Aligning Simulation-Based Education With Didactic Learning in Prelicensure Baccalaureate Nursing Education.

BACKGROUND: Research has shown there is a gap between academia and practice. Nursing stakeholders support the use of the clinical judgment model in developing competency for practice. PURPOSE: This study analyzed the effectiveness of simulation-based education on the development of clinical judgment and explored new graduate nurses' perceptions of their preparation for practice. METHODS: A longitudinal, explanatory, mixed-methods design with survey points at onset and end of the intervention and interviews 6 months postgraduation. RESULTS: The Simulation Effectiveness Tool-Modified (SET-M) was utilized for the pre- and posttest surveys. Two-tailed Mann-Whitney 2-sample rank sum tests were conducted and analyzed for all items on the SET-M. Significant differences were seen in pre- and posttest responses for 12 of the 19 SET-M survey items. CONCLUSION: The findings of this study support the deliberate alignment of didactic and practical teaching strategies to strengthen practice performance and bridge the gap.

How Health Experiences in Tanzania Foster Change in Nursing Student Perceptions of Diversity and Self.

ABSTRACT: International study abroad programs offered by American universities provide opportunities to experience global health care disparities. This qualitative phenomenological research using a hermeneutic approach was conducted to explore how clinical experience in Tanzania influenced the knowledge and attitudes of prelicensure baccalaureate nursing students toward culture, health care disparities, and health care outcomes. Two main themes emerged from the research: thinking as another and carrying it forward.

Evidence-Based Practice Competence in Nursing Students Preparing to Transition to Practice.

BACKGROUND: Opportunities to embed and evaluate evidence-based practice (EBP) competency in the clinical setting across nursing curricula are not well described in the literature. AIMS: This research aims to describe how clinical learning environments influence senior nursing students' integration of EBP competencies in their practice and perceptions of EBP competence development in a traditional baccalaureate nursing program. METHODS: A sequential, mixed-methods design was used with senior students upon completion of their last two clinical experiences in the nursing program. Students completed the EBP Work Environment Scale (Pryse, McDaniel, & Schafer, 2014) and semi-structured interviews. FINDINGS: Students appraised EBP Work Environments positively during preceptor-led experiences as opposed to instructor-led, group clinical experiences. Students described the evolution of emerging EBP competence throughout their nursing education and emphasized the importance of coursework in intentionally developing EBP competence. LINKING EVIDENCE TO ACTION: Assessment of clinical experiences and models that contribute to EBP competence is needed. Participants in this study emphasized the importance of coursework that builds on EBP competencies, and the tremendous value of nurse preceptors that encouraged growth in their ability to engage with EBP in clinical practice.

Effect of case study versus video simulation on nursing students' satisfaction, self-confidence, and knowledge: A quasi-experimental study.

BACKGROUND: Research on simulation in nursing education has demonstrated the positive impact active, experiential learning has on student satisfaction, self-confidence, and knowledge. As a result, simulation laboratories with high-fidelity human patient simulators have become a common adjunct to clinical teaching. It is important to also promote active learning in the classroom setting; however, there is limited evidence on using video simulations in large classrooms. OBJECTIVES: This study sought to determine if using a video simulated unfolding case study as part of the didactic classroom, as compared to a traditional written case study, improved students' satisfaction, self-confidence, and knowledge. DESIGN: A two-group, quasi-experimental design was used. SETTINGS: The study occurred at a University in the southeastern United States. PARTICIPANTS: A total of 165 baccalaureate nursing students participated. METHODS: The control group received a written case study, while the intervention group received video simulation of the same case study and student satisfaction, self-confidence, and knowledge were measured upon completion. Data analysis used descriptive statistics and t-tests. Qualitative comments were also provided by students and analyzed for themes. RESULTS: There were no statistically significant differences, with both groups reporting a high level of satisfaction and self-confidence. The percent of knowledge questions answered correctly was higher for the video simulation group for all seven questions. Four themes were identified from participant words: A better understanding, Able to apply learning to a patient scenario, Engaged in learning, and Visualizing it helps. CONCLUSIONS: Results suggest the use of video simulation in the classroom may deepen students' understanding of classroom content and provide an additional mode for learning to enhance classroom lecture. Use of video simulation to augment classroom teaching is suggested as a strategy for engaging learners.

Nurse Preceptor Role in New Graduate Nurses' Transition to Practice.

The transition to practice period is a challenging and demanding time for new graduate nurses. Leaving the structured environment of nursing school and entering professional practice can cause reality and transition shock for the new nurse resulting in unsafe patient care, as well as intention to leave their position or the profession. Successful transition to practice depends on the new nurse building confidence and gaining essential clinical reasoning abilities while orienting to their role. In critical care settings, patient care is more complex and fast-paced, which adds another dimension of overall stress to the new graduate. Structured orientation programs with trained preceptors have been found to be the most successful means of preparing new graduate nurses for clinical practice. Ensuring preceptors are provided with education related to the development of clinical reasoning is essential to successfully assist new nurses in their transition to practice. Safe and effective patient care, especially in the critical care unit, is dependent upon having nurses who are well prepared for their role through being provided guidance and support from trained preceptors.

The Lived Experience of Being a Male Nursing Student: Implications for Student Retention and Success.

BACKGROUND: Despite the need to improve gender diversity in the United States nursing workforce, limited studies have explored the experience of former male nursing students and research is needed to provide guidance about teaching and mentoring strategies that can promote male student retention and success. PURPOSE: This study was conducted to explore the lived experience of former male nursing students. METHODS: A descriptive phenomenological approach was used. Eleven males formerly enrolled in a pre-licensure, baccalaureate nursing program participated. Individual interviews were conducted, and themes were identified. RESULTS: Five themes emerged during data analysis: (1) gender bias exists, (2) being singled out, (3) doing manly stuff, (4) limitations in clinical settings, and (5) no male role models. CONCLUSIONS: Based on study findings, recommendations to promote male nursing student retention and success include improving media portrayals of male nurses, providing faculty development to heighten self-awareness of gender bias and understanding of barriers and facilitators in nursing education for male students, addressing negative experiences in maternity clinical rotations, and implementing mentorship programs to provide male role models for male nursing students.

New graduate nurses' preparation for recognition and prevention of failure to rescue: A qualitative study.

AIM AND OBJECTIVE: To explore new graduate nurses' experiences with recognition and prevention of failure to rescue. BACKGROUND: Failure to rescue is recognised as a quality-of-care indicator, a core measure of nursing care in hospitals, and a determinant for staffing in acute care facilities. Clinical reasoning is an essential component in preventing failure to rescue and should be emphasised in nursing education and new graduate orientation. Many nurses graduate without the ability to use clinical reasoning in providing patient care which can lead to adverse patient outcomes. DESIGN: A descriptive phenomenological design was used. METHODS: A purposive sample of 14 new graduate nurses from a nursing programme in the south-eastern USA, in practice for no more than eighteen months, was recruited. Individual one-on-one interviews were conducted from January-June 2016 and audio-recorded for accuracy. Data were evaluated using the consolidated criteria for reporting qualitative research (COREQ) guidelines. Recordings were professionally transcribed and reviewed. RESULTS: Using Giorgi's methods for data analysis, five main themes were discerned in the data: clinical preparation in school; experience with emergent situations; development of clinical reasoning; low confidence as a new graduate; and responding to emergencies. Within each theme, subthemes emerged. CONCLUSION: The words of the participants provided rich detail into the preparation of new graduate nurses and how nurse educators, managers and preceptors can better focus learning opportunities to prepare them for practice. Experiential learning combined with collaboration among education stakeholders will lead to a better prepared and more confident nursing work force. RELEVANCE TO CLINICAL PRACTICE: Better preparation and continued support of new graduate nurses lead to positive patient outcomes and more satisfaction with their choice of nursing as a profession.

LAGOS-NE: a multi-scaled geospatial and temporal database of lake ecological context and water quality for thousands of US lakes.

Understanding the factors that affect water quality and the ecological services provided by freshwater ecosystems is an urgent global environmental issue. Predicting how water quality will respond to global changes not only requires water quality data, but also information about the ecological context of individual water bodies across broad spatial extents. Because lake water quality is usually sampled in limited geographic regions, often for limited time periods, assessing the environmental controls of water quality requires compilation of many data sets across broad regions and across time into an integrated database. LAGOS-NE accomplishes this goal for lakes in the northeastern-most 17 US states.LAGOS-NE contains data for 51 101 lakes and reservoirs larger than 4 ha in 17 lake-rich US states. The database includes 3 data modules for: lake location and physical characteristics for all lakes; ecological context (i.e., the land use, geologic, climatic, and hydrologic setting of lakes) for all lakes; and in situ measurements of lake water quality for a subset of the lakes from the past 3 decades for approximately 2600-12 000 lakes depending on the variable. The database contains approximately 150 000 measures of total phosphorus, 200 000 measures of chlorophyll, and 900 000 measures of Secchi depth. The water quality data were compiled from 87 lake water quality data sets from federal, state, tribal, and non-profit agencies, university researchers, and citizen scientists. This database is one of the largest and most comprehensive databases of its type because it includes both in situ measurements and ecological context data. Because ecological context can be used to study a variety of other questions about lakes, streams, and wetlands, this database can also be used as the foundation for other studies of freshwaters at broad spatial and ecological scales.

Prelicensure Baccalaureate Nursing Students' Perceptions of Their Development of Clinical Reasoning.

BACKGROUND: Establishing a strong foundation for the development of clinical reasoning in nursing students is essential to ensure safe and effective patient care. This study explored prelicensure baccalaureate nursing students' perceptions of their development of clinical reasoning, as well as their perceptions of how it is taught. METHOD: In this phenomenological study, individual semistructured interviews were conducted to gather data related to participants' perceptions of their development of clinical reasoning. Data were analyzed using procedural steps delineated by Giorgi. RESULTS: Data analysis revealed three main themes: Instructor Characteristics, Importance of Clinical Reasoning, and Best Place to Learn Clinical Reasoning. Students recognized how clinical reasoning enhances safe and effective clinical practice and indicated the clinical arena was the most beneficial environment in which to learn clinical reasoning. CONCLUSION: Understanding students' perceptions of learning benefits nurse educators in planning nursing program curricula to enhance and facilitate the development of clinical reasoning. [J Nurs Educ. 2016;55(6):329-335.].

Evaluation of microbiological water quality in the Pettaquamscutt River (Rhode Island, USA) using chemical, molecular and culture-dependent methods.

We evaluated microbiological water quality in the Pettaquamscutt River (Rhode Island, USA), an estuarine river. Fecal coliform (FC) and enterococci (FE) bacteria, presence of Bifidobacterium adolescentis DNA (indicating human fecal contamination), and optical brightener (OB) fluorescence (associated with laundry detergents) were determined for 14 stations from May to September 2010. Six stations had high counts of FE and FC, and the presence of B. adolescentis DNA and high OB fluorescence indicated human fecal contamination - four had septic systems as likely sources of contamination; the others were in sewered areas. The ability of FC and FE to indicate human fecal contamination was assessed against a positive B. adolescentis test. FC and FE had false positive rates of 25% and 17%, respectively, and false negatives of 44% for FC and 63% for FE. Inclusion of molecular and chemical indicators should improve tracking of human fecal contamination sources in the river.