Nursing Commons^™

Testing The Impact Of An Asynchronous Online Training Program With Repeated Feedback, Aimee A. Woda, Cynthia Sherraden Bradley, Brandon Kyle Johnson, Jamie Hansen, Ann Loomis, Sylvia Peña, Maharaj Singh, Kristina Dreifuerst

College of Nursing Faculty Research and Publications

Background:

Learning to effectively debrief with student learners can be a challenging task. Currently, there is little evidence to support the best way to train and evaluate a debriefer's competence with a particular debriefing method.

Purpose:

The purpose of this study was to develop and test an asynchronous online distributed modular training program with repeated doses of formative feedback to teach debriefers how to implement Debriefing for Meaningful Learning (DML).

Methods:

Following the completion of an asynchronous distributed modular training program, debriefers self-evaluated their debriefing and submitted a recorded debriefing for expert evaluation and feedback using the DML Evaluation Scale …

Pediatric Fiberoptic Intubation Education Utilizing Simulation: A Quality Improvement Study, Aladin Bihorac, Jonathan Mangan

College of Science and Health Theses and Dissertations

Fiberoptic intubation has been used as a secondary option to intubate pediatric patients with difficult airways. Failure to understand how to properly use a fiberoptic scope could have severe consequences, such as increased trauma or mortality. This is a quality improvement research study that examines the effect of simulation training utilizing a pediatric flexible fiberoptic scope on the confidence and competence of Nurse Anesthesia Trainees (NATs). Competence was measured using time to successful intubation. The authors developed a survey tool to assess the confidence of the participants in intubating pediatric patients’ airways with a fiberoptic scope after educational training and …

Implementation Of A Structured Hybrid Training Program To Improve Clinical Skills And Staff Confidence In The Care Of Maternal And Neonatal Patients In The Emergency Department: A Quality Improvement Project, Melissa Hewitt

Doctor of Nursing Practice (DNP) Manuscripts

Caring for a pregnant woman or compromised newborn is often a stressful situation for all healthcare workers regardless of their experience or expertise. This stress is only heightened when the patient presents to a unit that may not be comfortable with the situation such as the Emergency Department (ED). Often units such as the ED do not receive adequate training in caring for maternal and neonatal patients. The infrequency of patient interactions coupled with their lack of knowledge can leave staff with decreased levels of confidence. Various research articles recommend that hospitals provide interdisciplinary team training for high acuity low …

Recognition Of And Response To Obstetric Emergencies: Developing A Virtual Competency-Based Orientation Program, Susan Morrison

Student Scholarly Projects

In order to improve outcomes in the perinatal setting, the development of a Virtual Competency-Based Orientation Program (CBO) toolkit is vital. Two toolkits, namely the Alliance for Innovation on Maternal Health (AIM) and the California Maternal Quality Care Collaborative (CMQCC), have been identified as effective in enhancing perinatal outcomes. AIM is a national initiative focused on improving maternal health outcomes, promoting safer birth practices, and saving lives through the implementation of best practices. CMQCC is a multi-stakeholder organization in California committed to eliminating preventable morbidity, mortality, and racial disparities in maternity care. Both AIM and CMQCC CBO toolkits incorporate research, …

Improving Central Line-Associated Bloodstream Infection Prevention Bundle Compliance To Reduce Infection Rates In A Pediatric Cardiac Intensive Care Unit., Aubree Croghan

Doctor of Nursing Practice Papers

Background: Central line-associated bloodstream infection (CLABSI) is the most common healthcare-acquired infection in pediatrics. A pediatric acute care facility in Kentucky created a specialized care team in an effort to track CLABSI bundle compliance and reduce central line infections. While rates of infection decreased, a significant number of infections still occurred and staff adherence to facility evidence-based policies and infection prevention interventions remained low.

Purpose: To reach the facility’s goal of zero central line-associated bloodstream infections, a quality improvement (QI) project was developed to improve staff knowledge of care and increase staff adherence to policy.

Methodology: To create the QI …

The Lived Experiences Of Faculty Conducting Post-Simulation Debriefing In Nurse Practitioner Programs, Jodi Borden Duncan

Doctoral Dissertations and Projects

Simulation-based education is a teaching–learning pedagogy widely used in nursing programs today. While much research has been done on student perceptions of simulation and the fact most learning occurs in the post-simulation debriefing session, little research has been done on how learning takes place in debriefing. Nurse practitioner faculty also use simulation as a teaching methodology, but the implementation of debriefing methods and faculty experiences with debriefing sessions are not known. As simulation may not be counted as direct clinical hours in nurse practitioner programs, more research must be done before the substitution of hours can be considered. The substitution …

Situation Awareness And Cognitive Load In Nursing Students Managing A Computer-Based Virtual Reality Simulated Deteriorating Patient, Tracy Chesney

Electronic Theses and Dissertations

Background: When a patient’s baseline clinical state shifts to a worse clinical state requiring a transfer to a higher level of care within the healthcare system, it is the hallmark of a deteriorating patient situation. Up to 37% of newly licensed nurses fail to identify and manage a deteriorating patient partly due to inexperience and a lack of expertise, contributing to lower situation awareness (SA), specifically in cue perception. Long-term memory schema development leads to expertise that allows individuals to develop higher SA necessary to identify and effectively manage patient deterioration. Expert nurses access long-term memory schema in managing deteriorating …

Tele-Sim For Nurse Practitioner Clinical Education: An Online, Real-Time, Educational Innovation Using Simulation And Telehealth For Learning Physical Assessment Skills, Kat Tremblay

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Background: Increasing numbers of nurse practitioner (NP) educational programs are being offered online, with little or no face-to-face contact among students and instructors. Students express lack of confidence in their physical examination skills and want live instructor demonstrations, observed practice, and real-time feedback from their clinical instructors.

Significance: NP students need to acquire physical examination skills to increase competency in assessing patients for enhanced clinical judgment and improved patient outcomes.

Purpose/Aims: to improve and measure the competency and confidence in the performance of advanced physical assessment skills of NP students in an advanced health assessment (AHA) clinical course with an …

Is Sepsis Hiding In Plain Sight? Implementation Of An Interprofessional (Ip) Sepsis Simulation To Detect Early Sepsis, Sarah Chang, Amanda Bennett, Anne Dean, Meaghan Anderson, Micheline Chipman

Costas T. Lambrew Research Retreat 2023

Early detection of hospital-acquired sepsis can be challenging. With highly effective IP teams and efficient healthcare systems, sepsis treated quickly can influence morbidity and mortality. This project is aimed at training IP teams in early recognition of sepsis using simulation. Nurses and providers rarely have opportunities to learn together. Simulation followed by an IP debrief is an excellent tool to collaborate for safe patient care.

Impact Of Personalized Interactive Storytelling On Suspension Of Disbelief In Clinical Simulation, Audra Renee-Smith Xenakis

Electronic Theses and Dissertations

The literature review found suspension of disbelief (SOD) in clinical simulation heavily weighted on educators alone within high-fidelity environments. The project examined a co-created narrative background story applied to a simulated patient’s clinical profile to determine achieving an improved connectedness toward the simulated patient leading to enhanced SOD and enhanced levels of learning and reaction. The studied population was third-semester associate degree nursing students over 18 years of age with prior clinical simulation experience who were not repeating the semester. The research methodology used a quantitative experimental design with cluster sampling, randomization, and post-Likert-scored questionnaires. The intervention group co-created personalized …

Investigating Students’ Lived Experience With Prebriefing Structure And Elements In Nursing Simulation Education, Meghan Liebzeit

UNLV Theses, Dissertations, Professional Papers, and Capstones

Prebriefing is a growing body of knowledge in nursing simulation education. It is recognized as an important factor in the simulation experience, however the practice of prebriefing varies widely making it difficult to understand what methods best prepare students for the simulation scenario. While research over the last decade has identified prebriefing increases confidence, skills, and clinical judgment, what content is important to include in prebriefing, or how it promotes the achievement of outcomes is under recognized.Implementing an intervention based on a pedagogically sound eight-week simulation clinical course, developed with the theoretical underpinnings of Vygotsky’s Zone of Proximal Development, Kolb’s …

Implementation Of A Glidescope Educational Program For Novice Student Registered Nurse Anesthesiologists, Joshua F. Snodgrass, Brian Bendel

Doctor of Nursing Practice Projects

GlideScope Video laryngoscopy carries a higher risk of injury to the pharyngeal cavity than direct laryngoscopy. Verathon is aware of this risk and has developed a proprietary “Four-step method” to mitigate it. This project aimed to reduce injuries related to GlideScope video laryngoscopy by providing first-year nurse anesthesiologists at Southern Illinois University Edwardsville with didactic and simulation education related to GlideScope video laryngoscopy and injury prevention. Didactic education was provided via a pre-recorded PowerPoint presentation. Simulation education was provided with the GlideScope and airway trainer manikins. The participants completed an identical 8-question pre-test and post-test to assess for knowledge gain …

Dnp Final Report: Translation Of Evidence-Based Practice: Developing Nurses' Ability To Recognize And Respond To Clinical Deterioration, Bryan Stephen Jordan

DNP Final Reports

Clinical deterioration is a serious physiologic disturbance or a sudden worsening patient condition increasing the risk of morbidity and mortality (Jones et al., 2013). Clinical deterioration compromises hemodynamic stability and produces marked physiological decompensation (Padilla & Mayo, 2017). Patients often exhibit physiological signs several hours or more before decompensation is readily apparent (Andersen et al., 2016; Khanna et al., 2019). The need for early recognition of clinical deterioration has been well-identified and documented (Ashbeck et al., 2021). Increasing time duration from the onset of clinical deterioration to intervention is associated with increased resuscitation and critical care requirements, the presence of …

How Does Obstetric Simulation Impact Undergraduate Pre-Licensure Bsn Student’S Clinical Judgement Related To Using And Understanding Fetal Monitoring?, Brandy Leona Clayton

Doctoral Dissertations and Projects

Obstetric simulation can impact undergraduate prelicensure Bachelor of Science in nursing (BSN) students’ clinical judgment related to using and understanding fetal monitoring. The purpose of this study aimed to determine if a relationship exists between a student's obstetrical simulation practice and increased knowledge gained for fetal monitoring interpretation. Simulation practice provides a tangible way to test knowledge and competency, but is there an effect on student learning with the knowledge and understanding of fetal monitoring, and can simulation practice create that knowledge? A purposive sample of 24 undergraduate prelicensure BSN nursing students, within their obstetrical course, with the intent to …

Using Specially Designed Software To Create A Simulation Space Design Assignment, Desiree A. Díaz, Mindi Anderson, Kathleen Bastedo, Corey Peterson

FDLA Journal

A college of nursing at a large southern university created a completely online graduate degree and online certificate related to healthcare simulation. In the organizational and operations simulation course, a paper/pencil assignment course was replaced with the use of an innovative online specialty software, i.e., widget, which allowed students the opportunity to design to scale a simulation space. The collaborative team of nursing and university technology and learning faculty jointly designed and created the widget. The purpose of this study was to describe the assignment and widget development and then to discuss the study to determine the usability and student …

Simulation: Are We Doing Enough?, Christopher Doneski

DNP Research Projects

Abstract

Objective: Simulation is a widely utilized tool for training healthcare professionals. Research examines and details the benefits of simulation, although there is no recommendation for the most effective amount. This project aims to determine if increased amounts of simulation benefit nursing residents' confidence and self-efficacy regarding the deteriorating patient. Method: Based on a review of literature regarding simulation use, nursing transition-to-practice programs, and patient deterioration, nursing residents were exposed to varying amounts of simulation and asked to respond to questionnaires regarding their perceived self-efficacy, satisfaction, and self-confidence utilizing a quasi-experimental, comparative design approach. Qualitative data was obtained through debriefing …

Mock Drills To Improve Inpatient Stemi Performance And Self-Confidence, Samantha Miniard

Doctor of Nursing Practice Projects

STEMI care can be challenging for med-surg telemetry nurses to recognize among inpatients because it is a high-risk low volume population. Frequently these patients’ present with atypical acute coronary syndrome (ACS), and not the classic chest pain seen when someone calls 911. However, the same treatment and care out-of-the hospital patients receive when calling 911 should be the same gold standard for in-hospital patients. More studies have been conducted to perfect the out-of-hospital STEMI care versus the in-hospital STEMI care. Mock drills can help improve knowledge, self-confidence, and performance with inpatient STEMI care. This DNP project was an evidenced-based quality …

The Impact Of Student-Led Lactation Education On Self-Efficacy In Clinical Simulation: An Integrative Literature Review, Kaitlyn Flores Yu

Honors Undergraduate Theses

Simulation is a critical component of nursing education. It provides a safe environment to practice and evaluate skills, supplements clinical hours, and removes barriers to a well-rounded education. Nurses are expected to be educators as part of our scope of practice, and simulation can facilitate this. One topic of nursing importance is lactation education, as breastfeeding has been shown to have multiple benefits for both mother and baby. National rates of exclusive breastfeeding for the first 6 months do not currently meet CDC recommendations. The pedagogy known as the Protégé Effect suggests that learning can be improved through teaching. Breastfeeding …

Educator Preparedness In The Use Of Simulation In Nursing Education, Marcelene E. Hart

Walden Dissertations and Doctoral Studies

AbstractNurse educators lack preparation when using simulation as a teaching modality in educating nurses and nursing students within their clinical environment. The purpose of this basic qualitative study was to understand nurse educators’ perceptions of the challenges in preparing for simulation-based training experiences for nurses and nursing students. Vygotsky’s constructivist theory was used as the conceptual framework for the study to emphasize students’ innate ability to learn using active and hands-on processes through simulation experiences. Questions were developed to explore the challenges nurse educators encounter when preparing for simulation activities. Survey questionnaire invitations were sent through email to hundreds of …

Improving Student Nurse Clinical Reasoning, Critical Thinking, And Clinical Judgment Through Simulation Debriefing, Deborah Brester

Walden Dissertations and Doctoral Studies

Simulation is an educational strategy in nursing education that incorporates structured activities that depict real-life situations to develop and enhance the knowledge, skills, and attitudes of nursing students by allowing them to analyze and initiate interventions for realistic situations in a simulated environment. Debriefing is a reflective process and is a key component in the simulation education process, but there is a lack of evidence on debriefing methods that enhance learning outcomes in nursing education. This study, which was guided by the National League for Nursing Jeffries simulation theory, was to determine the effect simulation debriefing, as assessed using the …

Educator Preparedness In The Use Of Simulation In Nursing Education, Marcelene E. Hart

Walden Dissertations and Doctoral Studies

AbstractNurse educators lack preparation when using simulation as a teaching modality in educating nurses and nursing students within their clinical environment. The purpose of this basic qualitative study was to understand nurse educators’ perceptions of the challenges in preparing for simulation-based training experiences for nurses and nursing students. Vygotsky’s constructivist theory was used as the conceptual framework for the study to emphasize students’ innate ability to learn using active and hands-on processes through simulation experiences. Questions were developed to explore the challenges nurse educators encounter when preparing for simulation activities. Survey questionnaire invitations were sent through email to hundreds of …

Simulation Psychological Safety Ecosystem: A Grounded Theory Study Of Nurses’ Experience With Psychological Safety In Prelicensure Simulation, Susan Eller

Dissertations

Over the past couple of decades, the utilization of simulation-based education in prelicensure nursing expanded in both frequency and functionality. Learning through simulation requires psychological safety where participants feel comfortable engaging to their fullest extent and can speak up or ask questions without fear of embarrassment to themselves or others. Professional simulation organizations provide recommendations for creating psychological safety, yet anecdotal stories from nurses report variability in their experiences ranging from positive to negative. Research regarding psychological safety in nursing education revealed some consistent themes of anxiety due to being observed or unfamiliar with simulation environments or expectations. The evolving …

Dnp Final Report: Developing Competence And Improving Patient Safety With Documentation Training In The Simulated Environment, Laura Zebreski

DNP Final Reports

With the advent of electronic health records, nursing documentation has declined in quality. Poor documentation exposes patients to safety risks. Nursing documentation is subject to legal standards set by the Texas State Board of Nursing. A DNP scholarly project was designed to create a learning and safety intervention to train student nurses to provide correct documentation before entering clinical settings. The goal of this project was to prepare nursing students to provide quality documentation that fulfills the legal standard to attempt to correct the current deficiencies seen in practice and promote patient safety. For this project, the students took a …

Trauma-Informed Care In Nursing Curricula: Development Of A Simulation-Based Educational Framework To Guide Health Professions, Heather Guest

Nursing Theses and Dissertations

Individuals of all ages, genders, social and ethnic backgrounds, and cultures suffer traumatic experiences. Trauma does not discriminate. The immense number of individuals struggling with trauma requires that health care providers approach patient care through a trauma-informed lens. Trauma-informed care is an evidence-based approach to patient-centered care and is vital to the healthcare provider-patient relationship. The increased responsibility of healthcare providers to provide trauma-informed care to all individuals demands a scientifically-based framework to guide the development of a trauma-informed health care professions education program. Healthcare simulation allows health professions’ students to experience real-life scenarios in a safe setting before transitioning …

End-Of-Life Simulation Education, Lucas Farris

MSN Capstone Projects

In the current healthcare workforce, there exists a lack of comfort and knowledge about providing end-of-life (EOL) care that will only continue to worsen without prompt changes to the delivery of education (Jablonski et al., 2020). The lack of knowledge and comfort expressed in providing EOL care leads to a nurse’s moral and physical difficulty when a patient chooses palliative care or hospice. This is a detriment to patients and should be a consideration for schools of nursing when developing curriculum and clinical activities. By promoting changes in curriculum and the addition of an EOL simulation at the undergraduate level, …

Utilization Of A Multimodal De-Escalation Class To Improve Staff Confidence When Caring For Behaviorally Escalating Patients, Tara B. Neuner

Graduate Theses, Dissertations, and Capstones

Workplace violence is a common challenge seen in the healthcare settings across the world. This problem is steadily increasing in all types of hospitals, including a level one trauma center located in an urban area. There has been a steady rise in the number of assaults and workplace violence reported from bedside staff at this hospital. The leadership of the organization formed a work group to help combat the workplace violence and staff assaults that were occurring. In this process, a behavior response team was created to help nursing staff with escalating behavior in patients, and to help de-escalate the …

Integration Of A Simulation Curriculum Across Semesters In An Acute Care Pediatric Nurse Practitioner Program, Katie L. Mcdermott, Jennifer K. Pfister, Jill C. Kuester, Leslie Talbert, Christine A. Schindler

College of Nursing Faculty Research and Publications

Introduction

Simulation is a common strategy for health care education. Research regarding simulation for nurse practitioner education is sparse. This paper describes the integration of a nine simulation session curriculum into a nurse practitioner program, including motivating factors, process description, and lessons learned.

Results

Students report high satisfaction and improved perception of confidence and competence of knowledge, skills, and performance.

Discussion

Integrated learning experiences and outcomes that span an educational program are needed in the transition to competency-based education. This description serves as a guide for other programs seeking to incorporate simulation-based education.

Mid-Simulation Debriefing: The Impact On Confidence And Clinical Judgement Of Nursing Students In A Baccalaureate Mother Baby Course, Tonya Broughton

Graduate Theses, Dissertations, and Capstones

Debriefing is a crucial aspect of healthcare simulation. This portion of the simulation experience encompasses the vast majority of student learning and reflection that takes place, and increases skills such as communication, clinical reasoning, and critical thinking. Traditionally debriefing is performed at the end of a clinical simulation experience after the simulation experience has concluded. In the maternal-newborn setting, there are often two phases of simulation. First is the care of the laboring mother and second is the delivery and care of the newborn. This study explored the effects of completing a mid-simulation debriefing in a maternal newborn simulation at …

Best Practices For Implementing Critical Care Orientation Programs For Newly Graduated Nurses After Reduced Hands-On Clinical Experience Due To The Covid-19 Pandemic: An Integrative Review, Anne-Marie Hinish

Doctoral Dissertations and Projects

The academic-practice gap has been described in the literature for years. Poorly implemented transition to practice can negatively impact patient outcomes, newly graduated nurses, and the nursing profession. Abbreviated prelicensure clinical experiences due to the COVID-19 pandemic have exacerbated the academic-practice gap’s impact on new nurse confidence, competence, safety, and retention. This integrative literature review aimed to identify best practices for developing and implementing a standardized new graduate nurse orientation program in the critical care setting that addresses and supports the transition from student to practitioner in an era of reduced hands-on clinical experiences due to the COVID-19 pandemic. Evidence …

Implementing Immersive Virtual Reality Into A Nursing Curriculum, Sue A. Schuelke, Krystal Davis, Sue Barnason

Innovations in Health Sciences Education Journal

Due to workforce demands, new undergraduate nurses are hired directly into fast-paced units and are expected to manage complex patients with rapidly changing conditions and respond to time-sensitive situations. It is important for nurse educators to prepare undergraduate nurses for transition into clinical practice upon graduation. Simulation has been a valuable tool to provide experiential learning and promote clinical decision-making. The next iteration of improving clinical simulation as an experiential learning modality for nursing students is Immersive Virtual Reality (IVR): a realistic, immersive simulation in a 3-dimensional environment that is experienced by body movements and hand controllers. IVR can incorporate …