Development of clinical decision-making among undergraduate nursing students: the effect of unfolding case-based learning.

OBJECTIVES: This prospective cohort study evaluated the effect of unfolding case-based learning on undergraduate nursing students' self-perceived clinical decision-making ability. METHODS: Students' self-reported responses to Jenkins's Clinical Decision Making in Nursing Scale were compared between the unfolding case-based learning cohort (n=140) and the comparison cohort (n=126) at a school of nursing in the United States. RESULTS: The results revealed similar students' responses between the two study cohorts. However, unfolding case-based learning significantly increased students' perceived proficiency in "search for information and unbiased assimilation of new information". CONCLUSIONS: Findings from the present study highlight possibilities presented by unfolding case-based learning in undergraduate nursing education. The study supports that unfolding case studies can be introduced early on, and then nurtured throughout the undergraduate program to influence the development of nursing students' clinical decision-making skills.

Changing the delivery of continuing professional education: An action research approach.

AIM: A participatory action research project was used to change the design and delivery of continuing professional education in a large Irish academic teaching hospital. BACKGROUND: Participation in continuing professional education, designed as a short course, is often a method to maintain competence for many nurses. Structured short education courses are often used to orientate and upskill new staff to specialist clinical areas. Traditionally many courses relied on face-to-face delivery over a period of weeks which is challenging for one clinical area to release staff to attend theoretical days in person. DESIGN: A six-stage participatory action research cycle over a 3-year period in a large Irish academic teaching hospital. METHODS: Multiple methods were used in the cyclical process of participatory action research. Constructive alignment theory and instructional design principles were used to redesign the educational framework. Data collection included audits of courses, questionnaires and focus groups with key participants. RESULTS: Analysis of the focus group themes included 1) underestimated time 2) the process of change 3) teaching and learning styles and 4) acceptance and integration. 20 learners completed the evaluation and reported a positive synergy between e-learning and clinical workshops. E-learning was reported as time-consuming. 75 % of learners reported they were motivated to learn. 90 % of the learners reported they gained new knowledge and skills, 84 % reported the clinical area benefited from the education and 80 % identified a direct improvement in their clinical skills in the specialist area. CONCLUSIONS: Participatory action research supports organisational change in continuing professional education. Constructive alignment theory supports the value of outcomes-based learning. In this context it resulted in successfully blending theory and clinical skills for nurses working in specialist areas. The redesigned continuing professional education framework was positively evaluated across nurses in the organisation.

Competency-Based Medication Administration and Error Reporting.

BACKGROUND: Accuracy is needed with medication administration, a skill that involves rule-based habits and clinical reasoning. This pilot study investigated the use of an evidence-based checklist for accuracy with oral medication administration and error reporting among prelicensure nursing students. Checklist items were anchored in the mnemonic C-MATCH-REASON© (Client, Medication, ADRs, Time, Client History, Route, Expiration date, Amount, Site, Outcomes, Notation). METHOD: Nineteen participants randomly assigned to crossover sequence AB or BA (A: checklist; B: no checklist) practiced simulation scenarios with embedded errors. Nursing faculty used an observation form to track error data. RESULTS: Using the C-MATCH-REASON© checklist compared with not using the checklist supported rule adherence (p = .005), knowledge-based error reduction (p = .011), and total error reduction (p = .010). The null hypothesis was not rejected for errors found (p = .061) nor reported (p = .144), possibly due to sample size. CONCLUSION: C-MATCH-REASON© was effective for error reduction. Study replication with a larger sample is warranted. [J Nurs Educ. 2024;63(5):320-327.].

Design and Implementation of a Nursing Capstone Across a Multisite Health System.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic created profound effects in nursing education. Using a robust academic-practice partnership, a college of nursing and a health care organization collaborated to launch Jefferson Capstone Experience (JCE), an education delivery model that included a one-to-one, 108-hour clinical preceptorship between an experienced RN and an undergraduate nursing student. METHOD: The expedited design, implementation, and evaluation of JCE is described. The mixed-method program evaluation included surveys, interviews, and focus groups with students, faculty, and preceptors. RESULTS: Students and preceptors reported high levels of satisfaction with JCE. All parties emphasized the importance of clear and timely communication, academic practice collaboration, and organization. A significant number of capstone graduates accepted a position with a capstone clinical partner. CONCLUSION: Although the logistics of planning and implementation were challenging, an immersive and largely positive experience was created for undergraduate students, which created a robust hiring pipeline of new-to-practice nurses. [J Nurs Educ. 2024;63(5):292-297.].

Community, Public, and Population Health Content in Nursing Curricula: National Survey Results.

BACKGROUND: Policy, societal, and system changes are prompting nursing programs to expand population health content in curricula. This study examined the current state of community, public, and population health (CPPH) education in nursing curricula throughout the United States. METHOD: This descriptive study examined CPPH education in nursing programs nationally. A survey was developed and distributed to nursing programs from January to May 2021. RESULTS: CPPH content integration occurred across all program levels, and the majority of the participants were involved in the development of CPPH-specific curriculum. Programs experienced reductions in CPPH curriculum due to coronavirus disease 2019 (COVID-19), lack of experienced faculty, budget constraints, and an emphasis on acute care. CONCLUSION: The continuation of CPPH education in current nursing curricula is critical. National and academic nursing organizations must continue to monitor CPPH content in nursing curricula to assure a competent CPPH nursing workforce. [J Nurs Educ. 2024;63(5):282-291.].

The Effect of Interprofessional Education on Student Readiness for Collaborative Practice.

BACKGROUND: Health care reform promotes interprofessional patient-centric health care models associated with improved population health outcomes. Interprofessional education (IPE) programs are necessary to cultivate collaborative care, yet little evidence exists to support IPE pedagogy within nursing and other health science academia. METHOD: This quasiexperimental study examined differences in pre- and posttest Readiness for Interprofessional Learning Scale (RIPLS) scores following an IPE intervention. The IPE intervention consisted of a video presentation and a debriefing session after a simulated interprofessional collaborative patient care conference that introduced baccalaureate nursing and health science students to the roles and responsibilities of clinicians in team-based primary care. Pre- and postintervention RIPLS scores were analyzed. RESULTS: Pre- and postintervention RIPLS scores increased across all subscales, with distinct variation between nursing and health science student subscales. CONCLUSION: This IPE intervention had positive effects on students' readiness for interprofessional learning. Additional research is warranted to support health science pedagogy. [J Nurs Educ. 2024;63(5):304-311.].

Pursuing Success in a Hybrid PhD Nursing Program.

BACKGROUND: Little is known about hybrid PhD nursing students' experiences. METHOD: The purpose of this study was to describe and analyze the experiences of PhD nursing students in a hybrid program using a convergent mixed methods design. Recent nursing PhD alumni (n = 18), and current PhD students (n = 4) were recruited at a research-intensive university in the southwestern United States. RESULTS: Four metainferences were identified: (1) the facilitator of faculty as both advisors and mentors; (2) the facilitator of peers as support, motivation, and a source of advice that preceded advisors; (3) the barrier of receiving conflicting feedback from advisory and dissertation committees; and (4) the barrier of not understanding the PhD student process. CONCLUSION: Peer support is fundamental for hybrid PhD nursing student success; conflicting feedback and not understanding the process are significant barriers. Strategies are recommended to mitigate barriers to facilitate hybrid PhD nursing students' success. [J Nurs Educ. 2024;63(5):328-331.].

The Effects of the COVID-19 Pandemic on Nursing Education Programs.

BACKGROUND: The U.S. Boards of Nursing (BONs) collect annual report data from their nursing programs as part of their approval process. This paper highlights the 2020 and 2021 annual report data on the effect of coronavirus disease 2019 (COVID-19) on all nursing programs in 17 BONs in 2020 and 19 in 2021. METHOD: Nursing programs answered 16 questions on the effect of COVID-19 on their programs. Because BONs require annual report data, all programs in the participating states answered the questions, which included 798 programs in 2020 and 929 in 2021. RESULTS: Major disruptions in nursing education occurred during the pandemic. Clinical experiences and didactic classes were greatly affected, though alternative strategies were used. Student and faculty attrition rates were particularly high in 2021. CONCLUSION: The authors call for a national forum where nurse leaders analyze what happened and make recommendations for future crisis events. [J Nurs Educ. 2024;63(5):312-319.].

Bibliometric analysis of nursing education reviews.

BACKGROUND: While the number of reviews of nursing education research has increased over the years, bibliometric studies about these reviews are limited. OBJECTIVES: The purposes were to: (1) examine the number of reviews of nursing education research published from 2018 through 2022, (2) identify journals publishing these reviews, (3) identify the types and topics of reviews in nursing education, and (4) analyze how these reviews are labeled (standard versus nonstandard). DESIGN: This was a bibliometric study of reviews in nursing education. METHODS: The search for reviews in nursing education was done using CINAHL Complete via the EBSCO host platform and was limited to articles published in peer reviewed journals. The results were imported into EndNote, and the title or abstract was used to identify the review type. The categorized reviews were then exported into Microsoft Excel. The titles and abstracts were searched to identify reviews in nursing education, resulting in 600 articles analyzed in this study. The topics of the reviews were identified via natural language processing techniques based on the Medical Subject Headings biomedical vocabulary in the manual tags with each article. RESULTS: The number of reviews has steadily increased over the years. The top journal in which reviews were published was Nurse Education Today (n = 197). Nearly a quarter (n = 149, 24.8 %) of the reviews were integrative, followed by systematic (n = 117, 19.5 %), scoping (n = 117, 19.5 %), and literature (n = 85, 14.2 %). There were 12 main topics: most reviews were on simulation, followed by critical thinking methods and the academic achievement of nursing students. CONCLUSION: This study documented an increase in the number of reviews of nursing education research over the last five years. The most common type was an integrative review, followed by systematic, scoping, and literature. Reviews on simulation were most common.

Examining Student Preparation for Advancing Care in a Diverse Society.

BACKGROUND: Although many nursing programs include health equity in their curriculum, research investigating the efficacy of such curricula often is lacking. METHOD: Using criterion sampling, school of nursing alumni who could speak about their graduate preparation and current experiences working with diverse patient populations were recruited for this study. Semistructured interviews were conducted with 22 alumni regarding their curricular, clinical, and co-curricular experiences as graduate students to better understand the strengths and gaps in their preparation as health professionals. RESULTS: Four major themes emerged from the analysis of interview transcripts (n = 22). These themes included: (1) diversity and representation; (2) implicit bias and microaggressions; (3) skills and knowledge areas; and (4) supplemental learning through co-curricular experiences. CONCLUSION: Implications for policy, curriculum innovation, and clinical practice can better prepare students to advance care for a diverse society. [J Nurs Educ. 2024;63(4):228-232.].

Work With ChatGPT, Not Against: 3 Teaching Strategies That Harness the Power of Artificial Intelligence.

BACKGROUND: Technological advances have expanded nursing education to include generative artificial intelligence (AI) tools such as ChatGPT. PROBLEM: Generative AI tools challenge academic integrity, pose a challenge to validating information accuracy, and require strategies to ensure the credibility of AI-generated information. APPROACH: This article presents a dual-purpose approach integrating AI tools into prelicensure nursing education to enhance learning while promoting critical evaluation skills. Constructivist theories and Vygotsky's Zone of Proximal Development framework support this integration, with AI as a scaffold for developing critical thinking. OUTCOMES: The approach involves practical activities for students to engage with AI-generated content critically, thereby reinforcing clinical judgment and preparing them for AI-prevalent health care environments. CONCLUSIONS: Incorporating AI tools such as ChatGPT into nursing curricula represents a strategic educational advancement, equipping students with essential skills to navigate modern health care.

Perceptions of nursing staff and students regarding attrition: a qualitative study.

OBJECTIVES: This research aims to explore the perceptions of nursing students and directors of bachelor of nursing degree courses regarding reasons for attrition amongst nursing students. METHODS: A qualitative descriptive study was conducted using inductive thematic analysis. The study included a purposeful sample of 12 students and 4 directors of bachelor of nursing degree courses. RESULTS: As reasons for attrition, the directors highlighted a lack of preparation for nursing studies and students' limited awareness of possibilities for support and learning. The students emphasized insufficient support from academic staff and poor course organization. Economic and family issues and a misunderstanding of the professional role of a nurse were cited as reasons by both directors and students. CONCLUSIONS: The findings provide important insight into attrition in the nursing programme. Further research is warranted, particularly in other contexts. Addressing student attrition requires a comprehensive approach that includes the provision of adequate support systems, mentorship, and resources for students.

Queering the Poster: Disruptive Knowledge at the AACN Diversity Symposium.

BACKGROUND: This article advances theory to practice by describing the application of queer norm-critical pedagogy to a poster given as part of a virtual session at the 2021 American Association of Colleges of Nursing Diversity Symposium. METHOD: The authors created and facilitated the experience of a queered, conceptual poster, inviting a critical appraisal of both the limits and the possibilities of knowledge sharing and co-creation among nurse educators and nursing scholars. RESULTS: The poster was and remains a multimodal, democratic, space/time-transgressing performance whose reach extended well beyond the Symposium in both time and (virtual) space. CONCLUSION: Inviting learners into this co-created, ongoing educational activity up-ends the hierarchies of conference participation, breaking the fourth wall. This kind of work also has potential for the classroom. With planning and creativity, nursing educators can use the methods described here to queer their teaching. [J Nurs Educ. 2024;63(4):265-267.].

Everyone Is Listening: Podcasts as an Innovative Educational Approach in Graduate Level Education.

BACKGROUND: Over the past decade, graduate level nursing education has transitioned from synchronous, classroom-based models to hybrid, asynchronous models. This change has increased the amount of screen-time for graduate learners and generated the problem of screen-fatigue. To reduce screen-based learning time, faculty transitioned a didactic critical care course to a podcast-based educational format. METHOD: This pilot study used a pre-course and post-course survey to evaluate the efficacy of podcasts in delivering course content, meeting course objectives, and understanding learners' perceptions of podcasts in education. RESULTS: Pre-course and post-course survey data demonstrated that podcasts successfully met course objectives and provided content that was equally or more engaging than screen-based lectures. CONCLUSION: Podcasts can be successfully incorporated into a didactic course as a content delivery modality and are an innovative strategy for engaging adult learners in an asynchronous, distance-friendly format while continuing to meet educational objectives. [J Nurs Educ. 2024;63(5):335-337.].