Implementation of an Evidence-Based Medicine Curriculum for Postgraduate Emergency Medicine Physician Assistant and Nurse Practitioner Fellows.

INTRODUCTION: Within physician assistant (PA) education, the inclusion of evidence-based medicine (EBM) is mandatory. Despite existing literature on EBM training methodologies for PA students and emergency medicine (EM) physician residents, there exists a dearth of published data concerning EBM instruction within postgraduate PA EM programs. A pilot study is described providing an overview of implementation of an EBM curriculum in a single-institution postgraduate physician assistant and nurse practitioner emergency medicine fellowship. METHODS: Quantitative data using pre-curriculum and post-curriculum surveys were collected. The curriculum included statistical concept screencasts, required attendance at a journal club with assigned topics for discussion, and used a critical appraisal tool designed to help fellows better analyze and understand the articles being reviewed. Upon graduation, fellows participated in structured interviews to collect qualitative data about the curriculum and application of learned concepts to the clinical setting. RESULTS: There was a statistically significant improvement in fellows' reported confidence in discussing the medical literature with practicing providers ( P = .02). However, there was no difference in prescores and postscores on EBM knowledge questions or on fellows' feelings of importance of EBM to clinical practice. Qualitative data revealed several themes, including helpfulness of tools provided in the curriculum, appreciation of curricular changes made secondary to fellow suggestions, and reports of improvement in reviewing medical literature and comfort in participation in local journal clubs upon graduation from the fellowship program. DISCUSSION: Limitations, including small sample size and validity concerns, are discussed. Positive changes were made to the curriculum based on qualitative data collected. The authors advocate for subsequent investigations into this subject within a multi-institutional and multispecialty context, thereby enhancing the breadth of the findings. Nevertheless, this study furnishes the initial accessible substantiation of the viability of introducing an EBM curriculum within this specific demographic.

The Efficacy and Use of a Pocket Card Algorithm in Status Epilepticus Treatment.

OBJECTIVE: To determine whether a pocket card treatment algorithm improves the early treatment of status epilepticus and to assess its utilization and retention in clinical practice. METHODS: Multidisciplinary care teams participated in video-recorded status epilepticus simulation sessions from 2015 to 2019. In this longitudinal cohort study, we examined the sessions recorded before and after introducing an internally developed, guideline-derived pocket card to determine differences in the adequacy or timeliness of rescue benzodiazepine. Simulation participants were queried 9 months later for submission of a differentiating identification number on each card to assess ongoing availability and utilization. RESULTS: Forty-four teams were included (22 before and 22 after the introduction of the pocket card). The time to rescue therapy was shorter for teams with the pocket card available (84 seconds [64-132]) compared with teams before introduction (144 seconds [100-162]) (U = 94; median difference = -46.9, 95% confidence interval [CI]: -75.9 to -21.9). The adequate dosing did not differ with card availability (odds ratio 1.48, 95% CI: 0.43-5.1). At the 9-month follow-up, 32 participants (65%) completed the survey, with 26 (81%) self-reporting having the pocket card available and 11 (34%) confirming ready access with the identification number. All identification numbers submitted corresponded to the hard copy laminated pocket card, and none to the electronic version. CONCLUSIONS: A pocket card is a feasible, effective, and worthwhile educational tool to improve the implementation of updated guidelines for the treatment of status epilepticus.

Facilitating problem-based learning among undergraduate nursing students: A qualitative systematic review.

OBJECTIVES: The purpose of this study was to identify and synthesize the best available evidence on the perspective of undergraduate nursing students on facilitating elements that contribute to their success with PBL. DESIGN: a qualitative systematic review of the literature according to meta-aggregative methodology using the JBI SUMARI system was conducted. DATA SOURCES: Data was collected across CINAHL, Medline, Embase, Eric, Teacher Reference Center and reference lists. RESEARCH METHODS: Out of 378 articles, 101 were retrieved for examination and eight were retained after methodological analysis. RESULTS: 51 findings, matched with a verbatim, were extracted and aggregated in five categories: 1) in PBL, the nursing tutor models clinical reasoning and leadership skills; 2) the quality of group interactions is critical to the success of nursing students with PBL; 3) nursing students go through the process of learning with PBL; 4) through PBL, nursing students acquire skills that foster clinical reasoning; and 5) when the PBL method is used as intended, nursing students understand its purpose and process. These categories were aggregated in two syntheses worded as recommendation for practice. CONCLUSIONS: The synthesized recommendations are: 1) tutors should be trained to effectively guide the team work of undergraduate nursing students along the PBL process in order for them to achieve its goal; and 2) nursing students should be securely introduced to PBL and experience the development of their clinical reasoning through PBL. Future research should focus on the strategies undergraduate nursing students use to succeed with PBL and the effectiveness of PBL in enhancing critical thinking and collaboration skills.

Nurse Faculty Knowledge of and Confidence in Teaching Genetics/Genomics: Implications for Faculty Development.

The aims of this project were to (1) assess nurse faculty members' knowledge of and confidence in teaching genetics/genomics to nursing students and (2) identify the needs of faculty members to inform a faculty development initiative. Significant knowledge gaps were noted, and more than 50% of respondents indicated that they lacked confidence in teaching genetics/genomics. Strategies to address this problem included identifying champions of genetics/genomics education, use of an educational template, and threading genetics/genomics throughout the curriculum.

Applications of VoiceThread© Technology in Graduate Nursing Education.

BACKGROUND: Online graduate courses provide opportunities for faculty to use technology and digital applications to enhance student learning and learning environments. In nursing education, as we become increasingly dependent on technology, it is important to ensure that both faculty and students add digital literacy to their repertoire of knowledge and skills. VoiceThread©, one type of Web-based digital application tool, allows students and faculty to verbally communicate and collaborate asynchronously. METHOD: This article discusses the use of VoiceThread technology in graduate nursing education and offers four examples of VoiceThread teaching methods: personal introductions, issues discussions, case presentations, and the elevator speech. RESULTS: Student participation in VoiceThread assignments is evaluated using leveled rubrics. A poll of the students in one of the graduate courses showed high overall satisfaction with VoiceThread in the online classroom. CONCLUSION: Strategies for effective use of VoiceThread technology to enhance student engagement and learning are recommended. [J Nurs Educ. 2016;55(11):655-658.].

Clinical research education: perspectives of nurses, employers, and educators.

The aim of this study was to understand the current environment around clinical research relating to nursing education and practice. This descriptive study analyzed data from 33 in-depth interviews with faculty members, nurse executives, staff development directors, and practicing nurses, as well as an online interactive brainstorming session with 28 deans of schools of nursing (or their designee). Patterns and themes that emerged within each group were identified and analyzed in relation to study objectives. Central themes emerged around participants' knowledge and attitudes about clinical research education for baccalaureate nursing students, factors enhancing or inhibiting inclusion of clinical research content in baccalaureate nursing programs, and professional roles nursing students could expect to assume after graduation. Although the participants agreed that mastery of clinical research knowledge and related skills is important, there was no agreement whether nurses should receive this education and training in baccalaureate programs or in staff development.

A clinical academic practice partnership: a clinical education redesign.

The clinical academic practice partnership (CAPP), a clinical redesign based on the dedicated education unit concept, was developed and implemented by large, private school of nursing in collaboration with 4 clinical partners to provide quality clinical education, to explore new clinical models for the future, and to test an innovative clinical education design. An executive steering committee consisting of nursing leaders and educators from the school of nursing and the clinical institutions was established as the decision-making and planning components, with several collaborative task forces initiated to conduct the work and to accomplish the goals. This article will describe methods to initiate and to organize the key elements of this dedicated education unit-type clinical model, providing examples and an overview of the steps and elements needed as the development proceeded. After 18 months of implementation in 4 different nursing programs in 4 different clinical institutions, the clinical redesign has shown to be a positive initiative, with students actively requesting CAPP units for their clinical experiences. Preliminary findings and outcomes will be discussed, along with nursing education implications for this new clinical redesign.

Using community-based participatory research in parish nursing: a win-win situation!

Parish nurses contribute to community health through the expertise and programming they provide to and through faith communities. Application of community-based participatory research (CBPR) principles helps develop, implement, and evaluate effective community interventions. University graduate students partnered with a Hospital Parish Nurse Program (HPNP) in an urban community to provide assessment data in a CBPR project that led the HPNP to focus resources and interventions on high obesity rates. The HPNP utilized data to write grant proposals to expand community services to impact obesity.

[The contibution of concept development to nursing knowledge? The example of transitoriness]. / Wissensvermehrung durch Konzeptentwicklung? Das Beispiel Vergänglichkeit.

To provide nursing practice with evidence, it is important to understand nursing phenomena in detail. Therefore, good descriptions including the identification of characteristics and attributes of nursing phenomena on various levels of abstraction, i. e., concepts, are needed. In this article the significance of concept development for nursing science will be demonstrated by drawing on the example of 'transitoriness'. The evolutionary concept analysis proposed by Rodgers (2000) is introduced in more detail. Drawing on transitoriness, the phenomenon is presented with the help of the evolutionary concept analysis by Rodgers (2000). The phenomenon's characteristics and attributes are identified, as well as potential areas of application. Moreover, areas are outlined, in which interventions for nursing practice can be developed, implemented and evaluated. Thus, nursing practice is updated to include new findings and innovation. Through concept analysis nursing phenomena can be described in more detail, enhanced or broadened for use in nursing practice. Such structured processes as concept analysis can be employed successfully for other nursing phenomena. Concept analyses can lead to the identification of tasks for the respective scientific discipline and professionals. Thus, concept analyses can lead to the concretisation of tasks in nursing.

Transitoriness in cancer patients: a cross-sectional survey of lung and gastrointestinal cancer patients.

OBJECTIVE: Despite earlier diagnosis and advancements in treatment, cancer remains a leading cause of death in the world (13% of all deaths according to the World Health Organization) among men and women. Cancer accounts for approximately 20% of the deaths in the USA every year. Here, we report the findings from a cross-sectional survey of psychosocial factors in lung and gastrointestinal cancer patients. The aim of the study was to explore the associations among transitoriness, uncertainty, and locus of control (LOC) with quality of life. Transitoriness is defined as a person's confrontation with life's finitude due to a cancer diagnosis. METHODS: A total of 126 patients with lung or gastrointestinal cancer completed eight self-reporting questionnaires addressing demographics, spiritual perspective, symptom burden, transitoriness, uncertainty, LOC, and quality of life. RESULTS: Transitoriness, uncertainty, and LOC were significantly associated with one another (r = 0.3267, p = 0.0002/r = 0.1994, p = 0.0252, respectively). LOC/belief in chance has a significant inverse relationship with patients' quality of life (r = -0.2505, p = 0.0047). Transitoriness, uncertainty, and LOC were found to have a significant inverse relationship with patients' quality of life (transitoriness state: r = -0.5363, p = 0.0000/trait: r = -0.4629, p = 0.0000/uncertainty: r = -0.4929, p = 0.0000/internal LOC: r = 0.1759, p = 0.0489/chance LOC: r = -0.2505, p = 0.0047). CONCLUSION: Transitoriness, uncertainty, and LOC are important concepts as they adversely influence patients' quality of life. Incorporating this finding into the care of cancer patients may provide them with the support they need to cope with treatment and maintenance of a positive quality of life.