The Effect of Simulation Techniques on Nursing's Student Knowledge and Practice

The purpose of this study was to compare student knowledge and confidence, related to the assessment and management of oral feeding readiness in medically complex infants, following a written case study versus a high-fidelity human patient simulation (HPS). A sequential, two-phase, embedded mixed methods design was conducted. Participants were two sequential cohorts of second-year speech-language pathology graduate students enrolled in a didactic Pediatric Dysphagia course. At the end of the course, students completed the same case scenario presented as a written case study (control group; N = 28) or as an HPS (experimental group; N = 24). Pre- and post-knowledge assessment results and self-assessments of confidence conducted at three time points were compared. All students made gains in knowledge, regardless of intervention (written case study or HPS). Despite different baselines, the percent change in knowledge was significant with the control group improving 33% and the experimental group improving 76% from baseline. Students in the experimental group demonstrated significantly greater gains in confidence with skills enhanced by the hands-on, immersive experience of HPS. Qualitative analysis further identified factors contributing to increased confidence with all students reporting that experience significantly contributes to their confidence in their ability to treat patients. While knowledge outcomes were similar between the groups, the confidence that the experimental group gained through the hands-on experiences of HPS fosters student development as confident professionals in assessing feeding readiness and managing medically complex infants. Results support integration of simulation into the graduate curriculum to support student learning. https://doi.org/10.23641/asha.19233504.

The community still perceives stunting as a negative stigma. It potentially risks the mental health of both the child and the mother. Mother resilience is crucial to deal with biopsychosocial stressors because of stunting. This research analyzes the effects of the REKIS (Resiliensi Komunitas Ibu Dengan Anak Stunting) innovation on knowledge, attitudes, behavior, and resilience regarding stunting in mothers with stunted children. This research was a quantitative study with a quasi-experimental design. The population was mothers with children diagnosed with stunting in the Gilingan Surakarta Health Center. There were 60 respondents with the total sampling technique, 30 in the control and 30 in the intervention groups. Pre-test and post-test data were collected using knowledge, attitude, behavior, and maternal resilience questionnaires. Data analysis used the Wilcoxon Rank Sum Test to test the difference in mean scores between the control and intervention groups. In addition, the Wilcoxon Signed Rank Test analyzes the difference in mean scores between the pre-and post-test. The results showed that all respondents had similar demographic characteristics (age, occupation, and education). Both groups had significant differences in pre and post-test mean scores on maternal knowledge, attitudes, behavior, and resilience (p<0.05). Significant differences were in the overall pre- and post-test mean scores on maternal knowledge, attitudes, and resilience (p<0.05). However, there was no significant difference in the pre-and post-test on maternal behavior. In conclusion, The REKIS innovation can increase the resilience of mothers with stunted children. It improves maternal knowledge and attitudes regarding stunting.

Aim of the studyReduced cognitive function is one of the problems caused by aging, which leads to reduced performance of the elderly. This is a study to evaluate the effects of transcranial Direct Current Stimulation (tDCS) on working memory in the elderly with normal cognitive impairments.Subject or material and methodsIn this clinical trial, 45 elderlies participating in a self-care educational course in Zahedan, Iran, in 2016, were assigned into three groups of F3, F4, and sham stimulation. From all the participants, 2-back, forward and backward digit span, and Mini Mental State Examination (MMSE) tests were taken.ResultsThe three groups showed no significant difference in the mean score of 2-back test at different time points.The three groups showed no significant difference in mean score of backward digit span test at different time points. The mean score of backward digit span test was significantly higher in the F3 group after the intervention.DiscussionDiscussion: The results of this study indicate that the score changes in the 2-back and the forward digit span tests were significant only in the F3 group. Also, the F4 group showed a significant difference at all the time points after the intervention, compared to before the intervention, but this change was less than that in the F3 group.ConclusionsThis study shows that tDCS can improve working memory performance via F3method. The tDCS can cause working memory improvement and naming facilitation by stimulation.

Weight loss through diet and physical activity (PA) is recommended for osteoarthritis (OA) management. The Group Lifestyle Balance Program (GLBP) is an evidence-based, behavior change program designed to promote weight loss in individuals with prediabetes or metabolic syndrome through PA and healthy eating. To date, the GLBP has not been evaluated on those with OA specifically. PURPOSE: To examine the effects of the GLBP on measures of body composition and physical function (PF) in overweight and obese (BMI > 27) individuals with OA (N=15). METHODS: This study used a single-group, quasi-experimental design with repeated measures. All participants received the GLBP and outcome variables were obtained at baseline, 3, 6, and 12 months. Lean mass (LM), fat mass (FM), and body fat percentage (BF%) were obtained via bioelectric impedance. Total weight (WT), Body Mass Index (BMI), and waist circumference (WC) were also obtained. Measures of PF included the Short Physical Performance Battery (SPPB), grip strength (GS), 30-second chair stand test (CS30), and the Long Distance Corridor Walk (LDCW). The SPPB includes the time to complete 5 repeated chair stands (5CS), balance testing (side-by-side stand, semi-tandem stand, and tandem stand), and an 8-foot walk. The Friedman test was used to examine differences in SPPB scores and one-way repeated measures analysis of variance was used to examine mean differences in scores for all other outcomes. RESULTS: Participants had a mean age of 70.20 ± 3.95 years and were primarily white (93%), female (80%) and college educated (67%). There was a significant effect of time for WT (F(1.448, 20.275) = 6.591, p = .011), BMI (F(1.529, 21.408) = 6.474, p = .010), and WC (F(2.898, 40.566) = 4.826, p = .006). Bonferroni post hoc analyses indicated WT (p = .001), BMI (p = .002), and WC (p = .022) significantly improved from baseline to 3 months. There was also a significant effect of time for 5CS (F(3, 42) = 3.190, p = .033) and CS30 (F(3, 42) = 6.956, p = .001). Post hoc analyses indicated CS30 scores significantly improved from baseline to 3 months and from baseline to 12 months (p = .007). There were no significant differences observed for any other outcome measure (p > 0.05). CONCLUSION: The GLBP may be effective at improving weight and physical function measures in people with OA, but more research is warranted.

State University of New York Upstate Medical University College of Medicine

Is Nephrology Fellowship Training on the Right Track?

Background: Social workers and nurses are critical to the amelioration of substance misuse, making their training in evidence-based practices such as screening, brief intervention, and referral to treatment (SBIRT) particularly pertinent. Online patient simulation (OPS) is one training modality that allows students to develop and practice SBIRT skills that they might not obtain through didactic instruction, but it can be time and resource intensive. The aim of this study was to test the effect of OPS, over and above in-person training, on students’ SBIRT attitudes, knowledge, and perceived skills. Methods: Social work and nursing students (N = 308) were recruited from a college in the northeastern United States. Students in the study were randomly assigned to either training as usual (TAU), which included pre-coursework videos, in-person didactic instruction, and role-plays, or the experimental condition (EXP), consisting of TAU plus access to self-paced SBIRT skills practice using OPS by SIMmersion. The SBIRT Attitudes, Self-perception of Skills, and Knowledge (AKS) survey was delivered at baseline, immediately post-training, and at 30-day follow-up (post-30) to assess overall changes as well as changes in the specific domains of SBIRT confidence, importance, and attitudes. Paired t tests were conducted to determine differences in mean scores between time points for the entire sample. Independent-samples t tests were conducted to test differences between EXP and TAU on AKS scores at each time point and to test differences between high and low OPS use. Results: Results showed a significant difference from pre- to post-training on composite AKS scores. There were no significant differences between TAU and EXP in composite scores or by AKS domain, and no differences within the EXP group for those with high and low use. Conclusions: Participants in EXP did not have significantly increased AKS scores, demonstrating that access to OPS did not produce an additive effect on the acquisition of self-perceived SBIRT knowledge, attitudes, and skills.

To estimate the dynamic causal effects of depressive symptoms on osteoarthritis (OA) knee pain. Marginal structural models were used to examine dynamic associations between depressive symptoms and pain over 48 months among older adults (n = 2,287) with radiographic knee OA (Kellgren/Lawrence grade 2 or 3) in the Osteoarthritis Initiative. Depressive symptoms at each annual visit were assessed (threshold ≥16) using the Center for Epidemiologic Studies Depression Scale. OA knee pain was measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale, rescaled to range from 0 to 100. Depressive symptoms at each visit were generally not associated with greater OA knee pain at subsequent time points. Causal mean differences in WOMAC pain score comparing depressed to nondepressed patients ranged from 1.78 (95% confidence interval [95% CI] -0.73, 4.30) to 2.58 (95% CI 0.23, 4.93) within the first and fourth years, and the depressive symptoms by time interaction were not statistically significant (P = 0.94). However, there was a statistically significant dose-response relationship between the persistence of depressive symptoms and OA knee pain severity (P = 0.002). Causal mean differences in WOMAC pain score comparing depressed to nondepressed patients were 0.89 (95% CI -0.17, 1.96) for 1 visit with depressive symptoms, 2.35 (95% CI 0.64, 4.06) for 2 visits with depressive symptoms, and 3.57 (95% CI 0.43, 6.71) for 3 visits with depressive symptoms. The causal effect of depressive symptoms on OA knee pain does not change over time, but pain severity significantly increases with the persistence of depressed mood.

University of Florida College of Medicine

We examined whether the differences in mean scores among gender and racial/ethnic groups on science performance assessments are comparable to the differences that are typically found among these groups on traditional multiple-choice tests. To do this, several hands-on science performance assessments and other measures were administered to over 2,000 students in grades five, six, and nine as part of a field test of California’s statewide testing program. Girls tended to have higher overall mean scores than boys on the performance measures, but boys tended to score higher than girls on certain types of questions within a performance task. In contrast, differences in mean scores among racial/ethnic groups on one type of test (or question) were comparable to the differences among these groups on the other measures studied. Overall, the results suggest that the type of science test used is unlikely to have much effect on gender or racial/ethnic differences in scores.

This study examined the effectiveness of a group spiritual care program on leukemia patients' hope and anxiety. This randomized controlled trial involved 94 leukemia patients hospitalized in the two oncology departments of Shahid Beheshti Hospital, Hamadan, Iran. This study was carried out from November 2022 to April 2023. The participants were selected based on the study inclusion criteria using the convenience sampling method then they were randomized to either the experimental (N = 46) or the control group (N = 48). The participants completed the written informed consent form, the demographic information form, and Beck's anxiety and Snyder's hope questionnaires. The spiritual care program was provided in six sessions (one 45-60min per week), including a spiritual needs assessment, religious care, spiritual care, psychological-spiritual care, supportive-spiritual care, and evaluation. The participants then completed Beck's anxiety and Snyder's hope questionnaires immediately, one and two months after the intervention. At baseline, there was no significant between-group difference in leukemia patients' mean scores of hope (P = 0.313) and anxiety (P = 0.141); however, immediately, one and two months after the intervention, a significant between-group difference in the mean scores of hope and anxiety was observed (P < 0.001). Also, from baseline to two months after the intervention, a significant decrease and increase in anxiety and hope mean scores, respectively, were observed in the experimental group (within-group difference) (P < 0.001). However, in the control group, from baseline to two months after the intervention, a significant increase and decrease in mean scores of anxiety and hope, respectively, were observed (within-group difference) (P < 0.001). As a result, it is recommended thatnurses should consider providing spiritual care to leukemia patients as a part of holistic care.

Objective: To evaluate the effectiveness of an environmental safety measures educational program on nurses’ knowledge and practices in hemodialysis units. Study Design: A quantitative, quasi-experimental studyPlace and Duration of Study: This study was conducted at the Adult Health Nursing, University of Babylon, College of Nursing, Iraq from 8th January 2024 to 18th June 2025. Methods: A quantitative, quasi-experimental study was conducted at Adult Health Nursing, University of Babylon, College of Nursing, Iraq. A total of 100 nurses from hemodialysis units was selected and divided equally into control and interventional groups. Results: Unsatisfied levels of knowledge and practices in both groups during the pre-test. However, the interventional group showed significant improvement in knowledge and practices in both post-tests. Conclusion: The educational program proved its effectiveness to improve nurses’ knowledge and practices toward environmental safety measures in hemodialysis units. Ongoing training and mentorship at the unit levels were recommended.

The aim of this study is to investigate the comparison between the use of Directed Reading Activity (DRA) and Directed Reading Thinking Activity (DR-TA) methods on students’ reading comprehension. The research design was a quasi-experimental study by comparing two strategies of two experimental groups and one control group pretest - posttest design. It involved 94 participants that consisted of two experimental groups and one control group of the students of State Islamic Senior High School (MAN) Pekanbaru of Riau province. Three research questions and nine hypotheses were posed in this study in order to find out the significant difference between DRA and DR-TA methods on students’ reading comprehension. Pretest and posttest were administered in this study and independent sample t-test and paired sample t-test were used to analyze the data. The research finding showed that there was no significant difference of post-test mean scores between the experimental class 1 using DRA method and the experimental class 2 using DR-TA method on students’ reading comprehension. DRA method contributed the effect of improvement on students’ reading comprehension 76% while DR-TA contributed 72%, and on the other hand the control class contributed 49%. At last, it can make an inference that both DRA and DR-TA methods can be applied in teaching reading comprehension especially at State Islamic Senior High School Pekanbaru of Riau province, and generally in Senior high school level in Indonesia.

Introduction: Workplace accidents have been a persistent problem in Malaysia’s manufacturing industry, particularly for small and medium-sized enterprises (SMEs). Employee behavior has been identified as a significant contributing factor to these accidents, and research has suggested that improving safety knowledge and attitudes can enhance safety behavior. Despite this, there have been no empirical intervention studies in Malaysia to investigate the effectiveness of safety intervention programs aimed at improving SME worker safety behavior. Therefore, this study aimed to assess the efficacy of the Occupational Hazard Self-Evaluation Module (OHSEM) intervention in enhancing safety knowledge, attitudes, and behavior (KAB) among SME workers in the manufacturing sector. Methods: A quasi-experimental design with control group was utilized to evaluate the effectiveness of the OHSEM intervention. The intervention was implemented over a 12-week period on production workers in the experimental group, while the control group received no intervention. A self-administered questionnaire was distributed to 88 production workers in both groups before and after the intervention to measure the improvement of safety KAB. Descriptive analysis and an independent t-test were used to analyse the data. Results: The post-test results showed that safety KAB for the control group was moderate (mean = 2.11), while the mean score in the experimental group was high (m=4.17). Furthermore, the t-test result revealed a significant difference in safety KAB mean scores between the experimental and control groups. Conclusion: This study provides empirical evidence on the effectiveness of the OHSEM intervention in enhancing safety KAB in SMEs in the Malaysian SME (manufacturing) sector.

Hypnobirthing can be used to deal with and go through pregnancy and childbirth preparation in a natural, relaxing, and comfortable way and to be useful in helping to supply oxygen to the baby during childbirth so that the babies born have better Apgar score. This study aimed to determine the effect of hypnobirthing on the Apgar score on normal primiparous parturient in Cirebon. This was a quasi experimental study using a post -test only with control group design. Samples were taken with consecutive sampling technique which amounted to 60 people consisting of 30 people in the intervention group and 30 people in the control group. The effect of hypnobirthing on the Apgar score was analyzed using unpaired Mann-withney. The results showed that there were significant differences in the first Apgar mean score (the first minute) among respondents who were given hypnobirthing with those not given hypnobirthing (p = 0.000) and there were no significant differences in the second Apgar mean score (5 minutes later) among respondents who were given hypnobirthing with those not given hypnobirthing (p = 0.792). The author suggests that midwives be able to apply hypnobirthing to pregnant women in their third trimester of pregnancy in order to reduce the occurrence of asphyxia in newborns