Nursing Student Perceptions of End-of-Life Communication Competence: A Qualitative Descriptive Study.

Effective communication skills are required when nurses care for patients and their families navigating life-limiting illness and the end of life. Educators have made great strides in integrating end-of-life content into prelicensure curricula. It is critical to evaluate nursing students' perceptions of their communication skills to empirically guide the development and implementation of future education interventions. The purpose of this qualitative descriptive study was to explore nursing students' perceptions of their verbal and nonverbal communication competence when providing end-of-life care. Students participated in an established high-fidelity simulation focused on difficult end-of-life conversations. Students explored their perceptions during postsimulation debriefing sessions. Colaizzi's method guided thematic analysis of the audio-recorded debriefings. One major theme emerged from the data: delivering bad news is difficult. Four subthemes further described this theme and its components: (1) reflecting on communication at end of life, (2) feeling uncomfortable, (3) calling for more exposure to end-of-life communication, and (4) fostering a supportive environment for patients and families. Results indicate that nursing students had anxiety and discomfort when engaging in end-of-life conversations. These findings support increased investments in additional training interventions to facilitate the development of student competence in end-of-life communication prior to entering the professional workforce.

Using Virtual Reality in Biomedical Engineering Education.

This study explored virtual reality (VR) as an educational tool to offer immersive and experiential learning environments to biomedical engineering (BME) students. VR and traditional two-dimensional (2D) videos were created and used to teach required communication skills to BME students' while working with clinical partners in healthcare settings. The videos of interdisciplinary teams (engineering and nursing students) tackling medical device-related problems, similar to those commonly observed in healthcare settings, were shown to BME students. Student surveys indicated that, through VR videos, they felt more immersed in real-world clinical scenarios while learning about the clinical problems, each team-member's areas of expertise, their roles and responsibilities, and how an interdisciplinary team operated collectively to solve a problem in the presented settings. Students with a prior in-person immersion experience, in the presented settings, reported VR videos to serve as a possible alternative to in-person immersion and a useful tool for their preparedness for real-world clinical immersion. We concluded that VR holds promise as an educational tool to offer simulated clinical scenarios that are effective in training BME students for interprofessional collaborations.

Efficacy of Clinical Simulation-Based Training in Biomedical Engineering Education.

The need for biomedical engineering (BME) students to be trained in real-world healthcare settings, where most medical device industry emerges, is imperative. Clinical immersion helps accomplish this training goal. However, the growing student population in the field of BME and a shortage of clinical collaborators offer serious limitations to the clinical immersion experience. This paper describes the use of a clinical simulation-based training (SBT) tool in BME education as an alternative resource to the real-world clinical immersion experience. Through the inclusion of simulation labs in BME courses, we assessed their efficacy in need-finding and enhancing students' understanding of the current challenges of existing medical technology. We also explored the possibility of offering cross-disciplinary learning environments in these simulation labs, including engineers and students from other healthcare disciplines such as nursing. Simulation labs served as a helpful tool in the need-finding phase of the design process, and the immersed students reported higher adaptive and life-long learning outcomes. Students also reported the simulation lab immersion to be valuable to their future goals as engineers. Furthermore, the SBT labs offered repetitive training in a controlled learning environment, inclusion of an interdisciplinary setting, and feedback through student reflections. The inclusion of simulation lab immersion and SBT labs in the two BME courses served as an useful and alternative educational tool that helped train students to better understand the needs of the healthcare industry while working in interdisciplinary settings.

Improving Biomedical Engineering Education Through Continuity in Adaptive, Experiential, and Interdisciplinary Learning Environments.

This study reports our experience of developing a series of biomedical engineering (BME) courses having active and experiential learning components in an interdisciplinary learning environment. In the first course, BME465: biomechanics, students were immersed in a simulation laboratory setting involving mannequins that are currently used for teaching in the School of Nursing. Each team identified possible technological challenges directly related to the biomechanics of the mannequin and presented an improvement overcoming the challenge. This approach of exposing engineering students to a problem in a clinical learning environment enhanced the adaptive and experiential learning capabilities of the course. In the following semester, through BME448: medical devices, engineering students were partnered with nursing students and exposed to simulation scenarios and real-world clinical settings. They were required to identify three unmet needs in the real-world clinical settings and propose a viable engineering solution. This approach helped BME students to understand and employ real-world applications of engineering principles in problem solving while being exposed to an interdisciplinary collaborative environment. A final step was for engineering students to execute their proposed solution from either BME465 or BME448 courses by undertaking it as their capstone senior design project (ENGR401-402). Overall, the inclusion of clinical immersions in interdisciplinary teams in a series of courses not only allowed the integration of active and experiential learning in continuity but also offered engineers more practice of their profession, adaptive expertise, and an understanding of roles and expertise of other professionals involved in enhancement of healthcare and patient safety.

Effects of High-Fidelity Simulation on Physical Therapy and Nursing Students' Attitudes Toward Interprofessional Learning and Collaboration.

BACKGROUND: The study purpose was to examine changes in physical therapy (PT) and nursing (RN) student attitudes toward interprofessional learning (IPL) and interprofessional collaboration (IPC) following a high-fidelity code simulation. METHOD: PT (n = 42) and RN (n = 35) students, while working together to transfer a simulated patient, had to respond to a sudden and unexpected medical emergency. Pre- and postsurveys included the Interdisciplinary Education Perception Scale (IEPS), Readiness for Interprofessional Learning Scale (RIPLS), and Attitudes Toward Health Care Teams Scale (ATHCTS). A control group (PT, n = 41; RN, n = 33) of students were also surveyed. RESULTS: Statistically significant between- (p < .003) and within-group differences (p ⩽ .006) occurred for the IEPS (competency and autonomy, perceived need for and perceptions of actual cooperation), the RIPLS (teamwork and collaboration, professional identity), and the ATHCTS (team value and efficiency). CONCLUSION: The IPL experience using high-fidelity simulation fostered the development of attitudes necessary for effective IPL and IPC. [J Nurs Educ. 2017;56(8):456-465.].

Nursing care at the end of life: a service learning course for undergraduate nursing students.

An elective course titled "Nursing Care at the End of Life" was designed for fourth-year nursing students in a baccalaureate nursing program. This course, taught by the authors, was designed to teach students about caring for the dying patient. Students were required to complete service learning with patients in a hospice or hospital setting. Students reported having a positive learning experience and gaining new knowledge and a deeper understanding of the needs of dying patients and their families.