The impact of covid-19 on the regulation of nursing practice and education.

To adapt to the environment resulting from a worldwide pandemic, states across the country enacted regulation changes impacting nursing education, entry into practice, and licensure. In this manuscript, the authors collected state board of nursing data from sources including websites and letters from the State Boards to deans, directors, and chairs. Information obtained reflected changes to regulation of practice and regulation of education. As the pandemic continues, associate degree educators will need to continue to stay abreast of nursing regulation changes made to meet healthcare workforce needs while also ensuring public safety.

Development of a Scale to Measure Synergy: A Tool to Evaluate Team-Based Learning in Nursing.

AIM: The purpose of this study was to develop and pilot an instrument to assess group synergy and team-based learning among nursing students. BACKGROUND: Little is known on how to evaluate soft nursing skills such as synergy. METHOD: Nurse faculty were recruited through purposive and snowball sampling to serve on an expert panel. Using the DeVillis framework, three rounds of data were collected using semistructured online surveys. The resulting scale of 34 items was piloted with teams of undergraduate nursing students taking part in a simulation experience. RESULTS: Item-content validity index ranged from .8 to 1.0 for each item. Scale-content validity index average was .93; scale-content validity index universal was .62. Exploratory factor analysis identified three factors. CONCLUSION: This study suggests that synergy is multifactorial and can be assessed by faculty. However, further testing of the scale is needed.

Anxiety and Stress in Live Disaster Exercises.

INTRODUCTION: Nurses play critical roles in disaster response, often preparing through simulated exercises. According to The NLN Jeffries Simulation Theory, simulations can lead to anxiety in participants that affects learning. The objective of this research was to measure and describe anxiety and stress levels of participants in a live disaster-training exercise. METHODS: A quasiexperimental/descriptive design using quantitative methods (amylase, cortisol levels) and qualitative methods (survey, focus groups) was used with a convenience sample of senior nursing students taking part in a disaster exercise. Participants completed self-reports of anxiety before and after the exercise using the State-Trait Anxiety Inventory (pre/post). Following the training, participants provided saliva samples for analysis of cortisol and amylase levels to measure physiological stress levels. Participants were also invited to take part in a focus group after exercise participation. RESULTS: A total of 22 participants were recruited. Significant elevation of self-reported anxiety levels was found on the State-Anxiety Inventory comparing pre- with post-training, but no Trait-Anxiety changes were noted. Amylase and cortisol levels were within normal ranges. Themes emerging from qualitative analysis include preparation, uncertainty, teamwork, realism, and decision making. DISCUSSION: Disaster training may be anxiety provoking and stressful. ED nurses should consider how to include best practice approaches for simulation in design of exercises to prepare for the increasing number of multicasualty events.

Effectiveness of Two Varying Levels of Virtual Reality Simulation.

AIM: The aim of the study was to assess two levels of immersive virtual reality simulation (VRS) to teach the skill of decontamination. BACKGROUND: Little is known about the use of VRS in providing disaster education, including retention. METHOD: Quasiexperimental design with repeated measures, supplemented by qualitative data, using a convenience sample of senior baccalaureate nursing students (n = 197) from four Midwest campuses was used. Students were randomly assigned to a group (two levels of immersive VRS and a control group) to learn the skill of decontamination. Cognitive learning, performance, and performance time were measured pre/post and at six months. RESULTS: Outcome measures were significant with immediate postintervention improvements and lower retention scores at six months. No significant differences were noted between groups. Students were satisfied with the VRS but found immersive VRS more interactive. CONCLUSION: VRS provides another alternative for simulated learning experiences; best practice approaches for its use still need to be explored.

The Student Experience With Varying Immersion Levels of Virtual Reality Simulation.

With increasing use of virtual reality simulation (VRS) in nursing education and given the vast array of technologies available, a variety of levels of immersion and experiences can be provided to students. This study explored two different levels of immersive VRS capability. Study participants included baccalaureate nursing students from three universities across four campuses. Students were trained in the skill of decontamination using traditional methods or with VRS options of mouse and keyboard or head-mounted display technology. Results of focus group interviews reflect the student experience and satisfaction with two different immersive levels of VRS.

National Disaster Health Consortium: Competency-Based Training and a Report on the American Nurses Credentialing Center Disaster Certification Development.

As the largest profession of health care providers, nurses are an integral component of disaster response. Having clearly delineated competencies and developing training to acquire those competencies are needed to ensure nurses are ready when disasters occur. This article provides a review of nursing and interprofessional disaster competencies and development of a new interprofessional disaster certification. An overview of a standardized disaster training program, the National Disaster Health Consortium, is provided as an exemplar of a competency-based interprofessional disaster education program.

Learning and Retention Using Virtual Reality in a Decontamination Simulation.

AIM: The purpose of this study was to examine the longitudinal effects of virtual reality simulation (VRS) on learning outcomes and retention. BACKGROUND: Disaster preparation for health care professionals is seriously inadequate. VRS offers an opportunity to practice within a realistic and safe environment, but little is known about learning and retention using this pedagogy. METHOD: A quasiexperimental design was used to examine the use of VRS with baccalaureate nursing students in two different nursing programs in terms of the skill of decontamination. RESULTS: Results indicate that VRS is at least as good as traditional methods and is superior in some cases for retention of knowledge and performance of skills. CONCLUSION: VRS may provide a valuable option for promoting skill development and retention. More research is needed to determine how to prepare nurses for skills that may not be required until months or even years after initial introduction.

Assessing performance outcomes of new graduates utilizing simulation in a military transition program.

This multi-site, quasi-experimental study examined the performance outcomes of nurses (n = 152) in a military nurse transition program. A modified-performance instrument was used to assess participants in two high-fidelity simulation scenarios. Although results indicated a significant increase in scores posttraining, only moderate interrater reliability results were found for the new instrument. These findings have implications for nurse educators assessing performance-based outcomes of new nurses completing transition programs.

An innovative approach to preparing nursing students for care of the elderly in the home.

Nurse educators must prepare future nurses for the increasing number of elderly requiring care in community-based settings. This quasi-experimental study examined the outcomes of a geriatric home care simulation experience for senior community health nursing students (n = 56). The experience included a home care visit to an elderly diabetic client using a high-fidelity human patient simulator as well as a geriatric home safety assessment exercise. Results indicated students were satisfied with the experience and that it had a positive impact on confidence, but no differences were found between groups in terms of learning. Additional analysis using Spearman's rho found outcomes of satisfaction and self-confidence were significantly correlated (rs=.378-.605) with simulation design, especially the provision of student support and a challenging problem to solve. Results provide nurse educators with evidence for developing geriatric simulation education experiences for preparing new graduates to care for the increasing number of elderly who desire to age in place.

High-fidelity simulation: factors correlated with nursing student satisfaction and self-confidence.

While available research suggests positive outcomes when using high-fidelity simulation in nursing education, little is known about factors associated with these outcomes. This descriptive, correlational study examined the effects of a simulation experience on two outcomes (student satisfaction and self-confidence) as well as factors correlating with these outcomes. This was accomplished by both descriptive statistical analysis (mean and standard deviation) in addition to correlational statistical analysis using bivariate statistics (Spearman's rho) and multiple linear regression. Results indicate that design characteristics, especially clear objectives and an appropriately challenging problem to solve, were significantly correlated with student satisfaction and self-confidence.