From Metacognition to Practice Cognition: The DNP e-Portfolio to Promote Integrated Learning.

BACKGROUND: Educating Doctor of Nursing Practice (DNP) students for an increasingly complex health care environment requires novel applications of learning concepts and technology. A deliberate and thoughtful process is required to integrate concepts of the DNP program into practice paradigm changes to subsequently improve students' abilities to innovate solutions to complex practice problems. METHOD: The authors constructed or participated in electronic portfolio development inspired by theories of metacognition and integrated learning. The objective was to develop DNP student's reflection, integration of concepts, and technological capabilities to foster the deliberative competencies related to the DNP Essentials and the foundations of the DNP program. RESULTS: The pedagogical process demonstrates how e-portfolios adapted into the doctoral-level curriculum for DNP students can address the Essentials and foster the development of metacognitive capabilities, which translates into practice changes. CONCLUSION: The authors suggest that this pedagogical approach has the potential to optimize reflective and deliberative competencies among DNP students. [J Nurs Educ. 2017;56(8):497-500.].

Quality of life for children with life-limiting and life-threatening illnesses: description and evaluation of a regional, collaborative model for pediatric palliative care.

The care of children in the U.S. with life-limiting illnesses is inadequate. Misallocated resources, flawed assumptions and models of care, and a lack of appropriate professional education foster a costly, inefficient system that falls short of its true potential. This article details the evolution of a regional, shared approach to address these issues, the District of Columbia Pediatric Palliative Care Collaboration (DCPPCC), and includes its evolution, preliminary clinical results, and assessment of barriers encountered.

Using clickers for clinical reasoning and problem solving.

This project explored how an audience response system (clickers), combined with case-based questions, resulted in increased student engagement, attention, and participation in an introductory clinical nursing course. Clicker questions and ensuing discussion were designed to enable students to practice reasoning through patient situations before entering the clinical setting. Findings suggest that nuanced discussion of all possible answers encouraged students to think more deeply about their initial answers and opened them up to new reasoning processes.

Ensuring NCLEX-RN success for first-time test-takers.

A major indicator of baccalaureate nursing program effectiveness is the pass rate on the National Council Licensure Examinations, Registered Nurse (NCLEX-RN) among first-time candidates. This article highlights the scope, instructional methods, and outcomes of the remediation program at Georgetown University School of Nursing & Health Studies (GU-NHS). With implementation of the multifaceted program, the NCLEX-RN pass rate for first-time takers at GU-NHS has been consistently above the national mean among all first-time candidates. Although it is impossible to determine which strategy made the greatest contribution to the success of the program, the cumulative effect is impressive and indicates the students are prepared for the challenge of the examination and contemporary nursing practice.

Tobacco and its trendy alternatives: implications for pediatric nurses.

Although acute and critical care pediatric nurses may not rank tobacco prevention and cessation among their top patient-care priorities, the importance of providing health education, especially during vulnerable moments, cannot be overlooked. This article provides an overview of trendy tobacco alternatives, such as bidis, clove cigarettes, hookah pipes, and smokeless tobacco, that entice youth. The significant health consequences of these tobacco products and the implications for pediatric acute and critical care nursing practice are also discussed.

Surviving the perfect storm: staff perceptions of mandatory overtime.

Historically, mandatory overtime has been used to provide adequate staffing in times of crisis; however, as a result of today's severe nursing shortage, hospitals and other healthcare institutions are more commonly using mandatory overtime as a daily management tool to meet staffing requirements. This practice has created turmoil between management and staff in providing quality healthcare. Nursing literature describing staff nurses' views of overtime is limited. This article offers a description of the environment at the Hospital for Sick Children, a private nonprofit rehabilitation and transitional care pediatric hospital in Washington, DC, and the challenges the hospital faces in staffing the patient care units. This article also reports the results of the hospital's efforts to poll the nursing staff on their opinions regarding both voluntary and mandatory overtime and identifies conditions that influence the nursing staff's decisions and perceptions about overtime. Survey results will be used to modify existing staffing strategies and implement new staffing policies.