Impact of Nursing Clinical Elective Courses on New Graduate Nurses' Clinical Practice: A Mixed-Methods Descriptive Study.

BACKGROUND: Clinical elective courses provide additional specialty knowledge for prelicensure nursing students; however, it is unknown how these courses impact nurses' clinical practice after graduation. PURPOSE: To describe how clinical nursing electives impact graduates' clinical practice. METHODS: A mixed-methods descriptive design was used. Students who graduated from a prelicensure nursing program were sent an electronic survey and participated in qualitative interviews. RESULTS: Thirty-three graduates completed the survey, with 9 participating in interviews. Sixteen graduates worked in clinical practice areas that were the same, or related to, the clinical elective they took. Many graduates felt that taking the elective course improved their confidence in the clinical setting and provided increased knowledge that put them at an advantage over their peers. CONCLUSION: Clinical electives may offer a means to meet health care system needs by preparing a more confident, knowledgeable new graduate in specialty areas in which nurses are needed most.

Color Does Matter: Nursing Assessment of Varying Skin Tones/Pigmentation.

BACKGROUND: The observation of color is an integral part of the nursing assessment. However, the current understanding of individual skin qualities and pigmentation has not yet been integrated thoroughly into foundational assessment courses, clinical education, simulation, and textbooks. EVIDENCE ACQUISITION: Literature is scarce regarding racial groups, skin color, and physical assessment for patients across the lifespan, but even more so for the neonatal population. Historically, many nursing textbooks did not provide visual pictures or observational assessment strategies for the assessment of the Black, Indigenous, and people of color (BIPOC) population. This is improving in some nursing textbooks; however, the descriptors of and visual differences and anticipated assessment findings for the BIPOC population are not comprehensive. RESULTS: Evidence-based assessment findings, which may occur in newborns with varying skin tones/pigmentations, are presented. IMPLICATIONS FOR PRACTICE AND RESEARCH: The most essential step to having an accurate assessment is acknowledging the importance of color awareness. Color blindness, while thought to support inclusivity, only contributes to exclusion of one of the most important components of a person's being-their color.

Parental reminiscing training and preschoolers' memory and metacognition: A randomized controlled trial.

This randomized controlled trial explored the effects of parental reminiscing training on preschoolers' memory and metacognition among French-speaking White parents and their typically developing children (24 females, 20 males; Mmonths = 49.64) in Belgium. Participants were assigned, with age stratification, to the immediate intervention (n = 23) or waiting-list group (n = 21). The assessments were conducted by blind evaluators before the intervention, immediately after, and 6 months later. Resulting specifically from the intervention, parents sustainably improved their reminiscing style (e.g., greater provision of feedback and use of metamemory comments). The effects of the intervention on children's outcomes were, however, less clear. Based on the social-constructivist approach, such effects could be expected to occur later. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Early Intervention for Steal Syndrome in Patients on Hemodialysis.

Dialysis access-associated steal syndrome (DASS) is a serious, challenging complication related to diminished arterial blood flow to the hand. Patients may not be routinely assessed for this diagnosis, resulting in a delayed presentation with severe hand pain, nerve damage, and tissue loss. This pilot project examined the feasibility of implementing an assessment tool to routinely screen patients for steal syndrome. The tool was used for all patients in three participating dialysis centers. Positive patients had a streamlined referral to vascular surgery for assessment and possible treatment. This pilot project demonstrates that education and subsequent routine screening for DASS within the dialysis facility is feasible, and can be incorporated into the workflow for both the dialysis facility and the servicing vascular surgery office. Early recognition of DASS will prevent severe injuries and tissue loss.

Preschoolers' memory recall of new information: relation to parental reminiscing.

The influence of parental reminiscing style (the way parents discuss past events with their children) on the development of children's autobiographical memory has been well documented. The specific mechanisms involved in this effect, however, remain unknown. We explored the association between specific components of parental reminiscing and preschoolers' episodic memory. Fifty-three parent-child dyads (MChild Age = 53.13 months, 29 females) from Belgium were tested twice within a delay of about nine months. At the first time point, parental reminiscing style was assessed via a parent-child discussion of a prior standardised event (a museum visit) focusing on both the structure of parental interactions and the addressed content. At each time point, children were administered with story-recall tasks in the form of true-false recognition about previously heard stories. Generalised linear mixed-effect models were conducted on an item-by-item basis. Results indicated that parental reminiscing is associated with preschoolers' recognition memory performance at both time points, but not all reminiscing components equally influence children's performance. Specifically, parents' concretisations and metamemory talk were found to impact children's memory. The identification of these components provided insights for exploring the processes underlying the reminiscing-memory influence (in-depth encoding of information, binding processes, and metacognition).

Relations between parental metacognitive talk and children's early metacognition and memory.

After decades of research suggesting that metacognition-that is, processes whereby people monitor and regulate their cognitive performance-did not emerge and is not related to children's performance until late childhood, recent studies have provided evidence that even preverbal infants can access their internal states. The existence of this basic metacognition raises the question of the variables influencing its development at such a young age and whether such early skills could predict successful cognitive performance. The current study had two main goals: (a) exploring the relation between parental metacognitive style and children's early metacognition and (b) determining whether these early metacognitive skills can predict children's memory performance. To this end, 2.5- to 4.5-year-old children (N = 72) and their parents were recruited. To assess parental metacognitive style, parent-child dyads were invited to participate in a 15-min session during which they played memory games. The parents' speech during this session was later coded for metacognitive content. Children's memory was assessed using cued recall and recognition tests. During one of these recognition tests, participants had the opportunity to ask for a cue to help them decide whether their response was correct (i.e., metacognitive measure). Results revealed that parental metacognitive style predicted both children's metacognitive accuracy and memory performance. Interestingly, a mediation effect of children's metacognitive skills on the relation between parental style and memory performance was found. These findings suggest that environmental factors such as parental metacognitive style are related to children's early metacognition, which in turn is linked to children's memory development.

Creating Inclusive Learning Environments for Chinese and American Pediatric Nursing Students.

During the COVID-19 pandemic, students from two schools of nursing, in China and the United States respectively, engaged in a transcultural simulation activity to explore how a global healthcare crisis has been managed within their different cultures. This article describes the development and implementation of the project and evaluates student perspectives on the simulation...s influence on increasing awareness of diversity, equity, and inclusion. Data for this project were collected through student verbal and written reflections and faculty comments. Results: Students reported the virtual simulation positively impacted their learning and enjoyed the opportunity to navigate through a virtual scenario collaboratively while discussing cultural similarities and differences. Faculty noted the simulation was valuable and described challenges faced during the development. Conclusions: Students and faculty found the simulation was a meaningful learning experience. Findings suggests that the transcultural simulation improved student knowledge of cultural competence and understanding of diversity, equity, and inclusion constructs.

Nursing Students From China and the United States: Learning Together Through Virtual Simulation.

AIM: The purpose of this project was to connect nursing students from schools of nursing in China and the United States for colearning using virtual simulations. BACKGROUND: With technology and international partnerships, nursing programs can offer global education without students traveling to other countries. METHOD: Virtual simulations were produced by each school for the project. Students completed them in two synchronous 1.5-hour virtual sessions, one month apart. At the end of each session, students completed the Simulation Effectiveness Tool-Modified and the Nurses Clinical Reasoning Scale. RESULTS: Scores on the Simulation Effectiveness Tool-Modified ranged from 75.0 percent to 100 percent on Simulation 1 (video vignettes focused on prioritization) and 88.9 percent to 100 percent on Simulation 2 (computer-based obstetrics case). Most students strongly agreed or agreed that the simulation improved their clinical reasoning skills. CONCLUSION: Virtual simulations allowed students to learn together and develop an awareness of differences in nursing practices across countries.

Increasing Home Healthcare Referrals and Access to Community Resources in Response to High Emergency Department Utilization.

The goal of this interprofessional quality initiative project was to decrease emergency department (ED) visits for nonemergency health problems by referring superutilizers to home healthcare or connecting them with existing community resources. An interprofessional team of students from schools of nursing, public health, and occupational therapy collaborated on a community assessment, investigated and gathered community resources, and interviewed key stakeholders at a rural ED to identify the root causes of high utilization. Using these data, we designed an algorithm for ED clinicians that provided an organized community resource collection and electronic resources for ED staff. We focused on encouraging an increase in the evaluation of patients for eligibility to receive home healthcare services.

The Impact of Caring: Teaching Students Empathy Through the Patient Voice.

The purpose of this educational brief is to describe an innovative learning experience focused on teaching students empathy for chronic illness, using patient voices. Panel members of individuals who had experienced acute and chronic illness from either the perspective of the patient or caregiver participated in a one-time session for undergraduate baccalaureate nursing students. Panel members presented their narrative to the students, engaging them in a question-and-answer session about the impact of nursing care on their experience. Both the panelists and the students found the experience meaningful. Over time the panel has varied in format, but has consistently humanized the patient experience, highlighted the importance of empathy, and conveyed the impact that nurses have on their patients and families. This innovative strategy proved to be very beneficial for students transitioning into their first clinical experience.

Hotspotting: Development of an Interprofessional Education and Service Learning Program for Care Management in Home Care Patients.

The purpose of this article is to describe a service learning opportunity where interprofessional teams of students worked together to address patients' social determinants of health through home visits. This article describes this process, known as "hotspotting," and presents the development of this project, including collaboration with a local home health agency, recruiting of students, and weekly team meetings for debriefing. Evaluation data, barriers with implementation, and next steps for sustainability are also discussed.

Reduced fibroblast interaction with intact collagen as a mechanism for depressed collagen synthesis in photodamaged skin.

This report provides evidence from a number of different approaches (i.e., comparison of cell shape in 1-microm sections of photodamaged versus healthy skin at the light microscopic level; comparison of cell shape and apposition to collagen fibrils in ultrathin sections of the same tissues examined by transmission electron microscopy, and fluorescence staining for adhesion site protein expression and actin filament architecture in frozen tissue sections) that dermal cells in healthy skin are attached to collagen fibrils over a large part of the cell border, have a flattened/spread (two-dimensional) appearance and have abundant actin in their cytoplasm. In contrast, cells in photodamaged skin are often in contact with fragmented collagen or amorphous debris rather than intact collagen, have a collapsed/elongated shape, and have a lower amount of actin. Collagen synthesis is reduced in severely photodamaged skin relative to collagen synthesis in corresponding sun-protected skin (N Engl J Med 329:530, 1993). We hypothesize that fibroblasts in severely damaged skin have less interaction with intact collagen and as a result experience a reduction in mechanical tension. Decreased collagen synthesis is (presumed to be) the result.

Complementary and alternative medicine use in families of children with cerebral palsy.

In order to assess patterns of usage of complementary and alternative medicine (CAM) in families of children with cerebral palsy (CP), 213 families with a child (0 to 18 years) with CP were recruited at the university medical center in Ann Arbor, MI, USA as part of a descriptive survey. Two hundred and thirty-five surveys were distributed. Mean age of the child was 8 years 6 months (SD 4y : 9mo) and 56% of the sample was male with 35% full-time independent ambulators, while the rest used an assistive device or a wheelchair. Fifty-four percent were in special education classrooms. Families were given a survey on functional status of the child with CP, CAM usage of the child and the parent, factors influencing the decision to use CAM, demographics, and clinical information. Of the families, 56%, used one or more CAM techniques. Massage therapy (25%) and aquatherapy (25%) were the most common. Children of families that used CAM were significantly younger (7y : 9mo, SD 4y : 7mo) than non-users (9y : 6mo, SD 4y : 6mo: t-test p < 0.01 two-tailed). Children with quadriplegic CP, with spasticity, and those who could not walk independently were more commonly exposed to CAM (Pearson's chi2 [P(chi)2] p = 0.01 two-tailed; for mobility, odds ratio [OR] of 2.5 with regression). Mothers with a college degree had a greater tendency to use CAM for their child than those without (P(chi)2 p = 0.01 two-tailed). Fathers of children who used CAM were older than fathers of those who did not (37y : 9mo versus 33y : 2mo, p = 0.04 two-tailed). There was no significant difference between groups for mother's age, father's education, income, or for population of home town. Parents who used CAM for themselves were more likely to try CAM for their child (70% versus 47%, OR 2.1), and were much more likely to be pleased with the outcome (71% versus 42%, OR 3.5). Child's age (younger), lack of independent mobility, and parental use of CAM were the most significant predictive factors identified via logistic regression.