Trauma-informed care: Insights from a Q-methodology study of advanced practice registered nursing students.

BACKGROUND: Trauma-informed care (TIC) aims to create a safe and supportive healthcare environment that empowers patients and cultivates understanding of the role trauma plays in short-term and long-term health. TIC also has the potential to improve health outcomes and foster clinician wellness. Nurse educators must design evidence-based instruction to develop advanced practice registered nurses (APRNs) who deliver high-quality TIC while also protecting their own wellbeing. OBJECTIVES: To identify patterns in subjective viewpoints about TIC among APRN students and describe how those patterns influence their learning experience in an advanced health assessment course. DESIGN: Q methodology was used to explore student perceptions of TIC. SETTING: A virtual advanced health assessment course at a large, midwestern university in the United States. PARTICIPANTS: Ninety-five APRN students from six specialty APRN programs. METHODS: Students completed an online Q-sort activity by ranking 32 TIC statements according to how well the statements aligned with their own perspectives. Q-sorts were analyzed using factor analysis and narrative responses to open-ended questions. RESULTS: Four factors were extracted that revealed different student viewpoints on TIC and their learning experiences: Comfortable/Confident Learners, Uncomfortable/Apprehensive Learners, Empathetic/Hesitant Learners, and Inexperienced/Uncertain Learners. CONCLUSIONS: All students acknowledged the need to learn about TIC to implement it effectively in practice. It is important for faculty to understand the potential range of divergent student viewpoints about TIC and acknowledge, accept, and support students who have anxiety related to learning about TIC.

Student Peer Review and Receptiveness to Feedback in Global Classrooms.

BACKGROUND: Development of skills in peer-to-peer feedback in multicultural and global contexts is important to excellent teaching practice in nursing education. PURPOSE: This study identified student attitudes toward giving and receiving peer-to-peer feedback between international peers in a graduate-level online instructional design course. METHODS: Twenty-one graduate nursing students in 2 nurse educator programs from the United States and Finland participated in this descriptive study. Pre- and postcourse Feedback Orientation Scale (FOS) scores were analyzed in combination with student reflections on learning experiences related to peer-review course activities. RESULTS: Mean pre- to postcourse overall FOS scores increased, suggesting greater student receptiveness to peer feedback, particularly in the dimensions of utility and self-efficacy. Postcourse reflections demonstrated increased appreciation for opportunities to triangulate feedback from multiple, diverse sources. CONCLUSIONS: Opportunities for graduate students in nurse educator programs to exchange peer-to-peer feedback with international peers foster growth in positive attitudes toward receiving and using peer feedback.

Trends, Future Directions, and Questions for Preparing Successful Nurse Faculty.

BACKGROUND: Many nurse educators enter the faculty role with little academic teaching experience. Although there is evidence that providing clear expectations and targeted training on teaching and learning is beneficial for new faculty members, inconsistencies and content gaps in orientation programs and prerequisite knowledge for nurse educators still pose challenges to faculty success. METHOD: This article reviews the current state of preparation for nurse educators, describes new knowledge and skills nurse educators need to prepare nursing students for practice, and suggests approaches to continuous growth and professional development. RESULTS: In addition to knowledge of foundational teaching concepts, nurse educators need advanced knowledge of technology, global health, and climate change. Today's learners are diverse and require equity-focused teaching and pedagogy responsive to individual learner characteristics and backgrounds. CONCLUSION: Ensuring nurse educators are prepared to deliver a high-quality education program requires up-to-date professional development, a comprehensive orientation, and ongoing faculty support. [J Nurs Educ. 2023;62(12):661-667.].

Identifying best practices for virtual nursing clinical education: A scoping review.

BACKGROUND: COVID-19 forced nurse educators across the world to rapidly shift clinical experiences from face-to-face to the virtual world without identification of best practices to guide this transition. PURPOSE: The purpose of this review was to identify best practices in virtual clinical experiences for undergraduate and graduate nursing students using the Community of Inquiry model as a framework. METHOD: A scoping review was conducted using the Joanna Briggs Institute Scoping Review process. Ten databases were searched systematically for literature related to virtual nursing student clinical experiences. The 36 articles retained for review were appraised using evidence-based rapid critical appraisal tools. RESULTS: The literature suggests virtual clinical experiences may positively impact clinical reasoning and judgement; knowledge gain, retention, and application; affective learning; communication and teamwork; competence; engagement; confidence; and satisfaction. However, increased anxiety, frustration with technology and access, difficulty asking questions, and increased cost were reported. Additional considerations included appropriate faculty training, student support, and accreditation and board certification requirements. Standards related to virtual clinical experiences and simulation for advanced practice registered nurses needs further study. CONCLUSION: Virtual clinical experiences resulted in positive student learning outcomes. Through the provision of quality virtual clinical experiences, nurse educators have the potential to maximize student learning and professional growth.

Application of the Nursing Process Using Moulage as a Problem-Based Approach to Teaching Dermatologic Content.

ABSTRACT: Teaching dermatologic conditions can be challenging in lecture-style format. A class activity was implemented in a prelicensure nursing course to enhance learning of dermatologic conditions while emphasizing the nursing process, evidence-based treatments, transmission-based precautions, and teamwork. Students worked in teams to identify moulage-based dermatologic conditions and follow the nursing process to develop a plan of care. Students presented their findings to faculty and peers. Positive student feedback on the activity included enhanced teamwork, application of the nursing process, visual emphasis on content, and understanding of holistic care. This activity is an innovative alternative to traditional lecture format.

Revitalizing the Muddiest Point for Formative Assessment and Student Engagement in a Large Class.

BACKGROUND: Ascertaining student understanding can be challenging in large-enrollment and hybrid or asynchronous courses. PROBLEM: Instructors needed an innovative instructional strategy to encourage student engagement and support learning in a large-enrollment, mixed-format pathophysiology class. APPROACH: A weekly, graded assignment was created by merging the formative assessment commonly referred to as the muddiest point (MP) with an asynchronous discussion board activity within the learning management system. Each week, students were required to submit a question and respond to a peer. Instructors created a remediation lecture based on the most common student questions. OUTCOMES: The majority of students reported they benefitted from the MP discussion boards and remediation lectures. CONCLUSIONS: The MP discussion board activity is a flexible, instructional strategy to determine areas of confusion, increase student engagement, and facilitate learning in large-enrollment classes offered in multiple formats.

Exploring the impacts of learning modality changes: Validation of the learning modality change community of inquiry and self-efficacy scales.

The rapid learning environment transition initiated by the COVID-19 pandemic impacted students' perception of, comfort with, and self-efficacy in the online learning environment. Garrison's Community of Inquiry framework provides a lens for examining students' online learning experiences through three interdependent elements: social presence, cognitive presence, and teaching presence. Researchers in this study developed and validated the Learning Modality Change Community of Inquiry and Self-Efficacy scales to measure health professions students' self-efficacy with online learning, while exploring how cognitive, social, and teaching presence is experienced by students who transition from one learning environment to another. The two scales demonstrate strong validity and reliability evidence and can be used by educators to explore the impacts of learning modality changes on student learning experiences. As learning environments continue to evolve, understanding the impact of these transitions can inform how educators consider curriculum design and learning environment changes.

Frameworks and Technology for Triangulation of Feedback to Support Learning.

Nurse educators and students are partners in co-creation of a classroom culture of assessment for learning rather than assessment of learning. Three essential sources of feedback-instructor feedback, peer feedback, and self-reflection-contribute to development of metacognitive skills necessary for nursing practice. Triangulation of feedback from multiple sources develops skills in peer evaluation, professional accountability, emotional regulation, and lifelong learning. Feedback processes are supported by creative use of learning technologies such as learning management systems, survey tools, videography using institutional equipment or students' personal devices, social annotation strategies and applications, and audience response systems.

Next Generation of Nurses: Considerations for Successful Recruitment.

As healthcare faces the great resignation, it is important that nurse leaders understand the impact of generational variations in the recruitment of nursing staff. This article discusses the specific characteristics of millennials and Generation Z nurses and offers suggestions for tailoring recruitment strategies for these 2 generational groups.

The effect of asynchronous group discussions on nurse practitioner student debriefing experience in virtual simulation.

ABSTRACT: Debriefing facilitates student learning of critical concepts and faculty evaluation of simulation learning outcomes. However, effective practices in debriefing after virtual simulation, including the impact of software-generated performance feedback and asynchronous group debriefing, are not well understood. Student perceptions of two different methods of postsimulation debriefing were explored by comparing software-generated performance feedback only versus software-generated feedback combined with an asynchronous, faculty-facilitated, online discussion based on the 3D Model of Debriefing. The Debriefing Experience Scale was used to evaluate self-reported debriefing experiences in 68 advanced practice nursing students before and after implementation of an online discussion-board debriefing strategy. Students reported an improved debriefing experience when simulation software-generated feedback was combined with asynchronous online discussion compared with automated software-generated feedback alone. Implications for faculty are discussed including lessons learned to support online, asynchronous debriefing experiences, and how to engage students in meaningful discussions that triangulate feedback from the simulation software, peers, and their instructor.

Peer Review: Factors That Motivate Students to Provide Supportive Peer Feedback.

BACKGROUND: Students who value peer feedback processes are more likely to provide supportive feedback to peers. PURPOSE: The purpose of this study was to explore the factors that motivate and demotivate students to provide supportive feedback to peers. METHOD: A secondary analysis of qualitative data collected from 148 graduate nursing students in 7 master's-level courses was conducted to identify the themes related to motivating and demotivating factors in peer review and how they related to students' sense of value for providing supportive peer feedback. RESULTS: Common themes included perceived potential for supportive peer feedback to improve self, peer, and team performance, and quality of patient care. Themes related to demotivation included lack of time and fear of negative impact on peers. CONCLUSION: Faculty should emphasize to students the positive impact of supportive peer feedback on nursing care. Assignments can be structured to promote a fair exchange of supportive feedback between peers.

Key strategies in scholarly writing instruction for doctor of nursing practice students: A Q-methodology study.

BACKGROUND: Development of scholarly writing skills in Doctor of Nursing Practice (DNP) students is essential to their capacity to advance nursing science after graduation. OBJECTIVES: The purpose of this study was to inform instructional design choices and teaching strategies for DNP writing courses by examining student viewpoints before and after completing a scholarly writing course. DESIGN: Q methodology was used to explore student self-perceptions of scholarly writing skills. SETTING: An online scholarly writing course at a large university in the midwestern United States. PARTICIPANTS: Twenty-six DNP students with either a bachelor's or master's degree in nursing. METHODS: Before and after a scholarly writing course, students ranked 34 writing competency statements according to how well the statements described them. RESULTS: Three pre-course and four post-course factors represented student viewpoints of their scholarly writing knowledge, skills, and attitudes before and after a writing course. CONCLUSIONS: Effective instruction in scholarly writing for DNPs should include explicitly directed pre-writing activities, frequent opportunities to give and receive feedback, and training on management of emotional aspects of writing.

Key ePortfolio features and strategies for student success in a competency-based clinical research program.

BACKGROUND: Student ePortfolios provide an interactive space for faculty, student peers, and potential employers to view skillsets and reflective expressions of students. EDUCATIONAL ACTIVITY: The adoption of ePortfolios in an interdisciplinary, competency-based, master's degree program in clinical research at a university in the Midwestern United States is described. Students submitted their ePortfolios as their culminating assessment. A survey was used to collect objective and open-ended responses from 104 students between 2015 and 2019 followed by a voluntary post-survey interview. Two ePortfolio platforms and instructional methods were compared. CRITICAL ANALYSIS OF THE EDUCATIONAL ACTIVITY: A user-friendly platform enhanced student engagement and reduced student and faculty frustration with the ePortfolio requirement. Thirty-seven students and alumni responded to an ePortfolio survey, and five students shared their experiences in a post-survey interview. Students described positive experiences related to their academic program and job search as a result of completing the ePortfolio. However, alumni were not strongly motivated to maintain their ePortfolio post-graduation. ePortfolios provide evidence of student acquisition of core competencies in a professional graduate degree. Facilitating the process of ePortfolio creation with instruction guides, exemplar ePortfolios, and an evaluation rubric support student success. A user-friendly ePortfolio platform with social media linking features will enhance exposure of the student's work to key stakeholders during and after their academic program. If the ePortfolio is to have an impact on a student's professional trajectory after graduation, it should contain meaningful examples of academic work that can be shared publicly and allow updating of ePortfolio content.

Conditional Process Analysis for Nursing Education Researchers.

Nurse faculty need methodologically rigorous yet accessible techniques to evaluate the impact of their teaching strategies and build a strong body of evidence in nursing education science. Conditional process analysis is one such technique that allows researchers to include multiple variables in a single model to disentangle complex influences that instructional processes, student characteristics, and classroom variables have on learning outcomes. Researchers are encouraged to consider conditional process analysis to test and explain the effects of their educational strategies. Practical tools and resources are described that make conditional process analysis feasible for faculty with a basic understanding of statistical methods. [J Nurs Educ. 2020;60(5):249-251.].

Effects of Knowledge and Value on Quality of Supportive Peer Feedback.

BACKGROUND: Motivational barriers and lack of knowledge about peer review inhibit creation of supportive peer feedback between nursing students. PURPOSE: The purpose of this study was to examine the effects of knowledge of peer-review practices and value for the process of creating supportive peer feedback on the quality of feedback nursing students create for their peers. METHOD: Data from 155 graduate nursing students were analyzed in this quasi-experimental, repeated-measures design, using analysis of covariance and conditional process analysis. RESULTS: Students who had high levels of knowledge and a strong sense of value for providing feedback to peers produced higher-quality supportive peer feedback. CONCLUSION: Even when a student has sufficient knowledge and skills to produce supportive peer feedback, their ability may not transfer to real peer-review contexts if they do not also have a strong sense of value for providing high-quality feedback to peers.

Frequency of participation in student response system activities as a predictor of final grade: An observational study.

OBJECTIVES: The purpose of this study was to determine whether frequency of participation in activities offered in a student response system was associated with students' final course grades in four different nursing courses and to explore whether that effect was dependent on the specific pedagogical context of each course. DESIGN: An observational approach with a predictive model was used to examine the effect of a student's frequency of responses to prompts in a student response system (Nearpod) on final grade. SETTING: This investigation was carried out in four high-enrollment nursing courses in a large Midwestern university in the United States. PARTICIPANTS: Students who participated in this study were enrolled in one of four core nursing courses: Pathophysiology, Health Assessment, Nursing Care of the Adult at the undergraduate level, and Pathophysiology at the graduate level. METHODS: Multiple regression analysis was conducted to examine the association between a student's frequency of Nearpod use and their final grade. RESULTS: The regression model explained 25.42% of the variance in final grade when controlling for course differences. The key finding from this study is that the more a student responded to prompts in Nearpod, the more likely they were to earn a higher final grade, but this effect was statistically significant only in undergraduate Pathophysiology. CONCLUSIONS: The positive association between more frequent Nearpod use and higher final grade appears to be dependent on contextual factors. These factors may include consistent use of Nearpod in class, detailed feedback and elaboration on student responses, and required participation in Nearpod activities.