Postgraduate Students’ Experience of Using a Learning Management System to Support Their Learning: A Qualitative Descriptive Study

Introduction Educational institutions worldwide have implemented learning management systems (LMSs) to centralise and manage learning resources, educational services, learning activities and institutional information. LMS has mainly been used by teachers as storage and transfer of course material. To effectively utilise digital technologies in education, there is a need for more knowledge of student experiences with digital technology, such as LMSs and especially regarding how LMSs can contribute to student engagement and learning. Objective This study aimed to gain knowledge about postgraduate nursing students’ experiences with the use of LMS in a subject in an advanced practice nursing master's programme. Methods A qualitative method with a descriptive design was employed. Two focus group interviews were performed with eight postgraduate nursing students from an advanced practice nursing programme at a university college in Norway. Data were analysed using qualitative content analysis. Results Three themes emerged from the data material: 1) A course structure that supports learning; 2) LMS tools facilitate preparation, repetition and flexibility; and 3) own responsibility for using the LMS for preparation before on-campus activities. Conclusion The course structure within the LMS seemed to be important to enhance postgraduate students’ ability to prepare before on-campus activities. Implementation and use of LMS tools can facilitate preparation, repetition and flexibility, especially when postgraduate students study difficult topics. Postgraduate students seem to have different views regarding their own responsibility for using the LMS to prepare before on-campus activities.publishedVersio

Technology-Supported Guidance Models Stimulating the Development of Critical Thinking in Clinical Practice: Mixed Methods Systematic Review

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The association between infant salivary cortisol and parental presence in the neonatal intensive care unit during and after COVID-19 visitation restrictions: A cross-sectional study

Objectives: Parent-infant interaction in the neonatal intensive care unit (NICU) promotes health and reduces infant stress. During the COVID-19 pandemic, however, NICUs restricted parent-infant interaction to reduce viral transmission. This study examined the potential relationship between pandemic visitation restrictions, parental presence and infant stress as measured by salivary cortisol. Methods: A two-NICU cross-sectional study of infants with gestational age (GA) 23–41 weeks, both during (n = 34) and after (n = 38) visitation restrictions. We analysed parental presence with and without visitation restrictions. The relationship between infant salivary cortisol and self-reported parental NICU presence in hours per day was analysed using Pearson's r. A linear regression analysis included potential confounders, including GA and proxies for infant morbidity. The unstandardised B coefficient described the expected change in logtransformed salivary cortisol per unit change in each predictor variable. Results: Included infants had a mean (standard deviation) GA of 31(5) weeks. Both maternal and paternal NICU presence was lower with versus without visitation restrictions (both p ≤0.05). Log-transformed infant salivary cortisol correlated negatively with hours of parental presence (r = − 0.40, p = .01). In the linear regression, GA (B = -0.03, p = .02) and central venous lines (B = 0.23, p = .04) contributed to the variance in salivary cortisol in addition to parental presence (B = -0.04 p = .04). Conclusion: COVID-19–related visitation restrictions reduced NICU parent-infant interaction and may have increased infant stress. Low GA and central venous lines were associated with higher salivary cortisol. The interaction between immaturity, morbidity and parental presence was not within the scope of this study and merits further investigation

Optimal Conventional Mechanical Ventilation in Full-Term Newborns

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Oxygen and ventilator treatment: perspectives on interprofessional collaboration in a neonatal intensive care unit

Abstract Background: The aim of this study was to explore perspectives on the collaboration between physicians and nurses managing oxygen and ventilator treatment of sick infants in a Norwegian neonatal intensive care unit. Methods and Findings: We performed a qualitative study using focus groups. We found that interprofessional collaboration concerning newborns on mechanical ventilation lacked co-ordination and was unsystematic. This led to inadequate utilization of the medical and clinical competency of the nursing staff. Nurses and physicians approached decision-making differently, and there was limited flexibility and dynamics in the allocation of responsibility between the professionals. Conclusion: Findings from this study indicate that nurses and physicians have the opportunity to improve the quality of care by developing high-quality communication, formulating plans together, and improving the co-ordination of the ventilator treatment. Further studies should develop and test interventions based on the professionals’ perception of relevant co-ordination strategies to improve mechanical ventilation and oxygen treatment to premature and sick newborn infants. Keywords: Quality of care; Collaboration; Oxygen treatment; Mechanical ventilation; Neonatal intensive care uni

Optimal conventional mechanical ventilation in full-term newborns: A systematic review

Background: Most studies examining the best mechanical ventilation strategies in newborn infants have been performed in premature infants with respiratory distress syndrome. Purpose: To identify and synthesize the evidence regarding optimal mechanical ventilation strategies in full-term newborns. Methods: Systematic review carried out according to the methods described in the PRISMA statement. Search Strategy: Searches in MEDLINE, EMBASE, CINAHL, and the Cochrane Library in March 2017, with an updated search and hand searches of reference lists of relevant articles in August 2017. Study Selection: Studies were included if they were published between 1996 and 2017, involved newborns with gestational age of 37 to 42 weeks, were randomized controlled trials, intervention or crossover studies, and addressed outcomes affecting oxygenation and/or ventilation, and/or short-term outcomes including duration of mechanical ventilation. Because of the large heterogeneity between the studies, it was not possible to synthesize the results in meta-analyses. The results are presented according to thematic analysis. Results: No individual study reported research exclusively in newborns 37 to 42 weeks of gestation. Eight studies fulfilled the inclusion criteria, but the population in all these studies included both premature and term newborns. Evidence about mechanical ventilation tailored exclusively to full-term newborns is scarce. Implication for Practice: Synchronized intermittent mandatory ventilation with a 6 mL/kg tidal volume and a positive end-expiratory pressure of 8 cm H2O may be advantageous in full-term newborns. Implication for Research: There is an urgent need for high-quality studies, preferably randomized controlled trials, in full-term newborns requiring mechanical ventilation to optimize oxygenation, ventilation, and short-term outcomes, potentially stratified according to the underlying pathology

Comparison of two behavioural pain scales for the assessment of procedural pain: A systematic review

Aim: To examine the clinical utility and measurement properties of the Critical‐Care Pain Observation Tool and the Behavioural Pain Scale when used to assess pain during procedures in the intensive care unit. Design: A systematic review was conducted, guided by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses checklist. Methods: A systematic search was conducted in CINAHL, MEDLINE, EMBASE and PsychINFO (01 October 2019). Study selection, data extraction and assessment of methodological quality were performed by a pair of authors working independently. Different psychometric properties were addressed: inter‐rater reliability, internal consistency, test–retest reliability, discriminant validity and criterion validity. Results: Eleven studies were included. Both Critical‐Care Pain Observation Tool and the Behavioural Pain Scale showed good reliability and validity and were good options for assessing pain during painful procedures with intensive care unit patients unable to self‐report on pain. The Critical‐Care Pain Observation Tool is to be preferred since this tool was shown to have particularly good reliability and validity in assessing pain during procedures, but the Behavioural Pain Scale is an appropriate alternative.publishedVersio

Comparison of two behavioural pain scales for the assessment of procedural pain: A systematic review

Aim: To examine the clinical utility and measurement properties of the Critical‐Care Pain Observation Tool and the Behavioural Pain Scale when used to assess pain during procedures in the intensive care unit. Design: A systematic review was conducted, guided by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses checklist. Methods: A systematic search was conducted in CINAHL, MEDLINE, EMBASE and PsychINFO (01 October 2019). Study selection, data extraction and assessment of methodological quality were performed by a pair of authors working independently. Different psychometric properties were addressed: inter‐rater reliability, internal consistency, test–retest reliability, discriminant validity and criterion validity. Results: Eleven studies were included. Both Critical‐Care Pain Observation Tool and the Behavioural Pain Scale showed good reliability and validity and were good options for assessing pain during painful procedures with intensive care unit patients unable to self‐report on pain. The Critical‐Care Pain Observation Tool is to be preferred since this tool was shown to have particularly good reliability and validity in assessing pain during procedures, but the Behavioural Pain Scale is an appropriate alternative

Research protocol: Technology-supported guidance to increase flexibility, quality and efficiency in the clinical practicum of nursing education

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