Snapshots of simulation: creative strategies used by Australian educators to enhance simulation learning experiences for nursing students

Electronic Workflow for High-Fidelity Clinical Simulation in Nursing

Recognizing the importance of following the International Nursing Association for Clinical Simulation and Learning Standards: Healthcare Simulation Standards of Best Practice to ensure a successful simulation-based experience, this study aimed to update an electronic workflow created to guide teachers in the development and conduct of a clinical simulation for undergraduate nursing students, according to the latest evidence published in the International Nursing Association for Clinical Simulation and Learning Standards; implement it for online access; and describe the results of its usability criteria evaluation. It is a technological production and study of quantitative nature, descriptive and exploratory. The workflow was reconfigured according to the Contextualized Instructional Design model. The usability criteria analysis occurred through the application of a questionnaire to 23 undergraduate nursing courses professors. It was possible to identify that the technology reached high levels of global classification among faculty, being classified as "excellent" (M [SD], 81.9 [14.9]) by the final score. In view of the results obtained, it is concluded that the Electronic Workflow for High-Fidelity Clinical Simulation in Nursing can serve as a reference to promote the best simulation-based learning for professional training in nursing.

End-of-life simulation: a cross-field evaluation in an undergraduate nursing programme

BACKGROUND

Death can cause a great deal of anxiety in nursing students for a variety of reasons. They are expected to provide a high level of care for patients, give the family the respect and patience they deserve and contend with the associated emotional attachments. This raised the question in today's educational world-can the use of technology and simulation aid students in preparing for an end-of-life scenario as part of an undergraduate nursing programme?

AIM

To explore the efficacy of the use of simulations in end-of-life care.

METHOD

A small study focusing upon the evaluation of an end-of-life simulated scenario for undergraduate second year cross-field Bachelor of Nursing students in a university setting. The simulated scenario consisted of a young patient who was dying and her mother. This project used a mixed approach to address varied students' learning styles and combined the need for visualisation and more structured base-sessions on the topic of death and end-of-life care. One student from the cohort group was randomly assigned as the nurse in charge, while other students were allocated to a scenario (out of a potential four) and provided care in real time. Subsequently, the impact of the scenario was assessed and students were immediately debriefed. Students' response to the scenario was important and needed to be considered, as it directly influenced the debriefing. There were some significant differences between how the students approached the scenario and their reaction to it.

RESULTS

Of the students who took part in the end-of-life simulated scenario, the majority strongly agreed that the simulation increased their clinical reasoning and learning.

CONCLUSION

The end-of-life scenario was deemed beneficial, despite the emotional impact on the learners involved.

A visit with Viv: Empathising with a digital human character embodying the lived experiences of dementia

The Visit, an immersive participatory artwork (viewed on a screen or virtual reality headset), was produced as part of a research programme investigating the subjective experience of dementia and the relational dynamic between people with dementia and others. It invites viewers to engage with a digital human character, 'Viv', as she shares her experiences of living with dementia. The experiences that Viv recounts are based on verbatim accounts from in-depth interviews with four women living with dementia. The artwork was designed with the combined aim of generating insights into the lived experience of dementia and establishing conditions under which viewers might cultivate empathy for the character portrayed. Viewers engaging with Viv were invited to complete pre- and post-engagement measures of state empathy alongside an assessment of emotional distance. State empathy was significantly greater after engaging with The Visit, and correspondingly, there was a significant decrease in emotional distance (aversion), suggesting that the aims were met.

Simulation in Clinical Nursing Education

Background:

Simulation constitutes a teaching method and a strategy for learning and understanding theoretical knowledge and skills in the nursing and medical field.

Objective:

To review and present modern data related to this issue.

Methods:

Literature review of data related to the issue derived from Medline, Cinhal, and Scopus databases, in English, using the following keywords: nursing, simulation, simulator, nursing laboratory.

Results:

The implementation of simulation enables students to practice their clinical and decision-making skills for some significant issues they may face in their daily work. The protected environment and the sense of security enhance students’ self-esteem and confidence, thus promoting learning. In this way, the gap between theory and practice is substantially reduced.

Conclusion:

The further development of simulation, along with other instructional techniques, can significantly help the efforts made by the students to become integrated and successful healthcare professionals.

Quick Response Codes: An Innovative Approach to Just-in-Time Education

BACKGROUND

Many nurses are digital natives who have grown up with advanced technology. Bedside competence is essential, and written policies and procedures guide our practice. Newer learning styles, time constraints, and available personnel may be barriers to historical approaches to information dissemination.

METHODS

Quick Response code technology was incorporated to provide just-in-time resources that can be readily accessed at the point of care.

RESULTS

Nurses have incorporated Quick Response codes in novel ways to provide quick resources in a dynamic environment. Examples include orientation documents, educational rollouts, infrequently used and high-risk equipment, and leadership updates.

IMPLICATIONS

Bedside nurses in our institution have embraced this technology. Benefits include engagement, increased knowledge, and a sense of value among our nursing team.

Evaluation of a nursing and midwifery exchange between rural and metropolitan hospitals: A mixed methods study

Introduction

This paper reports on the findings of the Nursing and Midwifery Exchange Program, initiated to promote rural and remote nursing and midwifery, and to facilitate clinical skills development and clinical collaboration between health services in Queensland, Australia. The project was undertaken over an 18-month period in one state of Australia, offering structured, temporary exchange of personnel between metropolitan and rural health services.

Background

Globally, there is an increasing awareness of nursing shortages, and with it, the need to ensure that nurses and midwives are prepared for specialist roles and practice. This is particularly important in rural and remote areas, where there are pre-existing barriers to access to services, and difficulties in attracting suitably qualified, permanent staff.

Methods

A mixed methods approach to the evaluation was undertaken with two cohorts. One cohort was the nurses and midwives who participated in the exchange (n = 24) and the other cohort were managers of the participating health services (n = 10). The nurses and midwives who participated in the exchange were asked to complete a questionnaire that included questions related to embeddedness and job satisfaction. The managers participated in a Delphi series of interviews.

Results

Those who participated in exchange reporting a higher score on the reported degree of understanding of rural client, which was accompanied with a moderate-to-large effect size estimate (d = 0.61). Nurses/midwives in the exchange group reported higher scores on their perceptions of aspects of their home community that would be lost if they had to leave, which was accompanied with a large effect size (d = 0.83). Overall, NMEP was reported by the participants to be a positive way to improve professional development opportunities for nurses and midwives. The findings also show the program supported practical collaboration and raised the profile of nursing and midwifery in rural areas.

Conclusion

Exchange programs support clinical and professional development, raising the awareness of different contexts of practice and related skills requirements, and thereby supporting a greater understanding of different nursing roles. In the light of increasingly complex care required by patients with chronic conditions being managed in community-based services, programs such as NMEP provide the opportunity to build collaborative networks between referring and referral centres as well as contribute to the ongoing skills development.

Shared learning to improve the care for young people and mental health within nurse education (SHYNE). Improving attitudes, confidence and self-efficacy

Preparing students for the complexities of practice is an ongoing challenge of pre-registration nurse education. One such complexity is the increase in children and young people with mental health problems. Pre-registration student nurses from child and mental health specialisms from one University participated in an innovative simulation session, whereby actors from a youth theatre group simulated young people admitted to an acute non-mental health hospital setting for treatment of self-harm injuries. This study used an uncontrolled pre and post design to determine the impact of the session on student nurses' attitudes, confidence and self-efficacy when caring for young people who self-harm. Attitudes towards self-harm was measured using a 13 item self-report questionnaire. Confidence was measured through Likert scale responses. Self-efficacy for working with children and young people who have self-harmed was measured through an adapted version of the Self-Efficacy Towards Helping (SETH) scale. In total 101 student nurses took part in the study and 99% completed post simulation outcome measures. At post-session, the students reported a statistically significant improvement in attitudes, self-efficacy and confidence towards children and young people who self-harm. A lack of confidence is frequently reported in the literature when caring for this client group in practice settings. Improvements in attitudes, confidence and self-efficacy can positively impact individual nursing practice. Furthermore the simulation literature indicates that the skills consolidated using such an educational approach are taken forward into clinical practice. While broad claims of success should be avoided, it is promising to find a learning method that is effective in addressing a contemporary and complex health issue. Shared Learning to Improve the Care for Young People and Mental Health within Nurse Education (SHYNE): Improving Attitudes, Confidence and Self-Efficacy.

Enhancing pre-licenced pharmacists' communication and interprofessional collaboration utilizing the RIPE model of interprofessional learning: A qualitative study

BACKGROUND

Interacting and engaging with other health care professionals can enhance communication and collaboration within the multidisciplinary healthcare team, contributing to improved patient safety and patient outcomes.

OBJECTIVE

To explore the student learning experience utilizing the Reflective Interprofessional Education Model (RIPE) model of interprofessional learning.

METHODS

Qualitative study utilizing data from seven (7) focus groups sessions. Data were transcribed verbatim using a transcribing service; and analyzed using Braun and Clarke's 6-phase process for thematic analysis.

RESULTS

Fifty-five Master of Pharmacy pre-licenced students (male n = 25; female: n = 30) participated in the study. The 7 focus groups consisted of 6-8 participants ranging between 18 and 28 min in duration. Thematic analysis generated four key themes: (i) Time management: managing interruptions in a time pressured acute care environment is challenging but necessary; (ii) Learning the Lingo: patient-centered communicating and engaging patients and family in care; (iii) Communication: developing interprofessional communication as a vital skill for healthcare professionals; and (iv) Teamwork: recognizing the importance of teamwork, relationships and respect.

CONCLUSIONS

Students found the simulated, acute care setting challenging for effective communication and collaboration with other health professional team members. It was also perceived that critical patient information can be lost or misinterpreted if there is poor interprofessional communication and collaboration, contributing to iatrogenesis and poor patient outcomes. Effective collaboration was perceived to be beneficial to enhancing confidence with engagement and communication, appreciation and respect for the expertise of other healthcare professions.

Applying integrated video assisted learning approaches for medical clerkship - potential adaptations in the post-COVID-19 era

Lockdowns and social distancing measures due to the ongoing COVID-19 pandemic have forced the delivery and assessment of educational material to be performed via online and virtual educational tools. Such disruption has greatly affected hands-on training programs essential to acquire clinical competencies, particularly modes requiring physical patient encounters. While most educational content has successfully been shifted to predominantly web-conferencing platforms, the essential clinical teaching at affiliated hospitals for undergraduate medicine clerkship years has been severely disrupted due to barring of students from hospital premises to minimise spread of COVID-19, presenting a problem requiring unique solutions to ensure that quality of education and subsequent healthcare is kept sufficiently high. To this degree, technological advances increasingly present several elegant solutions which may provide the required levels of educational delivery. In this article, we briefly discuss the number of options that could be deployed to aid in acquisition of requisite skills during the clerkship years, with a focus on wearable technologies and video recording/broadcasting. Given the ongoing pandemic, application of technological advances could provide, with some global coordination, the medical education community with numerous proactive solutions rather than just educational luxuries or novelties.

Literature review of audiovisual practices in Nursing education

ABSTRACT Objective: to carry out a literature review to characterize the production in the Nursing area about the use of movies and videos in Nursing education, related to underlying communication assumptions and contents taught. Method: integrative bibliographic review carried out in the PUBMED databases, CAPES journal portal, and SCIELO online library, with studies from 2007 to 2016. Results: 36 articles were included, in which audiovisual resources are part of the research subject. There are predominance of validation and effectiveness studies, in which audiovisual resources are used mostly as a reproduction of reality, mainly to develop clinical skills, with the purpose of illustrating procedures or bringing students closer to real contexts of action. Final considerations: the results point to a weak theoretical support of most of the studies. It is suggested that more empirical research be conducted to offer more consistent contributions to Nursing teaching.

Budget Friendly Simulation for Clinical Nursing Education: Putting It All Together

Clinical simulation in nursing has become increasingly valuable in helping students learn tasks and assessments in a nonthreatening environment. Evaluating student assessments can promote collegiality among faculty. This article focuses on three tips for faculty used by one university to objectively capture a clinical snapshot in a cost-effective manner: 1) write one's own scenarios, 2) create assessment forms using Word, and 3) employ bar scanning with quick response code readers.

Therapeutic communication in nursing students: A Walker & Avant concept analysis

Background and aim

Therapeutic communication, the fundamental component of nursing, is a complex concept. Furthermore, the poor encounters between nursing student and patient demonstrate the necessity of instruction regarding therapeutic communication. The aim of this study was to define and clarify this important concept for including this subject in the nursing curriculum with more emphasis.

Methods

A literature search was conducted using keywords such as “nursing student”, “patient” and “therapeutic communication” and Persian-equivalent words in Persian databases (including Magiran and Medlib) and English databases (including PubMed, ScienceDirect, Scopus and ProQuest) without time limitation. After extracting concept definitions and determining characteristic features, therapeutic communication in nursing students was defined. Then, sample cases, antecedents, consequences and empirical referents of concept were determined.

Results

After assessing 30 articles, therapeutic communication defining attributes were as follows: “an important means in building interpersonal relationships”, “a process of information transmission”, “an important clinical competency”, “a structure with two different sections” and “a significant tool in patient centered care”. Furthermore, theoretical and clinical education and receiving educators’ feedback regarding therapeutic communication were considered as antecedents of the concept. Improving physical and psychological health status of patient as well as professional development of nursing students were identified as consequences of the concept.

Conclusion

Nursing instructors can use these results in order to teach and evaluate therapeutic communication in nursing students and train qualified nurses. Also, nursing students may apply the results to improve the quality of their interactions with patients, perform their various duties and meet patients’ diverse needs.

Virtual versus face-to-face clinical simulation in relation to student knowledge, anxiety, and self-confidence in maternal-newborn nursing: A randomized controlled trial

BACKGROUND

Clinical simulations can provide students with realistic clinical learning environments to increase their knowledge, self-confidence, and decrease their anxiety prior to entering clinical practice settings.

OBJECTIVE

To compare the effectiveness of two maternal newborn clinical simulation scenarios; virtual clinical simulation and face-to-face high fidelity manikin simulation.

DESIGN

Randomized pretest-posttest design.

SETTING

A public research university in Canada.

PARTICIPANTS

Fifty-six third year Bachelor of Science in Nursing students.

METHODS

Participants were randomized to either face-to-face or virtual clinical simulation and then to dyads for completion of two clinical simulations. Measures included: (1) Nursing Anxiety and Self-Confidence with Clinical Decision Making Scale (NASC-CDM) (White, 2011), (2) knowledge pretest and post-test related to preeclampsia and group B strep, and (3) Simulation Completion Questionnaire. Before and after each simulation students completed a knowledge test and the NASC-CDM and the Simulation Completion Questionnaire at study completion.

RESULTS

There were no statistically significant differences in student knowledge and self-confidence between face-to-face and virtual clinical simulations. Anxiety scores were higher for students in the virtual clinical simulation than for those in the face-to-face simulation. Students' self-reported preference was face-to-face citing the similarities to practicing in a 'real' situation and the immediate debrief. Students not liking the virtual clinical simulation most often cited technological issues as their rationale.

CONCLUSIONS

Given the equivalency of knowledge and self-confidence when undergraduate nursing students participate in either maternal newborn clinical scenarios of face-to-face or virtual clinical simulation identified in this trial, it is important to take into the consideration costs and benefits/risks of simulation implementation.

Use of videos to support teaching and learning of clinical skills in nursing education: A review

Information and communications technology is influencing the delivery of education in tertiary institutions. In particular, the increased use of videos for teaching and learning clinical skills in nursing may be a promising direction to pursue, yet we need to better document the current research in this area of inquiry. The aim of this paper was to explore and document the current areas of research into the use of videos to support teaching and learning of clinical skills in nursing education. The four main areas of current and future research are effectiveness, efficiency, usage, and quality of videos as teaching and learning materials. While there is a clear need for additional research in the area, the use of videos seems to be a promising, relevant, and increasingly used instructional strategy that could enhance the quality of clinical skills education.

Enhancing Nursing and Midwifery Student Learning Through the Use of QR Codes

A recent teaching and learning innovation using new technologies involves the use of quick response codes, which are read by smartphones and tablets. Integrating this technology as a teaching and learning strategy in nursing and midwifery education has been embraced by academics and students at a regional university.

Little people, big lessons: an innovative strategy to develop interpersonal skills in undergraduate nursing students

Learning the skills of child health nursing requires more than technical skill development. Humanistic attributes such as being genuine, accepting and empathic are imperative in gaining the trust of a child and in helping them feel comforted and safe in a health care setting. Interpersonal theory has a long history in nursing and numerous contemporary theories have drawn on the seminal work of Peplau to advance nursing practice. However, rarely has this theory been applied to simulation learning. This paper reports on an innovative simulation technique that blends interpersonal theory with puppets. Qualitative evaluation using focus group method with fifteen undergraduate nursing students revealed that the pedagogy had a positive impact on characteristics of the learner, the learning process and on interpersonal communication skills development. The study deepened insights about the educative process and led to learning impacts that suggest that puppet-based learning is a powerful medium to bridge theory and practice, bringing the importance of interpersonal theory to life for students.