Reframing evidence-based practice curricula to facilitate engagement in nursing students.

Evidence-based practice underscores a modern approach to nursing to ensure delivery of safe, up-to-date and person-centred care in the evolving clinical environment. While most entry-to-practice nursing courses incorporate elements of evidence-based research curricula, nursing students commonly struggle to see the relevance of research in their training. This study sought to understand nursing students' satisfaction and perspectives on research after an undergraduate research subject was redesigned to make overt the connection between research and professional nursing practice. Satisfaction significantly improved on routinely collected satisfaction surveys over a one-year period (mean increase 0.57, 95% CI 0.40-0.77, P < 0.001; medium effect size, 0.64). Open-ended questions elicited five themes: change to preconceived ideas of research to something accessible and useful; clear link between research and clinical and professional nursing practice; comments on subject format and scaffolded learning; increased skills in effective searching and extracting evidence; and improvements for the future. Student satisfaction increased when the connection between research learning and professional practice was made overt in a core research subject. This approach, along with scaffolded activities to increase confidence, had a marked positive impact on student's attitude and understanding of the utility of evidence-based practice and confidence in scrutinising practice in the clinical environment.

Plastic with personality: Increasing student engagement with manikins.

BACKGROUND: Simulation allows students to practice key psychomotor skills and gain technical proficiency, fostering the development of clinical reasoning and student confidence in a low risk environment. Manikins are a valuable learning tool; yet there is a distinct lack of empirical research investigating how to enhance engagement between nursing students and manikins. OBJECTIVE: To describe student perspectives of a layered, technology enhanced approach to improve the simulation learning experience. EDUCATIONAL FRAMEWORK: Tanner's Model of Clinical Judgment underpins the entire curriculum. This study additionally drew on the principles of narrative pedagogy. INTERVENTION: Across ten teaching weeks, five separate case studies were introduced to students through short vignettes. Students viewed the vignettes prior to their laboratory class. In the labs, manikins were dressed in the props used in the vignettes. SETTING: The innovation was trialed in a second year core subject of a Bachelor of Nursing program in a large urban university in the autumn semester of 2014. DATA COLLECTION AND ANALYSIS: Following ethics approval, students were emailed a participant information sheet. A focus group of nine students was held. The discussion was digitally recorded and transcribed verbatim prior to being subject to thematic analysis. Students' comments (143) about the vignettes in their standard subject specific student feedback surveys were also considered as data. RESULTS: Four themes were identified: Getting past the plastic; knowing what to say; connecting and caring; and, embracing diversity. The feedback indicated that these measures increased students ability to suspend disbelief, feel connected to, and approach the manikins in a more understanding and empathetic fashion. CONCLUSIONS: In addition to achieving increased engagement with manikins, other advantages such as students reflecting on their own values and pre-conceived notions of people from diverse backgrounds were realized.

Multi-component weight-loss interventions for people with cardiovascular disease and/or type 2 diabetes mellitus: a systematic review.

OBJECTIVES: To determine whether weight loss interventions, which combine dietary, exercise and behaviour change strategies, result in reduced weight, body mass index (BMI) and waist circumference in people with coronary heart disease (CHD), hypertension (HTN) and/or type 2 diabetes mellitus (T2DM). DESIGN: A systematic review of studies published 1997 to 2010. DATA SOURCES: The electronic databases MEDLINE, PsycINFO, COCHRANE, CINAHL and EMBASE. REVIEW METHODS: Studies were included if samples were: ≥ 18 years old, overweight or obese (BMI 26-39.99 kg/m(2)), and diagnosed with CHD, T2DM and/or HTN. Only randomised controlled trials (RCTs) or systematic reviews of RCTs reporting group-based interventions that combined dietary, exercise and behavioural change strategies and outcomes for weight, BMI and/or waist circumference up to 12 months were included. Two researchers extracted data and appraised quality, with a third making final decisions. RESULTS: Eight RCTs were included (total n = 1428). Participants' mean age was 60.4 years and 61% were female. Interventions varied by contact time, content and delivery. Mean weight loss ranged from -2 kg to -4 kg (SD 4 kg) at 3-4 months, -1.3 kg to -8.2 kg (SD 4 kg) at 5-6 months and -0.87 (SD 0.57 kg) to -6.9 kg (SD 4 kg) at 12 months. Of the few studies that measured waist circumference the mean reduction was -3.1 cm at three and 12 months. CONCLUSIONS: Weight loss interventions that combine exercise, diet and behaviour change strategies result in minor weight loss at 3-12 months in people with CHD, T2DM or HTN. Further research is required to determine the most effective and efficient methods.

Providing simulation experiences for large cohorts of 1st year nursing students: evaluating quality and impact.

To provide each student within a large cohort the opportunity to participate in a small group simulation that meets recognised quality indicators is a challenge for Bachelor of Nursing programmes in Australia. This paper, as part of a larger longitudinal study, describes one approach used to manage a simulation for 375 1st year nursing students and to report on the quality of the experience from the student's perspective. To ensure quality was maintained within the large cohort, aspects of the simulation were assessed against the following indicators: alignment with curriculum pedagogy and goals; preparation of students and staff; fidelity; and debriefing. Data obtained from a student focus group were analysed in the context of the quality indicators. The following themes emerged from the data: knowing what to expect; assuming roles for the simulation; authenticity and thinking on your feet; feeling the RN role; and, preparation for clinical practice. This paper demonstrates it is possible to provide students in large cohorts with active participatory roles in simulations whilst maintaining quality indicators.

Evaluation of a critical care simulation series for undergraduate nursing students.

Simulation is increasingly being used to prepare and supplement clinical practice in critical care areas for undergraduate Bachelor of Nursing (BN) students, with some success. However, the effects of multiple, medium-high fidelity simulations for this purpose have not been previously assessed. The purpose of this study was to assess self-reported confidence and competence using scenario-based simulations. A pre-test post-test design was used to evaluate a series of simulations conducted over a semester. There were twenty seven scenarios, incorporating programmed mannequins, moulage and actors. The scenarios were embedded in a team-based process involving preparation and video-recordings used for debriefing. Third year BN students reported their confidence and competence before and after the simulation series and made comments on their perception of the experience. Multiple scenario simulations are effective in improving BN students' confidence and competence related to critical care practice and are an enjoyable experience for students.