The effectiveness of virtual reality technology in student nurse education: A systematic review and meta-analysis

AIM

The purpose of this study was to analyze the effectiveness of virtual reality technology in nursing education.

BACKGROUND

Virtual reality technology is regarded as one of the advanced and significant instructional tools in contemporary education. However, its effectiveness in nursing education remains a subject of debate, and there is currently limited comprehensive research discussing the impact of varying degrees of virtual technology on the educational effectiveness of nursing students.

DESIGN

Systematic review and meta-analysis.

METHODS

The present systematic review and meta-analysis were applied according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. The PubMed, Embase, CINAHL, ProQuest, Cochrane Library, Web of Science, and Scopus were searched for relevant articles in the English language. The methodologies of the studies evaluated were assessed using Cochrane Risk of Bias2 (ROB 2) tool and Joanna Briggs Institute (JBI) assessment tool. We took the learning satisfaction, knowledge, and skill performance of nursing students as the primary outcomes, and nursing students' self-efficacy, learning motivation, cognitive load, clinical reasoning, and communication ability were assessment as secondary outcomes. The meta-analysis was performed using R 4.3.2 software according to PRISMA guidelines. Heterogeneity was assessed by I2 and P statistics. Standardized mean difference (SMD) and 95 % confidence intervals (CIs) were used as effective indicators.

RESULTS

Twenty-six studies were reviewed, which involved 1815 nursing students. The results showed that virtual reality teaching, especially immersive virtual reality, was effective in improving nursing students' learning satisfaction (SMD: 0.82, 95%CI: 0.53-1.11, P < 0.001), knowledge (SMD: 0.56, 95%CI: 0.34-0.77, P < 0.001), skill performance (SMD: 1.13, 95 % CI: 0.68-1.57, P < 0.001), and self-efficacy (SMD: 0.64, 95%CI: 0.21,1.07, P < 0.001) compared to traditional teaching methods. However, the effects of virtual reality technology on nursing students' motivation, cognitive load, clinical reasoning, and communication ability were not significant and require further research.

CONCLUSIONS

The results of this study show that virtual reality technology has a positive impact on nursing students. Nonetheless, it is crucial not to underestimate the effectiveness of traditional education methods, and future research could analyze the impact of different populations on nursing education while improving virtual reality technology, to more comprehensively explore how to improve the quality of nursing education. Moreover, it is imperative to emphasize the integration of virtual education interventions with real-world experiences promptly. This integration is essential for bridging the gap between the virtual learning environment and real-life scenarios effectively.

REGISTRATION NUMBER

CRD42023420497 (https://www.crd.york.ac.uk/PROSPERO/#recordDetails).

The effect of interactive learning method on nursing students' learning of movement requirement: A randomized controlled study

BACKGROUND

Interactive learning is one of the active learning methods used to develop students' knowledge and skills.

OBJECTIVES

This study was conducted to determine the effect of the interactive learning method with questions prepared according to Bloom's taxonomy on nursing students' learning of the need for movement.

DESIGN

It is a randomized controlled study conducted in May 2023.

PARTICIPANTS

This study was conducted with 134 first-year nursing students taking the Fundamentals of Nursing course. The students were randomly divided into control (n = 67) and experimental (n = 67).

METHOD

The data was collected by using a form delineating descriptive characteristics, a test assessing the necessity of movement knowledge, an analysis of a specific case study, and an assessment form for gathering student opinions on interactive learning. The queries within the data collection form were tailored to align with Bloom's taxonomy. Following the theoretical instruction, each student participated in the mobility needs knowledge test and case analysis (pre-test). The instructional session for the control group involved conventional lecture-style teaching supplemented with a question-and-answer format, while the experimental group received instruction through an interactive learning approach. One week subsequent to this, all students retook the mobility needs knowledge test and case analysis (post-test). Subsequently, feedback regarding the interactive learning method was solicited from the students.

RESULTS

The knowledge test revealed a statistically significant difference, with the control group exhibiting a higher median comprehension score in the post-test compared to the experimental group (p < 0.05). Regarding the case analysis, statistical analysis demonstrated that the experimental group surpassed the control group in median scores for comprehension, synthesis, and total scores, with a significant difference (p < 0.05). Additionally, most students expressed favorable opinions toward the interactive learning approach.

CONCLUSIONS

It is recommended that studies on interactive learning be repeated in different subjects in nursing education.

CLINICALTRIALS

gov ID:NCT05868278.

Enhancing nursing education for Indigenous students: Indigenous nursing students' insights and strategies

BACKGROUND

Indigenous nursing students contended with far-reaching challenges during the pandemic that significantly altered their experiences of nursing education. These experiences are poorly understood by nursing educators and strategies for Indigenous nursing student success rarely involve the insights of current Indigenous nursing students.

AIM

The aim of this article is to offer Indigenous-student derived recommendations regarding strategies for improving their experiences and success within nursing education during the pandemic and beyond.

DESIGN AND METHODS

This qualitative study employed an Indigenous methodology including land-based learning, ceremony, and sharing circles.

PARTICIPANTS AND SETTING

Indigenous nursing students (n = 17) from a Western Canadian school of nursing participated in one of three sharing circles.

RESULTS

Indigenous nursing students recommended institutional and program adaptations along with increases to cultural safety for enhancing their experience in nursing education. Institutional and program strategies included: decreasing course loads and class sizes; an Indigenous-specific cohort; a transition program after course failure; increasing academic supports such as additional clinical skills and academic writing practice. Recommendations for increasing cultural safety included: mandatory and recurrent cultural safety training for faculty, staff and students; differential learning and evaluation strategies; and increased inclusion of Indigenous ceremonies and practices.

CONCLUSION

The findings of this study provide insights that can help guide curriculum development, pedagogical approaches, and policy development to improve nursing education for Indigenous students.

Implementation and dissemination of physical activity-related health competence in vocational nursing training: study protocol for a cluster-randomized controlled intervention trial

BACKGROUND

Although the nursing sector gains growing importance in an aging society, students representing the future workforce often show insufficient health. Acknowledging the health-enhancing effects of adequate physical activity, the educational system in Bavaria, Germany, has recently integrated the promotion of physical activity-related health competence (PAHCO) into the nursing curriculum. However, it cannot be assumed that PAHCO has sufficiently permeated the educational practices and routines of the nursing schools. Therefore, the goal of the present study is to examine and compare the effectiveness as well as implementation of different intervention approaches to address PAHCO in the Bavarian nursing school system.

METHODS

We randomly assign 16 nursing schools (cluster-based) to four study arms (bottom-up, top-down led by teachers, top down led by external physical activity experts, control group). Schools in intervention group 1 (IG-1) develop multicomponent inventions to target PAHCO via cooperative planning (preparation, planning, and implementation phase). Intervention groups 2 and 3 (IG-2, IG-3) receive both an expert-based intervention (developed through intervention mapping) via trained mediators to address PAHCO. External physical activity experts deliver the structured PAHCO intervention in IG-2, while teachers from the nursing schools themselves conduct the PAHCO intervention in IG-3. In line with a hybrid effectiveness implementation trial, we apply questionnaire-based pre-post measurements across all conditions (sample size calculation: nfinal = 636) to examine the effectiveness of the intervention approaches and, simultaneously, draw on questionnaires, interview, and protocol data to examine their implementation. We analyze quantitative effectiveness data via linear models (times-group interaction), and implementation data using descriptive distributions and content analyses.

CONCLUSION

The study enables evidence-based decisions about the suitability of three intervention approaches to promote competencies for healthy, physically active lifestyles among nursing students. The findings inform dissemination activities to effectively reach all 185 schools of the Bavarian nursing system.

TRIAL REGISTRATION

Clinical trials NCT05817396. Registered on April 18, 2023.

The patient safety curriculum: An interventional study on the effectiveness of patient safety education for Jordanian nursing students

INTRODUCTION

The purpose of the study was to assess the effectiveness of the World Health Organization's (WHO) patient safety curriculum (PSC) in improving the patient safety education for nursing students in Jordanian higher education programmes.

METHODS

An interventional design adopting a pre-test and post-test was used. A questionnaire survey was administered to 373 nursing students before and after the curriculum. Students were asked to complete pre-test and post-test questionnaires on self-awareness of patient safety.

RESULTS

Students had moderate knowledge of factors that influence patient safety and scored as the highest, (mean 3.45, SD 0.94). The greatest improvement was in the role of the health organisation in error reporting (the mean difference was 0.97, P = 0.001). Taking into consideration the essential measurements, the results obtained after the post-test regarding the two patient safety topics showed a significant increase after completing the training, demonstrating that the patient safety course was effective.

CONCLUSION

The study highlights the importance of developing a curriculum in nursing schools that incorporates patient safety education. The WHO PSC guide can be a great start in this domain.

Nursing faculty development program for digital teaching competence

BACKGROUND

Nursing faculties need to develop digital competencies to effectively use information, communication, and technology-based nursing education.

PURPOSE

The study aimed to develop and apply a theory-guided faculty development program on digital teaching competencies.

METHODS

A faculty development program was developed. Between March and April 2020, three five-hour web workshops participated by ninety-three faculty members were held. The program was assessed via mixed methods, combining satisfaction surveys post-workshop with content analysis of open-ended questionnaires to gauge participant evaluation of program content and learning experience.

RESULTS

Participants were highly satisfied with the program contents and their opportunity for integrating digital technology into education and improving faculty proficiency in digital teaching technology.

CONCLUSIONS

The program provides faculties with the self-confidence and essential skills to teach students using information, communication, and technology-based nursing education by enhancing their digital teaching competencies. It is critical to integrate both digital proficiency and nursing practice education.

Online degree programmes in nurse education-Students' perceptions and academic performance: An integrative review

OBJECTIVES

The aim of this integrative review is to identify, describe, and synthesise evidence regarding students' perceptions of online degree programmes in nurse education, their academic performance, and the factors associated with their academic performance.

DESIGN

Integrative review.

DATA SOURCES

Four databases, CINAHL, ERIC (Ebsco), PubMed/MEDLINE, and Web of Science were searched. The reference lists of included studies were reviewed to identify other relevant studies.

REVIEW METHODS

Whittemore and Knafl's method was used as a guideline for the integrative review. Peer-reviewed studies describing students' perceptions of-or academic performance in-online degree programmes in nurse education were included in the review without time limitations. The quality of the selected article was assessed using the Mixed Method Appraisal Tool.

RESULTS

Nursing students' perceptions of online degree programmes were categorised into enabling career development, content delivered online, and community belonging. Factors related to student's academic performance were associated with individual students and the characteristics of online learning environments. Factors associated with students' academic performance were individual self-direction, formal communication skills, and working and educational backgrounds. Factors associated with academic performance in an online learning environment were categorised into regular feedback and methods for learning.

CONCLUSIONS

Online degree programmes in nurse education contribute to developing pedagogy through a satisfactory work-life balance, students' experiences of community and support, pleasant digital content, and various teaching methods by faculties. The study findings of this review have implications for educators to develop and adopt strategies for advancing digital environments with the pedagogy that supports community building to meet the needs of individual students.

Reverse Mentoring in Nursing Education

BACKGROUND

Nurse educators are challenged to prepare an expanding number of diverse students with various sociocultural and generational differences. Whether diversity, sociocultural, and/or generational divides are contributory, a perennial decline exists of historically disenfranchised students finishing nursing programs. Reverse mentoring is an innovative adaption of traditional mentoring. Reverse mentoring is a practice that reverses traditional mentor and mentee roles, which may mitigate diverse and intergenerational misconceptions.

PURPOSE

To prepare a diverse nursing workforce, educators should integrate strategies to embrace differences, reduce biases, remove learning barriers, and value learning new teaching methods.

METHODS

A literature review revealed few articles on reverse mentoring in nursing education.

RESULTS

Reverse mentoring is a successful strategy in many Fortune 500 companies. Therefore, reverse mentoring may demonstrate promise in nursing education.

CONCLUSION

Exploring reverse mentoring in nursing education may reveal strategies to elucidate and mitigate biases and barriers in nursing education.

Evaluation of a virtual interprofessional oral-systemic health simulation experience in nursing, dentistry, medicine, and pharmacy education

PURPOSE

The annual teaching oral-systemic health (TOSH) virtual clinical simulation and case study activity exposes interprofessional teams of nurse practitioner, nurse midwifery, dental, medical, and pharmacy students to a virtual clinical simulation experience that uses oral-systemic health as a clinical exemplar for promoting interprofessional core competencies. The present study examines changes in participating students' self-reported interprofessional competencies following participation in virtual TOSH from 2020 to 2022. These findings are also compared to those from in-person TOSH (2019) to examine the equivalence of student outcomes of both the in-person and virtual programs.

METHODS

A pre- and post-test evaluation design was used to examine the effectiveness of exposure to the TOSH program on self-reported attainment of interprofessional competencies for participating students using the interprofessional collaborative competency attainment scale.

RESULTS

Analysis of pre- and post-surveys demonstrated statistically significant improvement in students' self-rated interprofessional experience competencies following the virtual TOSH program, which aligns with results from the in-person cohorts. Similar findings between the in-person and virtual cohorts indicated no statistically significant difference between the two formats.

CONCLUSION

These findings demonstrate the success of TOSH in promoting attainment of interprofessional competencies among future health professionals. We encourage administrators and faculty who lead health professional programs to take advantage of using virtual simulations as an integral component of interprofessional oral health clinical experiences where students from different health professions learn from and about each other in assessing and treating patients across the lifespan.

The effect of a stress management program on first-year nursing students' clinical stress: A randomized controlled experimental study

BACKGROUND

Clinical clerkships lie at the core of nursing education and are crucial for developing professional skills. However, nursing students, especially freshmen, often encounter significant stress during their clinical experiences.

OBJECTIVES

This study investigated the effect of a stress management program on first-year nursing students' clinical stress levels.

DESIGN

This randomized controlled experimental study adopted a pretest-posttest-follow-up test research design.

SETTINGS AND PARTICIPANTS

Participants were recruited using simple randomization. The sample consisted of 64 first-year nursing students (intervention = 32; control = 32) from the nursing department of the faculty of health sciences of a university in Türkiye.

METHODS

Participants were randomized into intervention and control groups. The intervention group attended a stress management program, one weekly session for five weeks (intervention). The research was conducted between 21.02.2022 and 20.05.2022. Data were collected using a personal information form, the Perceived Stress Scale, the Physio-Psycho-Social Response Scale, and the Coping Behavior Inventory. The data were collected pretest and posttest the intervention and two months follow-up test. The data were analyzed using the two-way repeated measures analysis of variance (ANOVA).

RESULTS

The changes in the Perceived Stress Scale mean scores, group*time interaction, were statistically significant (p < 0.05). The results showed that the changes in the Coping Behavior Inventory "problem-solving" subscale mean scores, group*time interaction, were statistically significant (p < 0.05). The multiple comparisons showed a statistically significant difference in posttest Physio-Psycho-Social Response Scale "social behavioral symptoms" and "emotional symptoms" subscale scores between the intervention and control groups (p < 0.05). The multiple comparisons showed a statistically significant difference in posttest Coping Behavior Inventory "problem-solving" and "avoidance" subscale scores between the intervention and control groups (p < 0.05).

CONCLUSION

The stress management program helps first-year nursing students experience less stress and develop problem-solving skills before they perform clinical clerkships. It also allows them to suffer from fewer emotional and social behavioral symptoms and exhibit fewer avoidance behaviors.

Work With ChatGPT, Not Against: 3 Teaching Strategies That Harness the Power of Artificial Intelligence

BACKGROUND

Technological advances have expanded nursing education to include generative artificial intelligence (AI) tools such as ChatGPT.

PROBLEM

Generative AI tools challenge academic integrity, pose a challenge to validating information accuracy, and require strategies to ensure the credibility of AI-generated information.

APPROACH

This article presents a dual-purpose approach integrating AI tools into prelicensure nursing education to enhance learning while promoting critical evaluation skills. Constructivist theories and Vygotsky's Zone of Proximal Development framework support this integration, with AI as a scaffold for developing critical thinking.

OUTCOMES

The approach involves practical activities for students to engage with AI-generated content critically, thereby reinforcing clinical judgment and preparing them for AI-prevalent health care environments.

CONCLUSIONS

Incorporating AI tools such as ChatGPT into nursing curricula represents a strategic educational advancement, equipping students with essential skills to navigate modern health care.

Assessing question characteristic influences on ChatGPT's performance and response-explanation consistency: Insights from Taiwan's Nursing Licensing Exam

BACKGROUND

Investigates the integration of an artificial intelligence tool, specifically ChatGPT, in nursing education, addressing its effectiveness in exam preparation and self-assessment.

OBJECTIVE

This study aims to evaluate the performance of ChatGPT, one of the most promising artificial intelligence-driven linguistic understanding tools in answering question banks for nursing licensing examination preparation. It further analyzes question characteristics that might impact the accuracy of ChatGPT-generated answers and examines its reliability through human expert reviews.

DESIGN

Cross-sectional survey comparing ChatGPT-generated answers and their explanations.

SETTING

400 questions from Taiwan's 2022 Nursing Licensing Exam.

METHODS

The study analyzed 400 questions from five distinct subjects of Taiwan's 2022 Nursing Licensing Exam using the ChatGPT model which provided answers and in-depth explanations for each question. The impact of various question characteristics, such as type and cognitive level, on the accuracy of the ChatGPT-generated responses was assessed using logistic regression analysis. Additionally, human experts evaluated the explanations for each question, comparing them with the ChatGPT-generated answers to determine consistency.

RESULTS

ChatGPT exhibited overall accuracy at 80.75 % for Taiwan's National Nursing Exam, which passes the exam. The accuracy of ChatGPT-generated answers diverged significantly across test subjects, demonstrating a hierarchy ranging from General Medicine at 88.75 %, Medical-Surgical Nursing at 80.0 %, Psychology and Community Nursing at 70.0 %, Obstetrics and Gynecology Nursing at 67.5 %, down to Basic Nursing at 63.0 %. ChatGPT had a higher probability of eliciting incorrect responses for questions with certain characteristics, notably those with clinical vignettes [odds ratio 2.19, 95 % confidence interval 1.24-3.87, P = 0.007] and complex multiple-choice questions [odds ratio 2.37, 95 % confidence interval 1.00-5.60, P = 0.049]. Furthermore, 14.25 % of ChatGPT-generated answers were inconsistent with their explanations, leading to a reduction in the overall accuracy to 74 %.

CONCLUSIONS

This study reveals the ChatGPT's capabilities and limitations in nursing exam preparation, underscoring its potential as an auxiliary educational tool. It highlights the model's varied performance across different question types and notable inconsistencies between its answers and explanations. The study contributes significantly to the understanding of artificial intelligence in learning environments, guiding the future development of more effective and reliable artificial intelligence-based educational technologies.

TWEETABLE ABSTRACT

New study reveals ChatGPT's potential and challenges in nursing education: Achieves 80.75 % accuracy in exam prep but faces hurdles with complex questions and logical consistency. #AIinNursing #AIinEducation #NursingExams #ChatGPT.

Effects of Standardized Patient Simulation and Mobile Applications on Nursing Students' Clinical Competence, Self-Efficacy, and Cultural Competence: A Quasi-Experimental Study

BACKGROUND

Simulation-based education has emerged as an effective approach in nursing education worldwide. We aimed to evaluate the effectiveness of a surgical nursing education program based on a simulation using standardized patients and mobile applications among nursing students.

METHODS

A mixed-methods design with a quasi-experimental longitudinal approach and focus group interviews was employed. The data were collected from 130 third-year nursing students at three different time points who were equally divided into experimental and control groups. This study measured the level of clinical surgical nursing competence, self-efficacy in clinical performance, cultural competence, and satisfaction with simulation experience. Four focus group interviews were conducted using open-ended questions to explore the participants' perspectives on the course's efficacy and satisfaction.

RESULTS

There were statistically significant differences in clinical surgical nursing competence (F = 8.68, p < 0.001), self-efficacy in clinical performance (F = 13.56, p < 0.001), and cultural competence (F = 10.35, p < 0.001) across time between the intervention and control groups. Student satisfaction with the simulation-based training was high, particularly regarding debriefing and reflection, with an overall mean satisfaction level of 4.25 (0.40). Students' perspectives regarding integrated hybrid training are categorized into three themes: educational achievement, dynamic learning experiences, and satisfaction and suggestion.

CONCLUSION

Simulation-based learning provides a dynamic and immersive educational experience that enables undergraduate nursing students to develop and refine essential clinical skills while also fostering confidence and cultural competence.

Behind the creative canvas: An innovative trauma-informed art-based educational approach using an immersive learning pedagogy

Trauma has been increasingly considered in mental health policies and strategies worldwide. However, the implementation of such initiatives into practice remains inconsistent resulting in a fragmented approach to trauma-informed care. One explanation for the current state of trauma services is the unpreparedness of mental health nurses in line with emerging traumagenic theoretical frameworks. We addressed this gap by implementing an innovative pedagogic project co-produced with people with lived experience of trauma. The aim of this qualitative study was to explore mental health nursing students' perspective on the usefulness of an art-based approach to learning about, and working with, trauma in a non-interactive virtual reality (VR) environment. Ten mental health nursing students have been conveniently selected to take part in a focus group. The thematic analysis revealed authenticity, the power of arts, and underutilisation of arts in mental health nursing as key themes following students' reflections and critical discussions. Recommendations to enhance trauma-informed nursing education and practice are made to support an approach that has the potential to instil positive changes in the way mental health nursing students perceive and work with trauma in their practice.

Clinical virtual simulation: predictors of user acceptance in nursing education

BACKGROUND

Using virtual patients integrated in simulators expands students' training opportunities in healthcare. However, little is known about the usability perceived by students and the factors/determinants that predict the acceptance and use of clinical virtual simulation in nursing education.

OBJECTIVES

To identify the factors/determinants that predict the acceptance and use of clinical virtual simulation in learning in nursing education.

METHODS

Observational, cross-sectional, analytical study of the use of clinical virtual simulation in nursing to answer the research question: What factors/determinants predict the acceptance and use of a clinical virtual simulator in nursing education? We used a non-probabilistic sampling, more specifically a convenience sample of nursing degree students. The data were collected through a questionnaire adapted from the Technology Acceptance Model 3. In technology and education, the Technology Acceptance Model is a theoretical model that predicts the acceptance of the use of technology by users.

RESULTS

The sample comprised 619 nursing students, who revealed mean values of perceived usefulness (M = 5.34; SD = 1.19), ease of use (M = 4.74; SD = 1.07), and intention to use the CVS (M = 5.21; SD = 1.18), in a Likert scale of seven points (1-the worst and 7 the best possible opinion). This study validated the use of Technology Acceptance Model 3 adapted and tested the related hypotheses, showing that the model explains 62% of perceived utility, 32% of ease of use, and 54% of intention to use the clinical virtual simulation in nursing by nursing students. The adequacy of the model was tested by analysis of the direct effects of the relationships between the internal constructs (PU-BI, β = 0.11, p = 0.012; PEOU-BI, β = -0.11, p = 0.002) and the direct relations between some of the constructs internal to the Technology Acceptance Model 3 and the external determinants Relevance for learning and Enjoyability. In the proposed model, the external constructs that best predicted perceived usefulness, ease of use, and behaviour intention to use the clinical virtual simulation in nursing were Relevance for learning and Enjoyability.

CONCLUSIONS

These study results allowed us to identify relevance for learning and enjoyability as the main factors/determinants that predict the acceptance and use of clinical virtual simulation in learning in nursing.

A spark of change: developing an innovative gerontological nursing intervention mapping initiative for training and education (IGNITE)

BACKGROUND

With an aging global population and advancements in medical technology, there is an urgent need for innovative gerontological nursing education programs. This study aimed to develop and evaluate the Innovative Gerontological Nursing Intervention Mapping Initiative for Training and Education (IGNITE) program. This program is a digital platform-based postgraduate nursing curriculum that employs the Intervention Mapping Approach (IMA) and Transformative Learning Theory to address the evolving needs of gerontological nursing.

METHODS

The IGNITE program's development process encompassed a comprehensive approach, including needs assessment, mapping of course objectives, integration of theory-based methods and strategies, course design, implementation, and rigorous evaluation. The pilot evaluation study involved pre- and post-tests focused on ageism, attitudes towards elder care, knowledge about older adults, transformative behavior change, and program satisfaction. The findings revealed significant improvements across all these dimensions, affirming the effectiveness of the program.

RESULTS

The program leveraged experiential learning, critical reflection, and rational discourse to facilitate transformative educational experiences. Notably, pre- and post-test comparisons showed marked improvements in attitudes towards older adult care and dementia care knowledge. Participants expressed high satisfaction with the program, with significant reported changes in transformative behaviors. The study also illuminated the initial negative attitudes of clinical nurses towards older adults and underscored the importance of transformative learning experiences in fostering empathy and understanding.

CONCLUSIONS

The IGNITE program lays a foundational framework for developing educational materials that promote transformative learning and self-reflection among healthcare professionals. This approach can lead to innovative nursing practices and personal growth. The application of the IMA and Transformative Learning Theory in gerontological nursing education shows significant promise. Future research should focus on exploring the long-term impacts of such programs and their applicability in diverse healthcare settings.

Investigating the fundamental levels of a signature pedagogy in nursing education: A scoping review

BACKGROUND

A signature pedagogy is a unique approach that provides a blueprint for curricular decision-making, as it reflects how we teach (surface structures), why we teach (deep structures), and what we believe are vital concepts or values all learners should embody (implicit structures).

OBJECTIVE

To investigate what is known from the existing literature about a signature pedagogy to support undergraduate nursing education.

DESIGN

This scoping review adopted Arksey and O'Malley's framework to guide the analysis of data. Two electronic databases were used to explore studies on educational strategies, content, and values published in Arabic, English, Filipino, French, Portuguese, and Spanish between 1972 and 2022.

RESULTS

A total of 258 articles were included in this review. The analysis revealed that the majority of articles were at the surface (n = 189), followed by the deep (n = 123), with the least number examining the implicit level (n = 90) associated with signature pedagogy levels. Results reflect a limited focus on implicit level; the core concepts and values that all learners should understand and grasp for their future practice to construct their professional identity and engage in healthcare transformation.

CONCLUSIONS

The findings from this scoping review, should not be an isolated movement within nursing education. The first step is to engage in discourse amongst all stakeholders, educational and healthcare nurse leaders, regarding the state of the profession. As a profession we need to understand what is the preferred future of nursing and what are the necessary educational processes to ensure the profession is actualizing their mandate. A call to action to develop a unique signature pedagogy should provide synergy between education and practice to enhance learner's competencies as a future professional.

Comparison of the impact of team-based learning and lecture-based learning on nursing students' core competencies: A systematic review and meta-analysis

AIM

This study aims to evaluate the effect of team-based learning on the core competence of nursing students compared with traditional teaching methods.

BACKGROUND

In recent years, team-based learning has been widely used as a learning and teaching method in the world. Not only the necessary knowledge, skills and attitudes, but also the core competence is necessary to cope with various clinical situations for nursing students. However, the effect of this new teaching method on core competence of nursing students is not consistent.

DESIGN

The study was designed according to the preferred reporting entries guidelines statement for systematic reviews and meta-analyses and population, intervention, comparison, outcome and study.

METHODS

Data were collected from PubMed, Embase, Web of Science, ScienceDirect and Scopus. The quality of studies was assessed using "The Newcastle Ottawa scale". A random-effect model of meta-analyses was conducted to generate pooled standardized mean differences (SMD) for core competence using Rev Man 5.4.1 software and STATASE 15. Moreover, subgroup, heterogeneity, sensitivity and publication bias analyses were conducted.

RESULTS

A total of 14 articles with 1942 participants were included in the meta-analysis. Compared with the traditional pedagogy among nursing students, team-based learning pedagogy significantly increased theoretical performance, professional effects (self-directed learning ability and communication ability) but did not affect practice skills. In addition, one study found that learning attitudes were not improved in students with high or low academic performance. This might mean that the teaching model should be implemented for a long time, which essentially changed students' learning attitudes to improve students' self-directed learning ability and core competence, especially for students with low scores.

CONCLUSIONS

In summary, findings indicated that team-based learning pedagogical approaches might be beneficial to improve teaching quality in nursing education. However, practice skills might not be sensitive to team-based learning because of the seriation of the original course. Nursing educators need to explore teaching strategies to cultivate high-quality nursing talents to cultivate nursing students with core competence and ensure that they are successfully qualified for new employment.

Outcomes of jigsaw technique in nurse education: A systematic review and meta-analysis

AIM

To determine the effect of Jigsaw technique in nursing education by meta-analysis method.

BACKGROUND

Innovative methods actively engage students in the learning process, contrasting with the traditional memorization-based methods. Jigsaw technique, as one of these approaches, allows students to collaborate in small groups with the aim of accomplishing a shared learning objective.

DESIGN

A meta-analysis of observational studies.

DATA SOURCES

Google Scholar, Science Direct, Pubmed, Web of Science, ProQuest, Medline, CINAHL and Cochrane Library electronic databases in English was systematically searched from inception from January 2011 to December 2022.

METHOD

This review used the preferred reporting items for meta-analyses (PRISMA) guidelines. The Cochrane Risk-of-Bias (RoB) Tool was used to assess the methodological quality of the included studies. Statistical analysis was conducted with the Comprehensive Meta Analysis (CMA) software.

RESULTS

In the study, 11 studies from 6 different countries were examined. It has been determined that the Jigsaw learning technique in nursing students is a method that enables students to increase their academic success compared with traditional learning methods. In addition, it has been determined because of studies that Jigsaw learning technique is effective in students; interpersonal relations, critical thinking, communication and clinical skills, as well as increasing motivation, self-concept and attitudes such as self-confidence. Funnel plot, Classic Fail-Safe N, Begg-Mazumdar Rank tests showed no publication bias.

CONCLUSION

As a result of the meta-analysis, it was determined that the Jigsaw technique had a positive effect on the academic achievement, skills and attitudes of nursing students.

Assessing the virtual reality perspectives and self-directed learning skills of nursing students: A machine learning-enhanced approach

AIM

This study aims to investigate nursing students' perspectives on virtual reality technologies and their self-directed learning skills, specifically focusing on how these variables interact and influence each other in the context of nursing education. We also discern potential disparities in these skills based on descriptive characteristics, using both traditional statistical and advanced machine learning approaches for a comprehensive analysis.

BACKGROUND

Rapid developments in technology, particularly during the Covid-19 pandemic, have brought virtual reality technologies to the forefront of nursing education. However, there is a gap in understanding how nursing students' perceptions of these technological relate to their development of self-directed learning skills.

DESIGN

A descriptive and cross-sectional study design is employed to both quantify nursing students' perspectives on virtual reality in their education and assess their self-directed learning skills. This approach integrates traditional statistical methods with advanced machine learning techniques, with the intention of offering a comprehensive and nuanced analysis to inform future teaching strategies in nursing.

METHODS

The study used a blend of survey scales and a tree-based machine learning model to measure and analyze nursing students' views, attitudes and self-directed learning levels. This dual approach allows for a more detailed assessment of the factors influencing self-directed learning abilities. Traditional statistical techniques were also applied to assess the reliability of the machine learning findings.

RESULTS

Findings reveal that nursing students generally held positive views towards virtual reality technologies and exhibited a high level of self-directed learning skills. Notable differences in self-directed learning skills were influenced by gender on the overall scale (p <0.001), with male students scoring higher than their female counterparts in both specific sub-dimensions and on the overall scale, but not by academic year. The machine learning analysis provided deeper insights into these variations, highlighting subtle distinctions in student demographics that traditional statistical methods did not fully capture.

CONCLUSIONS

The study offers valuable insights into interconnected nature of nursing students' views on virtual reality technologies and their self-directed learning skills. The results support the integration of virtual reality in nursing curriculum programs and underscore the importance of customizing teaching strategies based on insights gained from machine learning analyses. This approach has the potential to substantially improve both the learning experience and the overall quality of nursing education.

Enhancing delirium assessment and management through nursing education interventions: A scoping review

AIM/OBJECTIVE

The purpose of this scoping review was to explore the characteristics and outcomes of education interventions for nurses focused on delirium assessment and management.

BACKGROUND

Delirium is a prevalent acute and reversible neuropsychiatric syndrome in hospitalized patients. Delirium can cause cognitive, psychiatric and physical impairments and result in prolonged hospital stay, increased risk of readmission and elevated morbidity and mortality rates. Nurses play an essential role in managing delirium. There is a lack of understanding of the existing nursing educational interventions on delirium management.

DESIGN

The study was a scoping review.

METHODS

In this scoping review, we used Arksey and O'Malley's (2005) scoping review framework. We searched articles published between 2019 and 2023 in Academic Search Premier, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and MEDLINE using the following CINAHL/MeSH suggested subject terms: "delirium" in conjunction with "education" "intervention" and "nurse", "nurses" or "nursing." Studies on improving nursing knowledge and practices regarding delirium were included while those focusing on nursing students were excluded. Initial screening involved evaluating article titles and abstracts for relevance from 164 identified articles, followed by a full-text review of 42 articles. Finally, 17 articles were selected for comprehensive analysis. We extracted relevant information from each article and charted the findings in an evidence table.

RESULTS

The 17 selected articles showcased a variety of interventions used to educate nursing staff, such as workshops, simulations, group discussions, online modules and one-on-one coaching. Educational interventions primarily focused on delirium definition, risk factors, assessment and management. These educational interventions enhanced nurses' perception of delirium, boosting their confidence and knowledge in managing delirium. These interventions also led to increased compliance with delirium assessment and management protocols, which ultimately resulted in improved documentation accuracy and patient outcomes.

CONCLUSIONS

Findings from this scoping review suggest that nursing administration need to provide support and education for delirium prevention and management to enhance nursing staff confidence and competence in assessing and managing delirium. The use of interactive educational techniques has demonstrated profound benefits in schema development, expertize promotion and critical thinking. These findings have significant implications for future research, including the identification of essential nursing competencies for educational interventions and the assessment of long-term knowledge retention and its application in nursing practice.

Application of Network-Based PBL Model Combined with Role-Playing Method in Geriatric Nursing Teaching

Objective

To evaluate the effectiveness of using a combination of problem-based learning (PBL) and role-playing methods in geriatric nursing education through online networks.

Methods

The research objects of this paper were selected from nursing students, and the number of participants was 200. The research objects were selected from March 2019 to September 2021. The learning situation and related data of the above students were retrospectively analyzed. According to the teaching methods, the students were divided into groups. The students who received traditional teaching methods were included in the control group, with a total of 100 participants. The students who received network-based PBL mode combined with role-playing teaching were included in the observation group, with a total of 100 participants. The assessment results and learning effect evaluation of the two groups of students were compared, and the level of learning engagement and changes in critical thinking between the groups were compared.

Results

The scores of basic theoretical knowledge, clinical practice skills, and clinical case analysis of students in the observation group were higher than those of the control group (P < .001). The evaluation index of nursing students' learning effects was analyzed. The proportions of enhancing teacher-student interaction, improving team cooperation ability, improving autonomous learning ability and learning interest, improving analysis and problem-solving ability, improving theory combined with practice ability, improving communication and expression ability, improving work self-confidence, improving knowledge and vision, improving literature retrieval and evaluation ability in the observation group were higher than that in the control group (P < .001). After the teaching work, the overall learning input score, cognitive input score, behavior input score, emotional input score, learning harvest score, and learning satisfaction score of students in the observation group were higher than those of the control group (P < .001). After teaching, the scores of finding the truth, open mind, analytical ability, systematic ability, critical thinking self-confidence, curiosity and cognitive maturity of the students in the observation group were higher than those in the control group (P < .001).

Conclusion

The combined application of network-based PBL mode and role-playing method can significantly improve the teaching effects of geriatric nursing, with popularization value.

3D human anatomy augmentation over a mannequin for the training of nursing skills

BACKGROUND

The in-depth understanding of human anatomy is the foundation for safety in nursing practice. Augmented reality is an emerging technology that can be used for integrative learning in nursing education.

OBJECTIVE

The study aimed to develop a human anatomy-based skill training system and pilot test its usability and feasibility.

METHODS

Twenty-seven nursing students participated in 3D anatomy-based skill training for intramuscular injection and Levin tube feeding using HoloLens 2. Various user interfaces including pictures, videos, animation graphics, and annotation boxes assisted users with a comprehensive understanding of the step-by-step procedures for these techniques. A one-group pre-post test was conducted to observe changes in skill performance competency, usability, and learning satisfaction.

RESULTS

After study participation, a statistically significant improvement in skill performance competency (p< 0.05) was observed. The usability results showed that students were satisfied with the usefulness of the program (9.55 ± 0.49) and scored highly for the intention to participate in other educational programs (9.62 ± 0.59). A high level of learning satisfaction was achieved (9.55 ± 0.49), with positive responses in fostering students' engagement and excitement in the application of cutting-edge technology.

CONCLUSION

The 3D anatomy-based nursing skill training demonstrated good potential to improve learning outcomes and facilitate engagement in self-directed practice. This can be integrated into undergraduate nursing education as an assistant teaching tool, contributing to the combination of knowledge and practice.

Exploring the status and critical issues in mixed methods research in doctoral nursing education in the Philippines

BACKGROUND

Mixed methods research (MMR) can be a pathway for doctoral nursing students to create innovative and noble contributions for the advancement of nursing theory, practice, and education. Several issues and challenges must be identified to successfully train, mentor, and support doctoral nursing students in conducting MMR.

AIM

The study aimed to explore the status and critical issues in conducting, mentoring, and training MMR in doctoral nursing programs in the Philippines.

METHODS

A descriptive qualitative study was conducted by performing semi-structured online interviews with 10 purposively selected participants who were faculty and educators with doctoral degrees, involved in teaching and mentoring MMR among doctoral nursing students in the last 10 years. Data were analyzed using Braun and Clarke's thematic analysis.

FINDINGS

Four key themes emerged, namely, (1) perceptions on the use of MMR, (2) facilitators to use MMR, (3) barriers to the use of MMR, and (4) recommendations to promote the use of MMR focused on the student, faculty, and educational institution levels.

CONCLUSION

Providing educational, institutional, and research support for doctoral nursing students and faculty could flourish the use of MMR in doctoral nursing programs with deeper meaning and reasoning.

Supporting nursing degree apprentices: advice for higher education institutions and employers

A nursing degree apprenticeship offers an alternative route into nursing from the traditional preregistration nurse education programme by enabling apprentice employees to work and study at the same time. This route could address some of the issues associated with attrition from preregistration nurse education programmes, such as financial challenges. However, nursing degree apprentices may experience other challenges, for example suboptimal work-life-study balance and inadequate support from employers and higher education institutions (HEIs), resulting in dissatisfaction with or non-completion of their apprenticeship programme. This article examines some of the literature on apprenticeships and suggests ways in which employers, HEIs and nursing degree apprentices can work together to improve the apprenticeship experience.

Development and Effects of a Virtual Reality Simulation Nursing Education Program Combined With Clinical Practice Based on an Information Processing Model

The need to strengthen patient human rights and create a patient-centered healthcare environment is growing. Also as science and technology develop, new educational methods using virtual reality in nursing education are emerging. This study aimed to develop a virtual reality simulation nursing education program related to postoperative patient nursing based on an information processing model and to verify its effectiveness. Clinical practice-linked virtual reality simulation nursing education was conducted for a total of 4 weeks. Nursing students were divided into an experimental group (n = 22) experiencing virtual reality simulation combined with clinical practice and a control group (n = 22) having routine clinical practice. The analytical results of this study indicated that the information processing model-based virtual reality simulation nursing education program was effective in improving nursing students' performance confidence and clinical decision-making ability. Therefore, the virtual reality simulation program developed in this study can provide basic data for the development of a simulation curriculum in the future and can contribute to the development of clinical competency as a professional nurse by improving the performance confidence and clinical decision-making ability of nursing students.

Exploring the potential use of the metaverse in nurse education through a mock trial

BACKGROUND

The metaverse has been attracting attention as a space for the application of education, where integrating the real and virtual worlds offers immersive 3D experiences. Consequently, its potential for higher education, including nursing, is being explored as a dynamic alternative to traditional education.

OBJECTIVES

This study explores the applicability of metaverse in nurse education. It was conducted to implement a mock court on the metaverse platform and explore the learning experiences of nursing students through mock trials.

DESIGN

Qualitative study.

SETTINGS

A virtual mock court in VRChat (a virtual reality space).

PARTICIPANTS

Fourteen participants were divided into three groups.

METHODS

An orientation was conducted to explain the virtual space before the mock trial. On the day of the mock trial, a health survey of study participants was conducted in advance. After the mock trial, questionnaires and reflective diaries were written.

RESULTS

The experiences of nursing students were organized into eleven sub-themes and three themes: "core features of the metaverse platform," "participation in a mock trial in the VRChat virtual space," and "metaverse-based learning using a mock trial."

CONCLUSIONS

Nursing students participated and immersed themselves in learning while accepting the characteristics of the metaverse platform, which differs from face-to-face classes or existing educational methods. The metaverse enables reflective learning based on experiential learning and strengthens awareness of diverse viewpoints.

Storytelling: Manifesting Integral Interconnectedness in Holistic Nursing Education

This paper presents a middle-range theory of storytelling in nursing education. Both explanatory and predictive, the theory further develops the existing conceptual work on the topic of storytelling. It places storytelling as a pedagogical technique within the realm of holistic nursing theory and philosophy. Storytelling is seen as a manifestation of the process of integral interconnectedness. The theory suggests a mechanism by which storytelling, as mediated by narrative transportation and neuroplasticity, can be effective in promoting desirable outcomes for holistic nursing students, including the achievement of affective and cognitive educational objectives. The theory describes the relationship of storytelling to narrative transportation and neuroplasticity. Within the concept of storytelling, the Temporal Bidirectionality of Story and Experience and the Story Creation-Interpretation-Recreation Cycle of telling and listening are explained. This theory was developed using deductive reasoning combining existing nursing and non-nursing theories. Recommendations for research and application are included.

A visual ethnographic study on nurse lecturers' enactment of compassionate care within the adult pre-registration nursing curriculum

BACKGROUND

Nurse lecturers make a valuable contribution to developing the future nursing workforce. However, how this is nurtured within nurse education requires further exploration. There is limited research exploring the experiences of nurse lecturers providing compassionate care within the adult pre-registration nursing curriculum.

OBJECTIVES

This study explores how nurse lecturers enact compassionate care within the adult pre-registration nursing curriculum. To elicit shared patterns of behaviours and use creative methods to promote a critical dialogue.

METHOD

A visual ethnographic approach was used to explore nurse lecturers' experiences at a University in England. Using purposive sampling, nine auto-driven photo-elicitation interviews took place, and five participants attended a focus group to develop individual and collaborative concept maps. A thematic approach to data analysis was employed.

FINDINGS

Five themes were identified, illustrating compassionate care as the human condition involving appropriate behaviours and competent action. Compassionate care is threaded through the curriculum using different teaching and learning approaches, requiring a culture of shared human relationships. The combination of photographs, maps and descriptions provide a unique perspective of how nurse lecturers nurture and role model compassionate care to their students.

CONCLUSION

There are many ways compassionate care is experienced, enacted and enhanced by nurse lecturers within the adult pre-registration nurse curriculum. The five main themes act as a framework to guide nursing education and nursing practice. Future research should aim to understand better how compassionate care can be nurtured within different fields of nursing.

Postgraduate nursing students' experiences with simulation-based learning in palliative care education: A qualitative study

AIM

The aim of this study was to explore postgraduate palliative care nursing students' experiences with simulation-based learning focusing on communication skills, as a learning method in palliative care education.

BACKGROUND

Communication is one of several important competencies in palliative care and found to be challenging. Developing appropriate communication skills in palliative care requires education and practice. To provide postgraduate palliative care nursing students with the required knowledge and experience, practical and active learning approaches, such as simulation-based learning, can be applied. Several studies have explored undergraduate nursing students' experiences with simulation-based learning in palliative care. However, to our knowledge no studies have explored postgraduate palliative care nursing students` experiences with simulation-based learning focusing on communication skills in palliative care education.

DESIGN

An exploratory descriptive design.

METHODS

A qualitative method was employed. Three focus group interviews were conducted in May 2022 using videoconferencing (Zoom) with 11 postgraduate palliative care nursing students, eight of whom wrote reflective notes. Data were analysed using systematic text condensation.

RESULTS

Three categories were identified in the data analysis: 1) from uncertain expectations to the real experience of simulation-based learning; 2) being a skilled professional in everyday life versus being observed in the scenarios; and 3) the balance between self-confidence and challenges in experiencing professional development and mastery.

CONCLUSIONS

Postgraduate palliative care nursing students seemed to experience anxiety towards simulation-based learning in palliative care education, as well as variable expectations for the approach. This could be due to their unfamiliarity with the learning method. The need for repetition was underlined and the students indicated that they would like to be able to participate in several simulation sessions to familiarise themselves with the approach. The contrast between being a skilled professional in everyday life and the pressure of being observed and judged in the scenarios was an important finding. Students outlined the desire to feel safe, but also highlighted the importance of being challenged to experience professional development and enhanced mastery. Generally, the findings indicate that academic and psychological safety should be a focus during simulation-based learning and instructors should understand that students may have varied learning strategies, divergent learning experiences and shifting beliefs in their own competencies.

The use of smart glasses in nursing education: A scoping review

AIM

The aim of this scoping review was to give an overview of the usability and feasibility of smart glasses in nursing education. In addition, this study will highlight nursing students' experiences of using smart glasses in learning situations.

BACKGROUND

Healthcare is becoming increasingly complex and technological and so is nursing education. Technology enhanced learning aims to enhance the teaching-learning process through use of technology, for example through smart glasses.

DESIGN AND METHODS

A literature review using a scoping review methodology was conducted. Qualitative content analysis was performed to analyse data. 14 references were included in the analysis. References were found using the databases PubMed, SCOPUS and ERIC.

RESULTS

The analysis resulted in three categories; (1) Situations in which smart glasses have been used in nursing education, (2) Learning experiences from using smart glasses in nursing education, and (3) User experiences from using smart glasses in nursing education. Smart glasses were used in different learning situations and were in general positively evaluated by nursing students. Although, drawbacks of using smart glasses were noted which could negatively effect student learning.

CONCLUSIONS

Smart glasses have been used in a variety of learning situations in nursing education and enabled new learning situations. Students found smart glasses beneficial for their learning and smart glasses motivated and engaged students in the learning situation. Although, this was both user- and situation dependent. Technical issues could cause students to lose focus and there is need for technical support to facilitate the learning curve. By learning from others' experiences unnecessary drawbacks can be avoided.

Perception of graduates about the education of Nursing Technicians

OBJECTIVES

to interpret the perception of graduates from the nursing technician program on the learning process developed during their education.

METHODS

a qualitative study was conducted from March to September 2021, based on interviews with 20 graduates from a nursing technician program at a school in the Midwest of São Paulo, using thematic analysis and the NVivo tool.

RESULTS

the following themes were identified: traditional teaching methods, active learning strategies, valuing proactivity and experiences in professional practice.

FINAL CONSIDERATIONS

according to the graduates, the teaching process is essentially based on traditional methods, although there are initiatives to implement active strategies and recognition of the importance of advancing student proactivity and practical experience.

Content Analysis of Feedback Journals for New Nurses From Preceptor Nurses Using Text Network Analysis

This study aimed to identify keywords, core topic areas, and subthemes by analyzing feedback journals written by preceptor nurses to new nurses during the preceptorship period and to derive implications through word clustering. A total of 143 preceptor nurses' feedback journals for new nurses from March 2020 to January 2021 were converted into a database using Microsoft Office Excel. Text network analysis was performed using the NetMiner 4.4.3 program. After data preprocessing, simple frequency, degree centrality, closeness centrality, betweenness centrality, and community modularity were analyzed. In the feedback journals, the most central words were "study," "medication," "practice," "nursing," "method," "need," and "effort," whereas frustration, "new nurses" had low centrality. Five subthemes were derived: (1) learning necessity to strengthen new nurses' competency, (2) independence of new nurses, (3) emphasis on accuracy in nursing skills, (4) difficulties in understanding the nursing tasks expected of new nurses, and (5) basic competency of new nurses. The results of this study highlighted the experiences of new nurses and allowed for an assessment of journal feedback content provided by preceptor nurses. As such, the study provides basic data to develop a standardized education and competency empowerment program for preceptor nurses.

Co-creating digital educational resources to enhance quality in student nurses' clinical education in nursing homes: Report of a co-creative process

AIM

To report a methodological, co-creative approach for developing an interactive digital educational resource to enhance the quality of student nurses' clinical education in nursing homes and to elucidate the lessons learned from this approach.

DESIGN

This study applied a co-design methodology that builds on participatory design principles.

METHODS

Co-creating the digital educational resource included multiple sequential and interactive phases inspired by the design thinking framework. Workshops were employed as the primary co-creative activity.

RESULTS

Seven separate homogenous or joint heterogeneous workshops were conducted with student nurses, nurse educators, registered nurse mentors and e-learning designers (n = 36) during the active stakeholder engagement phases to inform the educational content, design and functionality of the digital educational resource. These were informed by, and grounded in, learning theory and principles.

CONCLUSION

Co-creative approaches in nursing education are an essential avenue for further research. We still lack systematic knowledge about the impact and benefits of co-created initiatives, stakeholders' motivations, barriers, facilitators to participation and the role of context in supporting effective co-creative processes to increase the quality of nursing education.

IMPACT

This paper demonstrates how digital educational initiatives to enhance quality in clinical nursing education can be co-created with key stakeholders through a novel methodological approach inspired by design thinking. To date, the methodological development process of co-created educational interventions has received limited attention and compared with the content and theoretical underpinnings of such interventions, has rarely been addressed. Therefore, this paper facilitates knowledge exchange and documents vital aspects to consider when co-creating digital educational initiatives incorporating multistakeholder perspectives. This promotes a stronger academic-practice partnership to impact and enhance the quality of clinical nursing education in nursing homes.

PUBLIC CONTRIBUTIONS

Student nurses, nurse educators, and registered nurse mentors worked alongside researchers and e-learning designers in the co-creative process.

A protocol for a scoping review of the use of mental simulation and full-scale simulation in practising healthcare decision-making skills of undergraduate nursing students

AIM

This scoping review aims to explore the effect of FSS and mental simulation on the decision-making skills of nursing students.

BACKGROUND

Full-scale simulation (FSS) has been the most used simulation modality in nursing education due to its applicability to enhance both technical and non-technical skills. However, FSS can be excessively costly and other factors such as technophobia and lack of trained staff and support make FSS less accessible, especially for nursing education. Therefore, a novel mental simulation that is interactive and supported by visual elements can be a substitute for FSS, at least for some of the skills, such as clinical decision-making. Reviews comparing the effectiveness of FSS and mental simulation on decision-making skills in nursing students are lacking. Further knowledge on the effectiveness of these two modalities on decision-making skills for nursing students is needed to inform the nursing education curriculum and to decide between the two modalities.

DESIGN

This protocol adheres to the guidelines outlined in the PRISMA extension for scoping reviews (PRISMA-scr) checklist.

METHOD

The methodological framework for scoping reviews will be followed for this scoping review. Scopus, EBSCOhost the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE and for the grey literature ERIC and BASE will be searched for related studies. The search will be limited to January 2008 and April 2023 (up-to-date) and English. A detailed search strategy was developed with an experienced research information manager and this strategy will be adapted to each database. A single screening will be performed by an author who will screen all abstracts and titles and full-text publications. After the study selection step of the framework, the data from the included studies will be charted using a data extraction form. The data will be synthesised by comparing the effect of FSS and mental simulation on decision-making skills.

CONCLUSION

A synopsis of the publication on FSS and mental simulation on nurse students' decision-making skills will be useful for stakeholders when choosing between two modalities to deliver decision-making skills to nursing students and also help to inform the nursing education and simulation practice.

SCOPING REVIEW REGISTRATION

Protocols.io (doi: 10.17504/protocols.io.e6nvw57y7vmk/v1).

Effectiveness of SBAR-based simulation programs for nursing students: a systematic review

BACKGROUND

Situation, background, assessment, and recommendation (SBAR) has been extensively used in clinical and nursing education. A structured communication program increases effective communication, positivity, and education satisfaction during inter-professional collaboration among nursing students. This systematic review aimed to identify and synthesize evidence on the effectiveness of SBAR-based simulation training for nursing students.

METHODS

A research protocol was developed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. The protocol for this study was registered in PROSPERO (CRD42021234068). Eight bibliographical databases were searched for studies published between 2001 and 2021, using relevant search terms. Searches were conducted in PubMed, Embase, Cumulative Index to Nursing and Allied Health, and Cochrane Central Register of Controlled Trials for literature in English, and DBpia, Research Information Sharing Service, Korean Studies Information Service System, and Korea Institute of Science and Technology Information for literature in Korean. After screening titles, abstracts, and full-text papers, pertinent data were extracted, and critical appraisals of the retrieved studies were performed. Data were analyzed using the framework approach, and the findings were presented in a narrative summary. The Effective Public Health Practice Project "Quality Assessment Tool for Quantitative Studies" was used to assess the quality of the included studies.

RESULTS

Twelve studies were included: 3 randomized controlled trials and 9 quasi-experimental studies. Two overarching themes were noted, namely communication clarity and critical thinking. The results of six out of 12 studies produced significant results in favor of SBAR-based simulation in terms of communication clarity. Divergent results were obtained regarding communication ability, critical thinking, confidence, learning self-efficacy, and attitude toward patient safety. The results of these studies highlight that communication clarity ultimately leads to positive results in terms of nursing students' behaviors related to patient safety.

CONCLUSIONS

This review provides a comprehensive update of the literature on the effectiveness of SBAR-based nursing simulation programs for nursing students. These programs were found to have positive learning outcomes because of clear and concise communication. Further studies on the effectiveness of various learning outcomes derived from SBAR-based programs are required.

Evaluation of a Theory-Based Virtual Counseling Application in Nursing Education

Effective communication skills in nursing are necessary for high-quality nursing care, but given the decline in nursing students' attitudes and their low self-confidence in effective communication with patients, a participatory and experiential training method is needed. Therefore, a virtual counseling application was developed using artificial intelligence and a three-dimensional avatar to facilitate learning of communication skills. This study aimed to evaluate the effectiveness of this theory-based virtual intervention on nursing students' learning attitudes, communication self-efficacy, and clinical performance. A longitudinal quasi-experimental study was conducted. Ninety-three undergraduate nursing students received virtual patient trainings with four clinical scenarios over 2 years. Data were analyzed using McNemar test and analysis of variance. Virtual patient training improved students' learning attitudes toward communication skills for scenarios involving the pregnant woman (20.4%, P = .03) and depressed patient (17.1%, P = .01) and enhanced perceived self-efficacy for scenarios involving the pregnant woman (22.6%, P = .002) and stressed nursing student (18.3%, P = .002). Students received lower clinical communication scores for pediatric, obstetric, and medical practicums compared with a previous cohort who received no training. Overall, this virtual counseling application can provide a valuable and cost-effective communication learning resource for the nursing curriculum.

Innovative digital technology adapted in nursing education between Eastern and Western countries: a mini-review

Advanced digital technologies have overcome the limitation of on-site teaching, especially after the COVID-19 epidemic. Various newly-developed digital technologies, such as e-learning, virtual reality, serious games, and podcasts, have gained renewed interest and come into the spotlight. Podcasts are becoming increasingly popular in nursing education as they provide a convenient and cost-effective way for students to access educational content. This mini-review article provides an overview of the development of podcasts in nursing education in Eastern and Western countries. It explores potential future trends in the use of this technology. The literature review demonstrates that nursing education in Western countries has already integrated podcasts into curriculum design, using the podcast to convey nursing education knowledge and skills and to improve students' learning outcomes. However, few articles address nursing education in Eastern countries. The benefits of integrating podcasts into nursing education appear far greater than the limitations. In the future, the application of podcasts can serve not only as a supplement to instructional methodologies but also as a tool for clinical practicing students in nursing education. In addition, with the aging population increasing in both Eastern and Western countries, podcasts have the potential to serve as an effective delivery modality for health education in the future, particularly for the older adult, whose eyesight declines with age, and those populations with visual impairments.

Promotion of Student Engagement Through the Application of Good Practices in Nursing Online Education

The purpose of this article is to review Chickering and Gamson's principles of good practice in teaching and to illustrate their applicability to nursing online education delivery. An additional purpose is to present examples of teaching methods used by faculty to promote engagement in online education courses during the pandemic. The original 7 best practices in education, including ( a ) encourages contact between students and faculty, ( b ) develops reciprocity and cooperation among students, ( c ) uses active learning techniques, ( d ) gives prompt feedback, ( e ) emphasizes time on task, ( f ) communicates high expectations, and ( g ) respects diverse talents and ways of learning, remain evidence-based guidelines today. The authors recommend the addition of 2 new best practices: ( a ) incorporating assignment flexibility to meet student learning preferences; and ( b ) applying learning to real-life situations. Having evidence-based guidelines for supporting the role of a teacher in the online learning setting is of paramount importance.

The effect of reinforcement using the Gimkit game on learning the subject in nursing students

AIM

This study was conducted to evaluate the effect of reinforcement using the Gimkit game and question-and-answer method on the achievement test scores of nursing students.

BACKGROUND

Advances in information and communication technology are one of the most important factors affecting change in health systems. The rapid pace of technological evolution has also significantly affected the nursing education curricula. As the nursing profession continues to change and grow, updating learning strategies in nursing education has become a necessity to prepare nursing students for today's health problems.

DESIGN

The study was conducted as a quasi-experimental model using the pretest-posttest control group model in non-randomized groups.

METHODS

The population of the research consisted of first-year students of the nursing faculty of a state university. The sample of the research consisted of first-year students of the nursing faculty who met the research criteria and accepted to participate in the research. The students participating in the research were divided into experimental and control groups using the simple random method. An achievement test, that is, a pre-test, was administered to both groups before the subject was presented. Afterwards, the same subject was presented to all groups by the same instructor during a 4-h training session. A reinforcement strategy using the Gimkit game was implemented with the students in the experimental group, while the traditional question-and-answer method was used as the reinforcement strategy in the control group. After the reinforcements, the achievement test, that is, the post-test, was administered to both groups again.

RESULTS

In the study, it was determined that there was no statistically significant difference between the pre-tests of the experimental group where the Gimkit game was used and the control group where the question-answer method was used (p = 0.223). In addition, a statistically significant difference was found between the post-test scores of the experimental group where the Gimkit game was used and the control group where the question-and-answer method was used (p = 0.009).

CONCLUSION

In the study, it was determined that the use of the Gimkit game was more effective on learning the subject than the traditional question-and-answer method.

Can online learning be a reliable alternative to nursing students' learning during a pandemic? - A systematic review and meta-analysis

OBJECTIVES

To compare online learning with traditional face-to-face and blended learning, based on randomized controlled trials, to determine the impact of online learning on nursing students' learning outcomes.

DESIGN

A systematic review and meta-analysis.

DATA SOURCES

A systematic search was conducted via English (PubMed, ERIC, Embase, CENTRAL, and CINAHL) and Korean databases (RISS, DBpia, and KISS).

REVIEW METHODS

Studies published up to the first week of April 2022 were reviewed with a focus on the participants, intervention, comparison, outcome, and study design format. Following a primary screening of titles and abstracts, and secondary screening of full texts, 10 randomized controlled trial studies were selected, of which eight were included in the meta-analysis. Two researchers independently reviewed the literature, and the final selection was made in consensus.

RESULTS

Online learning had a statistically significant positive effect on nursing students' knowledge, compared with no educational intervention (standardized mean difference (SMD) = 1.63; 95 % confidence interval (CI): 1.31 to 1.95). However, there was no significant difference in the impact of online learning on knowledge compared with blended learning (SMD = -0.14; 95 % CI: -0.70 to 0.41) and face-to-face learning (SMD = 0.37; 95 % CI: -0.32 to 1.06). Furthermore, compared with blended learning (SMD = -0.18; 95 % CI: -0.43 to 0.06) and face-to-face learning (SMD = 0.05; 95 % CI: -0.31 to 0.41), there was no significant difference in the impact of online learning on attitudes toward learning.

CONCLUSIONS

Online learning in nursing education is not significantly different from blended or face-to-face learning in terms of its impact on knowledge acquisition and attitudes toward learning. The results of this review and meta-analysis highlight the need for selective application of learning methods, taking into account learning environments as well as curricular subjects and topics.

The Experience of Patient Safety Error for Nursing Students in COVID-19: Focusing on King's Conceptual System Theory

Some nursing students experience errors related to patient safety, such as falls, medication administration errors, and patient identification errors during clinical practice. However, only a few nursing students report errors during clinical practice. Accordingly, the present study aimed to investigate patient safety errors that nursing students experience during clinical practice in the context of the COVID-19 pandemic. This study conducted in-depth interviews with 14 candidates for graduation from the Department of Nursing at a university in South Korea. In addition, after transcribing the collected data, a directed content analysis for the data based on King's interacting system theory was performed. As a result, four core categories were identified: (i) nursing students' perception of patient safety error occurrence, (ii) interaction between nursing students and others, (iii) interaction between nursing students and organizations, and (iv) nursing students' training needs related to patient safety errors. Consequently, this study identified the patient safety error-related experiences of nursing students during clinical practice during the COVID-19 pandemic. The results suggest that in the future, nursing education institutions must establish a system for nursing students to report patient safety errors during clinical practice for patient safety education and develop practical and targeted education strategies in cooperation with practice training hospitals.

A qualitative exploration of undergraduate nursing students' experience of emotional safety for learning during their clinical practice

BACKGROUND

During their clinical practice, nursing students learn to manage patient safety through their experiences, emotions, and interpersonal relationships.

OBJECTIVES

To explore contextual and mechanistic factors that facilitate a sense of emotional safety for learning in nursing students, particularly regarding patient safety events experienced during their placements.

DESIGN

A descriptive qualitative study using narratives and thematic analysis.

SETTINGS

A university in Northern Italy.

PARTICIPANTS

Undergraduate nursing students recruited through purposive sampling.

METHODS

Twenty cases relevant to the present study were selected from the "Sharing LearnIng from Practice for Patient Safety" (SLIPPS) project database containing 100 narratives collected using the patient safety learning Event Recording Tool. The data were analysed using thematic analysis according to Braun & Clarke's methodology. The themes that emerged from the thematic analysis were rearranged in Context-Mechanism-Outcomes.

RESULTS

Students identified clinical practice experiences as important occasions for their personal and professional development. Emotional safety and tutoring were the elements that effectively "govern" the students' learning and development process.

CONCLUSIONS

Emotional safety is key for nursing students because it enables them to constructively overcome any relational and emotional tensions that may develop during their clinical placements.

Use of Expert Modeling Videos in Undergraduate Nursing Education: A Systematic Review

BACKGROUND

Novice graduate nurses are failing to demonstrate competent patient care in today's complex health care environment. Therefore, nurse educators have begun to critically explore educational methods, through the use of technology, that may affect student learning and clinical competency. Expert modeling videos is one strategy that allows students to observe expert behavior prior to practice and build exemplary care.

METHOD

This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for conducting a systematic review. Inclusion criteria for articles were: (1) experimental and nonexperimental, (2) peer reviewed, (3) primary research, (4), published in English, and (5) written through January 2021.

RESULTS

Fifteen studies were identified that met all of the inclusion criteria.

CONCLUSION

Expert modeling videos have become an attractive educational strategy to promote learning in undergraduate nursing students. Future studies should focus on the use of these videos as a pedagogical strategy to transform learning in nursing education. [J Nurs Educ. 2023;62(2):89-96.].