Assessment methods and tools to evaluate postgraduate critical care nursing students' competence in clinical placement. An integrative review

The effect of humanistic behavior skills in nursing practice on caregiving competence

BackgroundThe need for care of patients is increasing day by day as societies age. In parallel with the increase in the need for care, the adequacy of the care provided and the factors affecting it gain importance.ObjectiveThis study aims to determine the effect of nurses' humanistic behavior skills on caregiving competence and the factors affecting it.MethodsThe study sample consisted of 445 nurses working in a state hospital and selected by random sampling method. The study data were collected between January and April 2023. Face-to-face interview method was used to collect the data. The questionnaire application was conducted in a period of approximately 15-20 min. The nurse information form including demographic characteristics, the humanistic behavior skills in nursing practice scale (HPAN) and the caregiving competence scale were used to collect the data.ResultsThe nurses' humanistic behavior skills affected their caregiving competence by 0.082. HPAN and age had an effect size of 0.084 on caregiving competence; HPAN, age and gender had an effect size of 0.124 in the triad model; HPAN, age, gender and average overtime worked in a month had an effect size of 0.136 in the quad model.ConclusionsIt was determined that as the humanistic behavior skills of the nurses increased, their caregiving competence also improved. The humanistic behavioral skills of the nurses affect care giving competence at a rate of 8.2%. In addition, age, gender, overtime work and working years also affect care giving competence.

Educational outcomes of emerging teaching methods in undergraduate nursing education: a systematic review and meta-analysis protocol

INTRODUCTION

Undergraduate nursing education is essential in preparing competent and compassionate healthcare professionals capable of addressing the complex challenges in today's healthcare landscape. This protocol proposes a systematic review of the educational outcomes of virtual/augmented reality, flipped classrooms, team-based learning and gamification compared with traditional or didactic methods in undergraduate nursing education.

METHODS AND ANALYSIS

A systematic review protocol based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol guidelines will be conducted. Experimental and observational studies published from 2014 through 2024 will be identified by searching the electronic databases PubMed, Scopus, Embase, Web of Science and CINAHL that compare emerging with traditional or didactic teaching methods among undergraduate nursing students. Two reviewers will independently assess titles and abstracts to identify relevant studies based on eligibility criteria. Two additional reviewers will extract data from full-text articles that meet these criteria, evaluate the risk of bias and assess the quality of the selected studies. The meta-analysis will include effect size, heterogeneity, subgroup analyses and publication bias tests.

ETHICS AND DISSEMINATION

Ethics approval is not required. The publication will be in peer-reviewed journals and presented at national and international conferences.

PROSPERO REGISTRATION NUMBER

CRD42024618288.

Clinical education: nursing students' experiences with multisource feedback using a digital assessment instrument in the emergency medical Service - a qualitative study

BACKGROUND

Clinical education in Emergency services (EMS) is unique due to its dynamic environment, brief patient encounters, and unpredictable cases. EMS provides valuable learning opportunities for nursing students, fostering person-centered care approaches and a variation of clinical training and learning. Formative feedback is crucial to develop knowledge and skills. Multisource feedback (MSF) offers a comprehensive assessment by incorporating feedback from various individuals, promoting self-reflection and targeted learning. MSF has not, to our knowledge, been systematically evaluated in the context of EMS, and therefore, the aim of the study was to describe nursing students' experiences with MSF during their clinical education in the EMS, using a digital instrument as a facilitating tool.

METHODS

A qualitative design with an inductive approach was used. Data were collected in 2021, using focus group interviews (n = 4) with 31 final-semester nursing students in Stockholm, Sweden, who had conducted clinical education in the EMS and received MSF through a digital instrument. Data were analyzed using reflexive thematic analysis, guided by Braun and Clarke's methodology.

RESULTS

Three themes revealed: feedback from sources familiar with the student's learning objectives, feedback from sources unfamiliar with the learning objectives, and general perceptions of MSF in the EMS. Students valued self-reflection and feedback from peers and supervisors for personal and professional growth. Patient feedback was challenging due to their limited contextual understanding and emotional states, while feedback from other healthcare professionals was appreciated but hindered by the healthcare professionals' workload and timing constraints. Overall, students appreciated MSF's diverse perspectives, enriching their learning, performance, and development.

CONCLUSION

This study underscores the value of MSF in nursing students' clinical education within the EMS. Feedback from peers, supervisors, and self-reflection enhances self-awareness, professional growth, and mutual support. Despite challenges like stress and logistical barriers, structured support and a digital instrument improved accessibility and alignment with learning objectives for the students. Incorporating patient and healthcare professionals' feedback enriches education by promoting patient-centred care and collaboration. MSF supported reflective practice, and team dynamics and highlights the need for refined feedback processes to optimize learning and professional development for nursing students during clinical education.

Clinical value analysis of integrated care model in reducing bleeding and complications during Da Vinci robot-assisted urology

This study aims to explore the effect of integrated care mode on patients in Da Vinci robot-assisted urology surgery and provide a new nursing scheme for clinic. A total of 93 patients from August 2022 to March 2024 were selected and divided into intervention group (43 cases) and control group (50 cases). The operation time, blood loss, first postoperative exhaust time, time to get out of bed, pain score (visual analog scale), psychological status (self-rating anxiety scale and self-rating depression scale), quality of life score (36-Item Short Form Survey), catheter retention time, patient satisfaction, incision healing, incidence of urinary system infection, nutritional status, and complication rate were compared between the 2 groups. There were no significant differences in baseline data and operative time between the 2 groups (P > .05), but the amount of intraoperative blood loss in the intervention group (250.32 ± 50.23) mL was less than that in the control group (320.56 ± 65.34) mL (P < .05). The first postoperative exhaust time and getting out of bed time in the intervention group were shorter than those in the control group (P < .05), and the pain visual analog scale score was lower than that in the control group (P < .05). The scores of self-rating anxiety scale and self-rating depression scale of mental state were better than those of the control group (P < .05), and the scores of quality of life were higher (P < .05). The retention time of catheter was shorter than that of the control group (P < .05), the patient satisfaction was 93.02% higher than that of the control group 78.00% (P < .05), and the grade A incision healing rate was 90.70% higher than that of the control group 76.00% (P < .05). The incidence of urinary system infection (4.65%) was lower than that of the control group (16.00%) (P < .05), the changes of serum albumin level and body weight were lower than that of the control group (P < .05), and the complication rate of 6.98% was lower than that of the control group (22.00%) (P < .05). Although the integrated medical care model did not significantly shorten the operation time, it was beneficial to the postoperative recovery of patients in many aspects.

Understanding ICU Nursing Knowledge, Perceived Barriers, and Facilitators of Sepsis Recognition and Management: A Cross-Sectional Study

IMPORTANCE

Nursing workforce changes, knowledge translation gaps, and environmental/organizational barriers may impact sepsis recognition and management within the ICU.

OBJECTIVES

To: 1) evaluate current ICU nursing knowledge of sepsis recognition and management, 2) explore individual and environmental or organizational factors impacting nursing recognition and management of sepsis using the Theoretical Domains Framework (TDF), and 3) describe perceived barriers and facilitators to nursing recognition and management of patients with sepsis.

DESIGN, SETTING, AND PARTICIPANTS

This cross-sectional survey was administered to nurses working in four general system ICUs between October 24, 2023, and January 30, 2024.

MAIN OUTCOMES AND MEASURES

Quantitative questions (single/multiple choice, true/false, and Likert-based questions eliciting agreement with a statement) were analyzed using descriptive statistics. Open-ended questions exploring barriers and facilitators to sepsis recognition and management were analyzed using qualitative content analysis.

RESULTS

A total of 101 completed survey responses were retained. Most nurses agreed early sepsis detection saves lives (n = 98, 97%, TDF domain Beliefs About Consequences) and that nursing care can improve patient outcomes (n = 97, 96%, TDF domain Optimism). Fewer nurses agreed it was easy to identify priority sepsis interventions based on order urgency (n = 53, 53%, TDF domain Memory, Attention, and Decision Processes). Reoccurring barriers and facilitators to sepsis recognition and management were commonly identified across the TDF domains of Knowledge, Skills, Environmental Context and Resources, and Social Influences, including competency deficit (with facilitators including support from colleagues), workload or staffing, and equipment or resource availability.

CONCLUSION AND RELEVANCE

ICU nursing sepsis recognition and management is impacted by numerous individual, environmental, and organizational factors. Recommendations include enhanced competency development or support, utilization of structured reinforcement measures (involving the interdisciplinary team and imploring the use of integrative technologies), and addressing equipment/resource-related gaps. Future research and improvement initiatives should use a theory-informed approach to overcome the pervasive, complex challenges impeding timely sepsis recognition and management.

Improving the evaluation of clinical competence in undergraduate students, evidence and technology: An integrative review

BACKGROUND

Assessment of clinical practice is integral to determining nursing students' knowledge, critical thinking, and overall clinical competency to ensure patients are receiving quality care. There are no best practice approaches to evaluating competency in undergraduate nursing students despite the necessity to attest to how students are meeting regulatory standards upon graduation. The use of technology in healthcare and post-secondary institutions has increased, however, within nursing education, technology use for clinical evaluation remains largely underused.

PURPOSE

This integrative narrative review aimed to synthesize literature on evaluating undergraduate nursing students' clinical competence and the role of technology in enhancing the assessment process.

METHODS

An integrative review was conducted to inform quality improvement projects relative to the assessment of students' clinical performance in an undergraduate nursing program in Canada. Authors searched the Cumulative Index to Nursing and Allied Health Literature (CINAHL) database for articles relating to competency, clinical performance evaluation, clinical evaluation tools, formative and summative evaluation, and technology in clinical evaluation. The main questions guiding this review were: How is competence assessed in relation to undergraduate students' clinical performance? And, how can technology enhance the assessment of students' clinical performance?

RESULTS

A total of 34 articles were included in this review. Current clinical evaluation processes use a combination of methods and tools to evaluate students' competence, however, there remains room for ongoing advancements. Adopting technology into the evaluation process can help students better understand competencies and learning outcomes, receive near real-time feedback from clinical instructors, and promote critical self-reflection. Technology has also reduced student and faculty workload with a more efficient and streamlined process. Further research is needed to understand how technology can best be incorporated into clinical evaluation processes.

CONCLUSION

Though under-researched, technology has been shown to be a valuable tool in the clinical evaluation process to promote student engagement in the assessment of clinical performance. In addition, considering factors such as the student and faculty relationship, preferences for feedback, and overall workload in the design of clinical evaluation processes is necessary.

Pass or fail: Teachers' experience of assessment of postgraduate critical care nursing students' competence in placement. A qualitative study

BACKGROUND

Learning in placement is essential to postgraduate critical care nursing students' education. Assessment of students' competence in placement is important to ensure highly qualified postgraduate critical care nurses. The placement model applied in Norway involves students being assessed by a preceptor in practice and a teacher from the university. The teacher has a more distant role in placement, and the aim of this study was to explore how the teachers experience the assessment of postgraduate critical care nursing students' competence in placement. Additionally, to explore the content of assessment documents used for postgraduate critical care nursing placement education in Norway.

METHODS

This study has a qualitative design with main data collection from individual interviews with 10 teachers from eight universities and colleges in Norway. Additionally, we performed a document analysis of assessment documents from all 10 universities and colleges providing postgraduate critical care nursing education in Norway. We followed the Consolidated Criteria for Reporting Qualitative Research.

RESULTS

The teachers experienced the assessment of postgraduate critical care nursing students' competence in placement as important but complex, and some found it difficult to determine what critical care nursing competence is at advanced level. A thematic analysis resulted in one main theme: "Teacher facilitates the bridging between education and practice." Furthermore, three themes were identified: "Assessment based on trust and shared responsibility"; "The teacher's dual role as judge and supervisor"; and "A need for common, clear and relevant assessment criteria".

CONCLUSIONS

Teachers have a key role in placement as they contribute to the bridging between education and practice by providing valuable pedagogical and academic input to the assessment process. We suggest that more teachers should be employed in joint university and clinical positions to enhance the collaboration between practice and education. Clear and relevant assessment criteria are essential for providing assessment support for both students and educators. Education and practice should collaborate on developing assessment criteria. Further, there is a need to collaborate on developing, both nationally and internationally, common, clear, relevant and user-friendly assessment tools.

Professional competence required in advanced practice nursing in critical care: An exploratory qualitative study

AIM

To identify the required competencies of advanced practice nurses (APNs) working with patients in critical care units in Norway.

DESIGN

An exploratory qualitative design.

METHODS

Four focus group interviews were performed with 18 nurses who worked in critical care units. The data were examined by inductive content analysis following Graneheim and Lundman's approach.

FINDINGS

Our study found that APNs in critical care require the following professional competencies to meet the needs of patients characterised by greater age, comorbidities and increased complexity: (1) intrapersonal skills as revealed in the subthemes of self-awareness; motivation and commitment; strong mental health and upholding ethical standards, (2) advanced clinical decision-making skills as identified in the subthemes of integration of theory and practice; complex practical and technical skills; dealing with increased delegated responsibility and taking the lead in managing increased practice complexity and (3) interpersonal skills, including peer guidance, practising collaboratively and the ability to position oneself.

Informal carers' information needs in managing behavioural and psychological symptoms of people with dementia and related mHealth applications: a systematic integrative review to inform the design of an mHealth application

OBJECTIVE

To review and synthesise the evidence on informal carers' information needs in managing behavioural and psychological symptoms of dementia (BPSD) of their care recipients and related mobile health (mHealth) applications to inform the design of an mHealth application.

DESIGN

This is a systematic integrative review guided by Whittemore and Knafl's five-stages framework. Six databases were searched: Cochrane, CINAHL, Embase, MEDLINE, ProQuest and PsycINFO. The key concepts included 'dementia', 'behavioural and psychological symptoms', 'informal carers' and ('information need' or 'mHealth application'). Peer-reviewed full-text articles published in English from 2000 to 2022 were included. The methodological rigour of studies was analysed using the Mixed Methods Appraisal Tool V.2018. Preferred Reporting Items for Systematic Reviews and Meta-Analyses-2020 reporting guidelines were followed.

RESULTS

This review included 34 studies, including quantitative (n=13), qualitative (n=17) and mixed-method (n=4) studies. Four major themes emerged from the reported studies: the need for addressing information needs on managing BPSD, the role of support systems in managing BPSD, self-care for carers and the role of mHealth applications in providing education and support for carers. In managing BPSD, carers seek knowledge about dementia and BPSD, the roles of the carers and misconceptions about BPSD. One study reported an mHealth application to monitor the behavioural issues of people with dementia.

CONCLUSION

Informal carers of people with dementia face a number of challenges when providing care for BPSD of their care recipients. The lack of knowledge on managing BPSD is a significant challenge. Support systems such as professional, social, residential, legal and eHealth have a significant role in managing the BPSD of people with dementia in the community. mHealth interventions are sparse to support BPSD management. These findings can be used in designing an mHealth application that addresses needs related to managing BPSD of informal carers of people with dementia.

PROSPERO REGISTRATION NUMBER

CRD42021238540.

An integrative literature review of kidney transplantation knowledge tools

PURPOSE

This study aimed to identify knowledge measurement tools for kidney transplantation (KT) and confirm their assessment methods, domains, and validity to provide useful information.

DESIGN

An integrative review based on Whittemore and Knafl's (2005) framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines.

METHODS

An integrative search was conducted using four English databases (PubMed, Embase, CINAHL, and the Cochrane Library) and the top three Korean databases (RISS, DBpia, and KISS). Search terms and strategies included ("kidney transplant*" OR "renal transplant*" OR "kidney replace*" OR "renal replace*" OR "kidney graft" OR "renal graft") & (knowledge OR awareness) & (scale OR tool OR instrument OR questionnaire OR inventory). The time limit was set to February 2022. The extracted data included the content of the tools, participants, and psychometrics. Quality of life was assessed using a psychometric grading framework.

RESULTS

A total of 15 studies and 13 tools were reviewed. Of these, seven studies (46.7%) targeted KT patients, five (33.3%) targeted KT candidates, and three (20.0%) included both groups. The number of items in the tools ranged from five to 33 items. Furthermore, seven tools comprised true-false questions and eight multiple-choice questions. The domains of the KT knowledge measurement tool used in each study differed across study participants. Both reliability and validity were confirmed in six tools, and only two showed a grade of "adequate" or higher.

CONCLUSION

A validated tool is required to measure KT knowledge. These tools can be used to evaluate the effectiveness of educational interventions in promoting self-management after KT.

PROTOCOL REGISTRATION NUMBER

CRD42022334559.