Evaluation of the Maryland Next Gen Test Bank Project: Implications and Recommendations.

AIM: The aim of this study was to evaluate the development and impact of a project to create a statewide test bank of Next Generation NCLEX®-style items. BACKROUND: Using a train-the-trainer model, champions created an open access resource of Next Generation NCLEX-style items to use to teach clinical judgment and then trained peers on item writing and test bank use. METHOD: Stufflebeam's CIPP (context, inputs, process, and products) model provided the framework for the evaluation. Data were synthesized from multiple sources including participation rates, item utilization, and survey data. RESULTS: Twenty faculty from 13 schools were trained as champions and submitted 54 case studies, 33 bowties, and 21 trend items to the test bank. Items were used over 60,000 times in the first year. CONCLUSION: The statewide test bank met a need for more teaching resources. The train-the-trainer model was an effective strategy for helping faculty learn to prepare for Next Generation NCLEX.

Creating a Peer Review Process for Faculty-Developed Next Generation NCLEX Items.

BACKGROUND: This article reports the findings from a pilot study of a peer review process used with a group of faculty champions who were writing items for a state-wide initiative to establish a Next Generation NCLEX item teaching test bank. METHODS: Champions were oriented to the peer review process in a face-to-face session and completed reviews using the Clinical Judgment Item Peer Review Form created for the project. RESULTS: Eighteen faculty from 13 different schools attended the session and completed 55 reviews of 40 cases and 35 stand-alone items. Champions took approximately an hour to complete each case study and related stand-alone item review and give actionable feedback. CONCLUSIONS: The peer review process benefits reviewers and authors learning to write Next Generation NCLEX questions. The process used in this project can be replicated by other faculty in their own programs.

Reading a Q Methodology Research Article.

Health care studies that use Q methodology have increased dramatically in recent years, but most nurses have not learned about this mixed methods approach in their research classes. This teaching column will help readers understand some of the unique terms and characteristics of Q methodology. Understanding this method can help nurses performing evidence-based practice and education. [J Contin Educ Nurs. 2022;53(1):10-12.].

A scoping review of Q methodology nursing education studies.

OBJECTIVES: The purpose of this review was to examine the characteristics of published Q methodology nursing education studies including the purposes, the methodological variations, and the major implications to inform best practices. DESIGN: Scoping review design using the Preferred Reporting Items for Systematic Reviews Extension for Scoping Reviews. DATA SOURCES: Academic Search Complete, CINAHL Complete, Education Research Complete, Embase, ERIC, Proquest Nursing and Allied Health, PubMed, PsycInfo, SocINDEX, and the Web of Science Core Collection. REVIEW METHODS: A comprehensive search of English language journal articles was conducted for Q methodology studies published between 2015 and 2020 that used undergraduate nursing students or nursing faculty as participants. Data were extracted using a modified version of the Assessment Review Instrument for Q Methodology. RESULTS: Eighteen studies from five countries met inclusion criteria. The majority were single-site studies and used nursing students as participants. The number of stimuli for sorting in the Q sample ranged from 21 to 60. Study aims fell into three broad domains: attitudes about patient populations or settings (N = 7), perceptions about teaching methods (N = 9), or beliefs about professional/practice issues (N = 2). Seven studies specifically explored simulation. Unique viewpoints discovered ranged from one to five in each study. Findings were used to inform teaching, create curricula, evaluate programs, and to generate more questions for study. Strategies for reporting the Q methodology research steps and findings varied significantly. CONCLUSION: Q methodology is a useful research approach to discover variations in perspectives to inform best educational practices. Use of a standardized flow sheet could enhance reporting the Q methodological approach which may lead to a better understanding and acceptance of the method in the discipline.

Viewpoints on Undergraduate Research Among Nursing Students Conducting Q-Methodology Studies.

BACKGROUND: This article describes using Q-methodology to evaluate changes in attitudes about research among baccalaureate nursing students conducting Q-methodology studies as part of an undergraduate honors research program. METHOD: Five senior students, who had designed Q-methodology studies, sorted 36 opinion statements about undergraduate research based on two conditions of instruction: (a) according to their current attitudes, and (b) according to their beliefs before they began the honors program. RESULTS: A two-factor final solution explained 70% of the variance. The Getting Ahead section of the study, associated with six sorting grids, also known as sorts, reflected positive beliefs about the professional benefits of engaging in undergraduate research. The Too Much Effort theme reflected beliefs held by three participants prior to engaging in the program. CONCLUSION: After engaging in an undergraduate research honors program where participants designed a Q-methodology study, this group of students reported gaining intellectual and practical skills and no longer found research to be as intimidating. [J Nurs Educ. 2021;60(2):96-98.].

Strategies to Teach the National Council of State Boards of Nursing Clinical Judgment Model.

BACKGROUND: There is a growing concern that novice nurses who achieve licensure do not have the clinical judgment to practice safely. The National Council of State Boards of Nursing (NCSBN) began the Next Generation NCLEX (NGN) project to find methods to better assess entry-level competency. The NGN project is based on an integrative clinical judgment model (CJM) with 6 well-defined cognitive steps. PROBLEM: Teaching and assessing clinical judgment skills using the NCSBN-CJM will take faculty planning and commitment. APPROACH: Clinical scenarios can be used to teach clinical judgment. Using prompts, instructors can deliberately lead students through the steps of recognizing cues, analyzing cues, prioritizing hypothesis, generating solutions, taking action, and evaluating outcomes. CONCLUSION: Committing to integrating a CJM throughout the curriculum, using realistic clinical scenarios, and having students work through all the steps of a selected model are important ways educators can help students prepare for safe clinical practice.

Teaching Q Methodology to Prelicensure Nursing Students.

Prelicensure nursing student exposure to undergraduate research education may have a significant effect on their research skills and use of evidence-based practice. There are potential benefits to introducing Q methodology to prelicensure nursing research students. Utilizing Q methodology principles and techniques, a class on Q methodology was integrated into a prelicensure nursing research and evidence-based practice course. The interactive classroom format and active student engagement in the step-by-step mock study were positive aspects of the class.

The physical demands and risks of working in healthcare simulation center.

BACKGROUND: The purpose of this study was to describe the physical demands and risks associated with working in a simulation center. METHODS: The 26-item online survey included questions about the physical nature of a simulationist's role and about what engineering and administrative controls they most commonly used. The sample consisted of 119 simulation operators and educators recruited from simulation interest groups based in the United States. RESULTS: Fifty-five percent of participants reported that their job description did not match their work, and 59% of participants believed that they experienced a musculoskeletal disorder resulting from their work in a simulation center. CONCLUSION: This study highlights the need to address workplace safety in simulation centers. Future research is needed to inform best practices for safe handling policies and procedures in simulation programs.

Operating Room Personnel Viewpoints About Certified Registered Nurse Anesthetists.

The purpose of this project was to explore what attitudes physicians, nurses, and operating room technicians had about working with Certified Registered Nurse Anesthetists (CRNAs) to better understand practice barriers and facilitators. This Q methodology study used a purposive sample of operating room personnel from four institutions in the Midwestern United States. Participants completed a -4 to +4 rank-ordering of their level of agreement with 34 attitude statements representing a wide range of beliefs about nurse anesthetists. Centroid factor analysis with varimax rotation was used to analyze 24 returned Q sorts. Three distinct viewpoints emerged that explained 66% of the variance: favoring unrestricted practice, favoring anesthesiologist supervision, and favoring anesthesiologist practice. Research is needed on how to develop workplace attitudes that support autonomous nurse anesthetist practice and to understand preferences for restricted practice in team members other than physicians.

Doctorate of Nursing Practice Students' Impressions of Uses for Visual Thinking Strategies.

Visual Thinking Strategies (VTS) is a structured art-viewing technique designed to teach critical thinking and aesthetic appreciation. Literature on how VTS might be used in nursing is just emerging. This qualitative descriptive study examined written responses to how 14 doctorate of nursing practice students thought they might use VTS in their practice after engaging in a classroom session. Three themes emerged for how nurses might use VTS: Facilitating Interpersonal Relationships, Changing Thinking in Practice, and As a Teaching Tool. This study contributes to the growing body of literature that suggests that art and VTS and can be used in nursing with practitioners of all levels to promote conversations that involve listening intently and considering other possibilities. J Contin Educ Nurs. 2017;48(8):365-368.

Using Q Methodology in Quality Improvement Projects.

Q methodology consists of a philosophical framework and procedures to identify subjective viewpoints that may not be well understood, but its use in nursing is still quite limited. We describe how Q methodology can be used in quality improvement projects to better understand local viewpoints that act as facilitators or barriers to the implementation of evidence-based practice. We describe the use of Q methodology to identify nurses' attitudes about the provision of skin-to-skin care after cesarean birth.

Using Q Methodology to Assess Learning Outcomes Following the Implementation of a Concept-Based Curriculum.

The use of a concept-based curriculum in nursing education is increasing, but assessing its impact remains challenging. This project discusses how Q methodology was used to evaluate our prelicensure program's outcome of creating practitioners who were ready to practice in diverse environments before and after a concept-based curricular revision. The successes and challenges of the revision are discussed.