Assessing the Impact of Unfolding Case Study Scenarios during High-Fidelity Pediatric Simulation among Undergraduate Nursing Students

Mapping the Landscape of Scenario-Based Simulation Teaching in Nursing: Insights From a Visual Bibliometric Analysis

OBJECTIVE

As scenario-based simulation teaching gains traction in nursing education, a thorough bibliometric analysis is essential to uncover the breadth and depth of existing research, highlight key trends, and address gaps in multicenter studies.

METHODS

This study systematically reviewed articles on scenario-based simulation teaching in nursing published from January 2010 to January 2024, sourced from the Web of Science core collection and Scopus databases. Employing CiteSpace and R language, we analyzed publication patterns, journal distributions, and keyword frequencies to map the field's evolution and collaborative networks.

RESULTS

Our findings reveal a steady increase in publications over the study period, with significant growth noted between 2015 and 2019. Higher education institutions, predominantly from the United States, China, the United Kingdom, and Germany, are at the forefront of research in this area. These nations also exhibit robust international collaborations. Key research hotspots include advancements in medical education methodologies and the integration of modern technologies.

CONCLUSION

This bibliometric analysis provides a comprehensive overview of nursing education's scenario-based simulation teaching landscape. It identifies enduring trends and emerging hotspots, offering a valuable foundation for future research and the development of innovative educational practices.

Active methodologies in teaching the nursing process: Scoping review

AIM

To map the use of active methodologies in nursing education for teaching the nursing process.

BACKGROUND

The nursing process is a systematic approach essential for clinical reasoning, guiding nursing diagnoses and care planning, execution and evaluation. Its teaching requires strategies that engage students in active learning to foster evidence-based practice.

DESIGN

Scoping review performed according to the Joanna Briggs Institute Manual for Evidence Synthesis.

METHODS

The review involved seven steps: defining review questions, establishing eligibility criteria, designing search strategies, screening and selecting evidence, extracting data, analyzing results and presenting findings. Searches were conducted in July 2023 and updated in February 2024 on the databases Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Literature on Health Sciences, Excerpta Medica dataBASE, Medical Literature Analysis and Retrieval System Online, Scopus, Web of Science and Google Scholar. The review targeted graduate and undergraduate nursing students (Population), the nursing process (Concept) and active teaching methodologies (Context), guided by the PCC framework.

RESULTS

The 101 included studies present key active strategies such as clinical simulation, case-based learning, web-based learning, problem-based learning, concept mapping, virtual simulation, electronic record systems, clinical practice and laboratory activities. Nursing assessment was the most frequently taught step, followed by diagnosis, interventions, evaluation and outcomes.

CONCLUSION

Active methodologies consistently demonstrated positive impacts on critical competencies, fostering critical thinking, clinical reasoning and judgment. Integrating these strategies with traditional approaches in undergraduate nursing curricula enhances the application of theoretical knowledge in clinical practice.

Call to Action: Bolstering the Diminishing Pediatric Nursing Workforce

BACKGROUND

Pediatric workforce shortages became more apparent with coronavirus disease 2019 (COVID-19) and the rise in other viruses. Among factors affecting these shortages are undergraduate and graduate curricula that include pediatric content and clinical experiences.

METHOD

A narrative review was conducted to examine the state of the pediatric nursing workforce, describe curricular models in undergraduate and graduate programs, and determine the effects of these models on pediatric content and clinical experiences as well as subsequent employment in pediatric nursing.

RESULTS

Curricula affect knowledge of pediatric content and clinical ability to practice, potentially resulting in direct care pediatric workforce shortages and subsequently the number of pediatric nurse practitioners, nurse scientists, and faculty.

CONCLUSION

Research is needed on specific shortages in the pediatric workforce, standardization of required pediatric content and clinical hours, and simulation versus in-person clinical experience to prepare graduates for practice, as well as practice perspectives of new graduates' ability to practice. [J Nurs Educ. 2024;63(12):806-812.].

The impact of unfolding case studies combined with think-aloud strategies on the clinical reasoning and self-directed learning abilities of postgraduate students: A mixed methods study

AIM

To conduct unfolding case studies and test their effectiveness in improving clinical reasoning, teamwork and self-directed learning among postgraduate students.

BACKGROUND

Postgraduate students, as advanced nursing professionals in clinical settings, are the driving force behind the rapid development of the nursing profession. Effective clinical reasoning is a fundamental nursing skill that postgraduate students must cultivate, having a direct impact on patient health outcomes. The development and usation of unfolding case studies, which reflect the evolving conditions of patients, combined with think-aloud teaching methods, can enhance postgraduate students' clinical reasoning abilities and foster communication and self-reflection, thereby achieving this goal.

DESIGN

Mixed methods design.

METHODS

The Nurses' Clinical Reasoning Scale and the Nursing Students' Self-Directed Learning Ability Scale were used to evaluate the clinical reasoning and self-directed learning abilities of nursing students. A qualitative exploratory design with a think-aloud interview technique was employed to explore the clinical reasoning process of nursing students in unfolding cases. Twenty-one nursing students completed the questionnaire survey. Data analysis was conducted using Wilcoxon signed-rank tests, Spearman correlations, regressions and inductive content analysis.

RESULTS

After implementing the case study, there was a statistically significant improvement in students' clinical reasoning, self-directed learning and teamwork abilities. Think-aloud analysis revealed that the cognitive strategies most employed by students in clinical reasoning were 'Making choices', 'Forming relationships', 'Searched for information' and 'Drawing conclusions'.

CONCLUSION

Unfolding case studies combined with think-aloud strategies provide a conducive learning environment for postgraduate students, effectively enhancing their clinical reasoning and self-directed learning abilities.

The effect of artificial intelligence supported case analysis on nursing students' case management performance and satisfaction: A randomized controlled trial

BACKGROUND

Rapid developments in artificial intelligence have begun to necessitate changes and transformations in nursing education.

OBJECTIVE

This study aimed to evaluate the impact of an artificial intelligence-supported case created in the in-class case analysis lecture for nursing students on students' case management performance and satisfaction.

DESIGN

This study was a randomized controlled trial.

METHOD

The study involved 188 third-year nursing students randomly assigned to the AI group (n=94) or the control group (n=94). An information form, case evaluation form, knowledge test and Mentimeter application were used to assess the students' case management performance and nursing diagnoses. The level of satisfaction with the case analysis lecture was evaluated using the VAS scale.

RESULTS

The case management performance scores of the students in the artificial intelligence group were significantly higher than those of the control group (p<0.05). There was no statistically significant difference in satisfaction levels between the artificial intelligence (AI) group and the control group (p>0.05).

CONCLUSIONS

The study's results indicated that AI-supported cases improved students' case management performance and were as effective as instructor-led cases regarding satisfaction with the case analysis lecture, focus and interest in the case. The integration of artificial intelligence into traditional nursing education curricula is recommended.

CLINICAL TRIALS REGISTRATION NUMBER

https://register.

CLINICALTRIALS

gov; (NCT06443983).

Effects of an unfolding case study on clinical reasoning, self-directed learning, and team collaboration of undergraduate nursing students: A mixed methods study

BACKGROUND

Clinical reasoning is an essential nursing competency that students must develop to provide safe patient care. Developing and utilizing unfolding case studies, which present constantly changing patient conditions to improve students' clinical reasoning and to foster communication and self-reflection, can help to achieve that imperative.

OBJECTIVES

To develop an unfolding case study and to test its effectiveness in improving clinical reasoning, team collaboration, and self-directed learning.

DESIGN

A mixed methods design.

SETTING

One university in Southern Taiwan.

PARTICIPANTS

Forty nursing students.

METHODS

An unfolding case study was developed based on the clinical reasoning model and unfolding cases model. The Nurses Clinical Reasoning Scale, Self-Directed Learning Instrument, and Questionnaire of Group Responsibility and Cooperation in Learning Teams were used. Forty nursing students completed questionnaires and nine of them participated in focus group discussions. Wilcoxon signed-rank, Spearman correlation, regression, and inductive content analysis were used to analyze data.

RESULTS

Students' abilities in clinical reasoning, self-directed learning, and team collaboration were statistically significantly improved after implementation of the unfolding case study. Emergent themes included "patient-centered communication," "group inspiration and learning," "thinking critically and reflecting on oneself," and "applying theoretical knowledge in care to meet patients' changing needs."

CONCLUSIONS

Unfolding case studies provide a safe environment in which nursing students may learn and apply knowledge to safe patient care.

Preparing for practice, the effects of repeated immersive simulation on the knowledge and self-efficacy of undergraduate nursing students: A mixed methods study

AIM

The aim of this study was to compare the effects of two immersive simulation-based education instructional designs, immersive simulation with team deliberate practice and immersive repeated standard simulation, when delivered over the same time on the knowledge and self-efficacy of nursing students.

BACKGROUND

Implementing immersive simulation-based education is not without its resource challenges, making it prohibitive for simulation educators to include it in their curricula. Subsequently, there is a need to identify instructional designs that meet these challenges.

DESIGN

A two-stage mixed methods approach was used to compare the two instructional designs.

METHODS

In stage one, data were collected using questionnaires and differences estimated using analysis of covariance. In stage two, data were collected from two focus groups and analysed using a qualitative content analysis approach. Data were collected as part of a doctoral study completed in 2019 and was analysed for this study between 2022 and 2023. The justification for this study was that the identification of effective designs for immersive simulation remains a key research priority following the increase in allowable simulation hours by the Nursing and Midwifery Council.

RESULTS

In stage one, there was no statistical significance in the participant's knowledge or self-efficacy between the models. In stage two, four themes were identified: vulnerability, development of knowledge, development of self-efficacy and preparation for placement. In contrast to stage one, participants reported that the repeated nature of both designs reinforced their knowledge base increased their self-efficacy, reduced their anxiety levels, and helped them to prepare for placement.

CONCLUSION

The results inferred that both designs had a positive impact on the participants. Overall, participants reported that it helped them prepare for placements. Based on the findings, wherever possible, repeated immersive simulation-based education designs should be used and not a standalone immersive simulation-based education scenarios. If resources allow, this could be either a repeated scenario, or if there are resource constraints to use, over the same time, immersive simulation with team deliberate practice, or a similar model. Thus, giving a potential return on investment, one that supports simulation educators making those sensitive decisions regarding the inclusion of immersive simulation with team deliberate practice in their curriculum. Further research is needed into this area to ascertain the design features that maximise this impact and support a move away from standalone scenarios to an approach that uses repetitive immersive simulation.

Development of clinical decision-making among undergraduate nursing students: the effect of unfolding case-based learning

OBJECTIVES

This prospective cohort study evaluated the effect of unfolding case-based learning on undergraduate nursing students' self-perceived clinical decision-making ability.

METHODS

Students' self-reported responses to Jenkins's Clinical Decision Making in Nursing Scale were compared between the unfolding case-based learning cohort (n=140) and the comparison cohort (n=126) at a school of nursing in the United States.

RESULTS

The results revealed similar students' responses between the two study cohorts. However, unfolding case-based learning significantly increased students' perceived proficiency in "search for information and unbiased assimilation of new information".

CONCLUSIONS

Findings from the present study highlight possibilities presented by unfolding case-based learning in undergraduate nursing education. The study supports that unfolding case studies can be introduced early on, and then nurtured throughout the undergraduate program to influence the development of nursing students' clinical decision-making skills.