Medicine and Health Sciences Commons^™

Addressing A Crisis In Nursing Practice: Exploring The Impact Of Multimedia Case-Based Learning On The Clinical Judgment Of Undergraduate Nursing Students, Macy Jenette Bennett

Theses and Dissertations

Clinical judgment is a priority nursing skill to ensure the delivery of safe and effective nursing care. New graduate nurses and nursing students lack the clinical judgment skills that are necessary for entry-level nursing practice. Nurse educators must therefore implement teaching strategies that facilitate clinical judgment. This study evaluated the clinical judgment of undergraduate nursing students after the implementation of multimedia case studies related to the concept of perfusion. Two research questions guided this study: (a) in what ways do undergraduate nursing students demonstrate clinical judgment after completing a series of perfusion-related multimedia case studies and (b) to what extent …

Evaluating The Military Medical Evacuation Dispatching And Delivery Problem Via Simulation And Self-Exciting Hawkes Process, Virbon B. Frial

Theses and Dissertations

The location, allocation, and utilization of military medical evacuation (MEDEVAC) resources significantly impact the quality and timeliness of medical care to injured troops. In 2009, Secretary of Defense Robert Gates introduced the Golden Hour mandate that entails the evacuation of critically-injured troops to military treatment facilities (MTFs) within an hour to prevent further complications. To develop high-quality policies that improve MEDEVAC system performance, several papers in the current literature assume that MTFs have both the capacity and capability of treating any patient, regardless of the type of injury. However, these assumptions are unrealistic when conducting high-intensity operations. While acknowledging MTF …

A Coupled Hazard Simulation And Post-Disaster Resource Optimization Framework, Stephen M. Cunningham

Theses and Dissertations

Extreme events, such as natural or human-caused disasters, cause mental health stress in affected communities. While the severity of these outcomes varies based on socioeconomic standing, age group, and degree of exposure, disaster planners can mitigate potential stress-induced mental health outcomes by assessing early, intermediate, and long-term treatment interventions by social workers and psychologists. However, local and state authorities are typically underfunded, understaffed, and have ongoing health and social service obligations that constrain mitigation and response activities. A resource assignment framework is developed as a coupled-state transition and linear optimization model that assists planners in optimally allocating constrained resources and …

Simulation Facilitator Competency: Validity And Reliability Of A Self-Assessment Tool, Mary (Molly) Kellgren

Theses and Dissertations

The use of simulation as a teaching and learning strategy continues to grow in nursing education. Standards of Best Practice, certification criteria, and simulation theory support the notion that facilitation of simulation requires a specialized skill set that differs from traditional classroom and clinical teaching. The discipline of nursing has already established valid and reliable tools for teachers within the classroom and clinical environments to complete self- and/or peer evaluation to inform teaching effectiveness. The National League for Nursing/Kellgren Simulation Facilitator (NLN/KSF) tool fills a gap in the literature by providing a valid and reliable tool to self-assess comprehensive facilitator …

The Effects Of A Repeating Simulation Experience On Senior Nursing Students, Laura Skoronski

Theses and Dissertations

Nurse educators are challenged with meeting the needs of students and patients. One method of educating students that is used widely across the United States is simulation. The purpose of this dissertation is to determine if participation in a repeating simulation experience has an impact on nursing students’ knowledge and clinical judgment. A conceptual analysis of simulation was undertaken to clarify the definition of simulation and confirm the appropriateness of Kolb’s theory and Tanner’s model as the theoretical framework for the study. A quasi-experimental pre-test/post-test with comparison with norms observational study design guided by Kolb’s Theory of Experiential Learning and …

Evaluating And Reducing The Effects Of Misclassification In A Sequential Multiple Assignment Randomized Trial (Smart), Jun He

Theses and Dissertations

SMART designs tailor individual treatment by re-randomizing patients to subsequent therapies based on their response to initial treatment. However, the classification of patients being responders/non-responders could be inaccurate and thus lead to inappropriate treatment assignment. In a two-step SMART design, by assuming equal randomization, and equal variances of misclassified patients and correctly classified patients, we evaluated misclassification effects on mean, variance, and type I error/ power of single sequential treatment outcome (SST), dynamic treatment outcome (DTRs), and overall outcome. The results showed that misclassification could introduce bias to estimates of treatment effect in all types of outcome. Though the magnitude …

High Fidelity Simulation Experience And Development Of Clinical Judgment: Recent Graduate Nurses’ Reflections, Martha Kay Lawrence

Theses and Dissertations

Introduction: Nurse faculty endeavor to educate future nurses who are able to effectively transition to competent practice after graduation. Shrinking clinical resources and shortages of qualified clinical faculty have contributed to the increasing utilization of high fidelity simulation (HFS) as a substitute for and enhancement of clinical practice in nursing education. The growing body of HFS research documents both student and faculty satisfaction and increased student self-confidence and self-efficacy. A significant gap in the literature is the lack of research on the translation of knowledge gained in HFS to practice. The aim of this research was to investigate recently graduated …

Evaluation Of Student Competence In Simulation Following A Prebriefing Activity: A Pilot Study, Sarah Black Beman

Theses and Dissertations

Background: Simulation-based learning (SBL) shows promise to potentially improve clinical competence in nursing education. The efficacy of evidence-based prebriefing activities and valid and reliable systems to evaluate those strategies is a gap in the literature. Preliminary evidence shows that prebriefing can improve participant outcomes. The goal of this pilot study was to compare the outcome of clinical competence for prelicensure nursing students based on assignment to one of the following prebriefing activities: standard, careplan, or concept mapping. Methods: This is a quasi-experimental double-blind, posttest only, comparison-group design, pilot study. The participants were from an associate degree professional nursing program. Out …

Nurse Educators’ Perceptions Of Using High-Fidelity Simulation In Teaching, Marlene Whigham

Theses and Dissertations

Nurse Educators’ Perceptions of Using High-Fidelity Simulation in Teaching. Marline Whigham, 2017: Applied Dissertation, Nova Southeastern University, Abraham S. Fischler College of Education. Keywords: nursing education, learning strategies, simulation, staff development, teaching styles.

High-fidelity simulation in nursing refers to the use of computerized manikins to offer realistic hands-on training to nursing students. The problem addressed by this dissertation was resistance among some faculty to the use of new computerized simulation technology in the nursing curriculum. The research question for this case study investigated how faculty members can incorporate simulation into the curriculum and barriers faced in setting the stage for …

Simulation-Based Interprofessional Education In A Rural Setting, Ann D. Scott

Theses and Dissertations

The purpose of this project was to examine the feasibility and acceptability of a simulation-based IPE experience for pre-licensure nursing, pharmacy, and medical students on a rurally-located campus. Using a mixed-methods, explanatory sequential approach, this project: 1) examined the feasibility of implementing a simulation-based IPE experience using telehealth tools; and 2) evaluated student perceptions of inter-professional teamwork, roles and responsibilities, and patient outcomes for collaborative practice, both pre- and post-scenario.

Quantitative data were analyzed using SPSS. Results revealed 94% agreed/strongly agreed the IPE experience resembled a real-life situation. 100% of nursing/medical students and 80% of the pharmacy students indicated they …

Sensitivity Analysis Of Geometry Changes In The Simulation Of Basilar Aneurysms, Paul Eserkaln

Theses and Dissertations

Computer simulation is a useful tool in the research and treatment of basilar aneurysms. Current technology allows researchers to create 3D models from cerebral vasculature in-vivo, allowing for the investigation of surgical options with minimal risk to the patient. The method used to construct these models overlooks smaller lateral arterial branches which are difficult to discern due to resolution limits of the imaging process. These lateral branches have minimal impact on the overall blood flow through the basilar artery, but they play a significant role in the health of the patient, so it is important to ensure sufficient blood will …

Does Simulation Improve Nursing Student Knowledge, Skills, And Attitudes In Identifying Delirium Superimposed On Dementia?, Sheryl A. Kelly

Theses and Dissertations

This dissertation is comprised of three manuscripts, to be submitted for publication, exploring the use of simulation in geriatric nursing education. The first manuscript is a literature review. Although, a number of articles exist on the use of simulation in nursing education, there is a paucity of research using simulation emphasizing the care of patients with dementia and delirium as a pedagogical strategy or those using a stringent research design.

The second manuscript provides an overview of two conceptual frameworks (National League for Nursing (NLN)/Jeffries Simulation Framework and situated cognition learning framework) and recommends merging them to guide researchers as …

Facilitating And Enhancing Biomedical Knowledge Translation: An In Silico Approach To Patient-Centered Pharmacogenomic Outcomes Research, Kourosh Ravvaz

Theses and Dissertations

Current research paradigms such as traditional randomized control trials mostly rely on relatively narrow efficacy data which results in high internal validity and low external validity. Given this fact and the need to address many complex real-world healthcare questions in short periods of time, alternative research designs and approaches should be considered in translational research. In silico modeling studies, along with longitudinal observational studies, are considered as appropriate feasible means to address the slow pace of translational research. Taking into consideration this fact, there is a need for an approach that tests newly discovered genetic tests, via an in silico …

Best Practices In High Fidelity Patient Simulation To Enhance Higher Order Thinking Skills, Kathryn S. Mock

Theses and Dissertations

Undergraduate nursing education has begun to use very expensive and time intensive high fidelity simulation activities without making full use of the ability to build higher order thinking skills in students. Current research in high fidelity patient simulation has tended to be subjective and focus on critical thinking. However, reflective thinking habits of mind must be in place before full use can be made of critical thinking skills. A comprehensive search of all reflective thinking literature used in conjunction with simulated patient experiences by healthcare students was undertaken. A guideline

was created for nurse faculty to use that outlined current …

Simulation Design Characteristics: Perspectives Held By Nurse Educators And Nursing Students, Jane Brekke Paige

Theses and Dissertations

Simulation based learning (SBL) is pedagogical method poised to innovate nursing educational approaches. Yet, despite a growing body of research into SBL, limited investigation exists regarding assumptions and beliefs that underpin SBL pedagogy. Even though key simulation design characteristics exist, the particular methods nurse educators use to operationalize simulation design characteristics and how these choices are viewed from the perspective of nursing students is unknown. Without understanding what motivates educators to design simulations as they do, it is difficult to interpret the evidence that exists to support chosen methods. Through the exploration of perspectives (points-of-view), underlying beliefs can be uncovered. …

Genes And Symptoms Of Schizophrenia: Modifiers, Networks, And Interactions In Complex Disease, Sarah Bergen

Theses and Dissertations

Understanding the genetic foundations of schizophrenia and the resultant symptom manifestations is an important step as we work toward development of new prevention and treatment strategies. This work has sought better understanding of this disease through use of three subject cohorts and two studies using simulated data exploring features of complex disease. First, we probed the symptoms of schizophrenia in subjects of African and European ancestry drawn from the Genetic Association Information Network (GAIN) schizophrenia study and found significant differences between groups, particularly in affective symptoms. The genetic basis of symptom variation was then explored in a selection of candidate …