Reducing Barriers for RN-BSN Education: The Assessment Competency Evaluation.

Health assessment skills are vital to professional nursing practice. Health assessment has traditionally been taught using lecture, teacher-developed tests, practice and live demonstration, and interactive and computer-based learning materials. Rapid advances in information technology during the past decade have greatly expanded distance learning options in higher education. Although much nursing education now uses the Internet, there has been limited use of the Web to teach psychomotor and clinical skills. This article describes how online instruction can be integrated into a health assessment course to teach physical examination skills. The development of instructional videos that can be digitally streamed onto the Web for ready and repeated access can also enhance online learning of technical and clinical skills. Student evaluation of this Web-enhanced course revealed that online assignments enabled them to pace their learning, thereby promoting greater flexibility and independence. Students were able to master the technical skills of working online with minimal difficulty and reported that working online was no more stressful than attending class. The most helpful aspect of the online course was the instructor-developed video that was digitally streamed online.

Objective: The purpose of this study was to get students’ perceptions about changes made to the health assessment course delivery format from face to face to blended learning (BL). Health assessment is a foundational course in nursing undergraduate programs. Research has suggested that students have high levels of satisfaction with a blended learning format.Methods: A survey was used to gather students’ perceptions about changing a health assessment course from face-to-face delivery format to a blended learning format. All second year BSN students who were registered for the course (N = 88) were invited to participate in the survey at the end of the semester.Results: Most students in this study preferred face to face course delivery. Qualitative results were grouped together into themes: 1) Engagement, 2) E-learning tool, and 3) Confidence. Opinions were mixed concerning the e-learning materials that were used. Overall, students felt they were confident in their assessment skills as they prepared to enter the clinical environment.Conclusions: Findings from this study will impact methods of teaching health assessment and other nursing courses in the future.

Nurse practitioners (NPs) require clinical competence in advanced health assessment skills to differentiate between normal, variations of normal, and abnormal patient findings. High-stakes clinical examinations, using live hands-on simulation scenarios and standardized patients (SPs) or other human role players, are accepted teaching and evaluation tools for NP students. Providing objective, valid, and reliable feedback to students during high-stakes clinical examinations is of considerable value for ongoing skill development. The study examined opportunities to improve the quality of student evaluation in simulation testing modes. A purposive sample of 17 video recordings of health students' comprehensive examination of an SP or physical examination teaching associate (PETA) from a nursing graduate level health assessment course was evaluated. Using a standardized rubric, students were scored live and after a comprehensive examination of a SP/PETA and via a secure web-based video platform by the faculty and an independent reviewer. Evaluator group examination score comparisons revealed that distributions of examination scores within evaluator groups were not similar. Median examination scores were significantly different between groups; faculty median examination scores significantly higher than SPs/PETAs. Efficiency of student evaluation may be increased by improving reviewer training, reducing checklist length, and adopting electronic scoring. Development of an exemplary teaching video providing explanation and detail for expected student skill performance will allow reviewers to practice and improve competence in reliable scoring, reduce time and effort of scorers, and increase accuracy of scoring.

Integration of visual thinking strategies to undergraduate health assessment course: A mixed-method feasibility study

We assessed the effectiveness of a simulation-based education program to improve novice nurses' clinical judgment skills. A simulation education program was implemented for 21 novice nurses. Surveys were conducted on program satisfaction, learning, and clinical judgment skills before, immediately after, and two months after the program. Novice nurses were highly satisfied with the simulation education program. The following nine categories were identified as learnings: provide psychological care for patients, conduct sufficient observation, conduct assessment and make judgment based on observational findings, consult and report appropriately to senior nurses, take response action calmly, collect necessary information, acquire knowledge, predict patients' conditions, and make environmental arrangements. The subscale score for theoretical and practical reasoning was significantly higher immediately after and two months after the program than before it. In addition, the subscale for grasping the condition by observation was significantly higher two months after the program than before and immediately after it. The novice nurses learned to sufficiently observe, obtain necessary information, and prospectively assess patients' conditions by taking part in the simulation education program. The subscale score for grasping the condition by observation was significantly higher two months after the program than before and immediately after it. After the simulation program, novicenurses were likely actively practicing nursing; therefore, this program may not be directly responsible for the improvement of these new nurses' clinical judgment. Nevertheless, we found that the completion of the simulation program was correlated with enhanced clinical judgment.

Effects of three-dimensional holograms on the academic performance of nursing students in a health assessment and practice course: A pretest-intervention-posttest study

Introduction: The Objective Structured Clinical Examination (OSCE) is utilized by medical schools to assess students’ competency in clinical skills. Literature has shown that first-year students who were tutored by fourth-year students (MS4s; near-peer) in practice OSCEs reported self-perceived improvement in OSCE skills. There is a lack of research regarding the effectiveness of first-year (MS1) pairs for reciprocal-peer practice OSCEs. This study aims to assess if virtual reciprocal-peer OSCEs provide comparable learning opportunities to virtual near-peer OSCEs.Methods: MS1 students were assigned to work with a near-peer or a reciprocal-peer for one week, and then switched protocols the second week. One student in each reciprocal-peer pair was assigned to act as a standardized patient (SP). Their partner took a history, interpreted physical exam findings, prepared a note, and gave an oral presentation. The pair then switched roles using a second case. The near-peer group followed the same procedure, without the reversal of roles.Results: A total of 135 MS1s participated in the first week and 129 in the second week. Students agreed that working with a near-peer was more valuable than a reciprocal-peer in the following parameters: peer feedback (N=113, 89%), history-taking skills (N=101, 80%), physical exam skills (N=102, 81%), and note-writing skills (N=109, 89%). Pairwise comparison utilizing Wilcoxon signed-rank test indicated participants preferred the choice of a fourth-year student partner over an MS1 partner (Z=1.436, p<0.001).Conclusion: Participants found working with a near-peer increased confidence in their clinical skills and near-peer feedback was more valuable. Although MS1s found that watching and evaluating their peers in a reciprocal-peer exercise was beneficial, students overwhelmingly preferred working with MS4s due to more valuable feedback.

Keck School of Medicine of the University of Southern California.

Assessment Briefs

Objective To explore the application effects of Flipped Classroom based on micro-lecture in the teaching practice of health assessment for nursing undergraduates. Methods Nursing undergraduates in the natural class of grade 2016 in Xi'an Creation College of Yan'an Universitywas randomly selected as the control group. A total of 55 students, with an average age of (20.22±1.13) years, were enrolled in the study. Another nat-ural class was chosen as the observation group, with a total of 54 students, with an average age of (20.37±1.21) years. Results At the end of the course, the students of the two groups received the course examination. The training scores of the control group were (80.13±1.73) and the observation group (90.67±1.53), while total score was (76.36±2.05) and (84.21±1.66) respectively. There were significant differences in the training results and the total score between the two groups (P<0.01). Comparing the results of teacher-student satisfaction test, 89.09% of the teachers were satisfied, 98.15% of the observation group while 94.55% of the students were satisfied, and 98.15% of the observation group. There was significant difference between the two groups (P<0.05, P<0.01). The satisfaction of teachers and students in the observation group was significantly higher than that in the control group, and the questionnaire survey showed that more than 90% of the students in the observation group were satisfied with the teaching effect. Conclusion The Flipped Classroom teaching based on micro-lecture could promote the students' mastery of the theoretical knowledge and practical skills of the health assessment course. Key words: Micro-lecture; Flipped Classroom; Health assessment; Practical teaching

In recent years,Teaching and Research Section of Surgery of Medical College of Xiamen University enhanced the training of interns' clinical practical skills by working out the clinical teaching system, strengthening the training of clinical skills, standardizing the assessment of clinical skills and completing the appropriate means of supporting measures. It was found that enhancing the training and assessment of interns' clinical skills greatly strengthened the interns' learning purpose, guaranteed the quality of clinical practice teaching, and improved the clinical practice abilities of interns at last. Key words: Clinical skills; Interns; Clinical teaching

Background: Mobile technologies allow students the opportunity to enhance learning while away from the traditional classroom setting. However, educational outcome research is lacking in the use of mobile health (m-health) applications in healthcare professional practice development. Objectives: The aim of this pilot study was to discover whether male and female urinary catheter insertion videos delivered via iPods increases students’ skills competency and self-confidence levels. Methods: A prospective replicated study including second year, semester two, undergraduate nursing student participants (NSP) (N=16) was conducted: nine control participants (no video iPods) and seven intervention participants (video iPods). Nursing students attending a mandatory skills class in a learning resource center (LRC) in a School of Nursing located in Northern California were asked to participate in the study. NSP completed a questionnaire regarding previous clinical exposure to urinary catheterizations and levels of competency and confidence in performing the skills prior to taking a required skills course. Directly following the completion of the questionnaire, the participants’ viewed a professional video and a clinical faculty demonstrating the skills. Thereafter the NSP were provided practice time with evaluative feedback. At the completion of the class, the intervention group was provided video iPods and the control group was afforded no technology for a period of two weeks. Following the two weeks, the NSP completed a follow-up questionnaire and a clinical evaluation of their urinary catheterization skills in the LRC. Results: Close to zero variation in urinary catheterization competency scores were determined because all of the NSP scored high in this area and, therefore meaningful comparisons were not determined. The confidence levels for performing the catheterization skills did not significantly change by group, procedure, or time and neither were the two-way interactions between group and time, nor between procedure and time significant. Conclusions: Video iPods may be used to enhance nursing skills. However, the results of this pilot study do not suggest a significant change in competency or confidence levels in performing the clinical skills. Further investigation is necessary because increasing the number of participants, video-viewing time, and monitoring the length of time-on-learning may have a positive influence on future student affect and learning outcomes.

Background: The South African–Cuban Medical Collaboration programme aims to alleviate the critical shortage of practitioners in local South African rural settings. The students who return from Cuban-based facilities in their fourth year experience difficulty, especially in clinical settings, upon joining the MB ChB final-year student programme at the University of KwaZulu-Natal. Attempts to support their skills acquisition for local practice have led to an investigation of their prior clinical skills exposures, the curricular context and exposures in Cuba in which skills had been acquired, and students’ perceptions of their competence in clinical skills.Methods: This descriptive, cross-sectional study explored the clinical experiences of the 2013 cohort of students. Qualitative and quantitative data were collected through questionnaires that explored the curricular approach and setting of clinical skills training in Cuba, the students’ exposure to clinical skills and their perceptions of their competence at performing these skills.Results: Students experienced the Cuban curriculum as didactic and lecture intensive as opposed to the systematic, problem-based curriculum offered in South Africa. Clinical training in Cuba occurs in hospital wards while local students first train in a clinical skills laboratory prior to hospital exposures. The majority of students self-reported a lack of clinical exposure to 35 of an overall 75 core-skills list as identified by the undergraduate UKZN curriculum. In addition, they reported an inability to perform 71 of the 75 (95%) skills independently.Conclusion: This study has highlighted a mismatch between the focus and scope of clinical training offered to students studying in Cuba and those at a South African institution.

Clinical judgment is defined as an understanding and interpretation regarding patient&amp;rsquo;s needs, health problems or concerns (Tanner, 2006). There are four interrelated processes in Tanner&amp;rsquo;s model that consist of noticing, interpreting, responding, and reflecting (Tanner, 2006). Because clinical judgment is extremely complex and encompasses many ways of thinking and types of knowledge, it requires a flexible capability to identify significant features of indeterminate clinical circumstances. Mixed methods study was conducted to describe senior nursing students&amp;rsquo; experience in using high-fidelity simulation to evaluate the development of clinical judgment skills. A convenience sampling of 30 senior nursing students who signed the consent, met the inclusion criteria, and attend the selected school of nursing in the fall of 2020 were used for this study. All participants answered questionnaires regarding the quantitative survey. Participants interviewed face-to-face and video call using Zoom meeting program and recorded using an audio recorder. Both the quantitative and qualitative findings identified that learning through high-fidelity simulation supports the improvement in the participants&amp;rsquo; clinical judgment skills. All participants reported their perceptions and experiences from using high-fidelity simulation develop and support their clinical judgment skills from the beginning through the end of the simulation, especially improving prioritizing data and working as a team with providing effective communication.

Background and Purpose. The determination of whether a student physical therapist (PT) has reached entry-level status for graduation purposes is partially determined by the physical therapist education program's evaluation tool used for rating student performance in the clinical setting. The determination of whether a graduate can practice physical therapy depends on graduate performance on the National Physical Therapy Examination (NPTE). Clinical performance as assessed by the clinical evaluation tool used by members of the Texas Consortium for Physical Therapy Clinical Education (Consortium), the Physical Therapist Manual for the Assessment of Clinical Skills (PT MACS), has not been evaluated with regard to the NPTE. Therefore, the purposes of this study were to assess the following: (1) the relationship between PT MACS section scores on the first and final clinical experiences with section scores on the NPTE among first-time test takers, (2) the relationship between PT MACS aggregate scores on the first and final experiences with the overall score on the NPTE among first-time test takers, and (3) the relationship of final PT grade point averages (GPAs) with NPTE scores among first time test takers. Subjects/Methods. This retrospective study used archived academic, clinical, and NPTE performance data collected by the directors of Clinical Education of 8 Texas PT professional education programs for classes graduating between 2004 and 2007. The total number of graduates was 985. Data were analyzed for relationships using Pearson product moment correlation coefficients. Results. Small, but significant, relationships were found between 2 PT MACS sections and corresponding sections on the NPTE (P Discussion and Conclusion. Although-several small, significant relationships were found between the PT MACS sections and corresponding NPTE sections, PT GPA demonstrated the greatest relationship with success on the NPTE, reinforcing the findings of previous studies. Based on results of the inter-item analysis, the PT MACS demonstrated good internal consistency reliability. Results of this study suggest that an assessment tool that tests all domains of learning cannot predict performance on a cognitive instrument such as the NPTE. Key Words: Physical therapy, Clinical education, Licensure examination. BACKGROUND AND PURPOSE Today's health care system requires that newly graduated physical therapists (PTs) enter the workforce prepared to meet the demands of total patient management. Graduates are expected to perform at a level that meets the standards of safe, effective, and efficient practice. The educational preparation of these graduates includes completion of both intense schedules of didactic classroom experience and complex clinical experiences. The combination of didactic preparation and clinical competence in entry-level skills must be assessed in order to determine the eligibility of a student to graduate from the PT education program. Clinical competence is assessed using evaluative tools specific to clinical skills that define entry-level standards. One such evaluative tool is the Physical Therapist Manual for the Assessment of Clinical Skills (PT MACS),1 developed by the Texas Consortium for Physical Therapy Clinical Education. Successful completion of an accredited professional physical therapist education program allows the graduate to apply for and take the National Physical Therapist Examination (NPTE). Entry-level competence is assessed using multiple-choice items that have been constructed based on a formal survey of physical therapists describing their current job activities and responsibilities. …