The Effectiveness of Simulation Use in Transition to Practice Nurse Residency Programs: A Review of Literature From 2009 to 2018

Innovative Technology to Improve Simulation Access for Rural Clinicians

Rural pediatric clinicians face barriers to accessing health care simulation, an educational standard to prepare for high-acuity, low-occurrence (HALO) events. Simulation is typically accessible in urban academic medical centers, as it is resource-intensive owing to the necessary equipment and expertise needed to implement training. Rural hospitals face geographic and financial barriers to providing simulation training. Paradoxically, rural clinicians may benefit from additional training owing to infrequent clinical HALO events in rural centers. Emerging simulation modalities, including mobile simulation, telesimulation, and extended reality, offer more accessible simulation alternatives for rural clinicians, addressing geographic and financial gaps in access.

Preventing Community-Acquired Pressure Injury in Spinal Cord Injury: Simulation for Registered Nurses

PURPOSE

The study purpose was to develop and assess a simulation for registered nurses to apply knowledge, skills, and attitudes in conducting a focused assessment in the clinic setting to prevent community-acquired pressure injuries (CAPrIs) in individuals living with spinal cord injury (SCI).

METHODS

Development, psychometric assessment, and pilot of a simulation for a nurse-patient clinic appointment to prevent CAPrIs at home. Evaluations were conducted via focus group.

RESULTS

The simulation required one round with five experts in preventing CAPrIs in SCI to reach 80% agreement. The simulation with a standardized patient and companion checklist was piloted with ( n = 4) post-baccalaureate registered nurse residents. Evaluation results indicated participants grew in knowledge, skills, and attitudes in conducting a focused assessment on prevention of CAPrIs.

CLINICAL RELEVANCE

Evidence-based nursing education is needed for CAPrI prevention for individuals living with SCI in the community setting. The simulation is replicable.

CONCLUSIONS

The online educational program, simulation, and checklist for nurses promoted knowledge, skills, and attitudes in assessment of CAPrI prevention.

The Role of the Simulation in Supporting Newly Graduated Nurses in Their First 5 Months of Working Transition: Findings From a Mixed-Method Study

AIMS

To understand the role of simulation in ensuring the development of the competencies expected by newly graduated register nurses (NGRNs) from the work initiation up to 5 months of transition.

METHODS

Mixed-method study design. A longitudinal phase employing the Nurse Competence Scale (NCS, from 0 to 100, excellent) to assess the perceived competencies among NGRNs (N = 151) at three time points (first day of work up to fifth month); followed by a qualitative phase involving four focus groups of preceptors (N = 16) to explore the potential role of simulation in the NGRNs' working transition. Integration was performed at findings level, using the building procedures and joint displaying the results.

RESULTS

During the different time periods, variations emerged in the NCS scores from 64.41 out of 100 in the first day of work to 61.82 after 15 days, reaching 69.25 and 73.21 at 3 and 5 months. Nine potentialities have been identified as having simulation supporting NGRNs during their transition to independent practice. Simulation may contribute to develop competencies in some competence domains (diagnostic function, managing situation, therapeutic intervention, quality assurance and working role) while not in others (helping role and teaching-coaching).

CONCLUSION

Early interventions, through integration of simulation sessions into strategies offered at the unit's level may be useful to ensure an effective working transition.

IMPACT

Problem the study addresses: Challenges in transition from education to working settings are increasing given the difficulties of the units in providing time and support to NGRNs.

MAIN FINDINGS

Competencies of NGRNs' are fluctuant in the five first months of work, and sub-optimal in certain domains. Simulation may support the full development of most competencies. Impact on research: Healthcare organisations can support NGRNs to ensure smoother transitions by integrating simulations in their strategy.

REPORTING METHOD

This study was conducted following the Good Reporting of a Mixed-Methods Study.

PATIENT OR PUBLIC CONTRIBUTION

Only healthcare professionals were involved.

Chutes and Ladders: Using Knowles to Guide Nurse Residents up the Benner Ladder Through Facilitation of Nurse Resident Ownership

This article discusses the collaborative efforts of two nurse residency program coordinators to increase engagement and improve outcomes within their respective programs. Inspired by the theories of Patricia Benner and Malcolm Knowles, the authors promoted self-directed learning by introducing resident-led committees. Implementing these committees helped improve program evaluation scores, build camaraderie, and provide personalized experiences for each cohort. [J Contin Educ Nurs. 2024;55(12):560-562.].

Implementing a Critical Thinking Tool to Evaluate Educational Needs for Inpatient Rehabilitation Nurses

BACKGROUND

Most critical thinking assessment tools are resource intensive and require significant time and money to administer. Moreover, these tools are not tailored to evaluate critical thinking skills among inpatient rehabilitation facility (IRF) nurses. This pilot study explores the efficacy of using short videos to evaluate critical thinking for nurses working in an IRF.

METHODS

We developed and filmed 3 clinical scenarios representative of common IRF events that require critical thinking on behalf of the nurse. Thirty-one IRF nurses participated in the study and independently scored their own critical thinking skills using a visual analog scale. Using the same scale, nurse managers and assistant managers who worked closely with the nurses also rated the critical thinking ability of each nurse. The nurse then viewed and responded in narrative form to each of the 3 videos. A scoring rubric was used to independently evaluate the critical thinking skills for each nurse based on the nurses' responses.

RESULTS

Nurses rated their own critical thinking skills higher than mangers rated them (m = 85.23 vs 62.89). There was high interrater reliability for scoring video 1k (0.65), video 2k (0.90), and video 3k (0.84).

CONCLUSION

The results demonstrate efficacy for further study of low-cost alternatives to evaluate critical thinking among neuroscience nurses providing IRF care.

Setting Learners up for Simulation and Clinical Success: Achieving Psychological Safety

Simulation is an effective method for learning and demonstrating competency in the clinical setting. Like protocols used by nurses in the practice setting, simulation educators have standards of best practice to guide their use of simulation for teaching and learning. By using the Healthcare Simulation Standard of Best Practice: Prebriefing, the simulation educators and nurse preceptors can create safe learning and working environments. Incorporating a standard prebriefing method and plan that carries throughout the clinical environment may be one way to decrease stress and anxiety of the nursing team and promote a psychologically safe working environment.

Implementing a Critical Thinking Tool to Evaluate Educational Needs for Inpatient Rehabilitation Nurses

ABSTRACT

BACKGROUND: Most critical thinking assessment tools are resource intensive and require significant time and money to administer. Moreover, these tools are not tailored to evaluate critical thinking skills among inpatient rehabilitation facility (IRF) nurses. This pilot study explores the efficacy of using short videos to evaluate critical thinking for nurses working in an IRF. METHODS: We developed and filmed 3 clinical scenarios representative of common IRF events that require critical thinking on behalf of the nurse. Thirty-one IRF nurses participated in the study and independently scored their own critical thinking skills using a visual analog scale. Using the same scale, nurse managers and assistant managers who worked closely with the nurses also rated the critical thinking ability of each nurse. The nurse then viewed and responded in narrative form to each of the 3 videos. A scoring rubric was used to independently evaluate the critical thinking skills for each nurse based on the nurses' responses. RESULTS: Nurses rated their own critical thinking skills higher than mangers rated them (m = 85.23 vs 62.89). There was high interrater reliability for scoring video 1k (0.65), video 2k (0.90), and video 3k (0.84). CONCLUSION: The results demonstrate efficacy for further study of low-cost alternatives to evaluate critical thinking among neuroscience nurses providing IRF care.

Prepared to learn but unprepared for work: A cross sectional survey study exploring the preparedness, challenges, and needs of newly graduated nurses entering a hospital-based transition program

The study aims to investigate new graduate nurses the perceptions of educational preparedness, their challenges, and their expectations during their transition to hospital care and introduction to work.

BACKGROUND

Previous research has raised questions about new graduate nurses' (NGNs) preparedness for work in the clinical setting, and transition programs have been implemented to smooth the transition process. Information about NGNs' expectations of both transition programs and their introduction to work when first entering the nursing profession is scarce.

DESIGN

A cross-sectional survey design was used.

METHOD

NGNs enrolled in a regional transition program in six hospitals were recruited from three-cohorts during September 2021, January 2022 and September 2022. After responding to a survey both a qualitative and quantitative approach was used when analyzing responses.

RESULTS

Quantitative and qualitative findings derived from 248 NGNs responses showed that 65% of the NGNs perceived that nursing education in general prepared them for clinical work, that they were prepared for and committed to workplace learning but require support from a well-designed transition program as well as from colleagues and managers in their ward unit. The conclusion is that the preparation provided by nursing education as well as organizational factors in the healthcare workplace influence new graduate nurses' readiness for clinical work, the challenges they perceive, and their needs for learning and support.

The value of simulation-based education in developing preparedness for acute care situations: An interview study of new graduate nurses' perspectives

AIM

This study aimed to explore how new graduated nurses experience a one-day simulation based education, contributing to providing care in acute situations two months after completion.

BACKGROUND

Simulation-based education is often offered to new graduated nurses as part of important workplace learning. Simulation-based education is a valid learning and teaching strategy and is suggested as a measure to improve nurses' ability in acute situations. However, studies are often conducted as pre-post evaluations immediately after completion of a simulation. Thus, knowledge of the clinical impact of simulation-based education on actual acute care situations could benefit both research and practice.

DESIGN/METHOD

During the winter of 2021-2022, 14 semi-structured interviews were conducted with newly graduated nurses two months after they completed the simulation-based education and the interviews were analyzed using thematic analysis.

RESULTS

The results are presented in three themes: a structured and shared strategy to handle acute situations, a developed role in acute situations and a more comprehensive understanding of acute situations. The results revealed that simulation-based education can contribute to the ability to care in acute situations in terms of action readiness and broad contextual understanding.

CONCLUSION

Simulation-based education can help develop the ability to care for patients in acute situations. However, differences in participant experiences must be acknowledged and processed in order for the implementation and outcome to be successful.

Effects of Blended Simulation on Nursing Students' Critical Thinking Skills: A Quantitative Study

Introduction

Critical thinking is regarded as imperative to healthcare quality and patient outcomes; therefore, effective strategies in nursing education are required to promote students' critical thinking abilities, leading to their success in clinical work. Accordingly, simulation-based education has been suggested as a measure for achieving this goal.

Objective

The aim of this study was to explore whether a nursing education course with blended simulation activities (hands-on simulations with high-fidelity manikins and a web-based interactive simulation program) could increase nursing students' critical thinking skills.

Method

A quasiexperimental, one-group pretest and post-test design was utilized. Data were collected through premeasurement and postmeasurement using a critical thinking questionnaire and were analyzed using paired sample t-tests, independent sample t-tests, and the nonparametric Wilcoxon signed-rank test. The effect size was calculated using Cohen's d formula.

Results

Sixty-one nursing students (57 women and four men, mean age 30 years) participated in the study. Findings of the paired sample t-test showed a significantly higher mean score for posteducation than pre-education, indicating a significant change in nurses' critical thinking capabilities (p < .001). The results for Cohen's d formula ( - 0.87) of the mean scores between pre-education and posteducation indicated a large effect size. The Wilcoxon signed-rank test also showed a statistically significant increase in the students' critical thinking abilities between pre-education and posteducation measures (p < .001). No statistically significant differences were found in the mean score according to age or sex.

Conclusion

This study concluded that blended simulation-based education can increase nursing students' critical thinking capabilities. As a result, this study builds on the use of simulation as a measure for developing and promoting critical thinking abilities during nursing education.

Learning From Non-Practicing Registered Nurses

One way to increase the number of RNs during a global nursing shortage is to recruit those currently not working in health care to rejoin the workforce. The goal of this project was to assess the attitudes and perceived learning needs of nurses who are not working in health care. An online survey was distributed via social media nursing groups to a self-selected sample of nurses not working in health care for the previous 2 years. Although the response rate was low (n = 18), there was interesting discussion on re-entry to nursing practice. Top reasons stated for not re-entering the workforce included burnout/stress, workplace conditions, lack of education/skills, and pay. Pharmacology, skills, and technology were the top three self-identified learning needs of the participants. Limited programs offer education for re-entry to practice. Nurse educators should develop learning materials to meet the needs of this special population. [J Contin Educ Nurs. 2022;53(11):486-490.].

Ability to Care in Acute Situations-The Influence of Simulation-Based Education on New Graduate Nurses

INTRODUCTION

Simulation-based education is frequently used in transition programs for new graduate nurses. Simulation-based education is implemented as a measure to practice nursing skills, gain experience, and prepare nurses for caring in challenging situations, such as acute situations. However, concerns about the data supporting the use of simulation are obtained from small studies that do not use validated measurement scales.

OBJECTIVE

This study aimed to explore the influence of simulation-based education on new graduate nurses' perceived ability to provide care in acute situations.

METHODS

A total of 102 new graduate nurses participated in simulation-based education as a mandatory part of an introductory program. They completed a premeasurement and a postmeasurement using the Perception to Care in Acute Situations scale. The Wilcoxon signed-rank test and the paired samples t test were used to test the statistical significance of outcomes for the simulation-based education, with the alpha set at 0.05. Cohen's d formula was used to calculate the effect size.

RESULTS

The Wilcoxon signed-rank test on the total scale score showed that simulation-based education resulted in a statistically significant change in the nurses' perceptions of their ability to care in acute situations (N = 99; Z = 7877; P < .001). The paired samples t test showed that the mean posteducation score was significantly higher (P < .001) in the total score. Cohen's d formula (-1.24) indicated a large effect size on the total score.

CONCLUSION

Simulation-based education can provide an effective means of improving new graduate nurses' perceived ability to provide care in acute situations.

Where Do We Go From Here?

The COVID-19 pandemic has impacted nurses transitioning to practice in a variety of ways over the past 2 years. Analysis from the Versant Database comparing new graduate nurses (NGNs) from 2018–2021 revealed a widened practice gap for NGNs in these specialty areas of practice: critical care, perinatal, and emergency. Additionally, NGNs achieved 100% competency validation sooner in 2020–2021. The analysis also revealed greater diversity of NGNs who participated in a transition to practice program in 2020–2021. Based on these findings, this article proposes recommendations for nurse leaders to consider as NGNs transition into the workforce.