Nursing Students in Clinical Placements Learning in Dyads: A Feasibility Study Using a Non-Randomized Pilot Trial

Purpose: To develop a protocol for a clinical education intervention using dyads and to assess the feasibility of implementing the approach with second year nursing students in their first clinical placement. The objectives were: 1) to evaluate and refine data collection procedures and outcome measures, 2) to evaluate the acceptability and sustainability of the intervention, and 3) to identify weaknesses of the intervention or threats to future implementation. Methods: A feasibility study was designed as a non-randomized pilot trial. The setting was the university site of a collaborative Bachelor of Science in Nursing program in Ottawa, Ontario. Three clinical groups consisting of 24 second-year students enrolled in both the French and English undergraduate programs comprised the sample. The intervention protocol was developed based on guiding principles reflective of the needs of our institution, as well as pedagogical priorities. Data were collected from clinical instructors and other stakeholders pre- and post-intervention through multiple means and analyzed descriptively. We followed the CONSORT extension to randomized pilot and feasibility trials to guide reporting of the study. Results: The intervention was deemed acceptable by the clinical instructors, as well as the managers and educators of the units. We received no negative feedback regarding the intervention, or the workload required to implement the intervention properly. For data collection instruments, the NSSES was completed more often and with greater ease than the VSI-NS. In all cases, the responses to the instruments were congruent with our expectations and student scores shifted in the anticipated direction. Clinical instructors were able to consistently observe patient care and reported having more time for teaching and mentorship. Conclusions: Using a dyad approach to clinical education appears to be a viable strategy, and our feasibility study supports the appropriateness of further research into the use of dyads for nursing clinical education. From a sustainability perspective, the intervention allowed for the safe implementation of larger group sizes without negatively affecting the learning environment or the integrity of the course objectives. Résumé Objectif : Élaborer un protocole d’intervention en formation clinique qui utilise des dyades et évaluer la faisabilité de mettre en place l’approche avec des étudiantes en sciences infirmières de deuxième année lors de leur premier stage clinique. Les objectifs étaient : 1) d’évaluer et de peaufiner les procédures de collecte de données et les mesures de résultats; 2) d’évaluer l’acceptabilité et la viabilité de l’intervention; et, 3) d’identifier les faiblesses de l’intervention ou les risques pour une future mise en place. Méthodologie : Une étude de faisabilité, a été menée sous forme d’un essai pilote non randomisé. Cette étude fut effectuée sur le site universitaire d’un programme collaboratif de baccalauréat en sciences infirmières à Ottawa, en Ontario. Les trois groupes cliniques étaient composés de 24 étudiantes de deuxième année inscrites aux programmes de premier cycle en français et en anglais. Le protocole d’intervention a été élaboré en se basant sur des principes directeurs reflétant les besoins de notre établissement et nos priorités pédagogiques. Les données ont été recueillies par plusieurs méthodes auprès des enseignantes cliniques et d’autres intervenantes avant et après l’intervention et elles ont été analysées de façon descriptive. Nous avons suivi la structure CONSORT des essais pilotes randomisés et des études de faisabilité pour guider la présentation de l’étude. Résultats : L’intervention fut jugée acceptable par les enseignantes cliniques ainsi que par les gestionnaires et les conseillères des unités. Nous n’avons reçu aucun commentaire négatif par rapport à l’intervention ou à la charge de travail requise pour la mettre en place adéquatement. Concernant les instruments de collecte de données, la NSSES (échelle d’auto-efficacité des étudiantes en sciences infirmières) a été remplie plus souvent et plus facilement que le VSI-NS (questionnaire sur les interactions verbales et sociales des étudiantes en sciences infirmières). Dans tous les cas, les réactions par rapport aux instruments correspondaient à nos attentes et les résultats des étudiantes changeaient dans la direction prévue. Les enseignantes cliniques ont pu observer systématiquement les soins aux patients et ont rapporté avoir eu plus de temps pour enseigner et faire du mentorat. Conclusions : L’utilisation d’une approche de dyade en formation clinique semble être une stratégie viable et notre étude de faisabilité appuie la pertinence de recherches plus poussées sur l’utilisation de dyades en formation clinique en sciences infirmières. Du point de vue de la viabilité, l’intervention permettait une mise en place sécuritaire de plus grands groupes sans conséquence négative sur l’environnement d’apprentissage ou l’intégrité des objectifs de cours

Spatiotemporal distribution of foot-and-mouth disease in Nepal between 2019 and 2021

Abstract Foot-and-mouth disease (FMD) is a highly contagious viral disease affecting cloven-hoofed livestock. It is caused by the FMD virus (FMDV), which has seven distinct serotypes (O, A, C, SAT I, SAT II, SAT III, and Asia 1). In Nepal, FMD is a prevalent and economically important livestock disease, with hundreds of outbreaks yearly across different regions. However, there is limited understanding of the recent epidemiological trends of FMD in the past few years in Nepal. This study aims to analyze the spatial and temporal distribution of FMD in Nepal from 2019 to 2021. The FMD and TADs Investigation Laboratory, under the Government of Nepal, conducts annual risk-based surveillance of FMD in the country. The nonstructural protein (NSP) serosurveillance and serotyping (for outbreak confirmation) data from this laboratory were used for the study. The samples were collected either by the laboratory staff or were sent to the laboratory. Data analysis and mapping were performed using Epi info version 7.2.5.0 and QGIS version 3.22.5, respectively. Our findings revealed that 37.65% of samples (n = 417) tested positive for serotyping. The highest number of positive cases occurred in March–April, followed by December. Geographically, the Terai region had the most positive cases, followed by hills and mountains. The positivity rate for serotyping did not significantly vary by animal species (p > 0.05). Serotype O was the dominant serotype in all years, accounting for 98% of cases, while serotype A was found in only 2% of serotype-positive samples. In NSP serosurveillance, out of 3216 samples tested, 15.07% (474/3146; 95% CI, 13.86–16.36) tested positive. NSP seropositivity varied significantly by year (p  0.05). In conclusion, FMD remains endemic in Nepal, with a consistent epidemiological pattern except that the Asia 1 serotype was not detected in the past years. We recommend expanding FMD surveillance activities to high-risk areas and collecting data on potential risk factors driving FMD infection in the country. This will enable the implementation of suitable control measures