Gett'n on the bus: evaluation of Sentinel City®3.0 virtual simulation in community/population health clinical placement.

Objectives The purpose of this project was to implement and evaluate the integration of a computer-based virtual simulation program into a community clinical course as an alternative or complement to conventional clinical with agencies or neighbourhoods. Securing quality community health clinical opportunities for undergraduate nursing students remains challenging. In addition, evidence of a theory-practice gap in community clinical education, particularly in non-traditional settings, suggests that nurse educators need to adopt different pedagogies to ensure that students will gain competencies necessary to practice community/population health nursing. In response, we piloted the use of Sentinel City®3.0, a virtual reality simulation program. Method A 5-point Likert-style questionnaire was administered to students randomly assigned to different clinical placements. Results Results indicated that there were no learning outcomes in which students in Sentinel City®3.0 reported percentages lower than students in agencies or geographical neighbourhoods. When there were statistically significant differences, students engaged in Sentinel City®3.0 performed better than students in other experiences. Conclusion We recommend further exploration of multi-contextual pedagogies for community clinical.

A, B, or C? A Quasi-experimental Multi-site Study Investigating Three Option Multiple Choice Questions.

There is nearly a century of educational research that has demonstrated that three option multiple-choice questions (MCQs) are as valid and reliable as four or five option, yet this format continues to be underutilized in educational institutions. This replication study was a quasi-experimental between groups research design conducted at three Canadian schools of nursing to examine the psychometric properties of three option MCQs when compared to the more traditional four option questions. Data analysis revealed that there were no statistically significant differences in the item discrimination, difficulty or mean examination scores when MCQs were administered with three versus four option answer choices.

Virtual versus face-to-face clinical simulation in relation to student knowledge, anxiety, and self-confidence in maternal-newborn nursing: A randomized controlled trial.

BACKGROUND: Clinical simulations can provide students with realistic clinical learning environments to increase their knowledge, self-confidence, and decrease their anxiety prior to entering clinical practice settings. OBJECTIVE: To compare the effectiveness of two maternal newborn clinical simulation scenarios; virtual clinical simulation and face-to-face high fidelity manikin simulation. DESIGN: Randomized pretest-posttest design. SETTING: A public research university in Canada. PARTICIPANTS: Fifty-six third year Bachelor of Science in Nursing students. METHODS: Participants were randomized to either face-to-face or virtual clinical simulation and then to dyads for completion of two clinical simulations. Measures included: (1) Nursing Anxiety and Self-Confidence with Clinical Decision Making Scale (NASC-CDM) (White, 2011), (2) knowledge pretest and post-test related to preeclampsia and group B strep, and (3) Simulation Completion Questionnaire. Before and after each simulation students completed a knowledge test and the NASC-CDM and the Simulation Completion Questionnaire at study completion. RESULTS: There were no statistically significant differences in student knowledge and self-confidence between face-to-face and virtual clinical simulations. Anxiety scores were higher for students in the virtual clinical simulation than for those in the face-to-face simulation. Students' self-reported preference was face-to-face citing the similarities to practicing in a 'real' situation and the immediate debrief. Students not liking the virtual clinical simulation most often cited technological issues as their rationale. CONCLUSIONS: Given the equivalency of knowledge and self-confidence when undergraduate nursing students participate in either maternal newborn clinical scenarios of face-to-face or virtual clinical simulation identified in this trial, it is important to take into the consideration costs and benefits/risks of simulation implementation.

Protective associations of school connectedness with risk of depression in Nova Scotia adolescents.

OBJECTIVE: To determine whether school connectedness demonstrated an independent protective association with risk of depression in students in grades 10 to 12 attending a high school in a rural community in southwestern Nova Scotia. METHODS: Students at a high school in rural Nova Scotia participated in a self-completion survey in May 2009. Students were asked about a wide range of health-related factors to determine their needs for health services and promotion. Examining girls and boys separately, we used logistic regression to examine associations of an established measure of school connectedness with risk of depression as measured by the 12-item Center for Epidemiologic Studies Depression (CES-D) Scale, while including numerous potential confounding variables in our models. RESULTS: The response rate was 95.2% among registered students present in class during the survey. Four hundred eight students (216 girls and 192 boys) completed both the CES-D12 and the School Connectedness Scale. Higher school connectedness was independently protective of risk of depression in girls (OR 0.85; 95% CI 0.78 to 0.93, P < 0.01) and in boys (OR 0.81; 95% CI 0.71 to 0.91, P < 0.01). CONCLUSIONS: Among adolescents in rural Nova Scotia, higher school connectedness has protective associations with risk of depression in both girls and boys, independent of a wide range of factors known to be associated with depression in adolescents. School may be a key place for helping adolescents to develop positive mental health.

High time for a change: psychometric analysis of multiple-choice questions in nursing.

Nurse educators teach students to develop an informed nursing practice but can educators claim the same grounding in the available evidence when formulating multiple-choice assessment tools to evaluate student learning? Multiple-choice questions are a popular assessment format within nursing education. While widely accepted as a credible format to assess student knowledge across disciplines, debate exists among educators regarding the number of options necessary to adequately test cognitive reasoning and optimal discrimination between student abilities. The purpose of this quasi-experimental between groups study was to examine the psychometric properties of three option multiple-choice questions when compared to the more traditional four option questions. Data analysis revealed that there were no statistically significant differences in the item discrimination, difficulty or the mean examination scores when multiple-choice test questions were administered with three versus four option answer choices. This study provides additional guidance for nurse educators to assist in improving multiple-choice question writing and test design.

Nursing graduates' perceptions of their undergraduate clinical placement.

Student clinical practice is a significant and essential part of nursing education. Accordingly, clinical placements need to be positive and valuable. The purpose of this study was to describe newly-graduated nurses' perceptions of their student clinical intersession placements and how these placements impacted their functioning as graduate nurses. Inductive semantic analysis of the data revealed four themes: developing nursing skills and knowledge; preparing for future employment; experiencing supportive relationships; and experiencing realities of work-life. Educators must ensure that clinical placements are in an environment that is conducive to learning and promotes the personal and professional development of nursing students. Positive clinical experiences are more likely related to how valued and supported students feel than the physical aspects of a placement; thus, it is imperative educators assess and focus on providing placements that offer a supportive learning environment.