Evaluating knowledge loss over multiple retention intervals can identify deficiencies and inform curricular development.

Nursing students struggle to retain enough anatomical knowledge to meet their entry to practice competencies, but what knowledge is missing and when this occurs has been previously unexplored. A cohort of 80 nursing students were given multiple choice quizzes to assess their anatomical knowledge on 11 different organ systems during their second, third, and fourth year. Results were analyzed in comparison to their first-year examination scores to determine knowledge loss. Results showed an overall knowledge loss of 33.5% in the second year, 31.8% in the third year, and 29.6% in the fourth year. There were significant differences in system specific results. Special senses (i.e., audition) had a 20.6% loss in the second year, increased in retention to a 17.3% loss in third year, and then decreased to a 37% loss in fourth year. The vascular system had a 46.1% knowledge loss at the second-year assessment, declined to 49% knowledge loss in the third year, but improved to 27.6% knowledge loss by the fourth year. A similar change was observed for the musculoskeletal system with second-year loss at 30.7%, third-year loss at 40.3%, and fourth-year loss at 26.6%. These data suggest there are significant differences in the amount of knowledge retained by nursing students depending on the system being tested and the year the test is taken. Identifying the areas and times where anatomical knowledge is lost and gained is valuable for instructors in any program so that specific topics can be targeted at different times with more effective educational strategies.

Second-Year Nursing Students' Retention of Gross Anatomical Knowledge.

Human anatomy is a foundational course in nursing education, however, there is growing concern that students do not retain enough anatomical knowledge to successfully apply it in clinical settings. The aim of this study was to determine retention level of anatomy knowledge among second-year nursing students from their first-year anatomy class, and to determine if there is a difference in level of retention based on organ system. For each system, second-year students were asked to answer 9 to 11 multiple-choice questions (MCQs), and the scores from these quizzes were compared to matched test items from their first-year anatomy examinations. There was a significant decrease in the overall mean score from 83.05 ± 8.34 (±SD) in first year to 54.36 ±12.9 in second year (P = 0.0001). Retention levels were system specific. System-specific knowledge retention was highest for the gastrointestinal system (89.7%), respiratory system (88.5%), and genitourinary system (83.6%). This was followed by the integumentary system (80.1%), special senses (79.4%), nervous system (74.9%), and musculoskeletal system (69.3%). Retention was lowest for the lymphatic system (64.3%), cranial nerves (58.8%), vascular system (53.9%), and head and neck (42.6%). The present study shows that nursing students' anatomy knowledge retention was comparatively higher than rates reported by others in medical and allied-health students. The researchers are now investigating knowledge retention in third- and fourth-year nursing students. Further investigation into why retention is higher for specific systems and intervention strategies to improve knowledge acquisition and retention in nursing students is recommended.

From linear care plan through concept map to Concepto-Plan: The creation of an innovative and holistic care plan.

Linear care plans have traditionally been used in nursing education to support nursing students in identifying potential and actual health care problems, and to follow up on those issues with nursing interventions. However, the linear care plan does not support the nursing student with learning in-depth critical thinking, clinical reasoning, creative thinking, and other ways of thinking. Concept mapping was introduced as a way to support the nursing student to improve upon critical thinking and clinical reasoning and to identify relationships among the patient's health care problems. The present manuscript features the development and evaluation of the Concepto-Plan (C-P), an innovative, holistic care plan that moves away from the linear care plan and improves upon the concept map care plan. The C-P focuses on the relationships among the data clusters and the nursing diagnoses and can be used to enhance the therapeutic relationship between the patient and the nursing student. Quality improvement data supports the effectiveness of the C-P for nursing students to organize and prioritize client-centred care while experiencing meaningful learning, professional self-reflection, clinical reasoning, creative and critical thinking skills and the ability to provide an individualized holistic care plan. As a result, the C-P has been integrated into the curriculum in two different nursing programs in two Canadian provinces.

Building Capacity for Evidence-Based Practice: Understanding How Licensed Practical Nurses (LPNs) Source Knowledge.

BACKGROUND: In Canada, all nurses are required to engage in evidence-based practice (EBP) as an entry-to-practice competency; however, there is little research that examines Licensed Practical Nurses' (LPNs') information seeking behaviors or preferred sources of knowledge to conduct EBP. AIMS: Due to the differences in education and roles of LPNs and Registered Nurses (RNs), it is both necessary and important to gain an understanding of how LPNs utilize evidence in their unique nursing practice. The purpose of this study was to investigate how LPNs source knowledge for their nursing practice. METHODS: A descriptive, cross-sectional survey of LPNs from Alberta, Canada asked participants to rank sources of knowledge that inform their practice. Responses were correlated with age and years of practice. Analysis of variance was used to determine if there were significant mean differences between average scores and place of employment. RESULTS: LPN participants used similar sources of knowledge as RNs. The top source of knowledge for both RNs and LPNs was the information they learn about each individual client and the least utilized sources of knowledge were articles published in nursing, medical, and research journals, tradition, and popular media. This finding is consistent with previous studies on RNs that found nurses do not often access current research evidence to inform their practice. LINKING EVIDENCE TO ACTION: Since relatively few LPNs access nursing and research journals, it is important to tailor EBP education information to the workplace context. Future avenues of research might explore the potential of using in-services and webinars to disseminate information and skills training on EBP to the LPNs, as this was a popular source of practice knowledge.