Utilizing high-fidelity simulation to improve newly licensed pediatric intensive care unit nurses' experiences with end-of-life care.

PURPOSE: New pediatric intensive care unit (PICU) nurses face distinct challenges in transitioning from the protected world of academia to postlicensure clinical practice; one of their greatest challenges is how to support children and their caregivers at the end-of-life (EOL). The purpose of this quality improvement project was to create, implement, and assess the efficacy of a high-fidelity EOL simulation, utilizing the "Debriefing with Good Judgment" debriefing model. DESIGN AND METHODS: Participants were nurses with 4 years or less of PICU experience from a 404-bed quaternary care, free-standing children's hospital in the northeastern United States. Data were collected with the Simulation Effectiveness Tool-Modified (SET-M) and the PICU EOL Simulation Evaluation Survey. RESULTS: Twenty-four nurses participated; the majority (54%) were 25-29 years of age. The SET-M results indicate that the EOL simulation was beneficial to their learning and increased nurse confidence in delivering EOL care. Responding to the EOL Simulation Survey, participants rated high levels of confidence with tasks such as utilizing unit and hospital-based supports, self-care, ability to listen and support families, and medicating their patients at the EOL. PRACTICE IMPLICATIONS: This high-fidelity EOL simulation is a robust teaching tool that serves to support the unmet needs of the PICU nurses who care for dying children. Nurse participants had a unique opportunity to practice procedural and communication skills without risk for patient or family harm. Findings from this project can serve to guide curriculum changes at the undergraduate level as well as provide direction for new nurse orientation classes.

Innovative Communication Learning: Combining TED Talks and Reflective Writing for Nursing Students.

BACKGROUND: As educational programs compete with online and open courseware, TED (Technology, Entertainment, and Design) Talks provide meaningful complementary content that can be easily integrated into curricula. PURPOSE: Evaluate an innovative approach to the standard lecture by combining media mixture with reflective writing. METHODS: Undergraduate nursing students were asked to view a TED Talk and write a brief narrative reflection as part of their preparation for a communication class. RESULTS: The video and reflective writing assignment were completed by 23/25 (92%) of students. Qualitative analysis of the reflective writing identified three primary themes: Communication as a Foundational Competency, Importance of Empathy, and Professional Role Development. CONCLUSION: This illustrative talk and narrative exercise provided an interactive learning experience for novice nurses that served as a compelling means to critically reflect on effective health-care communication skills, prior to entry into practice.