Evidence is accumulating that nurses completing pre-licensure programs are not equipped with the essential knowledge and skills for today’s nursing practice, nor prepared to continue learning for tomorrow’s nursing. Citing the need to improve quality and increase capacity, this paper offers three recommendations for transforming nursing education: (1) Create new nursing education systems which use existing resources in community colleges and universities and which provide for common prerequisites and a shared competency-based nursing curriculum and instructional materials. (2) Convene one or more expert panels to develop model pre-licensure curricula which: (a) can be used as a framework by faculty in community college-university partnerships for development of their local curriculum; (b) are based on emerging health care needs and widely accepted nursing competencies as interpreted for new care delivery models; (c) incorporate best practices in teaching and learning. (3) Invest in a national initiative to develop and evaluate new approaches to pre-licensure clinical education, including a required post-graduate residency under a restricted license. The author notes that these changes will require significant investment in the reforms, as well as in nursing education research and faculty development. The return on investment would be improved educational capacity and a better prepared nursing workforce, responsive to emerging health care needs and rapidly changing health care delivery systems. TRANSFORMING PRE-LICENSURE NURSING EDUCATION: PREPARING THE NEW NURSE TO MEET EMERGING HEALTH CARE NEEDS The Carnegie Foundation for the Advancement of Teaching joins a chorus of calls for transformation of pre-licensure nursing education (Benner et al., 2009b). Citing the shift of significant responsibility to nurses for managing complex medical regimens, as well as increasing complexity of community based practices, Benner and colleagues concluded that nurses entering the field are not equipped with the essential knowledge and skills for today’s practice nor prepared to continue learning for tomorrow’s nursing (p. 31). They found (1) weak curricula in natural sciences, technology, social sciences and humanities, and in developing cultural competency; (2) weak classroom instruction and limited integration between classroom and clinical experiences; (3) limited strategies in helping The Future of Nursing: Leading Change, Advancing Health Copyright National Academy of Sciences. All rights reserved.

The Future of Nursing: Leading Change, Advancing Health Key Messages and Report Recommendations

https://www.nursingsimulation.org/article/S1876-1399(12)00330-1/pdf

An Updated Review of Published Simulation Evaluation Instruments

http://lib.ajaums.ac.ir/booklist/24prof_nurs.pdf

Factors Influencing Recruitment and Retention of Nurse Educators Reported by Current Nurse Faculty

AIM This project was designed to explore the feasibility of using simulation for high-stakes assessment in pre-licensure RN programs. METHOD A think tank of experts recommended simulation scenarios suitable for assessing students at the end of their program. Two teams were formed: one to design the simulations, the other to develop the evaluation plan. Scenarios were piloted and refined, then sent to schools across the country. Student performances on video recordings were scored by raters. RESULTS Essential elements of simulation design, implementation, evaluation tools, and processes were found. CONCLUSION Well-designed and facilitated scenarios, delivered in the controlled environment of the simulation center, can be a reliable and valid tool for evaluating the clinical skills of students.

The National League for Nursing Project to Explore the Use of Simulation for High-Stakes Assessment: Process, Outcomes, and Recommendations.

AIM This article aims to assist educators and researchers in determining content validity (CV) and reporting a content validity index (CVI) for simulation scenarios. BACKGROUND Educators and researchers involved in health care curricula may not recognize the need to validate and/or do not know how to validate a simulation scenario. METHOD Two methods based on previous research that can be used to determine CV and report a CVI are discussed (Lynn and Lawshe). RESULTS Simulation scenarios need to be written so experts can fully understand the entirety of content and accurately assess whether items are relevant. Information for a CV template for experts is provided. CONCLUSION Determining item CV and reporting an overall CVI are important elements necessary to simulation scenarios, especially when the scenario is used in a high-stakes assessment or research.

Determining Content Validity and Reporting a Content Validity Index for Simulation Scenarios.

Background Summative simulated-based assessments are intended to determine students' competence in practice. These assessments need to be carefully designed and implemented especially when the results are used to make high-stakes decisions. Method Critical steps need to be followed to design simulations for summative assessment, ensure the validity of the assessment and reliability of the ratings, and train evaluators. Results Guidelines for using simulation for assessment in nursing are suggested. The guidelines are based on the literature and the authors' experiences from a project that examined the feasibility of using simulation for determining students' competence in performance at the end of the nursing program. Conclusion Summative simulation-based assessments need to be valid, measuring the knowledge and skills they are intended to, and reliable, with results being reproduced by different evaluators and by the same evaluator at another time. [J Nurs Educ. 2016;55(6):323-328.].

Summative Simulated-Based Assessment in Nursing Programs.

Aim This article reports one method to develop a standardized training method to establish the inter- and intrarater reliability of a group of raters for high-stakes testing. Background Simulation is used increasingly for high-stakes testing, but without research into the development of inter- and intrarater reliability for raters. Method Eleven raters were trained using a standardized methodology. Raters scored 28 student videos over a six-week period. Raters then rescored all videos over a two-day period to establish both intra- and interrater reliability. Results One rater demonstrated poor intrarater reliability; a second rater failed all students. Kappa statistics improved from the moderate to substantial agreement range with the exclusion of the two outlier raters' scores. Conclusion There may be faculty who, for different reasons, should not be included in high-stakes testing evaluations. All faculty are content experts, but not all are expert evaluators.

Establishing Inter- and Intrarater Reliability for High-Stakes Testing Using Simulation.

https://www.nursingsimulation.org/article/S1876-1399(14)00171-6/pdf

High-Stakes Evaluation: Five Years Later

Background Recognition is increasing that many psychomotor skills essential for safe nursing practice are not being retained. New theories and methods are emerging that, when applied in an organized pedagogical model, could influence initial learning and the retention of critical psychomotor skills. Method This article explains and applies emerging educational theories and concepts relevant to skills teaching in nursing. Results Theories and concepts on cognitive load, deliberate practice, mastery learning, overlearning, spaced learning, and skill decay are integrated to provide a framework for teaching skills in nursing. An example is included of using this framework for skills instruction and practice. Conclusion This framework may improve the nurse educator's ability to prepare learners to perform skills safely in both the skills laboratory and patient care settings and to retain skills. [J Contin Educ Nurs. 2019;50(6):257-262.].

Mary Anne Rizzolo

Papers

The National League for Nursing Project to Explore the Use of Simulation for High-Stakes Assessment: Process, Outcomes, and Recommendations.

Summative Simulated-Based Assessment in Nursing Programs.

Establishing Inter- and Intrarater Reliability for High-Stakes Testing Using Simulation.

High-Stakes Evaluation: Five Years Later

Emerging Theories Influencing the Teaching of Clinical Nursing Skills.