Training Nursing Skills: A Quantitative Study of Nursing Students' Experiences before and after Clinical Practice

Mid-career switch nursing students' perceptions and experiences of using immersive virtual reality for clinical skills learning: A mixed methods study

BACKGROUND

There has been an increase of mid-career professionals joining nursing. These adult students possess significant expertise in other areas and may benefit substantially in deliberate practice to acquire skills competency using immersive virtual reality (IVR) for clinical procedures before they practise in actual clinical settings.

OBJECTIVES

This study aims to (1) examine the impact of IVR clinical procedures on mid-career switch students in knowledge, game perception and user reaction; (2) to explore the mid-career switch students' perceptions and experiences in using the IVR clinical procedures.

DESIGN

A mixed methods feasibility study was used.

SETTING AND PARTICIPANTS

This study was conducted at a university in Singapore with 34 first-year mid-career switch students.

METHODS

This study is a single-group pre-test and post-test experimental study on learning clinical procedures using IVR in the home setting. The study took place from September to November 2021. Focus group discussions were conducted and analysed verbatim using thematic analysis.

RESULTS

The students demonstrated significant improvement of knowledge for subcutaneous insulin, but overall, the increase in combined scores for both intravenous therapy and subcutaneous insulin were not statistically significant. Three overarching themes included: 1) Learning and practice, 2) Challenges and barriers, and 3) Personal attributes. Most of the participants found the experiences to be engaging, relevant, and satisfying. Some reported experiencing giddiness, headache, and lack of familiarity with technologies.

CONCLUSIONS

IVR simulation can potentially be used as a supplementary learning tool to improve knowledge of clinical procedures in mid-career switch students.

Development and Validation of the Soft Skills Questionnaire for Nurses

Introduction

Skills challenge has been given great attention for its impact on employees' performance. Various approaches have been put forward to design professional development programs that help in preparing nurses to work in the field and ongoing training programs to keep them up to each new method and technique at the interpersonal improvement level.

Objective

To develop and validate a questionnaire that tests the communication and management skills, emotional intelligence, and confidentiality of nurses in Lebanon.

Methods

The questionnaire, consisting of 25 statements, was generated and developed by experts in the field of nursing, soft skills, and questionnaire development. The items of the questionnaire were assessed using face, content, and construct validity and data validation was examined through psychometric properties at the final stage of the validation. Internal consistency and reliability were assessed through Cronbach alpha ( α ). Further analyses were carried out to decide on the number of factors to be extracted using Oblimin Rotation method. All statistical tests were performed using Statistical Package for the Social Sciences (SPSS 20.0).

Results

Nineteen items of the 25-item scale had an I-CVI of 1.00 and the remaining six items had an I-CVI of 0.87. The S-CVI/UA was 0.76 and the S-CVI/Ave was 0.97, which meant that the items were good for the underlying construct. For the psychometric measures, the results were quite accepted and satisfactory. The Kaiser-Meyer-Oklin measure of sampling adequacy and the significance for the Bartlett's test for the whole questionnaire were quite acceptable with 0.680 and 0.000, respectively. Furthermore, the Cronbach alpha (α) value was 0.824 indicating a high internal consistency between the items of the questionnaire. While obtaining exploratory factor analysis for each section, results showed that Oblimin Rotation method should be applied to the last section in which three items were eliminated to maintain a simple factor structure.

Conclusion

This study shows that the 25-item Soft Skills Questionnaire is a valid and reliable tool for evaluating the level of communication of nurses, their emotional intelligence, confidentiality, and management.

Telehealth and Transformation of Nursing Care in Saudi Arabia: A Systematic Review

Introduction

Technological advancements have transformed nursing care, quality, and education across the globe. In the Kingdom of Saudi Arabia (KSA), the inventions and adoption of mobile technologies such as an e-health application (app) called SEHA continue to revolutionize the healthcare system in the country.

Purpose

The present systematic review is aimed at examining the technological impact on nursing in Saudi Arabia. The study provides a comprehensive analysis of telehealth and its role in nursing quality, nursing practice, and education.

Methods

The present study adopted a literature review methodology by deriving data from journal articles from different databases, for example, Web Science, Google Scholar, CINAHL, MEDLINE, and PubMed databases. Inclusive years for the search ranged from 2016 to 2022. A total of eight articles were found dovetailing to meet the research objectives and answer research questions.

Result

After appraising and analyzing the research, the present review found that (Abolfotouh et al., 2019) telehealth in nursing is loosely researched; (Ahmed et al., 2021) telehealth impacts nursing practice and quality by fostering nurse-patient communication promoting positive outcomes, seamless nursing care, and positive experiences; and (Albahri et al., 2021) telehealth and telemedicine is a central tenet of contemporary nursing education and practice.

Conclusion

From these findings, this analysis informed three key recommendations: the need to integrate telehealth into the nursing curriculum, telehealth training, and reskilling among healthcare workers (HCWs) in KSA and further primary studies focusing predominantly on telenursing. Overall, telehealth remains a fundamental transformation of nursing practice that forms a central ideology in the contemporary nursing process.

Nursing Students' Perceptions of Using Virtual Patients to Prepare for Clinical Practice

BACKGROUND

Educators are called on to provide opportunities for students to practice and integrate skills and knowledge to ensure preparation for the complexities of today's health care environment. This study explored nursing students' perceptions of using virtual patients to prepare for clinical practice.

METHOD

This study used an exploratory qualitative design. Four focus group interviews were conducted with 25 third-year nursing students. Data were collected and analyzed using thematic content analysis.

RESULTS

Four main themes and eight subthemes emerged. Main themes included personal engagement, learning environment, organizational factors, and improvement needed. Subthemes included being a computer game player, becoming confident in clinical practice, convenient to practice, an authentic stressful learning environment, organization, better to be combined with mannequin-based simulation, technology difficulties, and aural factors.

CONCLUSION

Although some perceived disadvantages were identified, the use of virtual patients could be an effective strategy to improve nursing students' preparation for clinical preparation. [J Nurs Educ. 2022;61(7):398-402.].

Learning effects of virtual versus high-fidelity simulations in nursing students: a crossover comparison

Background

Simulation is an alternative or complementary method for students who cannot obtain sufficient direct care experience, as they allow students to experience various clinical situations. Mixed learning is becoming increasingly common as a way to provide students with opportunities to experience real-life clinical scenarios. This study compared the learning effects of a virtual simulation and a high-fidelity simulation in a different order of presentation, with a focus on training for premature rupture of membranes in the field maternity nursing. Through this comparison, this study aimed to obtain evidence to support decision-making regarding the most effective way to utilize mixed simulation strategies.

Methods

A quasi-experimental, crossover-design study was performed with two randomly allocated groups of 26 junior nursing students each. The virtual simulation used the vSim® for nursing, and the high-fidelity simulation used a scenario developed by the research team. The learning effects were measured in terms of the problem-solving process, clinical reasoning, reflective thinking, satisfaction with the practicum, and self-confidence. The data collected with a structured questionnaire were analyzed using the Mann–Whitney test.

Results

The virtual simulation-first, high-fidelity simulation-second order led to significantly higher scores for reflective thinking (z = 3.53, p < .001) and self-confidence (z = 2.47, p = .013) than the other order.

Conclusions

The initial application of virtual simulation seemed to improve students’ thought processes, and then high-fidelity simulation seemed to allow them to perform actual practice better. Further trials of mixed learning methods are necessary to maximize learning effects in nursing education.

Trial registration

KCT0005767 at 2021–01-12 registered.

The Effect of Caring Training on the Implementation of Caring Behavior and Work Culture of Nurses in Providing Services to COVID-19 Patients in an Indonesia’s National Referral Hospital

BACKGROUND: Nursing services are one of the criteria for hospital health care. Nurses are the health care workers who have the most contact with patients. Nurses had relatively limited interaction with patients during the epidemic. As a result, it is necessary to increase caring behavior in service delivery. AIM: This study aims to determine the effect of caring training on the implementation of caring behavior and work culture of nurses in providing services to COVID-19 patients in an Indonesia’s National Referral Hospital. METHODS: This study used a quasi-experimental design, with one-group pretest-posttest approach. The study was carried out in Indonesia’s National Referral Hospital. The research was conducted between August and December 2021. The caring training lasted around 4 h. Purposive sampling was used to select the sample, which included as many as 92 persons. The Caring Behaviors Inventory-42 and value culture tools were used to collect data. Questionnaires and observation sheets were utilized to retrieve direct measurement data. The collected data were analyzed using a univariate test and a Wilcoxon test for bivariate analysis. RESULTS: The average age of nurses was 34 years old, with an average working time of 9 years. There was no significant difference in knowledge between before and after care training (p > 0.05). However, there was a significant difference in attitude, work culture, and caring behavior between before and after caring training (p < 0.05). CONCLUSIONS: When nurses provided care to COVID-19 patients in an Indonesian national referral hospital, the caring training had an impact on their behavior and work culture. The hospital should continue a compassionate training program, reinforce it with regulations, monitor assessments, and apply rewords and consequences.

The Effect of Managerial and Leadership Training and Simulation on Senior Nursing Students’ Career Planning and Self-Efficacy

Introduction

Enhancing nursing students’ professional knowledge and integrating simulation and clinical training into students’ education may affect their career planning and development.

Objectives

This study aimed to explore how managerial and leadership training and simulation affect career planning knowledge, career choice, and self-efficacy among senior nursing students. Additionally, it explored how students perceived the training they received.

Methods

This study employed a mixed methods design for collecting quantitative and qualitative data about the training. A quasi-experimental design using a pretest and posttest with a convenience sample of senior nursing students ( N = 80) at a Saudi nursing college guided the quantitative part. Nursing students were introduced to a managerial and leadership training and simulation intervention focused on career knowledge. The career planning questionnaire and a self-efficacy scale were used to collect quantitative data before and after the intervention, and the open-ended questions were used for qualitative data about the training they received. For the quantitative data, we used descriptive and inferential statistics, and for the qualitative data, we used content analysis.

Results

After the training sessions, nursing students’ career planning knowledge and self-efficacy scores were considerably enhanced, with a significant difference and positive associations ( p < .001). Four themes were driven from the qualitative analysis: student engagement, experiential learning and reflection, the teacher's role as facilitator, and teamwork.

Conclusions

Knowledge and preparedness are essential elements for career planning and development. Nursing curricula should provide students with ongoing educational opportunities to help them enhance their career planning and self-efficacy. As well, nurse managers play an important role in shaping the career paths of senior undergraduates and internship nurses. Career counseling sessions and career activities can be scheduled frequently before graduation and during the internship year, which is essential for prelicensure and orientation.

The Impact of a Training Intervention on Detection of Patient-Ventilator Asynchronies in Nursing Students

BACKGROUND AND AIM

Patient-ventilator asynchronies (PVA) are associated to negative outcomes for patients: increased respiratory work, mechanical ventilation time and ICU length of stay, and mortality. Some studies described the positive impact of a training intervention on the knowledge and attitudes of nurses in detecting PVA. The aim of this study was to evaluate the efficacy of a training intervention focused on detection of PVA.

METHODS

A before-after design on a single group of nursing students was used. The training intervention about detection of the correct respiratory waveform through graphic monitoring was conducted in a single edition course of 2 hours, for 25 participants. Measurements of correct detection of PVA through specific competency assessment tool were performed before (T0), immediately after (T1) and at 1 month (T2) from the training intervention between January and February 2020.

RESULTS

19 Nurse students completed the training. A total of 50 questionnaires were distributed (T0; n=19; T1; n=19; T2; n=12). PVA were correctly detected in 67.5% (77) of cases. Statistically significant difference There were differences in trainees performance between T0 and T1 [77,2% (CI95%: 68,7% - 85,8%; p=0.001)] and between T0 and T2 [75% (CI95%: 65,3% - 84,7%; p=0.001]. No significant difference was recorded between T1 and T2 (p=0.83) Conclusions: Nursing students increased their performance on analysis of the graphic monitoring of the respiratory waveforms and detection of asynchronies after a basic training intervention. These skills were retained after 1 month. Nurse student trained about PVA increased their competence potentially employed in critical care settings.

Students' Perspectives on Learning Practical Nursing Skills: A Focus Group Study in Norway

Practical nursing skills are complex and involve technical, theoretical, and practical aspects, caring perspectives adjusted to both patient and circumstances, as well as ethical and moral considerations. Patients' length of stay in hospitals is decreasing, and more advanced patient treatment is conducted in primary healthcare settings. Hence, education and nursing skills need adjustment in line with the rapidly evolving field of practice. Studies emphasize a need to uncover whether the technical aspect of nursing skills, in general, is challenging in students' learning. The aim of this study was to explore students' perspectives on practical nursing skills and how they can best learn these. Three focus group interviews were conducted with registered nurse students and intellectual disability nurse students in their last semester (n = 11). Conventional, inductive content analysis in line with recommendations from Hsieh and Shannon was used to analyze the data. Two main categories with subcategories were identified: (1) the content of practical skills, with subcategories (a) human-to-human relations, (b) organizational competence, and (c) technical mastering and (2) building competence, with subcategories (a) need for supervision, (b) planning the learning situations, and (c) relevance for practice. Students experienced that practical skills did not only include technical aspects but also the ability to establish a relationship to the patient and to organize their working day. Supervising was assumed as essential both when training in the simulation center and in clinical placement, as well as planning of the training, respectively. Students experienced that some skills learned in the university college were less relevant in clinical practice and that certain skills were difficult to perform in practice due to the type of clinical placement. Hence, there is a need to review the approach to and content of practical nursing skills' learning in healthcare undergraduate programs, to prepare students for clinical practice, and to ensure that they build the competence needed in healthcare services.

Building capacities of Auxiliary Nurse Midwives (ANMs) through a complementary mix of directed and self-directed skill-based learning-A case study in Pune District, Western India

Auxiliary nurse midwives (ANMs) play a pivotal role in provision of maternal and newborn health at primary level in India. Effective in-service training is crucial for upgrading their knowledge and skills for providing appropriate healthcare services. This paper aims at assessing the effectiveness of a complementary mix of directed and self-directed learning approaches for building essential maternal and newborn health-related skills of ANMs in rural Pune District, India.

METHODS

During directed learning, the master trainers trained ANMs through interactive lectures and skill demonstrations. Improvement and retention of knowledge and skills and feedback were assessed quantitatively using descriptive statistics. Significant differences at the 0.05 level using the Kruskal-Wallis test were analysed to compare improvement across age, years of experience, and previous training received. The self-directed learning approach fulfilled their learning needs through skills mall, exposure visits, newsletter, and participation in conference. Qualitative data were analysed thematically for perspectives and experiences of stakeholders. The Kirkpatrick model was used for evaluating the results.

RESULTS

Directed and self-directed learning was availed by 348 and 125 rural ANMs, respectively. Through the directed learning, ANMs improved their clinical skills like maternal and newborn resuscitation and eclampsia management. Less work experience showed relatively higher improvement in skills, but not in knowledge. 56.6% ANMs either improved or retained their immediate post-training scores after 3 months. Self-directed learning helped them for experience sharing, problem-solving, active engagement through skill demonstrations, and formal presentations. The conducive learning environment helped in reinforcement of knowledge and skills and in building confidence. This intervention could evaluate application of skills into practice to a limited extent.

CONCLUSIONS

In India, there are some ongoing initiatives for building skills of the ANMs like skilled birth attendance and training in skills lab. However, such a complementary mix of skill-based 'directed' and 'self-directed' learning approaches could be a plausible model for building capacities of health workforce. In view of the transforming healthcare delivery system in India and the significant responsibility that rests on the shoulder of ANMs, a transponder mechanism to implement skill building exercises at regular intervals through such innovative approaches should be a priority.