Effects of game-based learning integrated with the self-regulated learning strategy on nursing students' entrustable professional activities: A quasi-experimental study.

BACKGROUND: In the field of nursing education, the expertise and knowledge required to perform Leopold's Maneuvers are critical, forming an integral part of Entrustable Professional Activities for nursing students. As a result, mastering Leopold's Maneuvers has become a core component of nursing education. Despite this, the prevailing didactic methods in many nursing courses tend to limit interactive and contextual learning experiences, which can hinder students' ability to engage deeply with the subject matter. This lack of engagement may subsequently affect both the effectiveness of students' learning and students' clinical judgment capacity, essential elements in the competencies of Entrustable Professional Activities. METHODS: A quasi-experimental design was employed in this study, involving a total of 55 nursing university students, with 28 participants in the experimental group and 27 in the control group. The research incorporated game-based learning integrated with the self-regulated learning strategy, and employed a pretest, posttest, and questionnaires to assess students' learning performance, self-efficacy, and learning motivation. The experimental group participated in game-based learning with the self-regulated learning strategy, whereas the control group experienced game-based learning without the integration of self-regulated learning. Learning performance was analyzed using an independent samples t-test, while Analysis of Covariance was employed to compare the self-efficacy and learning motivation of the two groups. RESULTS: The findings showed that the integration of game-based learning with the self-regulated learning strategy can significantly improve students' learning performance, self-efficacy, and learning motivation. CONCLUSION: As an integral part of Entrustable Professional Activities, Leopold's Maneuvers were integrated into an interactive game-based learning environment, coupled with the self-regulated learning strategy in nursing education. This approach aimed at cultivating core competencies among nursing students. This study has demonstrated its efficacy in engaging students effectively, serving as a dynamic resource for immersive learning in Leopold's Maneuvers, aligning well with the design considerations for promoting Entrustable Professional Activities in nursing education.

Comparing didactic approaches for practical skills learning in Scandinavian nursing simulation centres: A qualitative comparative study.

AIM: To explore and compare the didactic approaches to practical skills learning at simulation centres in Scandinavian universities and university colleges. BACKGROUND: Academic simulation centres are an important arena for learning practical nursing skills which are essential to ensure competent performance regarding patient safety and quality of care. Knowledge of didactic approaches to enhance learning is essential in promoting the provision and retention of students' practical nursing skills. However, research on didactical approaches to practical nursing skills learning is lacking. DESIGN: A qualitative comparative design was used. METHODS: During November and December 2019, interviews were conducted with a total of 37 simulation centre directors or assistant directors, each of whom possessed in-depth knowledge of practical skills in teaching and learning. They represented bachelor nursing education in Denmark, Norway and Sweden. A qualitative deductive content analysis was conducted. RESULTS: The results revealed all five predetermined didactical components derived from the didactical relationship model. Twenty-two corresponding categories that described a variation in didactic approaches to practical skills learning in Scandinavian nursing simulation centres were identified. The didactical components of Learning process revealed mostly similarities, Setting mostly differences and Assessment showed only differences in didactic approaches. CONCLUSION: Although various didactic approaches were described across the countries, no common approach was found. Nursing educational institutions are encouraged to cooperate in developing a shared understanding of how didactic approaches can enhance practical skills learning. IMPLICATIONS FOR PROFESSION AND/OR PATIENT CARE: Cross-country comparisons of practical nursing skills learning in Scandinavian countries highlight the importance of educator awareness concerning the impact diverse didactic approaches may have on competent performance in nursing education. Competent performance is pivotal for ensuring patient safety and the provision of high-quality care. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution. REPORTING METHOD: This study followed the Consolidated Criteria for Reporting Qualitative Research reporting guidelines.

2022 Shandong Province university medical technical skills competition nursing track: An effective project to improve core competencies of nursing students.

Background: The core competencies of nursing students have gradually become the focus of attention of nursing educators. Nursing skills competitions are an important form of educational and teaching activity in universities and the nursing track at the Shandong Provincial University Students' Medical Technical Skills Competition gives nursing students an opportunity to demonstrate their clinical skills and knowledge. This study aims to describe the organisation and procedures of the nursing track, analyse the competition results and explore the impact the competition has on the core competencies of the nursing students. This will provide new ideas for future nursing professional education. Methods: Statistical analysis of the competition results was performed as a means of understanding the current status of theoretical knowledge and clinical skills of nursing students in Shandong Province. The impact of the competition on the core competencies of participating students was analysed by distributing questionnaires to universities in Shandong Province that participated in the competition. Results: 14 universities with nursing programmes participated in the competition, including eight public universities and six private universities. 220 questionnaires were distributed to nursing students at the participating universities and 218 were ultimately included, demonstrating an efficiency rate of 99.09%. Conclusions: The 2022 nursing track included the addition of a comprehensive written examination as a means of judging the competencies of nursing students in Shandong Province from a variety of aspects. Skills competitions are effective for improving the core competencies of nursing students and they will become an important means for nursing educators to reform education and improve the core competencies of nursing students in the future.

Nursing students' self-assessed level of nursing skills at the time of graduation in a Japanese University: A retrospective observational study.

Objective: This study aimed to clarify nursing students' self-assessed levels of nursing skills at a nursing university at graduation and discuss how education and clinical experiences for students and post-licensure nurses should be improved, especially focusing on oncology nursing. Methods: The study population comprised fourth-year students from 2017 to 2019 at the Faculty of Health Science and Nursing, Juntendo University, who had completed all stipulated clinical placements. The Japanese government determined 141 nursing skills and their target levels. Students subjectively evaluated their achieved levels for the 141 nursing skills after the final clinical placement. Results: Of the 141 nursing skills, 81 (57%) were rated as "skills with easy-to-achieve targets" and five were rated as "skills with difficult-to-achieve targets." All nursing skills in the two subcategories of environmental adjustment skills and comfort management skills were rated as "skills with easy-to-achieve targets." Nursing skills with low target achievement rates were for patients with oral intake difficulties, unstable respiratory status, and those requiring glycemic control. These skills are also important in oncology nursing. Conclusions: It cannot be concluded that the nursing university students fully achieved the target levels of nursing skills, as determined by the Japanese government. These findings may facilitate discussions on teaching nursing skills and their target levels at the time of graduation from nursing universities or post-employment.

Factors associated with practice readiness among newly qualified nurses in their first two years of practice.

BACKGROUND: Newly graduated nurses undergo stress and role adjustment as they transition into practice during the first year and continue to struggle beyond the first year. Determining their practice readiness can aid in the development of interventions to facilitate workplace readiness for nurses in their first two years entering the nursing profession. OBJECTIVES: To examine (i) extent of practice readiness of new nurses in their role; and (ii) associations between nurses' practice readiness and demographic and occupational variables, and reasons for choosing nursing profession. DESIGN: A cross-sectional study. SETTINGS AND PARTICIPANTS: A total of 445 registered nurses who graduated within the last two years and working in an academic medical centre in Singapore. METHODS: Participants completed an online questionnaire with questions from Casey-Fink Readiness for Practice Survey and questions related to key competencies for future practice. RESULTS: More than half (57.5 %) identified at least three skills and procedures which they were uncomfortable performing independently as they transition into the clinical practice, including: (i) responding to emergency (ii) tracheostomy care; and (iii) chest tube care. The top three reasons for choosing nursing as a career were: (i) nursing is a stable industry (54.2 %); (ii) I want to help people (52.1 %); and (iii) able to work anywhere in the world (44.3 %). Nurses were most concerned with areas of trials and tribulations (42.5 %) and clinical competency (36.6 %). When compared to nurses in their first-year post-graduation, those working in their second year reported more confidence in the ability to problem solve (p = 0.003), care for a person who is dying (p = 0.004), and less difficulties in prioritizing care needs (p = 0.04). They also perceived themselves as a good problem solver (p = 0.03). CONCLUSIONS: It is critical to continue supporting nurses' practice readiness beyond their first year of practice in their confidence and development of skills of higher complexity.

[Competency-based learning objectives of primary qualifying nursing studies and intended task profiles]. / Kompetenzziele von primärqualifizierenden Pflegestudiengängen und intendierte Aufgabenprofile.

INTRODUCTION: Since 2020, it has been possible in Germany to complete a primary qualifying degree in nursing in addition to vocational training in nursing. The study presented here investigates the extent to which the intended competence goals prepare students for the future fields of activity of university-qualified nurses. METHODS: The research question was answered (1) by means of a content analysis of module manuals for primary qualifying courses, specifically the information on the intended learning outcomes in the university part of the course, and (2) by evaluating the results of the analysis in focus groups with those responsible for the course. The areas of competence were used as evaluation criteria for the analysis of the module manuals. The text elements were coded using the analysis software MAXQDA. In the further course of the analysis, the competence areas were combined into three areas with a view to the task profiles (direct care, indirect care and competence area V/research competence) and the percentage weighting of the competence goals was calculated. Using study results from the project "Investigation of the implementation of the study programs within the framework of university nursing training according to the Nursing Professions Act", the hours spent in these areas and the distribution of presence and self-learning time for direct nursing were determined. The results and the reasons for the curriculum design were then discussed in focus groups with those responsible for the degree program. RESULTS: The module manuals reveal clear differences in formal design. The analysis of the learning outcomes specified in the module manuals according to the competence areas also shows considerable differences in the distribution of the percentages for the individual competence areas. In relation to direct care, the percentages range between 55% and 71%, the hours vary between 2,022 and 3,622 hours. With indirect care, the range is 246 to 520 hours. A comparatively high number of hours is planned for competence area V/research competence (869 to 1,426 hours). Also, the analysis leads to the conclusion that within the degree program with the lowest number of hours of face-to-face teaching only 690 hours of face-to-face teaching are spent on direct care, while the degree program with the highest number of hours provides 1,968 hours for face-to-face teaching. In the focus group discussions, the persons responsible for the degree program took a critical view of the hours spent on developing skills in indirect care in the primary qualifying degree programs. Those responsible for the degree programs also regard the very small number of face-to-face hours at some university locations as insufficient to develop direct care skills. DISCUSSION: The results suggest that the primary qualifying courses in some areas and at some study locations do not adequately prepare for the task profiles intended for HQP.

Assessment of Differential Perceptions of Core Nursing Competencies between Nurse Managers and Nursing Graduates: A Cross-Sectional Study.

BACKGROUND: The literature review on perceptions of nursing competencies shows a critical shortage of studies addressing this topic. AIM: To examine and compare perceptions of important nursing competencies of nursing graduates, and nurse managers. METHODS: A cross-sectional study was conducted among 148 students, who were recent graduates of the nursing school with RN degrees and had completed advanced training lasting 3 months at the Sheba Academic School of Nursing and the Academic School of Tel Aviv-Yafo, and 183 nurse managers with at least one year of seniority in the position in hospitals and community clinics in Israel. The recruitment and data collection of the nurse managers lasted 12 months, from July 2021 to July 2022, and for nursing graduates, two months, from June 2022 to July 2022. An online questionnaire was constructed and validated by five professional and experienced individuals in the research domains for adequate content validity. The questionnaire consisted of 47 items in total. Domains included: (1) professionalism in research; (2) skills for direct treatment; (3) support and communication; (4) professional knowledge; (5) personal abilities; and (6) critical thinking and innovation. RESULTS: Overall, 331 valid questionnaires were collected (85% response rate). The difference in the nurse's research professionalism index was found to be statistically significant with a higher rating given by nurse managers, p = 0.003. However, the difference in the direct treatment index of nurses was found to be statistically not significant, p = 0.610, between newly graduated nurses and nurse managers. The independent sample t-test indicated a significant difference with a higher rating among nurse managers in the nurse's support and communication index, p = 0.020; professional knowledge index, p < 0.001; personal abilities index, p < 0.001; and critical thinking index, p = 0.006, between newly graduated nurses and nurse managers. CONCLUSION: Nursing education programs aimed at training future nurses with core competences should include a curriculum designed to promote the acquisition of these six core competences leading to a congruence between the role expectations of nurse managers and those of newly graduated nurses.

A guide to cannulation in adults.

This article provides clinical guidance on performing cannulation on an adult. The site, equipment selection and aseptic non-touch technique will be discussed. The clinical procedural technique of cannulation will be explained and the article will also provide an awareness of the dangers and complications of this invasive technique for both the patient and the health professional.

First year nursing students' reflections about developing their verbal nursing skills during their nursing education in China: a qualitative study.

Objective: The aim of the study is to explore the expectations of a group of first-year nursing students in China about developing their verbal and social interactional skills during their nursing education. Background: Nursing students' communication skills were not fully developed in China. Students have many challenges to face regarding developing their nursing skills, especially interaction skills, when they start their education. Design: A qualitative design was used in this research. Method: Twelve second-semester undergraduate nursing students were interviewed on the basis of purposive sampling, and qualitative content analysis was employed. Results: The main theme was 'facilitating a caring nurse-patient relationship' and 'using a knowledge base for performing nursing care'. The first theme comprises two sub-themes, 'caring approach' and 'helping and involving the patient in care', with three and two categories, respectively. The second theme comprises the two sub-themes, 'knowledge needed to be able to understand the patient' and 'health and treatment information', with three and two categories, respectively. Conclusion: A synthesis of both knowledge and practice is needed to improve the nursing students' interaction and professional skills during their nursing education.

Innovative use of a flipped-classroom approach to teach fundamental nursing skills.

Prelicensure nursing students are required to master fundamental nursing skills. The COVID-19 pandemic created challenges in maintaining excellence while teaching skill acquisition. The purpose of this study was to evaluate skill validation scores and student satisfaction and self-confidence using a flipped classroom approach and a low-fidelity simulation model to innovatively teach skill acquisition. Researchers used a quasi-experimental method to compare skill validation scores of a control group and intervention group using independent samples t-test. Researchers also evaluated whether prelicensure nursing students had satisfaction and self-confidence with this teaching strategy. Findings suggested that skills validations scores were no different using a flipped-classroom approach than in-person instruction. Prelicensure nursing students were satisfied and self-confident following the implementation of this teaching strategy. This teaching strategy has the potential to decrease in-person clinical practice time, provide alternative opportunities for clinical make-up and remediation, and decrease cost.

Application of assessment-diagnosis-plan-implementation-evaluation teaching model based on skill competition in the teaching of "basic nursing" skills / 中国实用护理杂志

Objective:To explore the application effect of Assessmen-Diagnosis-Plan-Implementation-Evaluation(ADPIE) teaching model based on skill competition in the teaching of "basic nursing" skills in higher vocational colleges.Methods:This was a quasi experimental study. Convenience sampling method was adopted to select students from two classes of 2021 vocational nursing major of Pingxiang Health Vocational College from February to July 2022 as the research objects, among which 53 nursing students from Class 9 were selected as the experimental group and 55 nursing students from Class 13 were selected as the control group. The experimental group was taught based on the ADPIE teaching mode of skill competition. The control group was taught according to the conventional teaching mode, and the academic record and humanistic care ability of the nursing students in the two groups were compared.Results:The three dimensions of humanistic care ability in experimental group were cognition (70.82 ± 9.20) points, courage (59.58 ± 6.04) points, patience (57.17 ± 5.26) points, total score (187.57 ± 20.50) points. They were higher than those in the control group,which were (67.40 ± 8.83), (55.98 ± 9.03), (54.37 ± 5.96) and (177.75 ± 20.82) points, and there were statistical differences between the groups (t values were 2.61 to 3.42, all P<0.05). In addition, the three dimensions of academic performance: ordinary score (6.10 ± 1.22)points, course score (57.10 ± 6.27) points, objective structured clinical examination (OSCE) score (27.09 ± 2.13)points, total score (90.29 ± 9.69) points, they were also higher than those of the control group (5.06 ± 1.33), (52.73 ± 5.44), (25.35 ± 3.29), and (83.14 ± 10.06), and the differences between groups were statistically significant ( t values were 2.52-3.34, All P<0.05). Conclusions:ADPIE teaching model based on skills competition can improve the course scores and humanistic care ability of nursing students, and the teaching effect is significant.

Study of readiness and performance of nurses in evaluating clinical care and processes of care and nursing.

Background: Clinical care and nursing skills are important issues that can influence the efficacy of treatment, the health of patients, and medical errors. The aim of this study was to investigate the readiness of medical staff in the field of effectiveness and evaluation of clinical care and nursing skills. Materials and methods: This descriptive, cross-sectional study was performed on 99 medical staff working in hospitals from August 2020 to December 2021. The instrument used was a checklist for the effectiveness and evaluation of clinical care based on the findings of the nursing reports. Data were analyzed by statistical software. Results: The mean age of nurses was 37.5 years. Among the participants, 16.3% were male and 85.7% were female; 56.6% of nurses had completed clinical care. The overall performance of nurses in drug-related care and nursing processes was observed to be acceptable. Nurses were successful in performing many aspects of the nursing processes of repulsion, absorption, and dressing and showed good preparation. In relation to gavage, a high percentage of nurses performed the procedure well. However, in some cases, such as medication-related care, handwashing, and the use of personal protective equipment, where there is a possibility of touching the blood or other body fluids of the patients, the performance of nurses was moderate. Conclusion: The findings of this research demonstrated that there are limitations, strengths, and weaknesses in terms of some aspects such as medication, care and nursing processes, compliance with standards, and infection control, which can be considered to improve the performance of nurses in the future.

Cognitive changes with psychomotor skill acquisition through blended learning among nursing students: A qualitative study.

AIM: This study described nursing students' cognitive changes as they acquire psychomotor skills through blended learning. BACKGROUND: Deliberate practice, including feedback from teachers, is vital for acquiring psychomotor skills. Blended learning, a program that allows students to deepen their learning and improve their skills even when students and faculty are physically separated has attracted significant attention in recent years. Although blended learning has been used for learning in the cognitive domain, no study has examined its effectiveness in the acquisition of psychomotor skills. Understanding how students' cognition changes as they acquire skills in a blended learning environment could be a valuable resource for effective teaching. DESIGN: An inductive, qualitative description approach was adopted. METHODS: The program involved a basic nursing skill: making an occupied bed. Eleven second-year nursing students participated. The participants attended face-to-face lectures and e-learning courses comprising self-study content that was designed for easy and frequent reference. Students practiced for a skill test, which was conducted one month after the first lecture. Two interviews were conducted approximately one month apart. Before each interview, the participants' current practices were videotaped. During the interviews, they explained their thought processes and conscious awareness of their actions as they watched the videos. This study was conducted between April and May 2019. RESULTS: Six categories related to changes in participants' cognitive processes while acquiring the skill of making an occupied bed were identified: "feeling that it is easy to acquire," "practicing without much thought," "realizing the difficulty in translating thoughts into practice," "experiencing a sense of purpose in each technique," "gaining a perspective to evaluate one's skills," and "developing one's unique approach." CONCLUSIONS: In a blended learning environment, where a practice environment and audiovisual materials were provided, students could practice and improve their skills at their own pace even without the instructor's frequent advice. The findings show that metacognitive skills are essential to the development of psychomotor skills in a blended learning program because this program requires practicing while monitoring one's skills. Metacognitive skills affect the development of psychomotor skills and the ability to provide care. Therefore, initiatives that address the development of metacognitive skills, such as the current program, during the early stages of basic education programs can contribute to the development of nursing students' practical skills.

An Analysis of Priorities in Developing Virtual Reality Programs for Core Nursing Skills: Cross-sectional Descriptive Study Using the Borich Needs Assessment Model and Locus for Focus Model.

BACKGROUND: There are limitations to conducting face-to-face classes following the recent COVID-19 pandemic. Web-based education is no longer a temporary form of teaching and learning during unusual events, such as pandemics, but has proven to be necessary to uphold in parallel with offline education in the future. Therefore, it is necessary to scientifically organize the priorities of a learner needs analysis by systematically and rationally investigating and analyzing the needs of learners for the development of virtual reality (VR) programs for core nursing skills (CNS). OBJECTIVE: This study aimed to identify the priorities of learners' needs for the development of VR programs for CNS using the Locus for Focus Model and Borich need assessment model. METHODS: The participants included nursing students in South Korea who were in their second year or higher and had taken courses in fundamental nursing or CNS-related classes. The survey took place from May 20 to June 25, 2021. A total of 337 completed questionnaires were collected. Of these, 222 were used to conduct the final analysis. The self-report questionnaire consisted of 3 parts: perception of VR programs, demand for developing VR programs, and general characteristics. The general characteristics of the participants were analyzed using descriptive statistics. To determine the priority of the demand for developing VR programs for CNS, the Locus for Focus Model and the Borich priority formula were used. RESULTS: In all, 7 skills were identified as being of the top priority for development, including intramuscular injection, intradermal injection, tube feeding, enema, postoperative care, supplying oxygen via nasal cannula, and endotracheal suction. CONCLUSIONS: The analysis showed that nursing students generally needed and prioritized the development of VR programs for the nursing skills involving invasive procedures. The results of this study are intended to help in various practical education classes using VR programs in nursing departments, which are currently facing difficulties in teaching CNS on the web owing to COVID-19.

[The COVID-19 emergency management in Nephrology: a cross-sectional survey on the procedures management to deal with the pandemic].

From mid-March 2020, the pandemic caused by COVID 19 has placed health facilities in front of the need to implement a rapid and profound reorganization. However, many hospitals have not had time to organize a rapid and effective response, both for the speed of spread of the virus, and for the lack of previous experience with a pandemic of this magnitude. With the aim of assessing the knowledge and adoption of the procedures and recommendations disseminated by hospitals during the COVID-19 pandemic, in the dialysis and hemodialysis services of Italian centers, a cross-sectional survey was designed by the Society of Nurses in Nephrology (SIAN). The online survey was conducted among nurses who work in the Italian services of dialysis and hemodialysis during the first and second waves. The online survey was completed by 150 nurses. Although hospitals have set up protocols and procedures for patient management during the COVID-19 pandemic, among participants not all were aware of it. With regard to the training of personnel in the use of personal protective equipment, 18.6% declared that they have not received it. The majority implemented specific precautions for patient management, awareness and information.

From Centralized to Decentralized Model of Simulation-Based Education: Curricular Integration of Take-Home Simulators in Nursing Education.

In a centralized model of simulation-based education (Ce-SBE), students practice skills in simulation laboratories, while in a decentralized model (De-SBE), they practice skills outside of these laboratories. The cost of "take-home" simulators is a barrier that can be overcome with additive manufacturing (AM). Our objective was to develop and evaluate the quality of education when year one nursing students practiced clinical skills from home following normal curricular activities but in the De-SBE format. A group of expert educators, designers, and researchers followed a two-cycle, iterative design-to-cost approach to develop three simulators: wound care and urethral catheterization (male and female). The total cost of manufacturing all three simulators was USD 5,000. These were sent to all year one nursing students who followed an online curriculum. Twenty-nine students completed the survey, which indicated that the simulators supported the students' learning needs, and several changes were requested to improve the educational value. The results indicate that substituting traditional simulators with AM-simulators provided an acceptable alternative for nursing students to learn wound care and urethral catheterization off-campus in De-SBE. The feedback also provided suggestions to improve each of the simulators to make the experience more authentic.

The value of a redesigned clinical course during COVID-19 pandemic: an explorative convergent mixed-methods study.

BACKGROUND: The COVID-19 lockdown in March 2020 had a significant consequence for nursing students worldwide including limited access to learning situations in clinical rotation. Therefore, this study aims to explore how an innovative redesign of a clinical course in a time of pandemic supported nursing students in learning the fundamentals of care in their first year. The redesign involved the transformation of a traditional hands-on clinical course into a technology-enhanced learning environment. DESIGN: This was an explorative convergent mixed-methods study using both quantitative and qualitative methods. METHODS: Twenty-four first-year nursing students responded to an online questionnaire with open-ended questions. Two nursing students and one faculty member participated in individual online interviews, and three faculty members participated in an online focus group interview. All the data were collected in June 2020. The quantitative data were analyzed using descriptive statistics and the qualitative data using content analysis. The GRAMMS guideline was applied. RESULTS: The students achieved the learning outcomes regarding fundamental care, basic physical assessment skills, and clinical reasoning with the help of academic assignments, multimedia learning resources, and virtual patients. Further, six central aspects of the facilitator role in the virtual simulation were identified. The aspect that was considered most valuable involved uncovering the "red thread" between different areas of knowledge in the first year of nursing education; this supported the students to better understand how to think and talk like a nurse. CONCLUSION: This study offers insight into how a technology-enhanced clinical course can foster the learning of fundamental nursing care, basic physical assessment skills, and clinical reasoning skills; enhancing students' preparedness for clinical hours. Virtual patients' scenarios contributed to integrating different types of knowledge and skills that are important when providing nursing care for patients in clinical practice. This study also highlighted a gap in pedagogical competence among faculty members with regards to facilitating learning in a technology-enhanced learning environment. Study findings suggest promising pedagogical strategies that should be further developed post-pandemic, in response to the call for a renewal of nursing education using more technologically supported learning designs.

Practice readiness of new graduate nurses and factors influencing practice readiness: A scoping review of reviews.

BACKGROUND: For many years there has been concern that new graduate nurses may not have been adequately prepared for the workplace, often framed in terms of whether they are work ready or practice ready and able to deal with the 'reality shock' of transitioning from student to clinician. This has prompted significant research to investigate the practice readiness of new graduate nurses. OBJECTIVES: Identify what is known about the practice readiness of new graduate nurses upon commencement of employment, how practice readiness changes over their first year of employment and explore the factors which influence practice readiness. DESIGN: Scoping review of existing reviews guided by the framework developed by Arksey and O'Malley, with search results based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. METHODS: MEDLINE, CINAHL, PsycINFO, Scopus and Web of Science were searched to identify literature reviews synthesising evidence about new graduate nurses, work readiness, practice readiness, competency and transition to practice. New graduate nurses were defined as nurses who were working in any clinical setting as a nurse within their first year of employment after graduation. Database searching was supplemented with snowball searching and limited to English language papers published between 2011 and 2020. Full-text copies of included reviews were imported into an NVivo (Version 12) database to facilitate analysis and synthesis of findings. RESULTS: Forty-five reviews were included. The findings indicate that transition is influenced by a wide range of intrapersonal, interpersonal and organisational factors, many of which are beyond the control of new graduate nurses. The findings also suggest that, overall, there are no major concerns about the practice readiness of new graduate nurses consistently supported by strong evidence. However, there is evidence to suggest that they 'lack confidence' during the first few months of employment. CONCLUSIONS: The 'receptivity' of the clinical environment to new graduate nurses appears to be a critical influence on their experience of transitioning from student to clinician and can also influence their readiness for the role of a registered nurse. Rather than focusing on the question of whether new graduate nurses are adequately prepared for the workplace, it may be time to shift the question to whether the workplace is ready to support new graduate nurses. The findings suggest two research priorities for advancing our understanding of workplace support for new graduate nurses.

An Analysis of Stress Concerning Pediatric Emergency Care Nurses.

Objective The aim of this study was an exploratory evaluation of the association between the stressors and stress levels of nurses offering care to critically ill pediatric patients based on their clinical experience and working department in a university hospital. Methods The data were collected in October 2018 by administering a self-reporting questionnaire to 169 nurses. The initial analysis compared the anxiety levels between the nurse groups based on their workspace. The next analysis estimated the correlation between the total nursing care and stress levels related to caring for critically ill pediatric patients. We assessed the stress level using the visual analog scale (VAS) score and the total duration of working in the hospital, emergency department (ED), and pediatric department among the three nurse groups. Results Overall, 149 (88%) nurses responded to our survey. More nurses from the ED group completed the Advanced Life Support course (19% vs. 3% vs. 7%, p=0.032), and the total VAS scores of the ED group were significantly higher than those of the other groups (median: 80 vs. 56 vs. 54, p=0.005). In the ED group, the total VAS scores negatively correlated with the total duration of working in the hospital (r=-0.292, p=0.022), ED (r=-0.266, p=0.037), and pediatric department (r=-0.505, p<0.001). In the pediatric ward group, the total VAS scores negatively correlated with the total duration of working in the hospital(r=-0.322, p=0.014) and pediatric department (r=-0.375, p=0.004). In the ED group, the proportion of patients who had high anxiety levels with a short duration of working in the pediatric department was significantly higher than that of patients with a long duration of working in the pediatric department (51% vs. 11%, p=0.028). Conclusions The ED nurses, especially those with less clinical experience in pediatric care, felt anxious about pediatric emergency care more strongly than those in the other groups, regardless of age and disease. Establishing a pediatric medical care set and conducting off-the-job training might contribute to reducing anxiety related to pediatric emergency care.