Simulation as a Clinical Remediation Strategy for Undergraduate Nursing Students

Development of clinical competency is a critical component of undergraduate nursing education. However, often when students struggle in the clinical setting with skills such as critical thinking and clinical reasoning, evidence-based resources for remediation are lacking. Because simulation is a well-established nursing pedagogy, could it be a valuable tool in clinical remediation for such students? The aim of this integrative review of literature was to examine what was currently known about clinical remediation using simulation and how simulation contributes to clinical competency. A literature search of three data bases was conducted to identify pertinent research using keywords such as simulation, remediation, nursing, education, clinical reasoning, clinical safety, and clinical competence. A total of 1,645 total articles were retrieved from databases, and 76 were retrieved from additional sources. Ultimately, 24 articles met the inclusion criteria and three main themes emerged which were the use of simulation as a nursing pedagogy, simulation use in clinical remediation, and effectiveness of simulation for development of critical thinking and clinical reasoning skills. The current evidence supports simulation as an effective pedagogy for development of clinical competency skills, such as critical thinking and clinical reasoning, but there is a significant deficit of literature on the use of simulation as a tool for clinical remediation of undergraduate nursing students

Perceptions of Preparedness Among New Graduate Nurses: Traditional Curriculum Versus Concept-Based Curriculum

Concept-based curriculum (CBC) is a newer trend in nursing education curriculum aimed at preparing new graduates to enter the workforce as generalist nurses better suited to care for a more medically complex population. Using CBC, students are introduced to concepts in order to build conceptual understandings as they engage in knowledge and skill learning, as opposed to a traditional nursing curriculum that is taught in sections grouped by patient population and medical complexity. At a nursing school housed within a private university in the southeast, the traditional nursing curriculum was replaced with CBC in 2016. To better understand the preparedness of new graduate nurses, students graduating from both traditional curriculum and CBC curricular designs were asked about their perception of preparedness in five specific areas during their first three months of clinical practice. The results of the explanatory mixed-methods survey, which consisted of Likert scale responses and qualitative data, showed no statistically significant difference in perception of preparedness between the two groups. The outcomes of each individual curricula were not dramatically different, but the actionable data reinforces the importance of clinical learning

A Randomized Clinical Trial Assessing Continuous Glucose Monitoring (CGM) Use With Standardized Education With or Without a Family Behavioral Intervention Compared With Fingerstick Blood Glucose Monitoring in Very Young Children With Type 1 Diabetes.

ObjectiveThis study evaluated the effects of continuous glucose monitoring (CGM) combined with family behavioral intervention (CGM+FBI) and CGM alone (Standard-CGM) on glycemic outcomes and parental quality of life compared with blood glucose monitoring (BGM) in children ages 2 to <8 years with type 1 diabetes.Research design and methodsThis was a multicenter (N = 14), 6-month, randomized controlled trial including 143 youth 2 to <8 years of age with type 1 diabetes. Primary analysis included treatment group comparisons of percent time in range (TIR) (70-180 mg/dL) across follow-up visits.ResultsApproximately 90% of participants in the CGM groups used CGM ≥6 days/week at 6 months. Between-group TIR comparisons showed no significant changes: CGM+FBI vs. BGM 3.2% (95% CI -0.5, 7.0), Standard-CGM vs. BGM 0.5% (-2.6 to 3.6), CGM+FBI vs. Standard-CGM 2.7% (-0.6, 6.1). Mean time with glucose level <70 mg/dL was reduced from baseline to follow-up in the CGM+FBI (from 5.2% to 2.6%) and Standard-CGM (5.8% to 2.5%) groups, compared with 5.4% to 5.8% with BGM (CGM+FBI vs. BGM, P < 0.001, and Standard-CGM vs. BGM, P < 0.001). No severe hypoglycemic events occurred in the CGM+FBI group, one occurred in the Standard-CGM group, and five occurred in the BGM group. CGM+FBI parents reported greater reductions in diabetes burden and fear of hypoglycemia compared with Standard-CGM (P = 0.008 and 0.04) and BGM (P = 0.02 and 0.002).ConclusionsCGM used consistently over a 6-month period in young children with type 1 diabetes did not improve TIR but did significantly reduce time in hypoglycemia. The FBI benefited parental well-being