An international comparison of student nurse practitioner diagnostic reasoning skills.

BACKGROUND: Nurse practitioners (NPs) play a pivotal role in health care provision. Diagnostic reasoning is an important core skill of advanced practice. PURPOSE: The purpose of this study was to compare diagnostic reasoning skills of NP students. It also identified the variability in clinical teaching components of a sample of international NP curricula. METHODS: An international group of NP students completed an online survey using a validated diagnostic reasoning scale during the first year of their NP program. Program faculty surveyed provided data on core curricula. RESULTS: The NP students' ( n = 152) mean diagnostic thinking inventory (DTI) score was 142, flexibility in thinking subscale score mean of 73 with a knowledge structure in memory of 69. The programs surveyed required bioscience courses. Most programs provided opportunities for students to practice diagnostic thinking using individual precepted clinical hours (range 500-950) and objective structured clinical examinations. CONCLUSION: The lower scores of this group of NP students were similar to other NP students and first-year medical residents. Higher mean scores in the DTI reflect expertise and are developed over time. Courses providing a foundation of biomedical knowledge were identified in each program, with opportunities for the NP students to practice diagnostic thinking using objective structured clinical examinations and clinical practice hours. IMPLICATIONS: The use of the diagnostic reasoning inventory is a useful tool for evaluating student NP's diagnostic reasoning during their NP program. Nurse practitioner programs should consider the provision of dedicated clinical hours, including supervised clinical practice experiences and objective structured clinical examinations to improve diagnostic reasoning.

Country-level mentoring for advanced practice nursing: A case study.

AIM: To describe the mentoring process between the ICN Advanced Practice Nurse Network practice subgroup and the University of Pécs to support the emerging advanced practice role in Hungary, and explore the creation of a mentoring algorithm for faculty and other key stakeholders worldwide who wish to develop advanced practice nursing programs. BACKGROUND: Advanced practice nurses provide comprehensive clinical care and expand access to care in more than 70 countries. In March of 2017, a representative of the Faculty of Health Sciences of the University of Pécs requested assistance in curricula development for the inaugural advanced practice nursing program in Hungary. METHODS: A mixed-methods single case study was undertaken. The sources of evidence include interviews, e-mails, review of the literature, and related documents. Qualitative data were analyzed for content, and frequencies were calculated for quantitative indicators. FINDINGS AND DISCUSSION: The findings highlight the importance of clear communication, development of shared goals, and determination to see the project through. Enriching information was provided by colleagues from diverse global settings. Credibility was gained in Hungary from the support of national and international experts. CONCLUSION: The mentoring foundation and process facilitated the role development in Hungary and contributed to an increased understanding of advanced practice nurses' scope of practice. The intentional approach and the careful ongoing reflection may lead to future successful endeavors. Multinational engagement and collaborations will promote advanced practice nursing contributions globally. IMPLICATIONS FOR NURSING POLICY: Mentoring can effectively empower nurses and advanced practice nurses to work to their full capacity. The shared experiences of international mentoring colleagues can contribute to and support the development and acceptance of national policies for the advanced practice nursing roles.

An examination of student nurse practitioners' diagnostic reasoning skills.

AIM: To examine the diagnostic reasoning skills of two nurse practitioner student cohorts. INTRODUCTION: Nurse practitioners continue to play a pivotal role in health care provision. Diagnostic reasoning is a core skill of advanced practice. A comparative diagnostic reasoning study between two student cohorts was undertaken between 2018 and 2019. METHODS: A validated diagnostic reasoning scale was completed by nurse practitioner students in the United Kingdom and the United States of America at the beginning and end of their clinical placements. The study utilized descriptive quantitative statistics from the data submitted by 22 survey respondents from an online survey. RESULTS: Analysis of the diagnostic reasoning skills suggested there was a difference in the structural memory scores when compared with the beginning of their clinical placements and the final semester of their clinical placements. CONCLUSION: Diagnostic reasoning skills are a core skill of advanced practice. As students progress through their training, these skills improve. Despite the statistical difference in diagnostic reasoning scores, caution should be made in determining any larger implications due to the small number of participants in this study. Further study is needed in this area.

Evaluation of an international program for nurse practitioner students.

BACKGROUND: There are few opportunities for nurse practitioner (NP) students to develop relationships and exchange ideas with international counterparts. In addition, discovering differences in instructional pedagogy between programs is beneficial for every student. PURPOSE: To facilitate an international understanding of health care services and compare curricula of advanced practice programs through an international experience for first year NP students from the United Kingdom and the United States. METHODOLOGICAL ORIENTATION: The study used a qualitative analysis of responses from specified questions provided to both cohorts of students before and after the experience. SAMPLE: A virtual global exchange between 23 advanced practice students and their professors in the spring of 2018 culminated in a trip by the UK students and faculty to the United States in April of that year. CONCLUSIONS: The UK and US NP students positively evaluated the international encounter and pointed out specific educational activities that were most helpful to their training. IMPLICATIONS FOR PRACTICE: International experiences offer NP students the opportunity to experience health care delivery in an alternative cultural milieu.

Conducting research through cross national collaboration.

AIM: To explore the collaborative nature of an international research project with other advanced practice nurse researchers and critically analyse the process. BACKGROUND: Research within the nursing community is recognized internationally as important to ensure that nurses participate in cutting-edge health care and promote evidence-based practices, yet there is little detail found in literature on how a successful collaborative relationship is initiated and conducted in advanced practice research. DESIGN: Discussion paper: The purpose of this paper is to discuss the process of collaboration on a research study among advanced practice nurses from four countries who are members of an international organization. IMPLICATIONS FOR NURSING: The collaborative process in international nursing research can be challenging and rewarding. It is important to remember that there is a relationship between the complexity of the study and the time required to complete it. Keys to success include following established guidelines. CONCLUSION: This project was a valuable experience in developing collaborative relationships as well as creating partnerships for future research to build on the knowledge gained. The authors' linkages to universities facilitated their participation in the research and completion of the ethical review processes. The use of social media and university resources was indispensable.

The Impact of Cultural Competence Education on Short-Term Medical Mission Groups: A Pilot Study.

BACKGROUND: There are large numbers of short-term medical mission (STMM) groups traveling yearly from the United States to underdeveloped countries. Medical professionals educated in the Western biomedical model of treatment have an ethnocentric view of how to treat illness. PURPOSE: The purpose of this pilot study was to demonstrate that a 2-hour culturally sensitive educational program administered to medical professionals travelling to Haiti on a STMM could raise their cultural competency as measured by a specific tool. METHOD: The participants were invited to a short educational program designed to help them understand their own biases and make better treatment decisions for their patients based on the five constructs of Dr. Campinha-Bacote's cultural competence model. FINDINGS: Following an evidence-based educational program, the members of the STMM groups demonstrated improved levels of cultural competency. IMPLICATIONS: This program could provide an appropriate way to raise the cultural competency of medical mission health care providers.