Brazilian undergraduate nursing students’ critical thinking need to be increased: a cross-sectional study

ABSTRACT Objectives: to map Brazilian undergraduate nursing students’ critical thinking level and investigate the correlation between selected sociodemographic data and critical thinking domains. Methods: in this descriptive cross-sectional study, participants’ (N=89) critical thinking was assessed using the Health Science Reasoning Test. Correlation between critical thinking domains and sociodemographic data was assessed using the Pearson correlation coefficient. Results: the overall results showed a moderate level of participants’ critical thinking (mean = 70.7; standard deviation 5.7). A poor performance was identified in 5 of the 8 critical thinking domains. A significant positive correlation was found between education period and critical thinking (p<.001). Conclusions: poor level in students critical thinking domains may lead to negative consequences for their learning outcomes. Further studies should be carried out to confirm our results, in addition to investigation of teaching methods that encourage and ensure the development of students’ critical thinking skills during nursing education.

Haematological nurses' experiences about palliative care trajectories of patients with life-threatening haematological malignancies: A qualitative study

AIMS

To explore haematological nurses' experiences about the palliative care trajectories of patients with life-threatening haematological malignancies.

DESIGN

A qualitative study with a descriptive and explorative design.

METHODS

Data were collected through 12 individual semi-structured interviews of nurses who work with patients with haematological malignancies from four hospitals in Norway. The data were analysed using systematic text condensation. The study was reported according to the Consolidated Criteria for Reporting Qualitative Research checklist.

RESULTS

Three categories emerged from the data analysis: focus on a cure delays integration of palliative care, dialogue with patients facilitates palliative care and the need for enhanced interdisciplinary understanding.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution since nurses' experiences were explored.

En systematisk litteraturstudie om betydningen av ulike ernæringsintervensjoner på utvikling av intensive care unit acquired weakness

Bakgrunn: Stadig flere intensivpasienter overlever kompliserte intensivforløp. I ettertid sliter mange intensivoverlevere med muskelsvakhet, polynevropati og redusert fysisk funksjon som følge av intensive care unit acquired weakness (ICUAW). Ernæring er avgjørende for opprettholdelse av muskler, og flere studier har undersøkt ernæringsintervensjoners effekt på utvikling av ICUAW. Hensikt: Hensikten med denne systematiske litteraturstudien var å undersøke betydningen av ernæring på utvikling av ICUAW. Metode: Denne systematiske litteraturstudien ble gjennomført etter det metodiske rammeverket beskrevet av Booth, Sutton og Papaioannou. Et systematisk litteratursøk ble gjennomført i databasene Cinahl, Medline og Embase. Studier ble inkludert dersom de var randomiserte kontrollerte studier som undersøkte effekten av en ernæringsintervensjon som ble gitt mens pasienten var innlagt på intensivavdeling. Utfallsmålet i de inkluderte studiene måtte være ICUAW eller utfallsmål som favnes av ICUAW-begrepet, som muskelsvakhet, muskelatrofi eller redusert fysisk funksjon. Resultater: Tyve artikler oppfylte inklusjonskriteriene. Ulike ernæringsintervensjoner og ulike målemetoder på muskelsvakhet, muskelmasse og fysisk funksjon ble benyttet i primærstudiene. Studier som målte korttidseffekter av ernæringsintervensjoner, viste sprikende resultater. Ingen av studiene som målte ICUAW etter utskrivelse fra sykehus fant effekt av ernæringsintervensjonen mot ernæringen som kontrollgruppen fikk. Flere av de inkluderte studiene hadde for små utvalg til å finne forskjeller i endepunkt som betegnes som ICUAW ettersom flere av studiene var pilotstudier og andre hadde ICUAW som sekundærutfall.  Konklusjon: Denne litteraturstudien kan ikke fastslå hvilken betydning ernæring har for utvikling av ICUAW. På grunn av at intensivpopulasjonen er en heterogen pasientgruppe, har pasientene derfor ofte ulike behov for ernæring. Fremtidige studier bør designes ut fra intensivpasientenes individuelle ernæringsbehov. Videre er det et behov for standardisering av hvordan ICUAW måles,slik at resultater fra fremtidige studier kan sammenlignes.  ENGLISH ABSTRACT The significance of different nutritional interventions in the development of intensive care unit acquired weakness – a systematic reviewBackground: Enhancements in critical care have resulted in reduced mortality in patients admitted to the intensive care unit (ICU). However, the survivors of critical care experience reduced physical function termed intensive care unit acquired weakness (ICUAW). Nutrition is essential in the preserving of muscles and several studies have examined the effect of nutrition interventions on ICUAW. Aim: The purpose of this systematic review was to examine the significance of nutrition on the development of ICUAW. Methods: This systematic review used the methodological framework described by Booth, Sutton and Papaioannou. A systematic search was conducted in the databases Cinahl, Medline, and Embase. Studies were included if they were randomized controlled trials and investigated the effect of a nutrition intervention administered while the patient was admitted to the ICU. Outcome measures was covered by ICUAW, such as muscle weakness, muscle atrophy, or reduced physical function. Results: Twenty studies met the inclusion criteria. The included studies used different nutrition interventions and different outcome measures to determine muscle weakness, muscle mass, and physical function. The results of short-term outcomes were differing among the included studies. The nutritional interventions did not have effect on ICUAW when measured after hospital discharge. Few of the included studies were powered to find effect on ICUAW as several of the studies were pilot studies or had ICUAW as a secondary outcome. Conclusion: This systematic review found that the evidence is insufficient to determine the effect of nutrition in the development of ICUAW. Future research should consider that the critical care population is heterogeneous, and the patients may have different nutritional needs. There is a need to develop standardized outcome measures for ICUAW so that the results of future studies can be compared.

Simulation-Based Learning Supported by Technology to Enhance Critical thinking in Nursing Students: Protocol for a Scoping Review (Preprint)

Background

Critical thinking is a crucial skill in the nursing profession, so teaching strategies and methodology must be carefully considered when training and preparing nursing students to think critically. Studies on simulation-based learning supported by technology are increasing in nursing education, but no scoping reviews have mapped the literature on simulation-based learning supported by technology to enhance critical thinking in nursing students.

Objective

The proposed scoping review aims to systematically map research on the use of simulation-based learning supported by technology to enhance critical thinking in nursing students.

Methods

The proposed scoping review will use the framework established by Arksey and O’Malley and will be reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping reviews. A systematic, comprehensive literature search was performed in the LILACS, ERIC, MEDLINE, EMBASE, PsycINFO, and Web of Science databases. Pairs of authors independently selected the articles by screening titles, abstracts, full-text papers, and extract data. The data will be analyzed and thematically categorized.

Results

The development of a comprehensive and systematic search strategy was completed in June 2021. The database searches were performed in July 2021, and the screening of titles and abstracts was completed in September 2021. Charting the data began in February 2022. Analysis and synthesis will be performed sequentially, and the scoping review is expected to be complete by May 2023.

Conclusions

The results of this proposed scoping review may identify gaps in the literature and provide an overview of research on the topic of simulation-based learning supported by technology to enhance critical thinking in nursing students. The research may identify nursing students’ reported barriers and enablers for learning critical thinking skills through simulation-based learning supported by technology, and the results may help educators enhance their educational approach through knowledge of students’ firsthand experiences and further development of successful teaching strategies in nursing education.

International Registered Report Identifier (IRRID)

DERR1-10.2196/36725

Technology-Supported Guidance Model to Support the Development of Critical Thinking Among Undergraduate Nursing Students in Clinical Practice: Protocol of an Exploratory, Flexible Mixed Methods Feasibility Study

Background

Critical thinking is an essential set of skills in nursing education, and nursing education therefore needs a sharper focus on effective ways to support the development of these skills, especially through the implementation of technological tools in nursing education.

Objective

The aim of this study protocol is to assess the feasibility of a technology-supported guidance model grounded in the metacognition theory for nursing students in clinical practice.

Methods

Both quantitative (research questionnaires) and qualitative (focus group interviews) approaches will be used to collect data for a feasibility study with an exploratory, flexible mixed methods design to test a newly developed intervention in clinical practice.

Results

The intervention development was completed in December 2020. The intervention will be tested in 3 independent nursing homes in Norway.

Conclusions

By determining the feasibility of a technology-supported guidance model for nursing students in clinical practice, the results will provide information on the acceptability of the intervention and the suitability of the outcome measures and data collection strategy. They will also identify the causes of dropout and obstacles to retention and adherence.

International Registered Report Identifier (IRRID)

DERR1-10.2196/31646

Technological literacy in nursing education: A scoping review

BACKGROUND

Nurses are the key professionals in the introduction, implementation, and use of technology in clinical practice. A lack of technical expertise and technological understanding poses a challenge to the quality of health services and possibly to the safety, dignity, and quality of life of patients. Therefore, possessing technological literacy upon completing nursing baccalaureate studies is essential. However, no previous scoping review has mapped the existing studies of technological literacy in nursing education.

OBJECTIVES

To map and assess the published studies on technological literacy in nursing education and to identify how educational institutions operationalize, teach, measure, and maintain students' technological literacy throughout their educational programs.

DESIGN

A scoping review was conducted using the methodological framework of Arksey and O'Malley. The reporting was guided by the PRISMA extension for Scoping Reviews.

METHODS

A comprehensive systematic search of the MEDLINE, EMBASE, PsycINFO, ERIC, and CINAHL was performed for studies published from January 2008 through March 2020. Two authors independently assessed eligibility and extracted data. The reference lists of the included studies were also examined.

RESULTS

The review included 28 papers from 27 studies. Three thematic groupings with their respective subgroups were identified among the included papers: 1) the acquisition (simulated electronic documentation, diversified learning methods, and evaluation learning focus), 2) the measurement (digital/computer literacy/competence, nursing informatics competence, technology acceptance, and students' interests and preferences in technology), and 3) the maintenance (follow-up evaluation) of technological knowledge and skills.

CONCLUSIONS

Pedagogical models designed to teach an entire process for the acquisition, measurement, and maintenance of technological literacy are lacking. Studies are needed that bring technological competencies to a higher level, including problem-solving and critical thinking. Educators' competencies should be enhanced. Educational institutions need to ensure the readiness of future nurses for a technology-enriched environment by providing the necessary knowledge in technological literacy. "TWEETABLE ABSTRACT": Due to the importance of technological literacy to the nursing profession, educational institutions must ensure that it is taught to nursing students.

Technology-Supported Guidance Models Stimulating the Development of Critical Thinking in Clinical Practice: Protocol for a Mixed Methods Systematic Review

BACKGROUND

Critical thinking is an essential skill that nursing students need to develop. Technological tools have opened new avenues for technology-supported guidance models, but the challenges and facilitators of such guidance models, as well as how they stimulate the development of critical thinking, remain unclear.

OBJECTIVE

We developed a protocol for a mixed methods systematic review to investigate the use of technology-supported guidance models that stimulate the development of critical thinking in nursing education clinical practice.

METHODS

A convergent integrated design following the Joanna Briggs Institute Manual for Evidence Synthesis will be employed. A pair of authors will select the articles by screening titles and abstracts, and the methodological quality of the articles included in the review will be assessed by a pair of authors according to checklists for specific study designs. The data will be extracted using the standardized Joanna Briggs Institute mixed methods data extraction form and following a convergent integrated approach. The thematic synthesis for data transformation will be used.

RESULTS

Development of a comprehensive systematic search strategy was completed in October 2020. The database searches were performed on October 21, 2020. As of January 2021, analysis and synthesis is ongoing. Completion of this review is expected by January 2021.

CONCLUSIONS

By combining evidence from studies with varied methodological approaches, the results should provide broad insight into the use of technology-supported guidance models for clinical practice in nursing education with a focus on the development of nursing students' critical thinking. The results of this mixed methods systematic review can also be used to develop or improve current technology-supported guidance models for clinical practice in nursing education.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/25126.

Use of simulation-based learning among perioperative nurses and students: A scoping review

OBJECTIVES

Simulation-based learning has been extensively explored, especially in baccalaureate nursing programmes. Recently, simulation-based learning has been introduced in perioperative nursing. The aim of this scoping review is to investigate work published on the use of simulation-based learning in the field of perioperative nursing.

DESIGN AND DATA SOURCES

A scoping review was conducted using the methodological framework of Arksey and O'Malley to identify a broad range of relevant literature, regardless of study design. A comprehensive and systematic search was performed using Medline, CINAHL, Eric, Svemed+, PsychINFO and Embase in May 2016 and then was updated in February 2018. Each database was searched for literature published between 1st January 2005 and 8th February 2018.

REVIEW METHOD

Two authors independently assessed literature eligibility and extracted data to answer our research question 'What is known about the use of simulation-based learning in the field of perioperative nursing?'

RESULTS

Nine articles and one doctoral thesis were included in the review. There appears to be a paucity of research or results-oriented evidence regarding the use of simulation-based learning in the field of perioperative nursing. Different goals of simulation-based learning were reported. It was difficult to confirm whether these goals had been reached as none of the articles included control groups, and no evaluations had been undertaken against Kirkpatrick's level 3 to see changes in participants' behaviours, and level 4, to determine whether the training had a positive impact on, for example, patient outcomes.

CONCLUSION

Owing to the lack of research and the inadequate descriptions of design and method in simulation-based learning in most of the articles included, there is little evidence in the existing literature to guide practitioners of this learning in the field of perioperative nursing. This indicates a need for further research in this area.

The last three days of life: a comparison of pain management in the young old and the oldest old hospitalised patients using the Resident Assessment Instrument for Palliative Care

BACKGROUND

Pain is a common symptom in older patients at the end of life. Little research has evaluated pain management among the oldest hospitalised dying patients.

AIMS AND OBJECTIVES

To compare the pain characteristics documented by healthcare workers for the young old and the oldest old hospitalised patients and the types of analgesics administered in the last three days of life.

DESIGN

A retrospective cross-sectional comparative study.

METHODS

The study included 190 patients from a Norwegian general hospital: 101 young old patients (aged 65-84 years) and 89 oldest old patients (aged 85-100 years). Data were extracted from electronic patient records (EPRs) using the Resident Assessment Instrument for Palliative Care.

RESULTS

No significant differences were found between the young old and the oldest old patients with regard to pain characteristics. Pain intensity was poorly recorded in the EPRs. Most of the patients received adequate pain control. Morphine was the most frequently administered analgesic for dying patients. Compared to the oldest old patients, a greater proportion of the young old patients received paracetamol combined with codeine (OR = 3.25, 95% CI 1.02-10.40).

CONCLUSIONS

There appeared to be no differences in healthcare workers' documentation of pain characteristics in young old and oldest old patients, but young old patients were more likely to receive paracetamol in combination with codeine.

IMPLICATIONS FOR PRACTICE

A limitation of the study is the retrospective design and that data were collected from a single hospital. Therefore, caution should be taken for interpretation of the results. The use of systematic patient-reported assessments in combination with feasible validated tools could contribute to more comprehensive documentation of pain intensity and improved pain control.