Interprofessional Education on Adverse Childhood Experiences for Associate Degree Nursing Students

BACKGROUND

The health impact of adverse childhood experiences (ACEs) is significant. Nurses need knowledge and must work in multidisciplinary teams to address this problem. This study examined the effects of an interprofessional education (IPE) activity with nonhealth care students on associate degree nursing (ADN) students' ACEs knowledge and perspectives on IPE.

METHOD

The mixed-methods approach used a quasi-experimental pretest-posttest design with an intervention and control group and thematic analysis of focus group data.

RESULTS

Readiness for Interprofessional Learning scale mean scores indicated positive baseline IPE perspectives. Scores changed minimally for most measures in both the intervention and control groups on posttest. However, four major relevant themes related to ACEs knowledge and two related to interprofessional learning were identified.

CONCLUSION

IPE with nonhealth care students is an effective way to teach ADN students about ACEs and infuse interprofessional learning in a nonuniversity setting. However, outcomes are best captured with qualitative data. [J Nurs Educ. 2018;57(2):101-105.].

Impact of a Simulated Clinical Day With Peer Coaching and Deliberate Practice: Promoting a Culture of Safety

Nursing education is challenged to shift from task-based proficiencies to higher level competencies with patient safety as a priority. Using a quasi-experimental pretest/posttest design, a simulation-based, peer-coached, deliberate practice clinical substitution was implemented to compare nursing students' knowledge, skills, and attitudes for promoting safety. Our findings demonstrated improved knowledge and skill acquisition in the intervention and control groups. The former trended toward improved team communication attitudes and enteral medication skill performance. Additional research with larger samples is needed to further investigate this innovative strategy.

Use of Mindful Observer to Extend Simulation Learning Experience

Simulation is a teaching strategy that allows students to experience patient care situations in a safe environment. After these experiences, students will understand and respond more readily when exposed in clinical practice. An increase in student enrollment meant incorporating larger numbers of students into simulations. Faculty at an associate degree nursing program decided to use the observer role. At the time, mindfulness was being integrated throughout the curriculum. Use of a mindful observer during simulations resulted in an effective learning strategy as reported by students.

Active Learning Strategies to Enhance Nursing Students' Knowledge of Pharmacology

This article presents the author's experience using gaming and social media to enhance undergraduate nursing students' pharmacology knowledge. Although gaming may help with rote learning, active participation in gaming was not associated with higher exam or final course grades. Active participation in social media, on the other hand, was associated with higher exam and final course grades.

Effectiveness of Integrated Simulation and Clinical Experiences Compared to Traditional Clinical Experiences for Nursing Students

AIM

The focus of this research study was the evaluation of the effectiveness of using high-fidelity simulations to replace 50 percent of traditional clinical experiences in obstetrics, pediatrics, critical care, and mental health nursing.

BACKGROUND

Increasing student admissions to nursing programs require additional clinical learning opportunities to accommodate extra students.

METHOD

Three schools with associate degree nursing programs partnered to identify, implement, and evaluate a creative solution to this dilemma. The resulting quasi-experimental study investigated if substituting half of the conventional clinical experiences with simulations was as effective as traditional clinical activities in obstetrics, pediatrics, mental health, and critical care. One hour of simulation counted for two hours of clinical time. RESULTS Findings indicated combining simulations with conventional clinical experiences resulted in significantly higher scores on the pre-graduation exit exam than traditional clinical experiences alone.

CONCLUSIONS

Findings have implications for articulation and basic students in associate degree nursing programs.

Variability of Passing Grades in Undergraduate Nursing Education Programs in New York State

AIM

The purpose of this descriptive study was to provide information about passing grades and their corresponding numeric grades for undergraduate nursing programs in New York State. An additional purpose was to report on differences in grading between faculty teaching in associate versus baccalaureate nursing programs, full-time versus adjunct faculty, and tenured versus nontenured faculty.

BACKGROUND

There is a paucity of research on grade variability in undergraduate nursing programs.

METHOD

Three hundred eighty-four full-time and 96 adjunct faculty responded to an invitation to complete an online survey.

RESULTS

Grades are not uniformly awarded across institutions. Passing grades ranged from 70 to 85 percent (C- to B+, respectively), with a mean of 74.79 percent.

CONCLUSION

Wide variations in grades in different institutions across the country may undermine grade point average as a reliable measure of education, making it difficult to evaluate individual student performance.

How to succeed as an adjunct clinical nurse instructor

Adjunct clinical nurse instructors who are proactive about staying clinically current and who form collaborative relationships with nurses, physicians and other health care professionals are able to teach safe care and engender staff nurses' trust. It's important for nurse educators to continually work to remain effective in the clinical setting to provide an optimal learning environment for students and optimal working environment for staff.

Effect of simulation on the development of critical thinking in associate degree nursing students

AIM

The purpose of this study was to explore the development of critical thinking for students who received instruction using high-fidelity patient simulation (HFPS) versus low-fidelity simulation (instructor-written case studies).

BACKGROUND

Simulated patient care environments have become increasingly more sophisticated in nursing labs, with HFPS fast becoming the standard for laboratory teaching/learning.

METHOD

A convenience sample of first-semester associate degree nursing students participated in this quasi-experimental study. One group of students received weekly HFPS patient simulations and the other group received weekly case studies. Both groups took a pre- and posttest using the Health Studies ReasoningTest.

RESULTS

Both groups showed an increase in critical thinking skills; however, there was no statistically significant difference between the HFPS and case study groups.

CONCLUSION

Results suggest that high- and low-fidelity simulations are both associated with increases in critical thinking scores.

An initial investigation of the applicability of the Dreyfus skill acquisition model to the professional development of nurse educators

AIM

This investigation represents an attempt to design and validate a skill acquisition model for the nurse educator role.

BACKGROUND

The preparation and role development of nurse educators has become a significant focus for the profession.The NLN Nurse Educator Competencies and skill acquisition theory provide a basis for studying skill acquisition among nurse educators.

METHOD

A total of 339 nurse educators from North Carolina and West Virginia were surveyed using an instrument designed to assess skill among nurse educators.

RESULTS

The survey discriminated among five levels of skill (novice, advanced beginner, competent, proficient, and expert). Participants reported a proficient level of total skill acquisition and a proficient level for each of the eight NLN Nurse Educator Competencies. Internal consistency for the survey tool was high at .977.

CONCLUSION

Results of this study add to the body of knowledge of skill acquisition, role development, and transition.The study provides a unique method to study skill acquisition.

Development and evaluation of web-based animated pedagogical agents for facilitating critical thinking in nursing

The purpose of this study was to evaluate the effectiveness of Web-based animated pedagogical agents on critical thinking among nursing students. A pedagogical agent or virtual character provides a possible innovative tool for critical thinking through active engagement of students by asking questions and providing feedback about a series of nursing case studies. This mixed methods experimental study used a pretest, posttest design with a control group. ANCOVA demonstrated no significant difference between the groups on the Critical Thinking Process Test. Pre- and post-think-alouds were analyzed using a rating tool and rubric for the presence of eight cognitive processes, level of critical thinking, and for accuracy of nursing diagnosis, conclusions, and evaluation. Chi-square analyses for each group revealed a significant difference for improvement of the critical thinking level and correct conclusions from pre-think-aloud to post-think-aloud, but only the pedagogical agent group had a significant result for appropriate evaluations.

A conceptual model to support curriculum review, revision, and design in an associate degree nursing program

In light of declining NCLEX-RN first-write pass rates and the National League for Nursing call to transform nursing education, faculty at an associate degree nursing program in the southeastern United States began the process of intensive critique of its curriculum and program outcomes. Based on in-depth analysis and assessment of program outcomes, a conceptual framework was created to guide curriculum revision, development, and implementation processes. The framework serves as a guide for ongoing and systematic curriculum review and revision based upon evaluation findings. The basis of the conceptual framework was the result of an extensive literature review and an incorporation of the faculty-created philosophy.

Evaluating the impact of scenario-based high-fidelity patient simulation on academic metrics of student success

Despite the ongoing nursing shortage, nurse educators are responsible for preparing students to practice in highly complex health care systems. As nurse educators explore new learning strategies to support an increase in student admissions, they must also evaluate the impact of these strategies on the quality of the educational experience. The study reported here evaluated the impact of scenario-based, high-fidelity patient simulation used to increase student admissions in an associate degree and baccalaureate nursing program in north-central Texas upon students' sense of their own clinical competence, graduating grade point average (GPA), and performance on standardized exit examinations. These are measures commonly used by nurse educators as metrics of success.

The Virtual Clinical Practicum: an innovative telehealth model for clinical nursing education

The Virtual Clinical Practicum (VCP) involves a clinical nursing education delivery strategy that uses video teleconferencing technology to address time, distance, and resource barriers. Technology-delivered education can augment the existing curriculum by increasing student access to clinical experts in specialty areas, thus supporting efficient use of faculty resources. This article describes the implementation of the VCP process and student perceptions of its effectiveness and usefulness. The VCP was shown to be a successful method of clinical nursing education, offering students exposure to clinical situations not available by other means. Opportunities for dialogue, critical reflection, and synthesis allowed students to experience the benefits of a traditional experience, enhanced through technology and tailored to the specific needs of the students. Respondents overwhelmingly recommended further use of the VCP to augment existing clinical nursing education methods.

Becoming a nurse faculty leader: practices of leading illuminated through advancing reform in nursing education

PURPOSE

The purpose of this study was to explore the lived experience of becoming a nurse faculty leader.

BACKGROUND

In a recent study of 24 nurse faculty leaders across the United States about their experience of becoming a leader, many of the participants hesitated to call themselves leaders.

METHODS

This interpretive phenomenological study explored the meaning and significance of nurse faculty leadership. Exemplars of participant leadership development experiences are provided to assist readers in determining how the findings relate to their own practice.

FINDINGS

The data revealed that leadership emerges as an embodied practice when nurse educators become involved in advancing reform. Practical leadership strategies for advancing reform in nursing education are presented.

CONCLUSION

Leadership is learned through three everyday practices of advancing reform in nursing education: being involved with others; struggling to serve as a symbol and preserve authenticity; and creating an environment for change. This study offers new insight on leadership development, with practical implications for how leadership is taught in nursing curriculum and how nurses can more effectively own leadership roles.

HeartCode BLS with voice assisted manikin for teaching nursing students: preliminary results

The purpose of this study was to evaluate the effectiveness of HeartCode BLS, a self-directed, computer-based course for obtaining basic life support (BLS) certification. For part 2 of the course, students learned and practiced their cardiopulmonary resuscitation (CPR) psychomotor skills on a voice assisted manikin (VAM). Students from 10 schools of nursing were randomly assigned to two types of CPR training: HeartCode BLS with VAM or the standard, instructor-led (IL) course with manikins that were not voice assisted; 264 students trained using HeartCode BLS and 339 had an IL course. When students passed their respective courses and were certified in BLS, their CPR skills were tested using the Laerdal PC SkillReporting System. Students who trained using HeartCode BLS and practiced their CPR skills on VAMs were significantly more accurate in their ventilations, compressions, and single-rescuer CPR than students who had the standard, IL course with regular manikins.

Internalizing the concept of caring: an examination of student perceptions when nurses share their stories

Caring should be incorporated in the curriculum and the focus of nursing education. However, measurement of nurses' perceptions of caring abilities remains an area that is not well explored. This pilot study explored nursing students' perceptions of caring and their ability to form caring relationships with clients after hearing clinical nurses discuss their own caring experiences. Fourteen nursing students met with three clinical nurses who shared their stories about caring practice. Results indicate that although there was no statistically significant change, the mean score for caring efficacy was increased postintervention. Student comments also reflect that sharing stories about caring was beneficial, valued, and potentially an effective teaching strategy to help students internalize the concept of caring.

Mentoring as a teaching-learning strategy in nursing

Current nursing and faculty shortages necessitate development of strategies that prepare all students to function in their roles immediately after graduation. This study used a practicum experience through which nurse educator students mentored nursing students to enhance the teaching and learning of both groups. Study methods, evaluation, and results are discussed.

Using the human patient simulator to foster critical thinking in critical situations

New registered nurses are expected to utilize critical thinking when providing care to their patients, especially in critical situations. Using mini-scenarios on the human patient simulator, faculty members can foster critical thinking and expose students to critical situations in a nonthreatening environment. An example of one such scenario, using an oncology patient with hypercalcemia and ventricular tachycardia, is outlined in the article.

Journaling and dialogue pairs to promote reflection in clinical nursing education

This research focused on the use of writing to increase reflection and problem solving in the clinical setting. Two groups of associate degree students provided clinical care and maintained journals, answering a series of focused questions. One group of students worked as individuals in the clinical setting; the other consisted of students working in pairs. There were significant differences between levels of reflection of students who worked in pairs and those who were not paired. Three major themes were found in students' journals: emotions, connections between theory and practice, and learning.

The Triangle Technique: a new evidence-based educational tool for pediatric medication calculations

Many nursing student verbalize an aversion to mathematical concepts and experience math anxiety whenever a mathematical problem is confronted. Since nurses confront mathematical problems on a daily basis, they must learn to feel comfortable with their ability to perform these calculations correctly. The Triangle Technique, a new educational tool available to nurse educators, incorporates evidence-based concepts within a graphic model using visual, auditory, and kinesthetic learning styles to demonstrate pediatric medication calculations of normal therapeutic ranges. The theoretical framework for the technique is presented, as is a pilot study examining the efficacy of the educational tool. Statistically significant results obtained by Pearson's product-moment correlation indicate that students are better able to calculate accurate pediatric therapeutic dosage ranges after participation in the educational intervention of learning the Triangle Technique.

Concept maps as an assessment tool in a nursing course

A concept map can be thought of as a scheme representing visual knowledge in the form of a hierarchical graphic network composed of nodes and links. In the complex health environment, it is very important for nursing educators to cultivate in nursing students thinking and judgment skills. Concept mapping is an instructional strategy that requires learners to identify, graphically display, and link key concepts by organizing and analyzing information. Concept maps can be successfully used to teach conceptual thinking, thus increasing students' competence in critical thinking in the modern paradigm. The purpose of this study was to implement concept mapping as a learning strategy in a nursing course and to evaluate students' learning progress through the construction of concept maps based on scenarios. Forty-three students, who had enrolled in a 2-year nursing program and took Nursing I in the fall semester of 2002, were invited to participate in this study, which was approved by the institutional research committee. Written informed consent was obtained from all the students. The class met for 4 hours, once a week, for 16 weeks. Participants were divided into seven groups, and during the course, they were required to complete six concept maps, five of which dealt with physical functions, including activity and rest, fluids and electrolytes, neuroendocrines, sensory-perception, and sexuality. The last map dealt with role functions. All the first drafts of the concept maps received low scores, but the third and following drafts made by all the teams showed improvement. The results of this study indicated that the students developed their concept maps from a linear sequence of concepts at the beginning into a highly integrated web of concepts in the final draft. In this study, despite complaints about the heavy workload and time consumption, the students acquired problem-solving and critical-thinking skills by organizing complex patient data, analyzing concept relationships, and identifying interventions.

Innovative instructional strategy using cinema films in an undergraduate nursing course

Educators can develop innovative instructional strategies to engage students within the philosophical framework of Constructivism. To that end, the authors used films--Hollywood movies--to enhance their curriculum on neurological and psychopathological illnesses. During the fourth quarter of a seven-quarter associate degree nursing program, students developed case studies of the disorders portrayed in selected films. The authors outline the methods used to implement this approach and discuss evaluations from student and faculty perspectives.

Using Humor to Teach Postpartum Topics

I have found that these two hands-on activities--demonstration and return demonstration, and roleplaying of a postpartum woman--help promote learning in a relaxed environment.

Assigning readings: faculty perceptions and strategies

Nursing faculty routinely assign readings to undergraduate, prelicensure students. When asked what types of readings they required, almost all said they required readings from textbooks. Most expect students to either read or skim all the assignments before class. However, experience has taught faculty that often students do not read. Strategies are provided to enhance reading experiences or provide meaningful alternatives.

Teaching nursing without lecturing: critical pedagogy as communicative dialogue

This article is an interpretive analysis of the author's method of teaching nursing to a diverse student body in an associate degree program. Rather than lecturing, the author and her colleagues facilitate small-group discussions, engaging students in communicative dialogue.This method leads to flexibility and openness to student ideas as well as opportunities to share personal stories and dialogue with students. As a result, students are helped to overcome misunderstanding, misconceptions, and misinterpretations of the nursing literature.

The Professional Socialization of Graduating Students in Generic and Two-Plus-Two Baccalaureate Completion Nursing Programs

This non-experimental, descriptive study explored the differences in professional socialization between graduating students of two-plus-two baccalaureate completion nursing programs and generic baccalaureate nursing (BSN) programs. The survey population was graduating students from NLN-accredited baccalaureate nursing programs in a 15-state region. Autonomy, noted as a mark of professionalism, was measured by the Nursing Activity Scale developed by Schutzenhofer. No significant difference was found between the level of professional socialization of graduating students of two-plus-two baccalaureate completion nursing programs and generic BSN programs. No significant difference was found in professional socialization between students from the two basic RN education programs prior to BSN completion. A positive, but not significant, correlation was found between professional socialization and years of employment as an RN. No significant relationship was found between professional role socialization and area of major nursing experience for the baccalaureate completion nursing students.

Effects of a nursing literature reading course on promoting critical thinking in two-year nursing program students

Critical thinking is essential for professional nursing practice. Promoting critical thinking with teaching strategies has been a focus of nursing education and nursing research. Reading and writing assignments are teaching strategies for fostering critical thinking ability. We developed a course with the emphasis on critical reading and writing. The purposes of this study were to explore the effect of the course and teaching strategies on promoting critical thinking and to understand the learning experience and perception of nursing students as part of the course assessment plan. Quasi-experimental design and purposive sampling were used. 170 students of a two-year nursing program were grouped into an experimental and a control group depending on whether or not they took the course. The change in critical thinking ability was evaluated and determined based on performance in an article critique test before and after the course. Data was collected with an assessment tool developed for the purposes of the research and was analyzed with descriptive statistics, paired t-test, and two-factor analysis of variance with repeated measures and content analysis. The findings were: (1) The scores on the critique test at the end of the course in both groups were significantly higher than before the course (p<.001). The improvement in score of the experimental group, however, was significantly higher than that of the control group (p<.001). (2) Changes in thinking pattern and learning attitude, as well as a feeling of growth and achievement, were found in content analysis of students' self-evaluation of their learning experience and perception. Critical thinking skills were applied while learning the course. The results not only provide evidence to support the positive effect of reading and writing assignments on critical thinking ability but also confirm the teaching and learning activity design for the course.

Collaborative testing: an innovative approach to test taking

Collaborative testing was used with second semester associate degree nursing students during their fluid and electrolyte content to enhance collaboration and joint problem solving. Student nurses were randomly assigned a partner and allowed to change answers to test questions for 10 minutes at the end of the exam. Outcomes included an increase in student comprehension and test scores with decreased test anxiety.

Questions commonly asked about research

In this column Drs. Jacqueline Fawcett, Beryl Pilkington, Callista Roy, Susan Taylor, and Elizabeth Geden answer three questions commonly posed about teaching research, the research critique, and the relationship of research and theory. Contributors independently provided their answers to the questions, so they did not have the opportunity to engage in dialogue with one another.

The Benefits of Humor in Nursing Education

This study was designed to examine the perceived benefits of intentionally using humor in the nursing classroom. A multiple case study of three associate degree nursing instructors and their classes was developed with qualitative methods, which included observations, interviews, and surveys. Data were examined within and across cases for commonality or difference of experience. Strong connections were made between humor and learning. Teachers and students expressed benefits they believed were received from humor. Humor can be an effective, multipurpose teaching tool for nurse educators to convey course content, hold students' attention, relieve anxiety, establish rapport with students, and make learning fun. When combined with other teaching methods, humor can enhance student learning.

The pharmacology game

This article gives instructions for designing a visually attractive, entertaining, faculty-led computer game for pharmacology review in a nursing education program. The game uses Microsoft PowerPoint, a presentation program that is inexpensive, easy to master, and widely available. Instructions for using Visual Basic for Applications to customize the game are included to allow tracking questions asked and the score of groups playing the game. The game can be easily adapted to material by specific nursing programs with access to PowerPoint.

Students' preferences for collaborative learning processes

Collaborative learning processes facilitate problem solving for nurses practicing in multidisciplinary settings. The purpose of this research was to compare preferences of "nontraditional"- and "traditional-aged" students for instructional methods for Associate Degree nursing education. First- and second-year nursing students from nine randomly selected community college programs in North Carolina voluntarily completed the Student Orientations Survey (Morstain, 1976). The survey assessed instructional preferences regarding the purpose of obtaining an associate degree (achievement or imaging), the process (assignments or independent study), and the desired degree of collaboration with faculty (assessment and collaborative interaction). By ANCOVA, first-year students and those recently out of high school were more achievement oriented. First-year students preferred structured assignments and assessment. Older students were inquiry oriented. Second-year students preferred independent study. Second-year students and those aged 18 to 22 years preferred collaborative interaction learning. Ethnic and gender preferences were identified for inquiry and interaction learning.

An Exploration of Content on Legal Aspects of Practice in Nursing Programs

The paucity of literature on legal content in nursing curricula was used to frame the research question that guided this study. In what ways and to what extent are nursing educators addressing the subject of legal aspects of nursing practice? This study was designed to explore the area of legal aspects of nursing practice in nursing programs curricula. The researchers gathered information on numerous areas, including course content, methods of delivery, topics covered, and time devoted to legal content. The results revealed that content on legal aspects of nursing practice is commonly a component of nursing programs curricula and provided information on many areas; however, the results also revealed other areas that need to be researched.

Storytelling as a teaching-learning tool with RN students

The Registered Nurse student returning to school brings both a knowledge base and experiences that lend themselves to enriching the learning environment. These experiences have helped to develop the practical knowledge and expertise that is evident in their practice. When these experiences are shared in the form of stories, they provide a mechanism for transformation within the learner. This study focused on the use of storytelling in teaching and empowering RN students to become involved in their own learning and fostering critical reflection. The RN students in this study represented a diverse ethnic/racial group. As a result, students were challenged to understand and manage cultural diversity and value cultural differences. The use of storytelling engaged students in reflective thinking, writing, and learning activities that identified assumptions, alternative ways of thinking, teaching, and practicing nursing.

A Curriculum Self-Study of Writing Assignments and Reflective Practice in Nursing Education

Reflective practice is an ongoing process of purposeful thinking about one's clinical practice to develop understanding, insight, and clinical judgment. It can be enhanced through careful use of writing assignments that require reflection, evaluation, and thoughtful analysis. The uses of writing assignments in the undergraduate nursing programs at a midwestern college of nursing were studied over a 2-year period, using survey methodology. A purposive sample of all faculty who taught in baccalaureate or associate of science (ASN) programs (n=21) completed a questionnaire and were interviewed about the number and purpose of writing assignments in courses they taught. Quantification of the results in tabular form allowed the faculty to look at all writing assignments required of students across both programs with regard to the number, length, and nature of those assignments. Results were then recategorized by type of assignments, changes needed, and faculty assessment of the usefulness of these writing assignments. The summary of written assignments was then cross-referenced according to program, semester, and program level. This produced a working document that illustrated the quantity and type of writing assignments that each student, in each program, at a given level and semester must complete. Information was used by faculty teaching across courses to make changes that more effectively linked course writing assignments by association, themes, concepts, or areas of study. This process enables faculty to collaboratively develop writing assignments that facilitate the adult student's linking and associating concepts across courses, as a true exercise in critical thinking.