Student-led Doctor of Nursing Practice projects in the clinical environment: Viewpoint from hospital-based nurse scientists and leaders.

BACKGROUND: Exponential increases in Doctor of Nursing Practice (DNP) program enrollment have come with a rapid rise in the number of capstone projects conducted in clinical environments. However, misaligned priorities between students, faculty, and clinician leaders have created significant challenges. PURPOSE: Identify opportunities to strengthen collaboration between academic and clinical stakeholders to better support DNP projects and education. METHODS: Experienced hospital-based nurse leaders engaged in scholarly discourse supplemented by policy and research in DNP education. FINDINGS: Facilitating a DNP project requires significant investment of time, resources, and funds from the healthcare institution. Discord has arisen due to unclear responsibilities or decision-making ability for clinical stakeholders, ethical dilemmas for students who are also employees of the clinical site, and mismatched priorities between clinical need and student/academic project desires. Clinical leaders have raised significant concerns about DNP project proposals that are research-focused, diverge from healthcare institution goals, and lack a sustainability plan. DISCUSSION: Fortification of academic-practice partnerships and clarification of roles in the DNP student project are necessary to ensure that the project is of educational value to the student, a demonstration of learning for faculty, and of sustained clinical value to the healthcare system.

A Mini Chalk Talk Workshop for Fourth-Year Medical Students: Facilitating the Transition From Student to Resident Educator.

Introduction: There is increasing recognition that incoming interns benefit from formal training in teaching skills during UME. Many medical schools have capstone courses well suited for teacher-training content. Mini chalk talks (MCTs) are a common clinical teaching modality requiring a variety of teaching skills. We developed a session for our institution's capstone course in which students prepared and delivered MCTs. Methods: The voluntary flipped classroom session was offered virtually in 2021 and in person in 2022. Before the session, students reviewed materials on creating effective MCTs and developed and practiced their own MCT. During the 90-minute session, students presented their MCT to a group of students in the same or similar future specialties and received feedback from their peers and a facilitator. Results: Twenty-six percent of graduating students (95 of 370) in 16 specialties participated. Students had a statistically significant increase in confidence delivering effective MCTs (p < .01). On a 5-point Likert scale (1 = did not learn, 5 = a great amount), students' mean ratings of clinical knowledge and teaching skills gained from the session were 4.4 and 4.5, respectively. Qualitative feedback highlighted the benefits of receiving feedback on teaching (31 of 77 respondents, 40%), practicing teaching skills (21 of 77, 27%), and experiencing other students' MCTs (13 of 77, 17%). Discussion: Our MCT session provides a versatile, resource-efficient method of supporting students in transitioning to the role of resident educators. It also offers them an opportunity to receive valuable feedback on their teaching in a low-stakes environment.

Predictors of student preparedness for advanced pharmacy practice experiences.

BACKGROUND: A capstone course often serves as the final checkpoint of student readiness before the commencement of experiential training. The purpose of this study was to determine if the assessment components from the capstone course can serve as predictors of student performance during their Advanced Pharmacy Practice Experiences (APPEs). METHODS: Student data was analyzed to observe the correlation between performance in the Pharmacy Curriculum Outcomes Assessment (PCOA), student performance in the capstone course, and the overall grade point average (GPA) earned during APPEs. Spearman rank correlation analysis, multiple linear regression, and Mann-Whitney U test were used for statistical analysis. RESULTS: A statistically significant positive correlation was observed between the overall APPE GPA and students' capstone course grade, top drug competency exam score, pharmacy calculation competency exam score, and PCOA exam score. A significant regression equation was obtained during the analysis: (F(5, 97) = 5.62, p < 0.001), with an R2 = 0.225 (adjusted R2 = 0.185). In the linear regression model, capstone GPA emerged as a significant predictor (ß = 0.155; p = 0.019) of APPE GPA amongst the tested variables. Additionally, students scoring < 73% on the top drug competency exam in the capstone course or less than the reference group in the PCOA exam were found to have significantly lower GPA during their APPEs compared to other students. CONCLUSION: Performance on the top drug competency exam and the PCOA exam can serve as potential predictors of success during APPEs.

A Systematic Review of APPE Readiness Assessments Utilized by US Schools of Pharmacy.

OBJECTIVE: The 2016 Accreditation Council for Pharmacy Education standard 25.8 requires schools of pharmacy to assess student readiness for Advanced Pharmacy Practice Experiences (APPEs). We performed a systematic review to identify how schools of pharmacy in the United States assess student readiness for APPE rotations in accordance with Accreditation Council for Pharmacy Education accreditation guidelines. FINDINGS: From a search of 6 databases, we identified 1053 unique studies, of which 11 were eligible for inclusion in our review. The most commonly reported assessment method was the use of a capstone course; however, these courses varied significantly from school to school in duration, resources used, and content. Regardless of the specific approach used, first-time and overall pass rates were high. SUMMARY: We found that while most studies reported using some type of capstone course for APPE readiness assessment, there was variability in how these courses were structured and the assessment methods used within the courses. The future 2025 standards may dictate a more uniform structure for readiness assessments; however, further research is needed to identify best practices regarding the assessment of APPE readiness.

Evolution of a capstone exam for third-year doctor of pharmacy students.

BACKGROUND AND PURPOSE: Pharmacy capstone exams are an example of an assessment strategy to evaluate student competency and practice-readiness. Capstone exam processes have been discussed in the literature; however, description of format, evolution of the process, and implementation in the year prior to rotations is lacking. This manuscript discusses the development, implementation, and utilization of a third professional year pharmacy capstone exam to assess advanced pharmacy practice experience (APPE) readiness. EDUCATIONAL ACTIVITY AND SETTING: A pharmacy year three (PY3) capstone exam was initially developed prior to enrollment of the inaugural graduating class. Since the first iteration, utility has remained the same, but the overall development and implementation process has evolved due to changes in programmatic and student learning outcomes, curricular mapping, student and faculty feedback, and practice expectations. FINDINGS: The entities responsible for exam implementation perceive faculty and students have a positive perception of the exam evolution and improvements implemented. Specifically, feedback from students and faculty mentioned clear expectations, comfort with the new capstone exam process, and an appreciation for the focus on interrater reliability. As assessment is an iterative process, quality improvement strategies continue to be implemented to address feedback regarding the PY3 capstone exam. SUMMARY: Purposeful utilization of capstone exams in the third year is one method to assess APPE readiness. Sharing one college's experience with the evolution of such an exam, quality improvement methods, and experience in implementing reliability and validity measures may provide a model for institutions to implement similar assessment methods efficiently.

Engaging Students, Faculty, and External Professionals with a Data-Centered Group Capstone Project.

This paper presents the rationale and structure for a data-centered capstone project that provides an engaging and effective learning experience for students. Groups of students both select topics and self-direct research. Students are responsible for collecting, analyzing, and presenting data in both written and verbal forms. The project cultivates the ability to work as a team, communicate effectively, and explore and interpret data. We describe a method for involving external stakeholders including alumni, Executive Advisory Board members, or community business professionals. Extensive flexibility of the project allows variability in the conceptual focus, types of deliverables, and the mode of delivery.

MPH Capstone experiences: promising practices and lessons learned.

To ensure workforce readiness, graduate-level public health training programs must prepare students to collaborate with communities on improving public health practice and tools. The Council on Education for Public Health (CEPH) requires Master of Public Health (MPH) students to complete an Integrative Learning Experience (ILE) at the end of their program of study that yields a high-quality written product demonstrating synthesis of competencies. CEPH suggests written products ideally be "developed and delivered in a manner that is useful to external stakeholders, such as non-profit or governmental organizations." However, there are limited examples of the ILE pedagogies and practices most likely to yield mutual benefit for students and community partners. To address this gap, we describe a community-led, year-long, group-based ILE for MPH students, called Capstone. This service-learning course aims to (1) increase capacity of students and partner organizations to address public health issues and promote health equity; (2) create new or improved public health resources, programs, services, and policies that promote health equity; (3) enhance student preparedness and marketability for careers in public health; and (4) strengthen campus-community partnerships. Since 2009, 127 Capstone teams affiliated with the Department of Health Behavior at the Gillings School of Global Public Health at The University of North Carolina at Chapel Hill have worked with seventy-nine partner organizations to provide over 103,000 h of in-kind service and produce 635 unique products or "deliverables." This paper describes key promising practices of Capstone, specifically its staffing model; approach to project recruitment, selection, and matching; course format; and assignments. Using course evaluation data, we summarize student and community partner outcomes. Next, we share lessons learned from 13 years of program implementation and future directions for continuing to maximize student and community partner benefits. Finally, we provide recommendations for other programs interested in replicating the Capstone model.

An Examination of the Career Choices of Nursing Graduates After Completing a Perioperative Elective.

In light of the perioperative nursing shortage, academic leaders at a mid-Atlantic school of nursing and leaders of three health care systems implemented an academic-practice partnership with the goal of increasing interest in this specialty. Nursing researchers used a descriptive study design to collect data from nursing alumni who participated in the perioperative elective between 2017 and 2021. They found that 25 (38%) of 65 graduates who participated in the elective entered perioperative nursing and 38 (68%) of 56 graduates who answered a question on considering future employment as a perioperative nurse indicated they would do so regardless of their current employment status. Graduates who participated in the elective and experienced a perioperative capstone placement had low anticipated turnover scores and intended to remain in a perioperative position. Academic and health care leaders should consider academic-practice partnerships as a strategy to recruit and retain perioperative nurses.

An idea to explore: Interdisciplinary capstone courses in biomedical and life science education.

While biomedical and life science research have embraced interdisciplinarity as the means to solving pressing 21st century complex challenges, interdisciplinarity in undergraduate education has been more difficult to implement. As a consequence, disciplinary rather than interdisciplinary capstones have become ubiquitous. Disciplinary capstones are valuable for students because they enable them to integrate knowledge and skills within the discipline, but they are also limiting because the integration is within rather than across disciplines. In contrast to a capstone, which involves a single discipline, interdisciplinary capstones require two or more disciplines to combine and integrate across disciplinary boundaries. Interdisciplinarity, where two of more disciplines come together, is difficult to implement in the biomedical and life science curricula because student majors and finances are administered in ways, which reinforce institutional organization of schools and faculties and prevent collaboration. Here in this "idea to explore" we provide an interdisciplinary capstone model where students enroll in disciplinary courses, but then these disciplinary courses and students collaborate on interdisciplinary real-world problems. This interdisciplinary capstone model was implemented across two diverse and large biomedical and life science schools within two faculties in a research intensive, metropolitan university. This approach allows for integration of the biomedical, social and ethical perspectives required when solving problems in the real world, such as COVID-19. Interdisciplinary learning also better prepares students for higher degree research and future careers. Overcoming disciplinary curriculum silos and faculty barriers is critical if we are to meet expectations of acquiring interdisciplinarity as a key competency.

Modern public pealth problems and solutions: An undergraduate capstone course to prepare the next generation of public health practitioners to enhance health equity.

With a growing emphasis on health equity in public health practice and research, ensuring a competent and skilled public health workforce is critical to advancing the public health mission of a healthier nation. The expansion of undergraduate public health programs provides a unique opportunity for more extensive training and education of the next generation of public health professionals and to center undergraduate public health education around the need to be competent in addressing health disparities to achieve health equity. Following national accreditation standards set by the Council on Education for Public Health (CEPH), undergraduate Bachelor of Public Health (BSPH) students at the University at Buffalo (UB) must complete a capstone course before graduation. This course focuses on integrating and synthesizing knowledge acquired from the BSPH core curriculum through analysis, explanation, and addressing public health problems via an interdisciplinary approach. We designed the most recent iterations of the capstone class based on the model that includes cross-cutting skills as defined by CEPH, evidence-based decision-making skills, established learning objectives of the course, and centering on health equity. This course also builds on the students' previously acquired knowledge with an ultimate goal to prepare the graduating seniors for the "real world" health equity-related public health activities. As a part of the coursework, students complete case studies, article reviews, and active learning group activities that target each component of the model. The final products of the course are a synthesis paper and oral presentation based on a public health problem as identified through surveillance data, analyzing causes of this problem, identifying critical stakeholders, creating an evidence-based solution to the problem, and explaining how health inequities may be addressed through the proposed solution. Centering the culminating course for BSPH undergraduate students on health equity will help ensure a competent and skilled workforce, informed by accreditation standards and prepared to lead our national public health goal of improved and equitable population health.

Using the HyFlex model to deliver a capstone seminar course.

INTRODUCTION: The HyFlex course structure allows students to attend class in-person or via synchronous videoconferencing technology. This model has been described, but no data are available in pharmacy curricula. METHODS: Students enrolled in Grand Rounds (GR) were eligible. The GR Engagement Assessment Tool (GREAT) measured engagement three times during the semester. Eighteen statements across four domains were rated using a five-point Likert scale (1 = not true at all and 5 = completely true). Free-text responses were collected for qualitative analysis. The primary outcome was the difference in GR engagement between students attending in-person vs. remotely. Descriptive statistics were used for demographic information. Wilcoxon rank-sum tests compared Likert-scale responses between in-person and remote attendance. RESULTS: Surveys included 128 responses from 88 unique students. There were no differences between remote and in-person attendance for the boredom and elaboration domains. In-person students reported listening more intently (median 4, IQR [3,4]; P = .03). In-person students felt the material was more practical (median 4, IQR [4,5]) than remote students (median 4, IQR [3,4]; P = .002) and more applicable to other situations (median 3, IQR [3,5]) than remote students (median 3, IQR [2,4]; P = .04). Qualitative analysis of the entire cohort demonstrated five themes for satisfaction: safety, flexibility, convenience, technology, and professionalism. CONCLUSIONS: There were subtle differences in student engagement or satisfaction using the HyFlex model. This study supports the expansion of this methodology to similar courses where remote instruction is needed.

A Longitudinal Integrative Course Series to Prepare Students for Advanced Pharmacy Practice Experiences.

Background: This paper describes a series of integrative courses intentionally designed to prepare students for Advanced Pharmacy Practice Experiences (APPEs) in a block system curriculum. Innovation: Three integration blocks are interspersed throughout the didactic curriculum to serve as checkpoints to ensure competency as students progress in the curriculum, rather than waiting until the end to determine competency. Complex patient case discussions and a series of high-stakes assessments are used to reinforce and evaluate cumulative retention of knowledge, skills, and attitudes. Findings: Class of 2022 exam results showed that in the cohort of students who failed the high-stakes comprehensive knowledge assessment (CKA) and pharmacy calculations exams during the first integration block (IB), failure rates decreased in subsequent IBs, indicating early detection of knowledge deficiencies and either exam performance improvement in each IB or failure to progress to the next IB. A survey of the same cohort indicated that the final integration block prior to advanced pharmacy practice experiences (APPEs) helped improve confidence in applying key knowledge and skills into practice. Conclusion: The series of integration blocks designed and implemented at WesternU provides opportunities to reinforce knowledge and skills while requiring students to demonstrate maintenance of core competency as they progress through the curriculum.

Alternative capstone nursing experience to scale up testing and case investigation.

BACKGROUND: Surges related to the SARS-COV2 virus in the United States have underscored the critical importance of large-scale testing, case investigation and contact tracing. Baccalaureate nursing students have the potential to serve as surge capacity workforce in mitigation measures during this public health emergency. METHODS: Over the course of eight weeks (September-December 2020) baccalaureate senior capstone nursing students served as case investigators for a local health department (LHD) on Long Island, New York and surveillance pooled saliva testers for their college to ensure compliance with a state-wide COVID-19 testing mandate. To determine student perceptions working in these concurrent novel academic-partnerships during the COVID-19 pandemic, a descriptive survey of open-ended interview questions was completed by student participants (n = 10). RESULTS: Analysis of aggregate responses revealed common themes across the data set linking student learning and appreciation of the "eye-opening" experience to a sense of purpose, the value of communication, education and teamwork-all within the structure of public health nursing. CONCLUSIONS: Baccalaureate nursing students can effectively serve as an untapped workforce within an academic partnership to support surveillance testing and case investigation during the COVID-19 pandemic and future public health crises. This partnership had the added benefit of exposing nursing students to the critical nature of public health nursing during this historic time in our nation.

Promoting creativity of nursing students in different teaching and learning settings: A quasi-experimental study.

BACKGROUND: Interdisciplinary teaching provides students with multiple perspectives through instruction from faculty and students in other academic areas. Providing interdisciplinary teaching to students in nursing and interdisciplinary programs could help foster collaborations between students in nursing and students in fields such as design or engineering, which could expand students' understanding of the skills required to develop a working prototype. OBJECTIVE: To evaluate whether there is an effect of interdisciplinary teaching on nursing students' creative thinking abilities. DESIGN: A quasi-experimental study of two experimental and one control group with a pre-test/post-test design. SETTING: The study was conducted between September 2018 and January 2020 in classrooms of a university of science and technology in Taiwan. PARTICIPANTS: Nursing students (N = 191) enrolled in capstone courses participated in this study. Two groups of students were assigned to the intervention: Group 1, comprised of typical students (n = 80) or Group 2, comprised of students with teaching assistantships (n = 30). The control group (n = 81) was typical students. The intervention groups received instruction from interdisciplinary faculty in nursing and design and creativity training. The control group was taught by nursing faculty only, without creativity training. METHODS: The Taiwanese version of the Torrance Tests of Creative Thinking-Figural (TTCT-F) instrument assessed students' creative thinking abilities at the beginning (pre-test) and end of the 18-week course (post-test). Differences in pre-test/post-test scores between groups were examined with analysis of covariance. RESULTS: Comparisons between mean total and subscale scores for TTCT-F for the two intervention groups and controls demonstrated only Group 2 students (teaching assistants) had significantly higher scores than the control group. Teaching assistants also had significantly higher scores than Group 1. CONCLUSION: Findings suggest interdisciplinary teaching benefited creative thinking abilities of nursing students holding teaching assistantships. Therefore, it may be more important to first emphasize improvements in academic performance for typical nursing students in Taiwan and then incorporate interdisciplinary teaching into nursing programs to improve creative thinking.

Evaluation of pharmacy students' self-efficacy and performance in applying components of the Pharmacists' Patient Care Process within a capstone course and during advanced pharmacy practice experiences.

INTRODUCTION: Capstone courses are ideal for reinforcing and assessing the Pharmacists' Patient Care Process (PPCP). The purpose of this study was to assess pharmacy students' (1) self-efficacy in applying PPCP components before and after a capstone course, (2) performance in applying PPCP components in several assignments, and (3) self-efficacy in applying the PPCP during advanced pharmacy practice experiences (APPEs). METHODS: Student evaluation included: (1) electronic surveys to assess students' self-efficacy in applying three components of the PPCP (Collect, Assess, and Plan) via a pre-/retrospective pre-/post-survey design, (2) course evaluations, and (3) an electronic survey to assess students' self-efficacy in applying the PPCP after completing five APPEs. Faculty evaluation included rubrics assessing performance in applying the PPCP model given patient cases. Descriptive statistics, paired t-tests, and mixed-effects linear modeling were conducted. RESULTS: Sixty-four students participated in the course during spring 2018. The sum mean self-efficacy scores for the PPCP components significantly improved between the beginning and end of the course (P < .05). There was a significant increase in evaluators' ratings of students' ability to apply the PPCP (P < .05). The sum mean self-efficacy scores for the PPCP components did not change significantly between the end of the course and after completion of five APPEs, except for a few specific items. CONCLUSIONS: A capstone course integrating the PPCP in patient case assignments resulted in improved student performance and self-efficacy in applying three PPCP components (Collect, Assess, and Plan). Students' self-efficacy remained consistent after the course concluded and during APPEs.

Improving data quality and information utilization at Metema Primary Hospital, Amhara national regional state, Northwest Ethiopia 2018: Capstone project.

Quality data for evidence-based decision making become a growing concern globally. Available information needs to be disseminated on time and used for decision making. Therefore, an effective Health Management Information System is essential to make evidence-based decision. This study aimed to measure the change in data quality and information utilization before and after intervention. Facility-based pre-post interventional study design was conducted at Metema hospital from September/2016 to December30/2018. A total of 384 individual medical-records, HMIS registration-books and reports were reviewed. Training, supportive supervision and feedback were intervention packages. About 309 (80.5%) of charts were from outpatient department. Data recording completeness increased from 69.0% to 96.0%, data consistency increased from 84.0% to 99.5% and report timeliness enhanced from 66.0% to 100%. There was a statistically significant difference for data recording completeness between pre and post-intervention results with mean difference of -0.246 (-0.412, -0.081). Also, after the intervention, gap-filling feedback and supportive supervision were given to all departments. In addition, four quality improvement projects were developed at post-intervention phase. The level of data quality and use was improved after the intervention. So, designing and implementing intervention strategies based on the root causes will help to improve data quality and use.

Impact of an end-of-fourth-year emergency medicine bootcamp.

BACKGROUND: The final months of the fourth-year of medical school are variable in educational and clinical experience, and the effect on clinical knowledge and preparedness for residency is unclear. Specialty-specific "bootcamps" are a growing trend in medical education aimed at increasing clinical knowledge, procedural skills, and confidence prior to the start of residency. METHODS: We developed a 4-week Emergency Medicine (EM) bootcamp offered during the final month of medical school. At the conclusion of the course, participants evaluated its impact. EM residency-matched participants and non-participants were asked to self-evaluate their clinical knowledge, procedural skills and confidence 1 month into the start of residency. Program directors were surveyed to assess participants and non-participants across the same domains. A Fisher's exact test was performed to test whether responses between participants and non-participants were statistically different. RESULTS: From 2015 to 2018, 22 students participated in the bootcamp. The majority reported improved confidence, competence, and procedural skills upon completion of the course. Self-assessed confidence was significantly higher in EM-matched participants 1 month into residency compared to EM-matched non-participants (p = 0.009). Self-assessed clinical knowledge and procedural skill competency was higher in participants than non-participants but did not reach statistical significance. Program directors rated EM-matched participants higher in all domains but this difference was also not statistically significant. CONCLUSIONS: Participation in an EM bootcamp increases self-confidence at the start of residency among EM-matched residents. EM bootcamps and other specialty-specific courses at the end of medical school may ease the transition from student to clinician and may improve clinical knowledge and procedural skills.

How to form a software engineering capstone team?

This research paper answers the question that how shall the students of software engineering undergraduate courses form teams for the capstone projects that can be cohesive too. In this research, 128 criteria for team formation are proposed for building teams for self-managing software engineering capstone projects. A comparison is also conducted to ascertain the level of cohesion among those teams that were formed using the proposed criteria and those that were not formed using the proposed criteria. The criteria were identified through a combination of qualitative questionnaire survey targeted at the graduated students of the past batches of Computer Science degree program and through synthesizing the literature on engineering capstone project teams identified under the guidance of KSAO framework for software engineering students. To check the effectiveness of the criteria, 100 students were asked to form the teams using the proposed criteria and other 100 students formed the teams without the proposed criteria. Those students that had used the proposed criteria for building teams and those that had formed teams without using the proposed criteria were asked to fill the modified Group Environment Questionnaire to ascertain the level of cohesion among the team members. The results were analyzed qualitatively and through descriptive quantification. The results show that the level of cohesion in teams that were formed using the proposed team building criteria was higher. There was a need for team building criteria in the literature on software engineering capstone project teams that conforms to a conceptual, theoretical framework; this gap is now filled through this research. This paper may also serve as a literature review paper for some readers.

Preparing faculty to lead doctor of nursing practice projects: A faculty development pilot project.

Faculty expressed a need to improve knowledge and skills related to leading Doctor of Nursing Practice projects. A mentoring program was designed to provide faculty the skills to increase confidence when leading Doctor of Nursing Practice projects. The program included an assessment of confidence of six key skills. The intervention included didactic and individual experiential learning that coincided with student progression through project courses. Participants' self-identified areas of need included understanding application of translation science, methods, statistical choices, and all phases of analysis. Four of the six elements were improved from baseline, with two statistically significant, Project Analysis (M = 2.05, SD =0.88, p < .041) and Project Dissemination (M = 2.25, SD = 0.89, p < .046). The pilot project was a first step in assessing strategies for educating and mentoring faculty leading Doctor of Nursing Practice projects.