Usability testing of the sexual orientation and gender identity nursing education eLearning toolkit and virtual simulation games

Development and Usability Testing of a 3D Virtual Simulation Game in Teaching Intravenous Fluid Therapy in Nursing Education

Objective: To describe the gamification process of peripheral intravenous catheterization (PIVC) and intravenous fluid therapy (IFT) in nursing education and conduct usability testing of the 3D virtual simulation game. Materials and Methods: A 3D virtual simulation game was developed to teach PIVC and IFT based on the current literature, Kolb's Experiential Learning Theory, and Schell's Elemental Tetrad. The game, IntraveNurseGame, had 11 stages, and it rewarded the players with score-based titles based on Benner's clinical competence stages. Usability testing was conducted with 17 participants, including 5 nursing experts and 12 senior nursing students. Heuristic evaluation with experts, think-aloud method, and user tests were performed using the Game Evaluation Questionnaire and GUESS-20-TR-Scale. Qualitative and quantitative data analysis were used. Results: Experts were satisfied with the game experience and had fun. The game met their expectations and could help the nursing students learn the subject. Experts provided suggestions, including visual similarity of some animations, instructions regarding how to use the mouse cursor, and encouragement for students to remember the steps of the actual procedure by removing the instructions from some stages. Users scored the GUESS-20-TR mean score above the moderate level (5.71 ± 0.90), showing they were satisfied with the gaming experience. Conclusion: The 3D virtual simulation game had good usability features with some areas of improvement. The theories and elements used in this study can help nurse educators and researchers develop effective games and engaging game-rewarding systems. The usability testing provided valuable information for the games to be developed in the future.

Embedding cultural safety in nursing education: A scoping review of strategies and approaches

INTRODUCTION

Post-secondary institutions can no longer ignore calls to action. Nursing programs are responsible for addressing racism and discrimination by integrating cultural safety into baccalaureate nursing curricula. This scoping review of peer-reviewed literature will reveal how cultural safety is integrated into nursing education across North American post-secondary institutions.

MATERIALS AND METHODS

57 records met the criteria for this scoping review between the dates of January 2016 to July 2024. The database search was conducted from November 7, 2021, to November 9, 2021, and then updated on September 17, 2024, to include articles up to and including July 2024, yielding 3444 total search results (1448 from Medline; 1996 from CINAHL). Results were manually screened, and duplicates found were removed.

RESULTS

The articles were analyzed thematically to identify strategies for integrating cultural safety into undergraduate nursing education. Four main themes were identified: experiential, theoretical, analytical, and multimodal learning.

CONCLUSION

This scoping review highlights nurse educators' role in fostering cultural safety and the importance of considering multiple strategies in curricular development. Strategies include practice experiences, simulations, storytelling, and case-based learning. To provide safe nursing care, education must be inclusive and responsive to people of all races, genders, abilities, and sexual orientations. By applying the concept of cultural safety to nursing education, students are required to acknowledge bias and address issues of power, colonialism, racism, and discrimination that exist in healthcare. These findings provide a foundation for future, more focused research. Further studies could expand on this work by evaluating the effectiveness of specific pedagogical strategies and exploring ways to better support nurse educators in promoting culturally safe learning environments.

Gender inclusive and affirming practices across undergraduate nursing curriculum: A scoping review

OBJECTIVES

There are increasing calls for gender affirming care, yet there remains uncertainty as to how nursing education is preparing students. The purpose of this scoping review was to map gender inclusive and affirming practices across the three levels of curriculum (formal, informal, and hidden) in the education of undergraduate nursing students. This novel approach allows consideration of transgender and gender diverse nurses (students and educators).

DESIGN

Scoping review as per Arksey and O'Malley and Levac et al. DATA SOURCES: Four databases (Medline, Embase, CINAHL, and Scopus) were searched for literature that addressed transgender and gender diversity, discussed at any level of curriculum. In addition, we searched key schools of nursing websites for inclusion of gender inclusive and affirming practices in documents and faculty profiles. We limited our search of peer-reviewed articles and websites to those in English, from Canada and the USA.

REVIEW METHODS

The article search and extraction were conducted by two independent reviewers while the school of nursing websites were searched by the lead author.

RESULTS

Forty-seven articles were included and categorized as either (a) Doing (n = 32) (formal, intervention-based) or (b) Thinking (n = 15) (discussion- or evaluation-based) gender inclusive and affirming practices. Twenty-five of the intervention-based articles were single-instance occurrences of learning, primarily by simulation (n = 17). Recommendations at each level of curriculum are offered. Of the 22 schools of nursing websites searched, less than 2 % of faculty profiles list pronouns.

CONCLUSIONS

While there has been an uptake of formal interventions on gender affirming care there remains a gap in addressing gender inclusive and affirming practices at the informal and hidden curriculum levels. Gender inclusive and affirming practices across all levels of nursing education can help advance culturally safe practices for TGD patients and experiences for TGD nurses and students.

Analysis of Inclusive Gender, Sexuality and Sexual Orientation Data Elements in Academic Electronic Health Records

Findings from an analysis of three vended academic electronic health records used in health science education are presented in this article. The quality assurance project examined the lexical and semantic fit and content coverage of gender, sexuality, and sexual orientation data elements within the academic electronic health records. A semantic comparative content analysis using a cognitive walkthrough was conducted as a means of comparing the ideal set of gender, sexuality, and sexual orientation data elements with those found in the three vended academic electronic health records. The results indicated a need for alignment to the research literature, expert consensus, and technical standards similar to what is expected for electronic health records used in clinical practice because of a lack of ideal state data elements. The findings align with ongoing issues with bias and disparities seen in the care of the lesbian, gay, bisexual, and transgender population and a lack of diverse, inclusive media and teaching technologies in health science education. The quality project and findings can inform academic electronic health record vendors on how they can create more inclusive systems and bring awareness to healthcare educators about the potential for implicit and explicit bias in their teaching technologies.