The Impact of Simulation Sequencing on Perceived Clinical Decision Making

An emerging nursing education trend is to utilize simulated learning experiences as a means to optimize competency and decision making skills. The purpose of this study was to examine differences in students\u27 perception of clinical decision making and clinical decision making-related self-confidence and anxiety based on the sequence (order) in which they participated in a block of simulated versus hospital-based learning experiences. A quasi-experimental crossover design was used. Between and within group differences were found relative to self-confidence with the decision making process. When comparing groups, at baseline the simulation followed by hospital group had significantly higher self-confidence scores, however, at 14-weeks both groups were not significantly different. Significant within group differences were found in the simulation followed by hospital group only, demonstrating a significant decrease in clinical decision making related anxiety across the semester. Finally, there were no significant difference in; perceived clinical decision making within or between the groups at the two measurement points. Preliminary findings suggest that simulated learning experiences can be offered with alternating sequences without impacting the process, anxiety or confidence with clinical decision making. This study provides beginning evidence to guide curriculum development and allow flexibility based on student needs and available resources

Latina Adolescents\u27 Perspectives on Relationships

Objective: To explore adolescent Latinas’perspectives on relationships and generate knowledge to inform interventions. Setting: Seven Latina adolescents participated. Design: This qualitative study was guided by principles of community-based participatory research and utilized the photovoice method. Method: Participants took photos depicting elements of relationships and participated in guided discussions. They identified and named five elements of healthy relationships. Results: The five elements included commitment, communication, faith, amigos y amores (friends and lovers) and play. These elements occur across all forms of relationships. Conclusion: The results revealed important information that may be used to tailor health promotion interventions for Latina/o youth

The Impact of Supplemental Simulation on Newly Licensed Registered Nurses

Background Challenges exist for nursing students as they transition to their role as newly licensed registered nurses (NLRNs) due to a mismatch between their perceived readiness and role competency and the demands of the practice environment. Simulations with debriefing may be one strategy to better prepare students for the role of a NLRN. The purpose of this study was to explore whether supplementing traditional clinical experiences with simulation versus substituting simulation for traditional clinical experiences had an impact on NLRNs\u27 perception of competence, work stress, and job satisfaction. Sample A convenience sample of 115 NLRNs from two successive graduating classes in a Midwestern traditional baccalaureate nursing program who participated in the same curriculum with different uses of simulation were recruited. Methods A quasi-experimental design was used to compare the two groups of NLRNs at six months of practice. Results The NLRNs with supplemented simulation had higher job satisfaction. Conclusion These results suggest that programs that use simulation to supplement traditional clinical experiences may lead to increased job satisfaction in NLRNs

Nursing Student Perceptions Regarding Simulation Experience Sequencing

BACKGROUND: The use of simulated learning experiences (SLEs) have increased within nursing curricula with positive learning outcomes for nursing students. The purpose of this study is to explore nursing students\u27 perceptions of their clinical decision making (CDM) related to the block sequencing of different patient care experiences, SLEs versus hospital-based learning experiences (HLEs). METHOD: A qualitative descriptive design used open-ended survey questions to generate information about the block sequencing of SLEs and its impact on nursing students\u27 perceived CDM. RESULTS: Three themes emerged from the data: Preexperience Anxiety, Real-Time Decision Making, and Increased Patient Care Experiences. CONCLUSION: Nursing students identified that having SLEs prior to HLEs provided several benefits. Even when students preferred SLEs prior to HLEs, the sequence did not impact their CDM. This suggests that alternating block sequencing can be used without impacting the students\u27 perceptions of their ability to make decisions

The Impact of Simulation on Knowledge and Performance Gain Regarding Diabetic Patient Care

Background It is essential that nurses be prepared to provide quality care for patients with diabetes, a common condition today. The purpose of this study was to evaluate the impact of a high-fidelity simulation on traditional prelicensure nursing students\u27 knowledge and performance related to care of the diabetic patient. Methods This multisite, multimeasure study used a purposive, quasiexperimental pretest-posttest design. Results Simulation positively impacted performance change scores. Pretest scores were positively associated with simulation scores and posttest scores. Conclusions The findings from this study support the use of high-fidelity simulation to improve care of the diabetic patient

The Influence of Masculinity on Male Latino Adolescents’ Perceptions Regarding Dating Relationships and Dating Violence

In the United States, teen dating violence (TDV) is a concern across ethnic groups. Attitudes and correlates of violence differ by gender, culture, and acculturation. This study used a qualitative interpretive approach. Data were obtained in focus groups with 23 Latino male adolescents. Themes reflected contexts of participants’ lives, and definitions and nature of dating relationships and TDV. Participants described the importance of respecting dating partners, the destructive effects of TDV, and the pressure to display masculinity that can lead some young men to perpetrate TDV. These results may advance culturally relevant interventions to promote healthy relationships and prevent dating violence

Developing Situation Awareness in Simulation Prebriefing

BACKGROUND: Prebriefing before simulation is a recommended practice that increases learner satisfaction and improves performance. Promoting situation awareness through prebriefing facilitates optimal learning outcomes. METHOD: Endsley\u27s Model of Situation Awareness is applied to the cognitive work of nursing practice that occurs during the prebriefing phase of simulation. Perceiving, comprehending, and projecting about elements of a situation lead to clinical judgement, reasoning, decision making, and ultimately nursing actions. RESULTS: Developing situation awareness in prebriefing is a supported process that connects learners\u27 prior knowledge and experience with the needed knowledge, skills, and abilities in the simulation environment. These mental models become the foundation for understanding the relevance of perceived information, comprehending its meaning, and directing nursing actions. CONCLUSION: The simulation facilitator influences the development of situation awareness by focusing perception on key elements and scenario objectives, fostering psychological safety, and enhancing familiarity with the simulation environment during prebriefing

Using Clinical Instructor Perceptions to Improve a Pilot Simulation Course

Little is known about clinical instructors’ perceptions of student decision-making in relation to the block sequencing of simulation and traditional clinical experiences. Focus groups were conducted with 12 clinical instructors. Three common threads emerged from the data: right away, anxious but more confident, and scary and unsafe. Instructors noted that the more patient care experiences encountered, the more students developed efficient clinical decision-making skills. Major safety concerns regarding medication administration were identified, resulting in additional safety parameters instituted in the simulated environment

Self-Care Behaviors of African Americans Living with Heart Failure

African Americans have a higher risk of developing heart failure (HF) than persons from other ethnic groups. Once diagnosed, they have lower rates of HF self-care and poorer health outcomes. Promoting engagement in HF self-care is amenable to change and represents an important way to improve the health of African Americans with HF. This study used a community-based participatory action research methodology called photovoice to explore the practice of HF self-care among low-income, urban, community dwelling African Americans. Using the photovoice methodology, themes emerged regarding self-care management and self-care maintenance