Scoring methods in script concordance tests : an exploratory psychometric study

BACKGROUND:Despite the increasingly popular role of script concordance test (SCT) scoring methods in the evaluation of clinical reasoning, studies examining these methods in nursing are relatively scarce. This study explored the psychometric properties of five SCT scoring methods. METHOD:An SCT was administered to 12 experts and 43 learners. Scores were calculated using five methods and descriptive statistics. Differences in scores were assessed with the Mann-Whitney U test, and Spearman correlation coefficients were calculated for the different methods. RESULTS:The median scores of both experts and learners differed substantially according to the scoring method used. Learners' scores were statistically different from experts' scores (p < .01) for each method. Spearman coefficients (range, 0.44 to 0.95) were positive for the different methods. CONCLUSION:Further research is needed to refine the influence of SCT scoring methods for use in certifying assessment of clinical reasoning in nursing. [J Nurs Educ. 2023;62(10):549–555.

Effect of simulation-based education on the preparedness of healthcare professionals for the COVID-19 pandemic : a systematic review and meta-analysis

Healthcare organizations around the world have embraced simulation to prepare healthcare professionals to the COVID-19 pandemic. However, this pandemic implies additional educational challenges in rapidly designing simulation activities, while remaining compliant with health and safety measures to prevent the spread of the virus. The effect of simulation-based education in this context remains to be evaluated. Objective: The purpose of this systematic review was to describe the features and evaluate the effect of simulation activities on the preparedness of healthcare professionals and students to safely deliver care during the COVID-19 pandemic. Methods: Databases were searched up to November 2020 using index terms and keywords related to healthcare professions, simulation, and COVID-19. All learning outcomes were considered according to the Kirkpatrick model adapted by Barr et al. (2020). Reference selection, data extraction, and quality assessment were performed in pairs and independently. Results were synthesized using meta-analytical methods and narrative summaries. Results: 22 studies were included, 21 of which were single-group studies and 14 of those included pretest/posttest assessments. Simulation activities were mostly implemented in clinical settings using manikins for training on the use of personal protective equipment, hand hygiene, identification and management of COVID-19 patients, and work processes and patient flow. Large improvements in learning outcomes after simulation activities were reported in all studies. Discussion and conclusion: Results should be interpreted cautiously due to significant threats to the internal validity of studies and the absence of control groups. However, these findings are coherent with the overall evidence on the positive effect of simulation-based education. Future studies should include control groups if feasible.Les organisations de santé ont adopté la simulation pour préparer les professionnels à la pandémie de COVID-19. La conception en accéléré de simulations tout en respectant les mesures de prévention de la propagation du virus amène des défis. Dans ces conditions, l’efficacité de la simulation reste à être évaluée. Objectif : Décrire les caractéristiques et évaluer l’effet de simulations sur la préparation des professionnels de la santé et des étudiants pour fournir des soins sécuritaires pendant cette pandémie. Méthodes : Les bases de données ont été consultées jusqu’en novembre 2020 en utilisant des descripteurs et des mots-clés relatifs aux professions de la santé, à la simulation et à la COVID-19. Tous les résultats d’apprentissage ont été considérés. La sélection des articles, l’extraction des données et l’évaluation de la qualité ont été effectuées par paires. Les résultats ont été synthétisés par des méthodes méta-analytiques et des résumés narratifs. Résultats : 22 études ont été incluses ; 21 à groupe unique et, parmi ces 21, 14 évaluations pré-posttest. Les simulations ont principalement été déployées en milieux cliniques avec des mannequins pour la formation à l’utilisation d’équipements de protection individuelle, au lavage de mains, à l’identification et la prise en charge de patients atteints de la COVID-19 et à l’implantation de procédés organisationnels. Toutes les études rapportent des apprentissages importants après les simulations. Discussion et conclusion : Malgré les limites de validité interne et l’absence de groupes de contrôle, ces résultats sont cohérents avec l’état des connaissances sur les effets positifs de la simulation. De futures études devraient inclure des groupes de contrôle si possible

Health science communication strategies used by researchers with the public in the digital and social media ecosystem : a systematic scoping review protocol

Introduction The optimisation of health science communication (HSC) between researchers and the public is crucial. In the last decade, the rise of the digital and social media ecosystem allowed for the disintermediation of HSC. Disintermediation refers to the public’s direct access to information from researchers about health science-related topics through the digital and social media ecosystem, a process that would otherwise require a human mediator, such as a journalist. Therefore, the primary aim of this scoping review is to describe the nature and the extent of the literature regarding HSC strategies involving disintermediation used by researchers with the public in the digital and social media ecosystem. The secondary aim is to describe the HSC strategies used by researchers, and the communication channels associated with these strategies. Methods and analysis We will conduct a scoping review based on the Joanna Briggs Institute’s methodology and perform a systematic search of six bibliographical databases (CINAHL, EMBASE, IBSS, PubMed, Sociological Abstracts and Web of Science), four trial registries and relevant sources of grey literature. Relevant journals and reference lists of included records will be hand-searched. Data will be managed using the EndNote software and the Rayyan web application. Two review team members will perform independently the screening process as well as the full-text assessment of included records. Descriptive data will be synthesised in a tabular format. Data regarding the nature and the extent of the literature, the HSC strategies and the associated communication channels will be presented narratively. Ethics and dissemination This review does not require institutional review board approval as we will use only collected and published data. Results will allow the mapping of the literature about HSC between researchers and the public in the digital and social media ecosystem, and will be published in a peer-reviewed journal

Assessing and addressing sexual concerns in individuals diagnosed with coronary artery disease

Background/Aims Sexual concerns are frequently reported in people diagnosed with coronary artery disease. These concerns may be related to disorders in one or more phases of the sexual response cycle (i.e. desire, arousal and orgasm). Sexual concerns have been linked to anxiety, depressive symptoms and feelings of despair. As such, nurses should have an understanding of the aetiology of sexual concerns in this population and use appropriate assessment and support strategies. Methods This clinical article discusses several key aspects of evidence-based practice to assess and address sexual concerns in people diagnosed with coronary artery disease. Findings Early assessment of biological, psychological and pharmacological causes of sexual concerns should be carried out. Sexual counselling may be offered to meet specific information needs. Adding pharmacological agents and referring to a sex therapist can be considered to effectively address the sexual concerns of people within this population. Conclusions Approaches to sexual assessment, main information needs of patients with coronary artery disease regarding their sexual health, and support strategies are presented

Transfer of clinical decision-making-related learning outcomes following simulation-based education in nursing and medicine : a scoping review

Purpose : Simulation is often depicted as an effective tool for clinical decision-making education. Yet, there is a paucity of data regarding transfer of learning related to clinical decision-making following simulation-based education. The authors conducted a scoping review to map the literature regarding transfer of clinical decision-making learning outcomes following simulation-based education in nursing or medicine. Method Based on the Joanna Briggs Institute methodology, the authors searched 5 databases (CINAHL, ERIC, MEDLINE, PsycINFO, and Web of Science) in May 2020 for quantitative studies in which the clinical decision-making performance of nursing and medical students or professionals was assessed following simulation-based education. Data items were extracted and coded. Codes were organized and hierarchized into patterns to describe conceptualizations and conditions of transfer, as well as learning outcomes related to clinical decision-making and assessment methods. Results : From 5,969 unique records, 61 articles were included. Only 7 studies (11%) assessed transfer to clinical practice. In the remaining 54 studies (89%), transfer was exclusively assessed in simulations that often included one or more variations in simulation features (e.g., scenarios, modalities, duration, and learner roles; 50, 82%). Learners’ clinical decision-making, including data gathering, cue recognition, diagnoses, and/or management of clinical issues, was assessed using checklists, rubrics, and/or nontechnical skills ratings. Conclusions : Research on simulation-based education has focused disproportionately on the transfer of learning from one simulation to another, and little evidence exists regarding transfer to clinical practice. The heterogeneity in conditions of transfer observed represents a substantial challenge in evaluating the effect of simulation-based education. The findings suggest that 3 dimensions of clinical decision-making performance are amenable to assessment—execution, accuracy, and speed—and that simulation-based learning related to clinical decision-making is predominantly understood as a gain in generalizable skills that can be easily applied from one context to another

Effect of simulation on cognitive load in health care professionals and students : protocol for a systematic review and meta-analysis

Objective: The objective of this review is to assess the effect of simulation activities and their design features on cognitive load in health care professionals and students. Introduction: Simulation activities are now widely implemented in health care professionals’ education. However, the mechanisms by which simulations and their design features lead to health care professionals’ and students’ learning remains unclear. Still, because of their high interactivity and complexity, simulation activities have the potential to impact the cognitive load of learners. Synthesizing evidence regarding this phenomenon could help simulation educators identify the design features that affect learners’ cognitive load, and explain why some simulation activities are more effective than others. Inclusion criteria: This review will consider experimental and quasi-experimental studies in which the effect of a simulation activity on cognitive load in health care professionals or students from any discipline or level of practice is evaluated. All academic and health settings will be included. Methods: Following the guidelines of the JBI methods for systematic reviews of effectiveness, CINAHL, Embase, ERIC, MEDLINE, PsycINFO, and Web of Science will be searched for studies published in English or French, without a date limit. Retrieved studies will be independently screened for inclusion, then critically appraised for methodological quality by two reviewers using standardized JBI tools. Data extraction will be done independently using adapted tools from JBI. Where possible, data will be pooled using meta-analytical methods

Improving the recognition and management of hemorrhage : a scoping review of nursing and midwifery education

Background : Hemorrhage is a frequent complication that nurses and midwives must recognize and manage to avoid life-threatening consequences for patients. There is currently no synthesis of evidence on educational interventions in nursing and midwifery regarding hemorrhage, thus limiting the definition of best practices. Objective : To map the literature on nursing and midwifery education regarding the recognition and management of hemorrhage. Design : Scoping review based on the Joanna Briggs Institute guidelines. Data sources : Quantitative studies evaluating the effect of educational interventions with students, nurses, or midwives published in English or French, with no time limit. Review methods : Study selection, data extraction, and quality assessment were conducted by two independent reviewers. We characterized educational interventions based on the Guideline for Reporting Evidence-Based Practice Educational Interventions and Teaching. We categorized learning outcomes using the New World Kirkpatrick Model. Methodological quality appraisal was performed with tools from the Joanna Briggs Institute. Findings were synthesized using descriptive statistics and graphical methods. Result : Most of the 38 studies used a single-group design (n = 26, 68%) and were conducted with professionals (n = 28, 74%) in hospital settings (n = 20, 53%). Most were of low (n = 14; 37%) or moderate (n = 18, 47%) methodological quality. Most interventions focused on postpartum hemorrhage (n = 34, 89%) and combined two or more teaching strategies (n = 25, 66%), often pairing an informational segment (e.g., lecture, readings) with a practical session (e.g., workshop, simulation). Learning outcomes related to the management (n = 27; 71%) and recognition of hemorrhage (n = 19, 50%), as well as results for patients and organizations (n = 9, 24%). Conclusion : Considerable heterogeneity in interventions and learning outcomes precluded conducting a systematic review of effectiveness. High-quality, controlled studies are needed, particularly in surgery and trauma. Reflection on the contribution of nurses and midwives to the detection, monitoring, and management of hemorrhage could enrich the content and expected outcomes of hemorrhage education

Methodological reporting in feasibility studies : a descriptive review of the nursing intervention research literature

Background In reaction to weaknesses in feasibility studies reporting, the Consolidated Standards of Reporting Trials (CONSORT) statement published an extension for feasibility studies in 2016. Aim The aim of this study was to systematically review and appraise the reporting of feasibility studies in the nursing intervention research literature based on the CONSORT statement extension for feasibility studies. Method Papers published prior to January 2018 that described feasibility studies of nursing interventions were retrieved. Components of feasibility studies were coded, and code frequencies were analysed. Results The review included 186 papers. Although most papers (n = 142, 76.3%) included the label ‘pilot’ or ‘feasibility’ in their title, reporting for other components generally did not adhere to one or several CONSORT recommendations. Most papers reported objectives (n = 116, 62.4%), designs (n = 95, 51%), or rationales for sample size (n = 165, 88.7%) that were incongruent with the purpose of feasibility studies. Discussion This review results in two main implications for nursing research. First, we noted that the reporting of feasibility studies is weak. While all papers described feasibility studies, almost half focused exclusively on testing the effectiveness of an intervention. Second, we identified rationales for sample size along with key references that could offer guidance in reporting feasibility studies while being coherent with the CONSORT recommendations

The development of the MENTOR_D nursing intervention : supporting family involvement in delirium management

Background Although families are increasingly seen as allies to improve delirium management and reduce its consequences, their involvement in the postcardiac surgery setting is challenging considering patients' critical state and short hospital stay. To our knowledge, no theory-based nursing intervention exists that optimally supports the involvement of families in delirium management in the context of postcardiac surgery. Objectives We aimed to develop MENTOR_D, a nursing intervention to support the involvement of families in delirium management. Methods MENTOR_D was developed based on Sidani and Braden's (2011) intervention development framework. Narrative literature reviews paired with the clinical experience of an expert committee were used to inform these three steps: (1) develop an understanding of the problem under study; (2) define the objectives of the intervention and identify a theoretical framework for highlighting strategies to be used in the intervention; and (3) operationalize the intervention and identify its anticipated outcomes. Results As a result of the three steps, the MENTOR_D nursing intervention relies on a caring–mentoring relationship between a nurse and the family. The aim of MENTOR_D is to increase the presence of the family at their relative's bedside and their involvement in delirium management. MENTOR_D's content is delivered over three phases that are organised around the visits of the family at the patient's bedside. During these phases, families used their knowledge of the patient to tailor the delirium management actions. These actions include orientation and reminiscence and were aimed at diminishing anxiety and increasing sense of self-efficacy in families and diminishing delirium severity and improving recovery in patients. Conclusions A deep understanding of the underlying mechanisms of an intervention is key in its success to reach the targeted goals of effectiveness in practice. This understanding can be achieved through the careful development of a theory of the intervention before the operationalisation of its components and its testing. The proposed paper presents the theory of the MENTOR_D intervention, that is, its conceptualization and proposed mechanisms of action. Implications for practice As delirium continues to be a major complication, this intervention is a promising solution to increase families' involvement in delirium management and highlights the support that nurses can offer to facilitate this involvement. With its use in future studies and practice, it can be further refined

Effectiveness of adaptive e-Learning environments on knowledge, competence, and behavior in health professionals and students : protocol for a systematic review and meta-analysis

Background: Adaptive e-learning environments (AEEs) can provide tailored instruction by adapting content, navigation, presentation, multimedia, and tools to each user’s navigation behavior, individual objectives, knowledge, and preferences. AEEs can have various levels of complexity, ranging from systems using a simple adaptive functionality to systems using artificial intelligence. While AEEs are promising, their effectiveness for the education of health professionals and health professions students remains unclear. Objective: The purpose of this systematic review is to assess the effectiveness of AEEs in improving knowledge, competence, and behavior in health professionals and students. Methods: We will follow the Cochrane Collaboration and the Effective Practice and Organisation of Care (EPOC) Group guidelines on systematic review methodology. A systematic search of the literature will be conducted in 6 bibliographic databases (CINAHL, EMBASE, ERIC, PsycINFO, PubMed, and Web of Science) using the concepts “adaptive e-learning environments,” “health professionals/students,” and “effects on knowledge/skills/behavior.” We will include randomized and nonrandomized controlled trials, in addition to controlled before-after, interrupted time series, and repeated measures studies published between 2005 and 2017. The title and the abstract of each study followed by a full-text assessment of potentially eligible studies will be independently screened by 2 review authors. Using the EPOC extraction form, 1 review author will conduct data extraction and a second author will validate the data extraction. The methodological quality of included studies will be independently assessed by 2 review authors using the EPOC risk of bias criteria. Included studies will be synthesized by a descriptive analysis. Where appropriate, data will be pooled using meta-analysis by applying the RevMan software version 5.1, considering the heterogeneity of studies. Results: The review is in progress. We plan to submit the results in the beginning of 2018. Conclusions: Providing tailored instruction to health professionals and students is a priority in order to optimize learning and clinical outcomes. This systematic review will synthesize the best available evidence regarding the effectiveness of AEEs in improving knowledge, competence, and behavior in health professionals and students. It will provide guidance to policy makers, hospital managers, and researchers in terms of AEE development, implementation, and evaluation in health care