The impact of virtual simulation on the recognition and response to the rapidly deteriorating patient among undergraduate nursing students.

A major patient safety challenge is recognition and response to deteriorating patients since early warning signs are often not detected in a timely manner. Nursing students typically learn the skills for early identification through clinical placement, but clinical placements are not guaranteed to provide exposure to deteriorating patients. Nursing students require practice with emergency scenarios to develop their competency and confidence to act in this area. This study aimed to explore the impact of a virtual simulation intervention on the recognition and response to the rapidly deteriorating patient among undergraduate nursing students. A mixed methods study involving a quasi-experimental pre/post design and focus groups. The participants were third or final year undergraduate nursing students from five university sites across four countries (Canada, England, Scotland and Australia, n = 88). Students were randomly assigned to a treatment or control group. The treatment group received a virtual simulation intervention and participated in a focus group. The virtual simulation intervention had a significant effect on improving nursing student knowledge and clinical self-efficacy in the recognition and response to the rapidly deteriorating patient. Students reported that the virtual simulations decreased anxiety, helped them prioritize, filled gaps in their learning, and encouraged autonomous learning within a safe 'low risk' environment. Virtual simulation is an effective strategy for improving knowledge and confidence in recognizing and responding to the rapidly deteriorating patient among undergraduate nursing students.

Putting culture in the curriculum: a European project.

The purpose of this paper is to describe the rationale for and the method of designing a framework for a European curriculum to promote intercultural competence in health care students. The background relating to the migration of people into and across Europe is cited as the factor driving the need for such a project. The project group emerged from the European organisation known as COHEHRE (Consortium of Higher Education Institutes in Health and Rehabilitation in Europe). Composed of a group of nurse educators from 5 European countries it charts the process which led them to create a curriculum framework. The completed work is available in the form of a CD-ROM. The paper describes the steps taken to reach the project outcomes over 4 years. The methods of dissemination of the project outcomes are included. The discussion considers the journey of the group towards the outcomes of the project and identifies the need to discover how effective the framework is in achieving the aims of the group. In conclusion it articulates the hope that this work will improve the care which is shown to all recipients of health care whatever their cultural background.

European higher health care education curriculum: development of a cultural framework.

This article concerns the European Curriculum in Cultural Care Project (2005-2009), which aimed at developing a curriculum framework for the enhancement of cultural competence in European health care education. The project was initiated and supported by the Consortium of Institutes in Higher Education in Health and Rehabilitation, whose goal is to nurture educational development and networking among member institutions. The framework is the result of a collaborative endeavor by nine nurse educators from five different European countries. The production of the framework will be described in accordance with the following tenets: developing cultural competence is a continuing process, cultural competence is based on sensitivity toward others, and cultural competence is a process of progressive inquiry. Critique concerning the framework will be presented.

An evaluation of a European teacher exchange programme.

This longitudinal study evaluated a European teacher exchange programme within a UK School of Nursing and Midwifery. A cross case study design was employed over a three year period. A range of data methods were used which gave a clear, detailed and rich picture of the exchange experience. Overall analysis of the data generated two key themes, namely that of value and role identity. The study highlighted factors which were deemed to have positive and negative influences on the teacher exchange experience. It is concluded that a teacher exchange programme is of value to the School, by aiding personal and professional development and internationalisation. Recommendations from the study are included in the paper.

The internationalisation of the nursing curriculum.

This paper explores the complexities of the internationalisation of the nursing curriculum. It discusses one aspect of the international activity within a British University, a short student exchange programme and how this facilitates personal and professional learning. The paper focuses on the educational, professional, geo-political and philosophical ideas that influenced the development of these exchanges. The process of facilitating cultural and professional learning following Campinha-Bacote's model (1999) [Campinha-Bacote, J., 1999. A model and instrument for addressing cultural competence in health care. Journal of Nurse Education 38 (5) 203-7] for developing cultural competence is applied and discussed.

Clinical decision-making: theory and practice.

Nurses have to make important clinical decisions in their everyday practice. This article provides an introduction to the theory of clinical decision-making, describes the type of decisions that nurses make and outlines the different approaches that can be used to make a decision.