An evaluation tool to measure interdisciplinary critical incident verbal reports.

AIM: The aim was to develop a tool that educators can use to evaluate whether student interdisciplinary critical incident reports are effective. BACKGROUND: Graduate nurses are expected to give physicians concise reports on patient problems. Educators need a method to evaluate whether student reports are effective. METHOD: Students were given instruction and practice in giving verbal reports on critical incidents. An evaluation tool was piloted in this study. RESULTS: Using a paired t-test, it was found that the tool can measure a significant improvement in verbal reports (t = 9.72, df 35, p < .000). Interrater reliability was 94.8 percent. CONCLUSION: The tool can be used to identify weaknesses within a report so that students can receive specific feedback about their communication. As more interdisciplinary training occurs, this tool might be used to promote discussion between disciplines.

Nursing students' perceptions of the effect on critical thinking, assessment, and learner satisfaction in simple versus complex high-fidelity simulation scenarios.

This comparative study with high-fidelity simulation measured students' perceptions of the learning effectiveness of two different levels of assignments (simple vignettes versus complex scenarios). The assignments were evaluated on critical thinking, assessment, and learner satisfaction with the teaching method. No significant difference was found between the means of the simple versus complex assignments on any of the three variables or the total score. In the qualitative comments, students identified that both simple and complex scenarios can be used to help them learn different aspects of the nursing role. Faculty new to this technology can use simple scenarios to learn how to manage the simulation program and still create an effective learning activity.

Combining simulation, instructor-produced videos, and online discussions to stimulate critical thinking in nursing students.

Combining the use of several different types of technology enables an instructor to develop teaching methods to address a specific problem area that students encounter and can greatly affect student learning. This article discusses a program that was developed that utilized SimMan, instructor-produced videos, and online discussion to stimulate critical thinking in beginning-level nursing students. The goal was to make the student aware of the importance of an initial thorough assessment of a client. This is especially difficult since new students are focused on learning the skills and have not had enough clinical experience to appreciate the importance of assessment. The first two videos show a nurse who makes a very incomplete assessment of the client and misses important observations. This leads to the patient (SimMan) going into respiratory distress. The third video demonstrates a complete assessment. The students viewed and discussed the first two videos online. After the third video, students posted their own reflections of this activity including what they learned and how this would change their behavior. The outcome showed an increased awareness of the importance of assessment. Instructors observed a change in behavior, which included early assessment of the client.

Incorporating interprofessional communication skills (ISBARR) into an undergraduate nursing curriculum.

The AACN, in their 2008 Essentials of Baccalaureate Education for Professional Nursing Practice, recommends that colleges of nursing faculty incorporate competencies into their baccalaureate curriculum that focus on the development of professional communication skills. The authors provide a plan to incorporate a standardized communication tool (ISBARR) throughout all levels of an undergraduate curriculum.

Using online exercises and patient simulation to improve students' clinical decision-making.

Faced with increasingly complex clinical situations, nurses must respond with accurate clinical judgment. But del Bueno (2005) reports that only 35 percent of new graduate nurses exhibit entry-level expectations of the necessary critical-thinking skills. Croskerry (2003) argues that clinicians' education should be directed at developing cognitive strategies that reduce errors in clinical decision-making. A challenge for nurse educators is finding activities to help students analyze their thinking as they address clinical problems. The author describes an assignment, given to third-year baccalaureate students, that used both online learning and high-fidelity patient simulation. Through discussions with instructors and peers, as well as personal reflection, students gained insight into both their sound and faulty critical thinking and clinical decisions.

Lymphedema: an under-treated problem.

Lymphedema may affect patients who have had a disease, surgery, or treatments on the lymphatic system. Patient education stressing prevention and early identification of symptoms is essential in controlling this problem.

When orientation ends ... supporting the new nurse who is struggling to succeed.

A new nurse is often left with little support from peers after the orientation period is over. To encourage and support the nurse, a program was developed that used a second preceptor ("buddy") on the shift following the new nurse. Outcomes from this program included the following: new registered nurses received more positive feedback, teamwork between shifts improved, and problems with a new graduate were reported to management sooner and led to earlier interventions.

English-as-a-second language (ESL) nursing students: strategies for building verbal and written language skills.

With the growing number of foreign-born residents in the United States, nurse educators face the challenge of educating students who may have difficulty with the English language. There are an estimated 28.4 million foreign-born residents in the United States, which is the largest number in the history of this country (U.S. Census Bureau, 2001). The U.S. census report (2001) shows that the Hispanic/Latino population has increased by 57.9% since 1990 and now accounts for 12.5% of the total population. Another fast growing group is the Asian population that has increased by 48.3% since 1990 and now accounts for 3.6% of the total population. The Annual Report of the American Association of Colleges of Nursing (AACN, 2001) shows that the minority representation in baccalaureate programs has also increased with the Hispanic/Latino students at 4.8% and the Asian/Pacific Islander/Hawaiian students at 4.7% of the undergraduate nursing student population. Several authors (Abriam-Yago, Yoder, & Kataoka-Yahiro, 1999; Lester, 1998; Davidhizar, Dowd, & Geiger, 1998; Dowell, 1996; Andrews, 1992) have discussed the importance of increasing the number of ethnic minority nurses to insure the quality of healthcare to an increasingly diverse population. As the nursing shortage deepens, recruiting minorities into nursing is essential to meet the increasing demand. This change presents unique challenges and opportunities in nursing education. Colleges and universities will need to develop innovative programs to attract these nontraditional students, and support programs to help them complete the nursing curriculum.