Second Life and Classroom Environments: Comparing Small Group Teaching and Learning in Developing Clinical Reasoning Process Skills.

Medical education and clinical practice support the development of clinical reasoning competency. Traditionally, the process of clinical reasoning is taught through small group discussions in pre-clinical and clinical medical training, and the need exists to explore further teaching and learning approaches that develop clinical reasoning. This study compared teaching and learning the clinical reasoning process through the virtual platform of Second Life (SL) with the traditional classroom setting. Participants were first semester veterinary students; 34 participated virtually through SL, and 41 experienced traditional classroom interactions. Students and one facilitator engaged in three small group meetings to process a clinical case. A seven-item clinical reasoning rubric guided the teaching, learning, and assessment. Clinical reasoning assignments were scored on a grading scale from 0 to 4 with a maximum result of 28. Descriptive statistics for clinical reasoning assignment scores were (m = 14.0; SD = 2.6) and (m = 12.2; SD = 2.6) in SL and classroom interaction, respectively. Results indicated positive associations for all participants between the rubric item score of gathering historical information with (1) gathering physical examination information (p < 0.01) and (2) prioritizing patient's problems (p = 0.003). Additionally, the rubric item score of gathering physical examination information was positively associated with the rubric item score for prioritizing patient's problems (p = 0.02). Specifically for the SL cohort, results demonstrated that rubric item scores were significantly higher for gathering historical information (p = 0.03), gathering physical examination information (p < 0.01), and prioritizing patient's problems (p = 0.02). Small group interaction using SL and traditional classroom environments offers a comparable educational platform for developing clinical reasoning process skills.

Using the Virtual World of Second Life in Veterinary Medicine: Student and Faculty Perceptions.

Virtual worlds are emerging technologies that can enhance student learning by encouraging active participation through simulation in immersive environments. At Ross University School of Veterinary Medicine (RUSVM), the virtual world of Second Life was piloted as an educational platform for first-semester students to practice clinical reasoning in a simulated veterinary clinical setting. Under the supervision of one facilitator, four groups of nine students met three times to process a clinical case using Second Life. In addition, three groups of four clinical faculty observed one Second Life meeting. Questionnaires using a 4-point Likert scale (1=strongly disagree to 4=strongly agree) and open-ended questions were used to assess student and clinical faculty perceptions of the Second Life platform. Perception scores of students (M=2.7, SD=0.7) and clinical faculty (M=2.7, SD=0.5) indicate that Second Life provides authentic and realistic learning experiences. In fact, students (M=3.4, SD=0.6) and clinical faculty (M=2.9, SD=1.0) indicate that Second Life should be offered to future students. Moreover, content analyses of open-ended responses from students and faculty support the use of Second Life based on reported advantages indicating that Second Life offers a novel and effective instructional method. Ultimately, results indicate that students and clinical faculty had positive educational experiences using Second Life, suggesting the need for further investigation into its application within the curriculum.

The Health Information Technology Competencies Tool: Does It Translate for Nursing Informatics in the United States?

Information technology use in healthcare delivery mandates a prepared workforce. The initial Health Information Technology Competencies tool resulted from a 2-year transatlantic effort by experts from the US and European Union to identify approaches to develop skills and knowledge needed by healthcare workers. It was determined that competencies must be identified before strategies are established, resulting in a searchable database of more than 1000 competencies representing five domains, five skill levels, and more than 250 roles. Health Information Technology Competencies is available at no cost and supports role- or competency-based queries. Health Information Technology Competencies developers suggest its use for curriculum planning, job descriptions, and professional development.The Chamberlain College of Nursing informatics research team examined Health Information Technology Competencies for its possible application to our research and our curricular development, comparing it originally with the TIGER-based Assessment of Nursing Informatics Competencies and Nursing Informatics Competency Assessment of Level 3 and Level 4 tools, which examine informatics competencies at four levels of nursing practice. Additional analysis involved the 2015 Nursing Informatics: Scope and Standards of Practice. Informatics is a Health Information Technology Competencies domain, so clear delineation of nursing-informatics competencies was expected. Researchers found TIGER-based Assessment of Nursing Informatics Competencies and Nursing Informatics Competency Assessment of Level 3 and Level 4 differed from Health Information Technology Competencies 2016 in focus, definitions, ascribed competencies, and defined levels of expertise. When Health Information Technology Competencies 2017 was compared against the nursing informatics scope and standards, researchers found an increase in the number of informatics competencies but not to a significant degree. This is not surprising, given that Health Information Technology Competencies includes all healthcare workers, while the TIGER-based Assessment of Nursing Informatics Competencies and Nursing Informatics Competency Assessment of Level 3 and Level 4 tools and the American Nurses Association Nursing Informatics: Scope and Standards of Practice are nurse specific. No clear cross mapping across these tools and the standards of nursing informatics practice exists. Further examination and review are needed to translate Health Information Technology Competencies as a viable tool for nursing informatics use in the US.

Competency Skills Assessment: Successes and Areas for Improvement Identified During Collaboration Between Informaticists and a National Organization.

The Association of periOperative Registered Nurses (AORN) approached the Nursing Informatics Research Team (NIRT) with a request to collaborate and conduct a competency assessment for their organization. An online tool was developed to determine current technology in perioperative settings. This presentation shares the process used to conduct research that led to a method for assessing perioperative nurses' competencies skills in their practice as well as identified gaps in curricula that faculty could address. Both successes and areas for improvement are detailed. The outcome of the process demonstrated a need to understand what skills are being assessed as AORN did not know what technology existed or how existing equipment was being used.

Operationalizing the TANIC and NICA-L3/L4 Tools to Improve Informatics Competencies.

Two tools were developed for nurses to self-assess different levels of informatics competencies. The TANIC is used for all nurses to self-assess; the NICA-L3/L4 is a tool for the informatics nurse specialist (INS) to self-assess skill levels. There are 167 informatics items in the TANIC and 178 advanced informatics items in the NICA-L3/L4. These tools were piloted; the results presented here. Based on the evaluation, the tools have been integrated into informatics courses at the BSN and MSN programs at Chamberlain College of Nursing, and presented in two AACN webinars and other national conferences. Numerous requests have been honored to provide the tools for other schools of nursing to use in their courses, including DNP programs. Other requests include those from CNIOs and managers to include in their job descriptions for informatics nurses.

The coordinator role for a nursing online graduate practicum.

Although graduate students in nursing are adult learners and expert clinicians, they are often novices in the roles they seek upon graduation. Practicum experiences help students bridge the gap between theory learned in course work and beginning practice at the master's level. However, finding practica for online nursing graduate students at great distances is often a challenge. The value of having a point person for the coordination of students' practicum experiences in multiple settings is well known. What is less well known is how this coordination occurs across great distances in online courses that include a practicum component. The authors discuss the design and implementation of a practicum coordinator position in a graduate online program.

The integration of informatics content in baccalaureate and graduate nursing education: a status report.

Many experts, professional organizations, landmark reports, and nurse executives have called for a nursing workforce that demonstrates informatics competencies. However, surprisingly, gaps in the integration of informatics into nursing curriculum and development of informatics competencies among nurses remain. To obtain a clearer picture of the current status of the integration of informatics content into baccalaureate and graduate nursing education, the authors discuss their assessment of a 2012 published list of the top online schools of nursing in the United States.

Creating cross-disciplinary research alliances to advance nursing science.

PURPOSE: To demonstrate the utility of a developmental approach to building and sustaining cross-disciplinary research alliances. ORGANIZING CONSTRUCT: Cross-disciplinary collaborations offer great promise for advancing an evolving program of research. Funding agencies' commitment to interdisciplinary work further heightens these collaborations. Nurse researchers, however, are not necessarily equipped with the knowledge and skills needed to strategically and successfully build and maintain cross-disciplinary collaborations. METHODS: Successful strategies for forging, extending, and sustaining alliances are organized using a developmental approach and illustrated by exemplars. FINDINGS: The initial phase of forging alliances is focused on creating a limited network to support relatively clear-cut research goals. The cohesive cross-disciplinary team is subsequently extended beyond the initial team to strategically address broader research goals. As the team matures, emphasis shifts toward sustaining the team through shared leadership that more actively focuses on the development of the field than the development of individual programs of research. CONCLUSIONS: The advancement of nursing science requires nurse researchers to rethink the developmental phases of building appropriate research teams. Strategic approaches for forging, extending, and sustaining cross-disciplinary alliances position nurse researchers as leaders in innovative cross-disciplinary research. The development of cross-disciplinary teams supports translational research and, by extension, the science that undergirds practice. CLINICAL RELEVANCE: Research that reflects cross-disciplinary perspectives is particularly well suited to addressing the complex health issues encountered by patients, families, and communities.