical reasoning. The interviews were digitally audio-recorded and transcribed verbatim. Two researchers conducted data analysis independently and followed seven phases: (re)reading the transcripts, extracting significant statements, formulating meanings from significant statements, aggregating formulated meanings into themes, developing a description of the phenomenon's essential structure, generating of the fundamental structure of the phenomenon, validating of the findings through participant feedback. The process employed MAXQDA analytics Pro 2022 software. Consolidated Criteria for Reporting A Qualitative Research checklist was used for reporting.

FINDINGS

From uncertainty experiences in nurses' clinical reasoning, 10 themes emerged: ambiguity and decision latitude, communication, work ethic, difficulty interpreting and predicting outcomes, cognitive performance impairment, incivility, core competence vagueness of postanesthesia nurses, high-tech care, (in)security and risk, and occupational stress.

CONCLUSIONS

The experiences of uncertainty in clinical reasoning of nurses in postanesthesia care units are highly focused on patient safety. Exploring these experiences has made uncertainty more tangible and explicit, which will enable nurses in postanesthesia care units to prepare for adaptive responses to deal with uncertainty when it occurs in clinical practice.

To Clap or Not to Clap: Relevance of "Applause" in Simulation-Based Learning Sessions

INTRODUCTION

Applause is a common behavior during simulation case learning sessions. Some simulation facilitators believe that this should not be allowed, arguing that it can mislead students when they make mistakes during simulation. This study was conducted to explore the opinions of students about spontaneous applause (initiated by the participants), as a habitual behavior in the simulation sessions, in the undergraduate and postgraduate nursing degrees.

METHODS

A qualitative research study was conducted based on the content analysis of 7 focus groups composed of simulation students (N = 101, both undergraduate and graduate students). The participants were asked to conduct a debate about the following question: What is your opinion about the spontaneous applause given to participants by their peers at the completion of the scenario as they go to the debriefing, and why? An inductive method of content analysis was used to interpret the data.

RESULTS

The majority considered applause as a sign of support; one student disapproved of the practice. For most participants, receiving spontaneous applause from their peers after finishing the simulation represented a spontaneous example of moral support that reduced the participants' stress.

CONCLUSIONS

Applause within the context of clinical simulation is a motivational act, which should not be repressed by the facilitator, as long as it is a spontaneous and genuine act by the participants once the simulation experience ends.

Levels of motivation and basic psychological need satisfaction in nursing students: In perspective of self-determination theory

BACKGROUND

Motivation is the first and most important constituent element of learning behavior. One of the most important theories in this field is self-determination theory (SDT) which is a general theory of motivation. According to this theory, the satisfaction of basic psychological needs of autonomy, competence, and relatedness are effective in the internalization of incentive. Hence this theory can be a good foundation for reforming medical education programs.

OBJECTIVE

The aim of this study was determining the basic psychological need and the effect of it on level of motivation and self-determined motivation of nursing student in the field.

METHODS

This is a cross-sectional, descriptive-analytical study done through a census on 243 nursing students of Guilan University of Medical Sciences. Data gathering tool was demographic information, motivation level, and basic psychological needs questionnaire. Data were analyzed using independent t-test, Spearman and Pearson correlation, Man-Whitney, backward regression considering P < 0.05.

RESULTS

The findings showed that the majority of students (51.9 %) were female and, the mean age was 21 years. Statistical tests indicated a significant relationship between levels of motivation, basic psychological needs, and demographic variables. However, the regression coefficients indicated that the need for competence and relatedness could be a suitable predictor for internal motivation.

CONCLUSION

Basic psychological needs satisfaction, especially needs of competence and relatedness in the clinical field by instructors can lead to internalization of their incentive and positive outcomes.

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

AIM

To evaluate the effects of high-fidelity simulation training on attitudes towards older people and empathy among undergraduate nursing students.

BACKGROUND

People 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.

METHODS

A 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.

RESULTS

After 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.

CONCLUSIONS

Our 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.

Does Self-Directed Learning with Simulation Improve Critical Thinking and Motivation of Nursing Students? A Pre-Post Intervention Study with the MAES© Methodology

Motivation and critical thinking are fundamental for the development of adequate learning. The purpose of the present study was to assess the motivation for learning and critical thinking among nursing students before and after self-directed simulation-based training using the MAES© methodology. A cross-sectional and descriptive quantitative study was conducted with a sample of third-year nursing students. The instruments utilized were the Spanish-adapted version of the Motivated Strategies for Learning Questionnaire (MSLQ-44), and the Critical Thinking for Nursing Professionals Questionnaire (CuPCPE). The students improved their levels both of motivation components, (such as self-efficacy, strategy use, self-regulation) and critical thinking components (such as personal characteristics, intellectual and cognitive abilities, interpersonal abilities and self-management, and technical abilities). These improvements could be a result of the intrinsic characteristics of the MAES© methodology (as a team-based, self-directed, collaborative and peer-to-peer learning method).

What do I take home after the simulation? The importance of emergent learning outcomes in clinical simulation

BACKGROUND

Clinical simulation learning includes a debriefing after the simulated experience. Debriefing consists of several stages. In this work we focus on the last stage (summary or transfer phase), in which the participants present the most relevant of what they learned during the session.

OBJECTIVES

To analyze the perception of 4th year Nursing Degree students on the most significant aspects they learned during the simulation sessions.

METHOD

A qualitative, cross-sectional and descriptive study was conducted, with students in their last year of the Nursing Degree at the Catholic University of Murcia. The opinions of 67 students from 5 groups, on the debriefing phase, were analyzed, by comparing them with the objectives that were initially proposed during the design of the scenarios used in the simulations.

RESULTS

A total of 78 clinical scenarios were analyzed, with 292 pre-established learning objectives, on a total sample of 67 students. The participants provided a total of 464 learning outcomes that were significant for them, of which 101 coincided with those that were initially planned (21.8%), while the rest, 363 (78.2%), were considered emergent (not planned a priori). For the most part, the learning outcomes described by the students were technical knowledge and/or skills (70.5%), as compared to non-technical knowledge and/or skills (29.5%).

CONCLUSION

For the most part, the learning outcomes considered by the students to be significant did not correspond with the objectives set a priori in the design of the scenarios. Most were emergent elements, especially those that referred to the technical knowledge and skills. The emergent knowledge must be considered crucial by the educators for the teaching and training of students.

Finding the right balance: student perceptions of using virtual simulation as a community placement

OBJECTIVES

Finding appropriate community clinical placements has been challenging in recent years, most especially during the COVID-19 pandemic. During the 2020-2021 semesters, a university in the province of Alberta, Canada chose to use the community health virtual simulation program, Sentinel City®3.1, to provide clinical placements for three groups of undergraduate students. This expository paper, co-authored by students and faculty, sought to further explore how virtual simulation can be used to best support student learning by identifying practices that students find most helpful.

METHOD

Jeffries' (2005) simulation framework was used to guide a quality improvement analysis which explored feedback received from 16 students regarding the use of Sentinel City®3.1 as a clinical placement, with additional contributions from the student co-authors.

RESULTS

Students felt Sentinel City®3.1 was an effective tool to learn community and population health concepts, however, all students indicated that they would have preferred more opportunities to work with real communities.

CONCLUSION

Virtual simulation programs like Sentinel City®3.1 might be best as a learning supplement rather than as students' sole clinical placement experience.

Self-Learning Methodology in Simulated Environments (MAES©) as a Learning Tool in Perioperative Nursing. An Evidence-Based Practice Model for Acquiring Clinical Safety Competencies

Background: The self-learning Methodology in Simulated Environments (Spanish acronym: MAES©, (Murcia, Spain) is a type of self-directed and collaborative training in health sciences. The objective of the present study was to compare the level of competence of postgraduate surgical nursing students in the clinical safety of surgical patients, after training with the MAES© methodology versus traditional theoretical–practical workshops, at different points in time (post-intervention, after three months, six months post-intervention, and at the end of the clinical training period, specifically nine months post-intervention). Methods: We conducted a prospective study with an experimental group of surgical nursing postgraduate students who participated in MAES© high-fidelity simulation sessions, and a control group of postgraduate nursing students who attended traditional theoretical–practical sessions at two universities in Catalonia (Spain). The levels of competence were compared between the two groups and at different time points of the study. Results: The score was higher and statistically significantly different in the experimental group for all the competencies, with a large effect size at every measurement point previously mentioned. Conclusions: The postgraduate nurses were the most competent in the clinical safety of surgical patients when they trained with the MAES© methodology than when they learned through traditional theoretical–practical workshops. The learning of surgical safety competencies was more stable and superior in the experimental group who trained with MAES©, as compared to the control group.