Showing papers in "Journal of Nursing Education in 2014"
TL;DR: The need for more nurses, current attrition rates among schools of nursing, at-risk student characteristics, and previous attempts to increase student success are examined, as well as recommendations for other nursing programs facing issues with student attrition.
Abstract: With the passage of the Affordable Care Act and as the number of aging and diverse individuals in society increases, access to health care will expand and the need for more competent and diverse nursing graduates will increase. An adequate number of nurse graduates is imperative to meet societal demands; however, this is complicated by high nursing student attrition rates. This article examines the need for more nurses (including those from diverse backgrounds), current attrition rates among schools of nursing, at-risk student characteristics, and previous attempts to increase student success. Applying the evidence to practice, findings from a multipronged approach to increase student success within an associate degree nursing program located within a historically Black college and university in the midwestern United States are discussed. The program's successes and opportunities for improvement are examined, as well as the recommendations for other nursing programs facing issues with student attrition.
131 citations
TL;DR: The identified content of patient safety was learning from errors, responsible individual and interprofessional team working, anticipatory action in complex environments, and patient safety-centered nursing.
Abstract: Preventing adverse events and enhancing patient safety in health care are key objectives of nursing education. This integrative literature review critically appraises the content of patient safety in prelicensure nursing education, the teaching and learning methods used, and subsequent nursing student learning. The studies (N = 20) reviewed reveal that patient safety in nursing curricula was not necessarily obvious. However, patient safety was taught within both academic settings and clinical environments. The identified content of patient safety was learning from errors, responsible individual and interprofessional team working, anticipatory action in complex environments, and patient safety-centered nursing. The teaching and learning methods used included combining multiple methods. Patient safety curricula included continuing improvement in patient safety competency, sensitivity to nursing students' role, and having a supportive learning environment. Patient safety in the nursing curriculum requires broad, comprehensive attention and development as a specific theme with an interprofessional approach.
98 citations
TL;DR: This article comprehensively reviews the available nursing simulation literature about the phenomenon of prebriefing and critically evaluates its current role as a component of nursing simulation.
Abstract: Simulation has gained much attention in the literature for its contributions to nursing education; however, the simulation process itself and how each of the components-prebriefing, scenario, and debriefing-are effective for learning are understudied. Specifically, how prebriefing may enrich simulation for learners without adequate prior clinical experience or how it may develop complex thinking skills and clinical judgment is not well understood. This article comprehensively reviews the available nursing simulation literature about the phenomenon of prebriefing and critically evaluates its current role as a component of nursing simulation. Gaps in the reviewed literature regarding the definition and purpose of prebriefing, alternate learning structures used in prebriefing, and use in relation to learner outcomes were identified. Implications for undergraduate nursing education and recommendations for further research are discussed.
93 citations
TL;DR: Results revealed differences in frequency of engagement in and attitudes toward academic dishonesty by gender, semester in the program, and ethnicity, and relationships were also found among peer behavior, personal beliefs and values, and frequency of engaging in academics dishonesty.
Abstract: This quantitative study identified sociodemographic and situational conditions that affected 336 nursing students' engagement in academic dishonesty, their attitudes regarding various forms of academic dishonesty, and the prevalence of academic dishonesty in which they engaged and witnessed. More than half of the participants reported cheating in the classroom and in the clinical settings. A positive relationship was found between the frequency of cheating in classroom and clinical settings. Results revealed differences in frequency of engagement in and attitudes toward academic dishonesty by gender, semester in the program, and ethnicity. Relationships were also found among peer behavior, personal beliefs and values, and frequency of engaging in academic dishonesty.
92 citations
TL;DR: The author's recent experiences with flipping a statistics course for nursing students in a PhD program, including practical considerations and student outcomes and reaction are presented, which deepened the level of student learning in a way that may not have occurred using a traditional format.
Abstract: Flipped classrooms are so named because they substitute the traditional lecture that commonly encompasses the entire class period with active learning techniques, such as small-group work. The lectures are delivered instead by using an alternative mode--video recordings--that are made available for viewing online outside the class period. Due to this inverted approach, students are engaged with the course material during the class period, rather than participating only passively. This flipped approach is gaining popularity in many areas of education due to its enhancement of student learning and represents an opportunity for utilization by instructors of statistics courses in nursing education. This article presents the author's recent experiences with flipping a statistics course for nursing students in a PhD program, including practical considerations and student outcomes and reaction. This transformative experience deepened the level of student learning in a way that may not have occurred using a traditional format.
91 citations
TL;DR: The legal impact of privacy concerns when social media is used as a teaching tool is explored and standards of conduct and privacy considerations related to social media are educated.
Abstract: The astonishing popularity of social media and its emergence into the academic arena has shown tremendous potential for innovations in teaching. The appeal of using social media in the learning environment is enhanced by accessibility and affordability. However, it has also broadened the scope of consideration for protecting student privacy. This article explores the legal impact of privacy concerns when social media is used as a teaching tool. Institutions of higher learning must formulate guidelines that will govern appropriate social media use so that novel teaching modalities can be safely explored. Students must be educated by faculty regarding the standards of conduct and privacy considerations related to social media. The National Council of State Boards of Nursing has issued the White Paper: A Nurse's Guide to the Use of Social Media, a must-read for nursing faculty in the current academic arena.
90 citations
TL;DR: The findings of the systematic review generally support Tanner's original model of clinical judgment and reasoning in nursing, although the role of experience in clinical reasoning and judgment is still not well understood or fully established.
Abstract: A systematic review was conducted to examine the findings on clinical judgment and reasoning in nursing that have emerged since Tanner's review in 2006. Electronic databases were searched to locate primary research studies about clinical judgment and reasoning in nursing. Fifteen studies were extracted and analyzed using the five main conclusions outlined by Tanner. The findings of the systematic review generally support Tanner's original model, although the role of experience in clinical reasoning and judgment is still not well understood or fully established. In recent literature, researchers have furthered their knowledge by using tools for improving these skills in both nursing students and practicing nurses, although no one strategy has been identified as being more effective. This is reflected in the consideration of a sixth conclusion on clinical judgment and reasoning in nursing-education strategies to improve clinical judgment may influence what a nurse brings to the situation.
87 citations
TL;DR: The NASC-CDM scale may be a useful assessment tool for nurse educators to help novice clinicians improve CDM skills.
Abstract: Clinical decision making (CDM) is a cornerstone skill for nurses. Self-confidence and anxiety affect the learning and adeptness of CDM. This study aimed to develop and test a quantitative tool to assess undergraduate nursing students' self-confidence and anxiety during CDM. The 27-item Nursing Anxiety and Self-Confidence with Clinical Decision Making (NASC-CDM) scale is a 6-point, Likert-type tool with two subscales. Two samples of prelicensure associate and baccalaureate nursing students participated in the pilot (n = 303) and main testing (n = 242) phases of the study. Construct validity assessment, using exploratory factor analysis, produced a stable three-dimensional scale. Convergent validity assessment produced positive, moderate, and statistically significant correlations of the tool sub-scales with two existing instruments. Internal consistency reliability was assessed for each subscale (self-confidence, α = .97; anxiety, α = .96). The NASC-CDM scale may be a useful assessment tool for nurse educators to help novice clinicians improve CDM skills.
81 citations
TL;DR: A survey of a nationally representative sample of 3,120 full-time nurse faculty members in 269 schools and programs that offered at least one prelicensure degree program found major contributors to burnout were dissatisfaction with workload and perceived inflexibility to balance work and family life.
Abstract: The current and projected nurse faculty shortage threatens the capacity to educate sufficient numbers of nurses for meeting demand. As part of an initiative to foster strategies for expanding educational capacity, a survey of a nationally representative sample of 3,120 full-time nurse faculty members in 269 schools and programs that offered at least one prelicensure degree program was conducted. Nearly 4 of 10 participants reported high levels of emotional exhaustion, and one third expressed an intent to leave academic nursing within 5 years. Major contributors to burnout were dissatisfaction with workload and perceived inflexibility to balance work and family life. Intent to leave was explained not only by age but by several potentially modifiable aspects of work, including dissatisfaction with workload, salary, and availability of teaching support. Preparing sufficient numbers of nurses to meet future health needs will require addressing those aspects of work-life that undermine faculty teaching capacity.
76 citations
TL;DR: Simulation is effective at increasing self-efficacy among novice nurses, compared with traditional control groups, and was favored over control teaching interventions in improving self- efficacy in studies with experimental designs.
Abstract: The influence of simulation on self-efficacy for novice nurses has been reported inconsistently in the literature. Effect sizes across studies were synthesized using random-effects meta-analyses. Simulation improved self-efficacy in one-group, pretest-posttest studies (Hedge's g=1.21, 95% CI [0.63, 1.78]; p<0.001). Simulation also was favored over control teaching interventions in improving self-efficacy in studies with experimental designs (Hedge's g=0.27, 95% CI [0.1, 0.44]; p=0.002). In nonexperimental designs, consistent conclusions about the influence of simulation were tempered by significant between-study differences in effects. Simulation is effective at increasing self-efficacy among novice nurses, compared with traditional control groups.
72 citations
TL;DR: To prepare students for professional practice, one university embedded Tanner's model of clinical judgment within the nursing curricula and integrated simulations and there was interest in seeking students' opinions of "what matters most" in the design and delivery of simulations.
Abstract: As the pedagogy of health care simulation matures, the level of guidance provided and types of simulation components included increasingly vary. To prepare students for professional practice, one university embedded Tanner's model of clinical judgment within the nursing curricula and integrated simulations. There was interest in seeking students' opinions of "what matters most" in the design and delivery of simulations, which may vary from the academic's viewpoint. Senior undergraduate nursing students (N = 150) from three types of study programs rated 11 simulation components in relation to clinical judgment. The three student groups rated all components above 2.9 on a 5-point Likert scale, with some variation across groups for component rankings. The highest ranking components for applying clinical judgment were facilitated debriefing, postsimulation reflection, and guidance by the academic. The lowest ranked components were patient case notes and briefing and orientation to the simulation area. Age and previous nursing experience did not influence the study variables.
TL;DR: The purpose of this article is to provide an overview of the Poisson distribution and its use in Poisson regression and an illustrative example is presented with an application from the ENSPIRE study.
Abstract: Nurse investigators often collect study data in the form of counts. Traditional methods of data analysis have historically approached analysis of count data either as if the count data were continuous and normally distributed or with dichotomization of the counts into the categories of occurred or did not occur. These outdated methods for analyzing count data have been replaced with more appropriate statistical methods that make use of the Poisson probability distribution, which is useful for analyzing count data. The purpose of this article is to provide an overview of the Poisson distribution and its use in Poisson regression. Assumption violations for the standard Poisson regression model are addressed with alternative approaches, including addition of an overdispersion parameter or negative binomial regression. An illustrative example is presented with an application from the ENSPIRE study, and regression modeling of comorbidity data is included for illustrative purposes.
TL;DR: Simulation is significantly more effective than traditional training in helping to improve nursing students' knowledge acquisition, knowledge retention, and confidence about ACLS.
Abstract: This study examined the effect of simulation on nursing students' knowledge of advanced cardiac life support (ACLS), knowledge retention, and confidence in applying ACLS skills. An experimental, randomized controlled (pretest-posttest) design was used. The experimental group (n = 40) attended an ACLS simulation scenario, a 4-hour PowerPoint presentation, and demonstration on a static manikin, whereas the control group (n = 42) attended the PowerPoint presentation and a demonstration only. A paired t test indicated that posttest mean knowledge of ACLS and confidence was higher in both groups. The experimental group showed higher knowledge of ACLS and higher confidence in applying ACLS, compared with the control group. Traditional training involving PowerPoint presentation and demonstration on a static manikin is an effective teaching strategy; however, simulation is significantly more effective than traditional training in helping to improve nursing students' knowledge acquisition, knowledge retention, and confidence about ACLS.
TL;DR: A near-peer teaching experience, using upper-level nursing students as standardized patients, was created as an educational intervention and the premises of social cognitive theory were incorporated into this teaching activity.
Abstract: Simulation in nursing education uses specific patient scenarios to provide students with hands-on learning experiences. A near-peer teaching experience, using upper-level nursing students as standardized patients, was created as an educational intervention. The premises of social cognitive theory, which include cognitive, behavioral, and environmental factors, were incorporated into this teaching activity. The upper-level students played the role of a patient, while they also practiced leadership, teaching, and mentoring of first-semester nursing students. In the scenario, the first-semester students provided care to the patient, while focusing on safety, identifying the problem, and practicing clinical decision making. Faculty were present to provide guidance and promote communication in debriefing. Near-peer teaching provided a learning opportunity for all students, facilitated teamwork, and encouraged knowledge and skills attainment.
TL;DR: A qualitative and quantitative research study of the influence of a 2-week service-learning medical experience of a nursing student group who traveled abroad to Belize, Central America is presented.
Abstract: One method of gaining knowledge, skills, and experience with different cultures for nurses and nursing students is through an international immersion program of training in language, culture, and community nursing. This article presents a qualitative and quantitative research study of the influence of a 2-week service-learning medical experience of a nursing student group who traveled abroad to Belize, Central America.
TL;DR: There was a clear distinction in the reasoning skills of the novice students compared with students with more clinical experience, and Tanner's model of clinical judgment in nursing is used to understand the findings.
Abstract: The purpose of this project was to examine the clinical judgment and reasoning skills of nursing students in high-fidelity simulation. Two levels of students (N = 104), novices and those who are slightly more advanced, participated in individual videotaped simulations. Afterward, interviews were conducted to explore what the student was thinking and feeling during simulation. Five themes emerged from the interviews: thinking like a nurse, assessment, looking for answers, communication, and magical or reflective thinking. There was a clear distinction in the reasoning skills of the novice students compared with students with more clinical experience. Tanner's model of clinical judgment in nursing is used to understand the findings of the study.
TL;DR: Qualitative findings from a mixed-methods study that focused on clinical judgment in the simulated perioperative care of an older adult, affirming the value of expert role models are reported.
Abstract: Nurse educators must foster development of clinical judgment in students to help them provide the best care for the increasing population of older adult patients. This article reports qualitative findings from a mixed-methods study that focused on clinical judgment in the simulated perioperative care of an older adult. The sample was composed of treatment and control groups of prelicensure students (N = 275) at five sites. The treatment group watched a video of an expert nurse role model caring for a patient similar to the simulation patient, whereas the control group did not watch the video. Four weeks after simulation, participants cared for real-life, older adult perioperative patients. After the simulated and real-life care experiences, participants completed questionnaires related to clinical judgment dimensions. These two data sets revealed rich findings about the students' simulation learning, affirming the value of expert role models. Transferability of simulation learning to practice was also explored.
TL;DR: This study supports peer-assisted learning as an effective teaching strategy for learning nursing skills and implementing the roles of the professional nurse in the clinical setting.
Abstract: Peer-assisted learning was implemented at a private university. Senior nursing students were assigned to assist sophomores during their fundamentals clinical experience. The aim of this study was to evaluate the effectiveness of peer-assisted learning in the clinical setting and to ascertain students' perceptions of fulfilling the roles of the professional nurse. During a 2-year period, 342 students participated in peer-assisted learning. Major outcomes identified by sophomores were reduced anxiety and increased confidence. A major benefit for seniors was reflection on their professional development, which strengthened their confidence and facilitated transition into the role of professional nurse. Future research should examine the impact of diversity and learning styles on this strategy and faculty perception of peer-assisted learning at achieving learning outcomes and relieving faculty burden. This study supports peer-assisted learning as an effective teaching strategy for learning nursing skills and implementing the roles of the professional nurse.
TL;DR: This review offers nurse educators and researchers a comprehensive, practical examination of the methods and evaluations for simulationdebriefing in the educational setting, clarifies terminology, and describes how the debriefing methods, phases, approaches, elements, and evaluations are interrelated.
Abstract: Debriefing is the most important aspect of simulated learning, but actual debriefing practices are not evidence based or widely known. Expert opinions on effective simulation debriefing have been widely published and likely guide debriefing in nursing education. However, various terms are used to discuss simulation debriefing, making it difficult to distinguish debriefing methods. Also, the means for evaluating simulation debriefing are lacking. The purpose of this review is to identify and examine methods and evaluations for simulation debriefing in the educational setting. Twenty-two methods and seven evaluations for simulation debriefing were found. Four areas of differences among methods-suggested uses, design features, supplemental resources, and means for evaluation-were demonstrated. This review offers nurse educators and researchers a comprehensive, practical examination of the methods and evaluations for simulation debriefing in the educational setting, clarifies terminology, and describes how the debriefing methods, phases, approaches, elements, and evaluations are interrelated.
TL;DR: The reliability and validity of a patient safety competency self-evaluation (PSCSE) tool used to assess nursing students' perception of their own competency regarding patient safety and to develop educational strategies integrating patientSafety competency into nursing curricula is evaluated.
Abstract: This study aimed to evaluate the reliability and validity of a patient safety competency self-evaluation (PSCSE) tool An exploratory factor analysis (EFA) was used to investigate the compositions of the PSCSE The internal structure of the PSCSE was schematized using a confirmatory factor analysis (CFA) Three hundred fifty-four students attending six schools of nursing participated in the study On the basis of the results of the CFA, the PSCSE consisted of 12 factors (four for attitude, six for skill, and two for knowledge) with a good model fit It was confirmed that the structures of the PSCSE were identical between EFA and CFA The PSCSE consisted of multidimensional structures of the 12 factors and hierarchical models of three categories The PSCSE can be used to assess nursing students' perception of their own competency regarding patient safety and to develop educational strategies integrating patient safety competency into nursing curricula
TL;DR: Suggestions for implementing and integrating recommendations given in the Guidelines for Assessment and Instruction in Statistics Education (GAISE) report into statistics education for nursing students are included.
Abstract: Statistics coursework is usually a core curriculum requirement for nursing students at all degree levels. The American Association of Colleges of Nursing (AACN) establishes curriculum standards for academic nursing programs. However, the AACN provides little guidance on statistics education and does not offer standardized competency guidelines or recommendations about course content or learning objectives. Published standards may be used in the course development process to clarify course content and learning objectives. This article includes suggestions for implementing and integrating recommendations given in the Guidelines for Assessment and Instruction in Statistics Education (GAISE) report into statistics education for nursing students.
TL;DR: In this paper, the authors focused on the ability to predict NCLEX-RN pass rates on the basis of prenursing academic aptitude variables and the Assessment Technologies Institute (ATI) nursing aptitude program.
Abstract: Accurately predicting NCLEX-RN® success has a positive impact on all nursing education stakeholders. This study focused on the ability to predict NCLEX-RN pass rates on the basis of prenursing academic aptitude variables and the Assessment Technologies Institute (ATI) nursing aptitude program. The ATI predictors were the Test of Essential Academic Skills (TEAS) and fi ve ATI subject tests: Fundamentals, Medical Surgical, Nursing Care of Children, Mental Health, and Maternal Newborn. The prenursing variables comprised the prenursing grade point average, a prerequisite communication course, and the ATI TEAS composite subscores of TEAS Reading, TEAS Math, TEAS Science, and TEAS English. This study included participants from four baccalaureate nursing programs in the California State University system. Results of canonical correlation, multiple linear regression, and logistic regression revealed a significant correlation among prenursing, ATI scores, and NCLEXRN fi rst-try pass rates. Prediction of NCLEX-RN success rate using standardized testing data was supported, with the strongest predictors being the ATI Medical Surgical and ATI Mental Health tests.
TL;DR: The authors call for a professional dialogue about the use of first-time pass rate (F-TPR) as an indicator of program quality, offer alternative methods for using the F-T PR as one measure of programquality, and suggest further research.
Abstract: The first-time NCLEX-RN(®) pass rate is considered by many to be the primary, if not sole, indicator of the quality of prelicensure nursing education programs. Used by state boards of nursing, educational program accreditors, and nursing faculty, the first-time NCLEX-RN pass rate influences important decisions about overall program quality, admission and progression policies, curricula, and teaching and learning practices. In this article, the authors call for a professional dialogue about the use of first-time pass rate (F-TPR) as an indicator of program quality, offer alternative methods for using the F-TPR as one measure of program quality, and suggest further research. One program's experience with low F-TPRs is offered as an exemplar of the unintended negative consequences that occur when the F-TPR is used as a sole criterion by a state board of nursing in judging a program's quality.
TL;DR: Nursing education should focus on increasing students' self-confidence in their EBP competencies to support engagement in EBP implementation behaviors, because a nursing workforce ready to deliver care using an evidence-based approach has the potential of improving patient outcomes.
Abstract: With evidence-based practice (EBP) as an expected core competency for all health care professionals and the integration of EBP competencies in nursing curricula, the process of translating EBP knowledge to EBP implementation behaviors among graduating baccalaureate nursing students was examined. A sample of 174 students in four states participated in this online survey. Results showed students scored low on their EBP knowledge test and engagement in EBP implementation behaviors. However, students were moderately confident in their EBP readiness. EBP readiness was a significant mediator between knowledge and engagement in implementation behaviors. Nursing education should focus on increasing students' self-confidence in their EBP competencies to support engagement in EBP implementation behaviors. A nursing workforce ready to deliver care using an evidence-based approach has the potential of improving patient outcomes.
TL;DR: Findings indicate gaps exist in the preparation of clinical faculty and Graduate education, comprehensive orientation programs, and continuing professional development may help to ensure faculty are effective in managing and evaluating student learning.
Abstract: Nursing faculty who teach in clinical settings face complex situations requiring evidence-based educational and evaluative strategies, yet many have had limited preparation for these tasks. A convenience sample of 74 nursing faculty participated in a survey about clinical teaching in prelicensure nursing programs. Most faculty developed teaching skills through conferences (57%), orientation at their educational institution (53%), or exposure in graduate school (38%). Thirty-one percent reported having no preparation for clinical teaching. Faculty felt least prepared to manage students with learning, physical, or emotional disabilities and incivility. Twenty-six percent had no preparation for evaluating students in the clinical setting, and only 17% had worked with a faculty mentor. Few evidence-based teaching strategies were used by the faculty. These findings indicate gaps exist in the preparation of clinical faculty. Graduate education, comprehensive orientation programs, and continuing professional development may help to ensure faculty are effective in managing and evaluating student learning.
TL;DR: The goals of this learning activity were to decrease the well-known classroom-clinical gap by enhancing engagement, providing deeper understanding of cardiac function and disorders, enhancing critical thinking, and improving clinical application.
Abstract: This article reports the outcomes of a kinesthetic learning strategy used during a cardiac lecture to engage students and to improve the use of classroom-acquired knowledge in today's challenging clinical settings. Nurse educators are constantly faced with finding new ways to engage students, stimulate critical thinking, and improve clinical application in a rapidly changing and complex health care system. Educators who deviate from the traditional pedagogy of didactic, content-driven teaching to a concept-based, student-centered approach using active and kinesthetic learning activities can enhance engagement and improve clinical problem solving, communication skills, and critical thinking to provide graduates with the tools necessary to be successful. The goals of this learning activity were to decrease the well-known classroom-clinical gap by enhancing engagement, providing deeper understanding of cardiac function and disorders, enhancing critical thinking, and improving clinical application.
TL;DR: Instructional style and strategies received positive student feedback and were found to promote a student-centered environment and active learning, thus assisting students and educators alike in overcoming obstacles imposed on learning environments.
Abstract: Nursing students are challenged by content-laden curricula and learning environments that emphasize testing outcomes. Likewise, educators are challenged to support student-centered learning in a manner that encourages students to connect and act upon their personal motivations. This article describes the use of cognitive load theory (CLT) as an instructional design framework for an undergraduate pharmacology for nursing course. Guided by the principles of CLT, four instructional strategies were used in this course: (a) opening review activities, (b) providing students with lecture notes, (c) a "Top Five" prototype approach, and (d) deciphering "Need to Knows" from "Nice to Knows." Instructional style and strategies received positive student feedback and were found to promote a student-centered environment and active learning. On the basis of this feedback, cognitive load theory may be a successful and effective framework for undergraduate pharmacology and other nursing courses, thus assisting students and educators alike in overcoming obstacles imposed on learning environments.
TL;DR: The purpose of this study was to provide additional evidence of the validity and reliability of the SCT in evaluating clinical reasoning in nursing students by replicating a previous study.
Abstract: The purpose of this tool validation study was to provide additional evidence of the validity and reliability of the Script Concordance Test (SCT) in evaluating the clinical reasoning competency of nursing students by replicating the study conducted by Deschenes, Charlin, Gagnon and Goudreau (2011). The question this researcher attempted to answer was: Can script concordance testing be utilized in nursing education to accurately assess clinical reasoning skills? The study was conducted on a convenience sample of 48 first year bachelor of nursing students. The Script Concordance Test from the Deschenes et al. (2011) study was administered to the students and 13 panel members. A scoring grid was developed using the aggregate scores method based on the modal responses of the panel. The reliability of the scores was measured by Cronbach's alpha coefficient and the scores of the students and panel were compared using a t-test. The difference between the panel and student scores was statistically significant and the reliability of the scores was high. The SCT provides a reliable, standardized, and easy to administer method of evaluating clinical reasoning in nursing students.
TL;DR: Students' critical thinking scores showed significant improvement after the use of simulation courseware using high-fidelity simulators and standardized patients, and bivariate transformation of upper and lower groups in critical thinking achievement revealed a significant difference in the clinical judgment ability between the two groups.
Abstract: This study examined the effect of integrated pediatric nursing simulation courseware on students' critical thinking and clinical judgment. Ninety-five senior nursing students participated in this study. Every student followed the established courseware schedule, as well as the regular pediatric nursing practicum. The courseware schedule included two simple simulation scenarios and one comprehensive scenario on the first day of the first, second, and third weeks of the practicum. Students' critical thinking scores showed significant improvement after the use of simulation courseware using high-fidelity simulators and standardized patients. No significant predictors were found for improvement in critical thinking, but bivariate transformation of upper and lower groups in critical thinking achievement revealed a significant difference in the clinical judgment ability between the two groups. Simulation courseware supplementation is an innovative learning strategy for improving nursing students' critical thinking and clinical judgment during clinical practicum. Clinical judgment may play a role in facilitating nursing student improvement in critical thinking ability.
TL;DR: Predictors of undergraduate faculty use of high-fidelity human patient simulation support that nursing faculty's beliefs about HFHPS were strongly associated withHFHPS use, and self-efficacy beliefs and further exploration of the meaning of a safe environment for student learning should be addressed in future studies.
Abstract: High-fidelity human patient simulation (HFHPS) is an innovative teaching tool. However, limited data exist regarding factors affecting faculty use of HFHPS in undergraduate nursing education. Using a convergent, parallel, mixed-methods design, predictors of undergraduate faculty (N = 139) use of HFHPS were explored. Data were collected using a Web-based survey. Results indicated a high percentage of HFHPS use in nursing programs but a low percentage of HFHPSs substituting for traditional clinical hours. Faculty who substituted clinical hours with HFHPS had lower self-efficacy beliefs around HFHPS than other faculty surveyed. Qualitative data supported the quantitative findings, including themes that HFHPS provided a safe environment for learning, but it was a mixed result. Results support that nursing faculty's beliefs about HFHPS were strongly associated with HFHPS use. Specifically, self-efficacy beliefs and further exploration of the meaning of a safe environment for student learning should be addressed in future studies.