Thai trauma nurses' knowledge of neuroprotective nursing care of traumatic brain injury patients: A survey study

Improving Cognitive Empathy Through Traumatic Brain Injury Experiential Learning: A Novel Mixed Methods Approach for Speech-Language Pathology Graduate Education

PURPOSE

The aim of this study was to gauge the impacts of cognitive empathy training experiential learning on traumatic brain injury (TBI) knowledge, awareness, confidence, and empathy in a pilot study of speech-language pathology graduate students.

METHOD

A descriptive quasi-experimental convergent parallel mixed methods design intervention pilot study (QUAL + QUANT) was conducted with a diverse convenience sample of 19 first- and second-year speech-language pathology graduate students who engaged in a half-day TBI point-of-view simulation. The simulation was co-constructed through a participatory design with those living with TBI based on Kolb's experiential learning model and followed the recommendations for point-of-view simulation ethics. After setting goals, participants engaged in four station activities completing cognitive communication activities of daily living, while experiencing manipulations to their sensory systems. Activities included reading while wearing goggles with blurred or double vision, listening with tinnitus and auditory processing disorder, and taking notes during a manipulated college lecture. Participants also interacted with an individual living with TBI and responded to targeted prompts throughout the day. Quantitative outcomes were measured using published TBI knowledge and empathy scales and analyzed with descriptive, parametric and nonparametric statistics, while qualitative data were analyzed through thematic analysis. Data were then triangulated through mixed methods. Mixed methods design quality was ensured by following the Mixed Methods Appraisal Tool (Hong et al., 2018).

RESULTS

After experiential learning, significant increases in speech-language pathologist (SLP) TBI knowledge, empathy, and awareness of TBI symptom and symptom impacts were found. Many, but not all, participants also reported changes in clinical confidence.

CONCLUSIONS

Cognitive empathy training using experiential learning appears to be a viable method to increase SLP knowledge, empathy, and symptom awareness for TBI clinical care. Future research should replicate the study with different types and locations of speech-language pathology graduate programs to consider TBI empathy training as a standard training method to improve both individual and provider outcomes.

PLAIN LANGUAGE SUMMARY

Individuals and families living with traumatic brain injury (TBI) say their providers lack necessary knowledge; do not seem to understand what living with TBI is like; and can be dismissive, uncaring, and lacking empathy. Health care providers do not automatically imagine the world from the patient's perspectives, to "walk in another's shoes"; it takes intentional effort and training. This project attempted to train those specific empathy skills for speech-language pathology graduate students through experiential learning. Experiential learning is a process where people engage in meaningful activities and spend lots of time reflecting on their experiences. Working with people living with TBI, we built a half-day workshop where 19 graduate students completed normal daily activities (such as texting, reading) through different stations that provided insights into what it may be like to have a TBI, such as wearing goggles to induce blurred or double vision, having ringing in their ears (tinnitus), and watching an overwhelming manipulated college video lecture. Afterward, participants listened to a person living with TBI and asked questions. This was important because engaging in activities without interacting with someone living with TBI misses a key idea about listening to and learning from individuals and families. We measured TBI knowledge, empathy, and confidence by looking at surveys pre- and posttraining and reading students' written reflections. Participants reported significant changes in how they think about brain injury and how they will provide clinical care for people living with TBI in the future.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.28098254.

Misconceptions about traumatic brain injury among nursing students: A cross-sectional study

AIM

This study aimed to evaluate nursing students' potential misconceptions about traumatic brain injuries and the relationship between these misconceptions and students' sociodemographic characteristics.

BACKGROUND

Although traumatic brain injuries have severe consequences, misconceptions about traumatic brain injury are widespread among healthcare professionals. Studying misconceptions about traumatic brain injury among nursing students can help enhance nursing curricula for better traumatic brain injury care and rehabilitation.

DESIGN

This is a cross-sectional observational study reported according to the STROBE guideline.

METHODS

We conducted a survey among nursing students in Morocco using a questionnaire "Common Misconceptions about Traumatic Brain Injury". A total of 550 nursing students from multiple nursing institutes in different cities in Morocco participated in the study. We calculated the average percentage of misconceptions for 7 different questionnaire domains. To study the relationship between misconceptions and sociodemographic factors, we used a t-test for independent samples and ANOVA, considering the total score for each participant.

RESULTS

Out of the 550 nursing students who participated in the study, most were female and the 20-21 years old category represented two-thirds of our sample. The domain related to "Amnesia" had the highest rate of misconceptions, followed by "Recovery", while the "brain damage" domain had the lowest rate of misconceptions. The overall mean score of misconceptions was higher than the value defined in our study as a reference cut-off. Interestingly, there were significant differences in the total score of misconceptions based on variables such as age, state of origin, city of the Institute and year of study.

CONCLUSIONS

Misconceptions about traumatic brain injuries were prevalent among nursing students, which could have a negative impact on patient assessment, treatment and education. The findings indicate the need to improve the level of knowledge related to traumatic brain injury among nursing students and to strengthen the nursing curriculum in Morocco.

Evidence-practice gaps in initial neuro-protective nursing care: A mixed methods study of Thai patients with moderate or severe traumatic brain injury

AIMS

This paper aims to identify the frequency and nature of evidence-practice gaps in the initial neuro-protective nursing care of patients with moderate or severe traumatic brain injury provided by Thai trauma nurses.

BACKGROUND

Little is known about how Thai trauma nurses use evidence-based practice when providing initial neuro-protective nursing care to patients with moderate or severe traumatic brain injury.

DESIGN

A mixed methods design was used to conduct this study.

METHODS

Data were collected from January to March 2017 using observations and audits of the clinical care of 22 patients by 35 nurses during the first 4 h of admission to trauma ward. The study site was a regional hospital in Southern Thailand.

RESULTS

The major evidence-practice gaps identified were related to oxygen and carbon dioxide monitoring and targets, mean arterial pressure and systolic blood pressure targets and management of increased intracranial pressure through patient positioning and pain and agitation management.

CONCLUSION

There were evidence-practice gaps in initial neuro-protective nursing care provided by Thai trauma nurses that need to be addressed to improve the safety and quality of care for Thai patients with moderate or severe traumatic brain injury.