Knowledge and Competency of Novice Nursing Students in Nasogastric Tube Feeding: Is Simulation Better than Case Scenario?

OBJECTIVES: As the millennial generation enters the nursing profession, simulation takes on a key role in effective pedagogy. We sought to examine the efficacy of simulation versus case scenario as a teaching method for novice nursing students in the skill of nasogastric tube (NGT) feeding. We assessed the knowledge, competency, self-confidence, and satisfaction among these nursing students. METHODS: This quasi-experimental study was used to compare the efficacy of simulation and case scenarios in promoting knowledge, clinical competency, self-learning, and self-confidence among novice nursing students in the Middle East. The study sample included 69 students registered for the Fundamentals of Nursing Laboratory course at the College of Nursing, Sultan Qaboos University, Oman, during the spring and fall 2016 semesters. Thirty-five students were assigned to the intervention group and attended a simulation, while 34 students were assigned to the control group and were given the standard case scenario used in teaching this course. The competency of the students on NGT feeding skill was measured after a simulation or case scenario. RESULTS: In both groups, the majority of students were ≤ 20 years old, female, hailed from rural areas, and had a cumulative grade point average of > 2.5. Data showed a significant improvement in the mean scores of competency between the intervention and control groups (t (67) = 3.869, p < 0.001) suggesting that simulation was effective in gaining competency compared to the case scenario. There was a positive statistical significance between satisfaction and self-confidence among the intervention group. CONCLUSIONS: Simulation has an effective role in clinical education for teaching practical skills. However, in this study, there was a statistically significant difference in the mean scores between the two methods of teaching. This helped us to conclude that competency gained by novice students' learning a skill through simulation, was better than the competency gained through case scenario. We recommend simulation as an effective pedagogy among novice nursing students. KEYWORDS: Self Confidence; Female; Students, Nursing; Clinical Competence; Personal Satisfaction; Oman; Enteral Nutrition; Learning.

Academic and Demographic Predictors of NCLEX-RN Pass Rates in First- and Second-Degree Accelerated BSN Programs.

Relatively few studies have addressed predictors of first-attempt outcomes (pass-fail) on the National Council Licensure Examination-Registered Nurses (NCLEX-RN) for accelerated BSN programs. The purpose of this study was to compare potential predictors of NCLEX outcomes in graduates of first-degree accelerated (FDA; n=62) and second-degree accelerated (SDA; n=173) BSN programs sharing a common nursing curriculum. In this retrospective study, bivariate analyses and multiple logistic regression assessed significance of selected demographic and academic characteristics as predictors of NCLEX-RN outcomes. FDA graduates were more likely than SDA graduates to fail the NCLEX-RN (P=.0013). FDA graduates were more likely to speak English as a second or additional language (P<.0001), have lower end-of-program GPA and HESI Exit Exam scores (both P<.0001), and have a higher proportions of grades ≤ C (P=.0023). All four variables were significant predictors of NCLEX-RN outcomes within both FDA and SDA programs. The only significant predictors in adjusted logistic regression of NCLEX-RN outcome for the pooled FDA+SDA graduate sample were proportion of grades ≤ C (a predictor of NCLEX-RN failure) and HESI Exit Exam score (a predictor of passing NCLEX-RN). Grades of C or lower on any course may indicate inadequate mastery of critical NCLEX-RN content and increased risk of NCLEX-RN failure.

Impact of a concept map teaching approach on nursing students' critical thinking skills.

Nurses confront complex problems and decisions that require critical thinking in order to identify patient needs and implement best practices. An active strategy for teaching students the skills to think critically is the concept map. This study explores the development of critical thinking among nursing students in a required pathophysiology and pharmacology course during the first year of a Bachelor of Science in Nursing in response to concept mapping as an interventional strategy, using the Health Education Systems, Incorporated critical thinking test. A two-group experimental study with a pretest and posttest design was used. Participants were randomly divided into a control group (n = 42) taught by traditional didactic lecturing alone, and an intervention group (n = 41), taught by traditional didactic lecturing with concept mapping. Students in the concept mapping group performed much better on the Health Education Systems, Incorporated than students in the control group. It is recommended that deans, program directors, and nursing faculties evaluate their curricula to integrate concept map teaching strategies in courses in order to develop critical thinking abilities in their students.

Perceived benefits and challenges of repeated exposure to high fidelity simulation experiences of first degree accelerated bachelor nursing students.

This study explored perceptions of first-degree entry-level accelerated bachelor nursing students regarding benefits and challenges of exposure to multiple high fidelity simulation (HFS) scenarios, which has not been studied to date. These perceptions conformed to some research findings among Associate Degree, traditional non-accelerated, and second-degree accelerated Bachelor of Science in Nursing (BSN) students faced with one to two simulations. However, first-degree accelerated BSN students faced with multiple complex simulations perceived improvements on all outcomes, including critical thinking, confidence, competence, and theory-practice integration. On the negative side, some reported feeling overwhelmed by the multiple HFS scenarios. Evidence from this study supports HFS as an effective teaching and learning method for nursing students, along with valuable implications for many other fields.

Culture and Cultural Competence in Nursing Education and Practice: The State of the Art.

PROBLEM: The concept of cultural competency has developed a substantial presence in nursing education and practice since first attracting widespread attention in the 1990s. While several theories and corresponding measures of cultural competency have been advanced and tried, much work remains, as many nursing professionals continue to call for greater evidence-based research and attention to patient perspectives and outcomes. METHODS: Using a method provided by Hawker et al. to appraise articles, this paper compares nine recent (2008-2013) studies (including two composite studies) related to cultural competency, undergraduate curricula, and teaching strategies in nursing to assess the state of the art in this important area of care. FINDINGS: The studies applied phenomenological, study abroad, online, and service learning strategies, four of which relied on some version of Campinha-Bacote's IAPCC© model. These studies reported a general improvement in competency among students, though generally only to a level of cultural awareness, and admitted being constrained by several common limitations. CONCLUSION: Improved results and more realistic expectations in this area may require a closer understanding of the nature of the "culture" that underlies cultural competence. Harkess Kaddoura.

International academic service learning: lessons learned from students' travel experiences of diverse cultural and health care practices in morocco.

Academic service learning (ASL) is an active teaching-learning approach to engage students in meaningful hands-on activities to serve community-based needs. Nine health professions students from a private college and a private university in the northeastern United States volunteered to participate in an ASL trip to Morocco. The participants were interviewed to reflect on their experiences. This article discusses the lessons learned from students' ASL experiences regarding integrating ASL into educational programs. The authors recommend a paradigm shift in nursing and dental hygiene curricula to appreciate diversity and promote cultural competency, multidisciplinary teamwork, and ethics-based education.

The effect of preceptor behavior on the critical thinking skills of new graduate nurses in the intensive care unit.

Little research has been conducted to examine the effect of preceptor behaviors on the critical thinking of new graduate nurses in the intensive care unit (ICU). This study explored the perceptions of new graduates on the effect of preceptor behaviors and strategies on the development of their critical thinking skills, using a qualitative exploratory descriptive design. Data were collected with demographic surveys and semistructured interviews. Data were analyzed with a qualitative content analysis approach. The study showed that relationships between new graduates and their preceptors played a key role in the development of critical thinking skills in new graduate nurses, and specific practical implications were suggested. The study data are useful for critical care nurses, preceptors, nurse educators, and clinical nurse specialists. The findings contribute to efforts to enhance the preceptor-preceptee relationship and develop critical thinking skills in new graduates.

Student perception of travel service learning experience in Morocco.

PURPOSE: This study explores the perceptions of health profession students participating in academic service learning in Morocco with respect to adapting health care practices to cultural diversity. METHODS: Authors utilized semi-structured, open-ended interviews to explore the perceptions of health profession students. Nine dental hygiene and nursing students who traveled to Morocco to provide oral and general health services were interviewed. After interviews were recorded, they were transcribed verbatim to ascertain descriptive validity and to generate inductive and deductive codes that constitute the major themes of the data analysis. Thereafter, NVIVO 8 was used to rapidly determine the frequency of applied codes. The authors compared the codes and themes to establish interpretive validity. Codes and themes were initially determined independently by co-authors and applied to the data subsequently. The authors compared the applied codes to establish intra-rater reliability. RESULTS: International service learning experiences led to perceptions of growth as a health care provider among students. The application of knowledge and skills learned in academic programs and service learning settings were found to help in bridging the theory-practice gap. The specific experience enabled students to gain an understanding of diverse health care and cultural practices in Morocco. CONCLUSION: Students perceived that the experience gained in international service learning can heighten awareness of diverse cultural and health care practices to foster professional growth of health professionals.

New graduate nurses' perceptions of the effects of clinical simulation on their critical thinking, learning, and confidence.

Critical thinking has been a crucial outcome of nursing educational programs. Effective nurses should be knowledgeable about complex patient situations and confident in their skills. One teaching strategy recently adopted by some educators to develop nurses' critical thinking, learning, and confidence is simulation. Simulation incorporates scenarios and case studies developed to replicate real-life clinical situations. Learners are asked to solve clinical problems and make critical decisions based on the information provided. Little research has been done on how simulation experiences promote critical thinking, learning, and confidence, especially in new graduate nurses. This study explored the perceptions of new graduate nurses of how clinical simulation developed their critical thinking skills, learning, and confidence throughout their hospital clinical training. Ten new baccalaureate nursing graduates voluntarily participated in this study, which used an exploratory descriptive design. Data were collected by demographic questionnaires and semi-structured interviews and were analyzed using content analysis. Participants reported that simulation prepared them well to care confidently for critically ill patients. Simulation also helped them learn to make sound clinical decisions to improve patient outcomes. The findings have crucial implications for nursing education, practice, and research. They provide evidence to support the use of simulation as a teaching strategy to promote critical thinking skills, learning, and confidence.

Effect of the essentials of critical care orientation (ECCO) program on the development of nurses' critical thinking skills.

It is essential for nurses to develop critical thinking skills to ensure their ability to provide safe and effective care to patients with complex and variable needs in ever-changing clinical environments. To date, very few studies have been conducted to examine how nursing orientation programs develop the critical thinking skills of novice critical care nurses. Strikingly, no research studies could be found about the American Association of Critical Care Nurses Essentials of Critical Care Orientation (ECCO) program and specifically its effect on the development of nurses' critical thinking skills. This study explored the perceptions of new graduate nurses regarding factors that helped to develop their critical thinking skills throughout their 6-month orientation program in the intensive care unit. A convenient non-probability sample of eight new graduates was selected from a hospital that used the ECCO program. Data were collected with demographic questionnaires and semi-structured interviews. An exploratory qualitative research method with content analysis was used to analyze the data. The study findings showed that new graduate nurses perceived that they developed critical thinking skills that improved throughout the orientation period, although there were some challenges in the ECCO program. This study provides data that could influence the development and implementation of future nursing orientation programs.