Augmenting pediatric nursing clinical education with low-cost simulations.

Issues in pediatric nursing and research education.

The study explored factors influencing implementation of simulation-based education (SBE) in nursing and midwifery education in Malawi. This study aimed to identify factors influencing nursing and midwifery educators in selected training institutions and clinical sites. The study covered one district and four central hospitals, five professional training institutions, Ministry of Health and Nurses and Midwives Council of Malawi officials. Using mixed-methods approach, quantitative data were gathered from 293 participants, including 149 final-year nursing and midwifery students, and 144 clinical instructors. Qualitative data were obtained from 24 faculty members, 11 clinical instructors and two key informants. Researchers conducted 37 in-depth interviews, 10 focus group discussions and eight desk reviews. Descriptive statistics were used to analyse the quantitative data, while content analysis was used for qualitative findings. Five themes emerged from qualitative data: absence of simulation in regulatory body syllabi, insufficient formal training, demand for knowledgeable clinical instructors, inadequate human and material resources, and resistance to change. Survey results indicated that 83% of the participants had theoretical SBE knowledge but lacked practical skills, with only 13% considering SBE as a current teaching method. Educators emphasised lack of infrastructure, skills laboratories, teaching hospitals, equipment, and a deficit in formal training as critical barriers to SBE implementation. The study concluded that skilled educators, appropriate infrastructure and resources could facilitate SBE implementation in Malawi. Recommendations included regulatory body support, formal training for educators, utilisation of low-fidelity simulators, and establishment of SBE centres and corners in health facilities.

Background: The regulation of nursing practice and the development of nursing education curricula both make extensive use of the language of competence. Implementing competency-based education (CBE) is a crucial topic of contemporary educational science generally and nursing education specifically. Nursing educators have intense needs to be trained on such valuable approach. Aim: to determine the effect of implementing instruction module about CBE on educators’ knowledge, skills, and attitude at Faculty of Nursing -Damanhour University. Design: A quasi- experimental research design was used. Setting: the study was carried out at the Faculty of Nursing, Damanhur University. Subjects: 62 nurse educators who were selected conveniently and divided into control and study groups and 25 courses’ specifications, and 25 courses’ matrixes selected conveniently from the previously written courses specification and matrixes. Tools: Three tools were used. Tool (I): "Nurse Educators’ Competency- Based Education Knowledge Questionnaire". Tool (II): "Nurse Educators’ Competency- Based Education Attitude Rating Scale". Tool (III): "Nurse Educators’ Competency- Based Education Planning Skills Rubric". Results: revealed that there was apparent improvement in the study group’s scores than control group regarding CBE' knowledge, CBE' planning skills and attitude toward CBE after implementing the CBE' instruction module. Thus, there was a statistically significant difference between the study and control groups after such intervention in favor of the study group. Conclusion: implementing the developed CBE' instructional module among nurse educators in Faculty of Nursing, Damanhour University, Egypt, showed significant value and positive impact in improving nurse educators’ CBE knowledge, planning skills and attitude toward CBE. Recommendations: Conducting the study in different nursing faculties in Egypt. Spreading CBE culture between nurse educators and nursing students as an effective mean for better future nursing education career theoretically and clinically.

This study aimed to examine the current status and key challenges of pediatric nursing clinical education in South Korea and to provide strategic directions for quality improvement based on competency-based learning outcomes. A cross-sectional survey was conducted among 89 pediatric nursing faculty members working at various universities nationwide between February and July 2024. Quantitative data were analyzed using descriptive statistics, and qualitative responses were analyzed using inductive content analysis. Practicum objectives primarily focused on inpatient care (98.9%) and core nursing skills (83.1%), while communication and problem-solving (22.4%) and ethics (21.3%) were underrepresented. Although high-fidelity simulation use reached 33.7%, interactive tools such as virtual reality (17.9%) and nursing process evaluations (7.8%) remained underutilized. Six themes emerged from the analysis of faculty perspectives on enhancing clinical practicum education: structural barriers in securing sites, inconsistent learning environments, overcrowding, limitations of observation-only learning, regulatory constraints, and excessive faculty burden. This study proposes establishing standardized clinical protocols, expanding hybrid simulation-based models to compensate for shrinking clinical sites, and institutionalizing industry-academic cooperative frameworks to ensure the quality and equity of pediatric nursing education. These approaches are essential to enhancing the quality and equity of pediatric clinical nursing education in Korea.

BackgroundWhile many nursing programs in developed countries have implemented simulation-based education as a pedagogic method of teaching, implementation of simulation in developing countries like Tanzania is rare. Traditional methods of auditorium lectures are widely conducted in low-income nursing and midwifery education institutions. Such pedagogy provides students with theoretical knowledge yet with limited hands-on exposure for clinical skills, which might affect the professional integration of students and quality care delivery. This study explored perceptions of simulation-based education among diploma nursing students and midwifery students in one of the urban nursing schools in Tanzania.MethodAn exploratory qualitative study design was employed. Thirty-four nursing and midwifery students who had experience with simulation-based education were selected purposively to participate in focus group interviews. Data was collected in July 2023. Data analysis was conducted based on Graneheim and Lundman’s content analysis approach.ResultsTwo major themes emerged from the analysis: (1) Strengthened confidence through practice in a safe teaching environment. This theme included three sub-themes: (i) Increased overall confidence, (ii) reduced fear through practice in a safe environment, and (iii) enhanced knowledge and skills in procedures and equipment. The second theme was as follows: (2) Enhanced critical thinking and reasoning in debriefing and included two sub-themes: (i) Integrating theory into practice, (ii) communication in neonatal emergency management.ConclusionNursing and midwifery students perceived simulation-based education as an effective method to prepare for clinical practice and quality neonatal care. Introducing simulation-based education in nursing education may benefit students’ learning and strengthen the sustainability of skilled healthcare providers in low-income contexts where resources are scarce. Further research is needed to assess whether students can transfer knowledge into clinical skills practice.

PurposeThe purpose of this systematic review was to explore the benefits and challenges in the implementation of simulation-based education (SBE) in the classroom and clinical settings in sub-Saharan Africa. The objectives of this systematic review were to identify the benefits of utilising SBE in the classroom and clinical practice in sub-Saharan Africa and to assess the challenges in the implementation of SBE in the classroom and clinical practice in sub-Saharan Africa.Design/methodology/approachFive databases were searched for existing English literature (Medline, CINAHL and Science Direct), including grey literature on the subject. Out of 26 eligible studies conducted in sub-Saharan Africa between 2014 and 2021, six studies that used mixed-methods design were included. Hawker et al.’s framework was used to assess the quality of the studies. Quantitative data were presented using descriptive and inferential statistics in the form of means and standard deviations while qualitative data were analysed and presented thematically.FindingsQuantitative findings showed that participants rated SBE highly in terms of teaching (93.2%), learning (91.4%) and skill acquisition (88.6%). SBE improved the clinical skill competency from 30% at baseline to 75% at the end. On the other hand, qualitative findings yielded themes namely: improved confidence and competence; knowledge acquisition and critical thinking; motivation and supervision; independent, self-paced learning; simulation equipment and work schedules; and planning and delivery of simulation activity. Pedagogical skills, competence and confidence are some of the elements that determine the feasibility of implementing SBE in the classroom and clinical settings.Practical implicationsSBE could help to bridge the gap between theory and practice and improve the quality of care provided by nurses. Simulation-based training is effective in improving the clinical skills of midwives and increasing their confidence in providing care. However, SBE trainees require motivation and close supervision in classroom settings if simulation is to be successfully implemented in sub-Saharan Africa. Furthermore, careful planning of scenarios, students briefing and reading of content prior to implementation facilitate effective simulation.Originality/valueWhile there may be a lack of literature on the use of SBE for training nurses and midwives in the developing world, there is growing evidence that it can be an effective way to improve clinical skills and quality of care. However, there are also significant challenges to implementing simulation-based training in resource-limited settings, and more research is needed to understand how best to address these challenges. This study fills this gap in the literature.

The caesarean section (CS) rate is over 25% in many high-income countries, with a substantial minority of CSs occurring in women with low-risk pregnancies. CS decision-making is influenced by clinician and patient beliefs and preferences, and clinical guidelines increasingly stipulate the importance of shared decision-making (SDM). To what extent SDM occurs in practice is unclear. To identify women's birth preferences and SDM experience regarding planned CS. Survey of women at eight Sydney hospitals booked for planned CS. Demographic data, initial mode of birth preferences, reason for CS, and experiences of SDM were elicited using questions with multiple choice lists, Likert scales, and open-ended responses. Quantitative data were analysed using descriptive statistics and qualitative data using content analysis. Responses of women who perceived their CS as 'requested' vs 'recommended' were compared. Of 151 respondents, repeat CS (48%) and breech presentation (14%) were the most common indications. Only 32% stated that at the beginning of pregnancy they had a definite preference for spontaneous labour and birth. Key reasons for wanting planned CS were to avoid another emergency CS, prior positive CS experience, and logistical planning. Although 15% of women felt pressured (or were unsure) about their CS decision, the majority reported positive experiences, with over 90% indicating they were informed about CS benefits and risks, had adequate information, and understood information provided. The majority (85%) of women appeared satisfied with the decision-making process, regardless of whether they perceived their CS as requested or recommended.

Competence and competency-based nursing education: Finding our way through the issues

This study highlights the low English writing and speaking skills of students of the Information Systems Study Program at Nurdin Hamzah University. To address this challenge, a rule-based expert system application named M.E.G.A for Job Seekers was developed using the ADDIE model approach (Analysis, Design, Development, Implementation, and Evaluation). This application functions as a self-assessment tool to improve students' professional communication readiness, especially in compiling CVs, job application letters, and interview preparation. The sampling technique used was purposive sampling, with subjects consisting of language experts, instructional media experts, and educational technology experts to validate the product. Meanwhile, 100 second-semester students of the Information Systems Study Program at Nurdin Hamzah University were used as the sample for testing the practicality, attractiveness, and effectiveness of the application. This study used quantitative data from questionnaires and tests, as well as qualitative data from open-ended responses by experts and students. The quantitative data were analyzed descriptively, while the qualitative data were validated through triangulation and content analysis to support the development of the application. The results showed high scores in the aspects of functionality, attractiveness of appearance, and improvement of learning outcomes. Pre-test and post-test analysis showed significant improvements, while statistical analysis supported the pedagogical reliability of this system. The application has proven effective in supporting independent learning that is relevant to the needs of the world of work and has the potential to be adopted by other study programs. This study contributes to the development of digital learning through the integration of AI-based expert systems for the development of 21st-century skills.

Our purpose in this research study was to examine perceptions of food and nutrition educators (FNEs, i.e., Registered Dietitians Nutritionists and Family and Consumer Science teachers) and young adults (ages 18–25) on the status of cooking and food skills among young adults. Using a cross-sectional survey design, FNEs (<em>n</em> = 93) and college-attending young adults (<em>n</em> = 270) in the United States completed electronic surveys. The qualitative and quantitative data were collected and analyzed using a convergent mixed-methods approach. The qualitative data from open-ended survey responses collected from young adults and FNEs were analyzed using <em>coding reliability thematic analysis</em>. The quantitative data used Fisher’s Exact Test to compare the importance of food skills between FNEs and young adults. In the quantitative data, young adults and FNE reported the top five food skills essential for young adults with slight variations between the two groups. For young adults, “cooking meat and poultry” was their top skill while FNEs chose “reading and following a recipe” as the top food skill. Three themes were constructed through coding reliability thematic analysis: (1) definition of cooking, (2) perceptions of the purpose of cooking, and (3) young adults’ autonomy in cooking. We concluded that young adults understood the benefits of cooking and eating healthily, but many felt overwhelmed by it. While educational food skill interventions should focus on foundational skills, cooking should be taught with consideration of young adults in mind (e.g., time and money limitations) to make the skills practical and enduring.

The American Association of Colleges of Nursing (AACN) is shifting the nursing education paradigm to competency-based education. Competency-based nursing education focuses on the nursing students' demonstration of knowledge. This shift in nursing education will rely on performance measures and data to determine success. Data and artificial intelligence can provide the nursing student with a targeted evaluation from the nursing faculty. Building on prior applications of "precision" and the use of data to drive precision medicine or precision nursing, nursing informatics is well-positioned for this paradigm shift to support data and artificial intelligence in nursing education. Little is understood about the concept of "precision nursing education" and its implications. We completed a concept analysis and defined the concept of "precision nursing education" as the use of data and artificial intelligence to measure student nurses' performance with competency-based nursing education.

BackgroundWe report on the longitudinal quantitative and qualitative data resulting from a two-year trajectory (2008–2011) based on the DIagnosis of Sustainable Collaboration (DISC) model. This trajectory aimed to support regional coordinators of comprehensive school health promotion (CSHP) in systematically developing change management and project management to establish intersectoral collaboration.MethodsMultilevel analyses of quantitative data on the determinants of collaborations according to the DISC model were done, with 90 respondents (response 57 %) at pretest and 69 respondents (52 %) at posttest. Nvivo analyses of the qualitative data collected during the trajectory included minutes of monthly/bimonthly personal/telephone interviews (N = 65) with regional coordinators, and documents they produced about their activities.ResultsQuantitative data showed major improvements in change management and project management. There were also improvements in consensus development, commitment formation, formalization of the CSHP, and alignment of policies, although organizational problems within the collaboration increased. Content analyses of qualitative data identified five main management styles, including (1) facilitating active involvement of relevant parties; (2) informing collaborating parties; (3) controlling and (4) supporting their task accomplishment; and (5) coordinating the collaborative processes.ConclusionsWe have contributed to the fundamental understanding of the development of intersectoral collaboration by combining qualitative and quantitative data. Our results support a systematic approach to intersectoral collaboration using the DISC model. They also suggest five main management styles to improve intersectoral collaboration in the initial stage. The outcomes are useful for health professionals involved in similar ventures.

Generations X, Y, and Z

Background: The Integrated Care Programme for Older Persons in Ireland (ICPOP) aims to change the way health and social care for older persons is planned and delivered, with the aim of improving patient experience, quality and outcomes.¹ A key component of ICPOP is the implementation of new ways of working across healthcare teams. Simulation based education (SBE) can help support the interprofessional educational needs of these newly established teams in a dedicated supported environment,² and has the potential to promote change in healthcare delivery. Alongside this, SBE can also be utilised for system probing, where patient safety issues can be identified and remedied through system changes and training.² Methods: An interprofessional simulated education session was designed and developed following consultation with ICPOP team members. It was delivered in a simulation laboratory with participants from several disciplines including doctors, nurses, physiotherapists, occupational therapists, and therapy assistants from ICPOP and the acute hospital Frailty at the Front Door (FFD) Team. A prebriefing session was facilitated for participants. The simulation session followed the journey of a frail older person who experienced a fall and had presented to the Emergency Department. Participants representing team members from the acute hospital setting formulated a care plan and simulated the onward referral to the integrated care team. Afterwards, a debriefing session was facilitated by a medical simulation professional. Involved were the participants of the simulation, patient and participant involvement group members, and stakeholders from hospital, community and national service providers who were observers during the session. Feedback on the sim was obtained through an online questionnaire. Results: 12 participants provided quantitative and qualitative online feedback. A content analysis was undertaken on collected qualitative data. Overall all twelve enjoyed participating in the simulation and reported that they would be eager to engage in future SBE. The simulation highlighted areas for quality improvement pertaining to existing communication structures. All participants stated they found the simulation relevant to their area of practice and expressed that their practice would change as a result of the simulation, with improved communication noted as a key learning outcome by many. Participants noted that relationships developed through SBE could potentially deliver more efficient patient care and better patient outcomes. Discussion: Through SBE we identified key areas for quality improvement for older adults moving between multidisciplinary services. Following this systems probe approach, ICPOP and FFD now share weekly meetings and are collaborating on a patient information leaflet. Future SBE sessions are planned to explore the continuum of older adult care, bringing together teams from primary care, rehabilitation and specialist inpatient services, with the aim of fostering collaboration and forging new partnerships. 1.ICPOP Steering Group. Making a start for integrated care in for older persons - A practical guide to the local implementation of Integrated Care Programmes for Older Persons. 2017. 2.Sollid SJ, Dieckman P, Aase K, Søreide E, Ringsted C, Østergaard D. Five topics health care simulation can address to improve patient safety: results from a consensus process. Journal of patient safety. 2019 Jun;15(2):111.

The present study set out to address the issue as to whether the implementation of portfolio assessment would give rise to Iranian pre-intermediate EFL learners’ autonomy. Participants comprised 60 pre-intermediate female learners within the age range of 16 to 28 studying English in a private language institute, a Cambridge Open Centre (IR056). They were randomly divided into two groups each consisting of 30 participants. An independent sample t-test confirmed their homogeneity in terms of language proficiency at the outset of the study. Moreover, they were homogenized in terms of autonomy through employing a validated questionnaire. The portfolio assessment was integrated into the experimental group while traditional assessment was assigned to the control group. The study adopted a mixed-method approach for the purposes of data collection and analysis. Data were collected by means of a questionnaire, a semi-structured interview, and participants’ portfolios. Quantitative data were analyzed using independent samples t-test. Qualitative data were analyzed inductively through content analysis. The recurring themes emerging from the interview and participants’ portfolios were compared with the findings of the questionnaire. The results of both quantitative and qualitative data analyses revealed that portfolio assessment significantly enhanced learner autonomy in the experimental group, and offered them an opportunity to reflect upon their learning process, growth, and progress overtime. Drawing upon the findings, some pedagogical implications are presented and finally, some avenues for future research are highlighted.