Challenges Experienced by Nurse Educators in Promoting Acquisition of Clinical Reasoning Skills by the Undergraduate Nursing Students: A Qualitative Exploratory Study

Background: Clinical reasoning is an essential skill for nursing students since it is required to solve difficulties that arise in complex clinical settings. However, teaching and learning clinical reasoning skills is difficult because of its complexity. This study, therefore aimed at exploring the challenges experienced by nurse educators in promoting acquisition of clinical reasoning skills by undergraduate nursing students. Methods: A qualitative exploratory research design was used in this study. The participants were purposively sampled and recruited into the study. Data were collected using semi-structured interview guides. Thematic analysis method was used to analyze the collected data The principles of beneficence, respect of human dignity and justice were observed. Results: The findings have shown that clinical learning environment, lacked material and human resources. The students had no interest to learn the skill. There was also knowledge gap between nurse educators and clinical nurses. Lack of role model was also an issue and limited time exposure. Conclusion: The study revealed that nurse educators encounter various challenges in promoting the acquisition of clinical reasoning skills among undergraduate nursing students. Training institutions and hospitals should periodically revise the curriculum and provide sufficient resources to facilitate effective teaching and learning of clinical reasoning. Nurse educators must also update their knowledge and skills through continuous professional development if they are to transfer the skill effectively.

Assessing the Levels of Clinical Reasoning Skills Using Self-Assessment of Clinical Reflection and Reasoning in Undergraduate Nursing Students: A Descriptive Comparative Study

Background: Clinical reasoning is a critical cognitive skill that enables undergraduate nursing students to make clinically sound decisions. A lapse in clinical reasoning can result in unintended harm to patients. The aim of the study was to assess and compare the levels of clinical reasoning skills between third year and fourth year undergraduate nursing students. Methods: The study utilized a descriptive comparative research design, based on the positivism paradigm. 410 undergraduate nursing students were systematically sampled and recruited into the study. The researchers used the Self-Assessment of Clinical Reflection and Reasoning questionnaire to collect data on clinical reasoning skills from third- and fourth-year nursing students while adhering to ethical principles of human dignity. Descriptive statistics were done to analyse the level of clinical reasoning and an independent sample t-test was performed to compare the clinical reasoning skills of the student. A p value of 0.05 was accepted. Results: The results of the study revealed that the mean clinical reasoning scores of the undergraduate nursing students were knowledge/theory application (M = 3.84;SD = 1.04);decision-making based on experience and evidence (M = 4.09;SD = 1.01);dealing with uncertainty (M = 3.93;SD = 0.87);reflection and reasoning (M = 3.77;SD = 3.88). The mean difference in clinical reasoning skills between third- and fourth-year undergraduate nursing students was not significantly different from an independent sample t-test scores (t = −1.08;p = 0.28);(t = −0.29;p = 0.73);(t = 1.19;p = 0.24);(t = −0.57;p = 0.57). Since the p-value is >0.05, the null hypothesis (H0) “there is no significantno significant difference in clinical reasoning between third year and fourth year undergraduate nursing students”, was accepted. Conclusion: This study has shown that the level of clinical reasoning skills of the undergraduate nursing students was moderate to low. This meant that the teaching methods have not been effective to improve the students clinical reasoning skills. Therefore, the training institutions should revise their curriculum by incorporating new teaching methods like simulation to enhance students’ clinical reasoning skills. In conclusion, evaluating clinical reasoning skills is crucial for addressing healthcare issues, validating teaching methods, and fostering continuous improvement in nursing education.

Application of Academic Salons in Cultivating the Scientific Research Skills of First-Year Nursing Master’s Students

Objective:To explore the application effect of academic salons on developing the scientific research skills of first-year nursing master’s students.Methods:According to Wallas’four-stage model of the creative process,from November 2022 to February 2023,66 first-year nursing master’s students from the School of Nursing at Zhejiang Chinese Medical University were selected using a convenient sampling method to participate in a multidisciplinary academic salon consisting of a total of 8 sessions held once every two weeks.Before the first and after the last academic salon,postgraduate research skills evaluation questionnaires and perception of research skills acquisition questionnaires were used to assess first-year nursing master’s students.A semi-structured interview was conducted with nine students after the final academic salon.Results:The total scores for scientific research skills and sense of achievement among first-year nursing master’s students after the academic salon were higher than those before the salon,and the difference was statistically significant.The interview results showed that the“salon theme,”“tutor comments,”and“sharer output”are the focus of the first-year nursing master’s students in the academic salon.Conclusions:Academic salons can enhance postgraduate students’scientific research skills and foster a greater appreciation for scientific research.We can enhance academic salons by carefully choosing relevant themes,inviting knowledgeable presenters and expert tutors to provide feedback,and prioritizing equality and effective communication.

The Impact of Simulation Education on Self-Efficacy in Pre-Registration Nursing Students

This literature review primarily aims to explore and synthesise the previous studies in simulation education research conducted over the past five years related to the effects of simulation training on the self-efficacy of undergraduate pre-registration nursing students. The second aim of this study is to explore additional outcome variables that were examined in the previous studies. Five electronic databases were searched systematically. These databases were MEDLINE, CINAHL Plus, Scopus, Embase and PsycINFO. The PICO model was employed to identify the search terms, with a thesaurus being used to provide synonyms. Reference lists of relevant articles were examined and hand searches of journals were also undertaken. The quality of each study was assessed using the Simulation Research Rubric (SRR). A total of 11 studies were included. All studies explored the impact of simulation education on undergraduate pre-registration nursing. Six studies explored nursing students’ competence and performance and two papers examined their critical thinking. Problem solving, learning motivation, communication skills and knowledge acquisition were examined once. The majority of studies indicated that simulation training has a positive impact on pre-registration nursing students’ self-efficacy and other outcome variables. Furthermore, the study results indicate that simulation training is more dependable than traditional training, and students were extremely satisfied with the simulation training. However, most of the studies included in this review had several gaps, including study design, sample size and dissimilarities between the scales used. Further research with large samples, reliable and valid instruments, and outcomes measures (such as critical thinking and transferability of skills) is required to provide better insight into the effectiveness of simulation in undergraduate nursing education. .

Entrepreneurship training:its influences on innovation potentials among nursing students

Objective:To evaluate the influences of entrepreneurship training on the innovation potential among nursing students.Methods:A quasi-experimental design was utilized to conduct this study.The study was conducted in the classroom at the faculty of nursing,and the“i Hub”center at Ain Shams University(ASU)in Cairo,Egypt.A purposive sample of 42 nursing students who participated in the“Ain Shams University-innovate”competition from the Faculty of Nursing of ASU were included in this study.Data collection tools included(1)Nursing students'innovation skills assessment questionnaire and(2)Innovative projects evaluation tool.Results:There was a statistically significant difference between the mean scores of nursing students'total innovation skills pre-and post-implementation of entrepreneurship training,where P-value<0.05.Conclusions:The results of the current study support the research hypothesis because the implementation of entrepreneurship training positively affects nursing students'innovation potential.Developing entrepreneurship education in nursing and integrating it into nursing programs will stimulate creativity,innovation,and entrepreneurship among nursing students and health care services.

The Impact of Internships on the Skill Acquisition Among Nursing Students in Vocational Colleges of Shandong Province

This research investigates the impact of internships on skill acquisition among nursing students in vocational colleges in Shandong Province.By employing a mixed-methods approach involving surveys and interviews,the study re-veals the positive influence of internships on students’clinical competencies,professional qualities,and readiness for the workforce.Survey findings indicate heightened practical capabilities and increased confidence among students.Interviews emphasize the pivotal role of mentors in guiding skills development and professional growth.However,challenges such as resource constraints and workload imbalances during internships are also highlighted.These insights contribute to the en-hancement of nursing education and the preparation of competent nursing professionals in the region.

Effectiveness of experiential teaching method on the development of nursing students’skill competence:a systematic review and meta-analysis

Objective:Skill competence is essential for nursing students and experiential teaching method has become increasingly popular in China’s nursing education.To systematically evaluate the effects of experiential teaching method on the development of nursing students’skill competence,and to provide evidence for nursing education.Methods:The China National Knowledge Infrastructure,VIP,Wanfang Data,PubMed,and Web of Science databases were searched from their inception until November 28,2019.We screened the studies according to inclusion and exclusion criteria,extracted the data,and assessed the quality.Then,a meta-analysis was conducted.Results:Totally 15 studies were included,and 1,633 nursing students were analyzed by Review Manager5.3 and Stata15.1 software.The results show that the experiential teaching method can significantly improve nursing students’nursing skills such as training(SMD=1.05,95%CI:0.95–1.16,P=0.000),learning interest(ES=0.93,95%CI:0.79–1.06),ability to analyze and solve problems(ES=0.75,95%CI:0.55–0.94),ability to judge and innovative thinking(ES=1.01,95%CI:0.77–1.25),abilities of understanding and perception(ES=0.59,95%CI:0.34–0.83),and teaching satisfaction(ES=1.26,95%CI:1.13–1.4).Conclusions:The results suggest that the experiential teaching method is more effective for the nursing students’skill competence than traditional teaching in China.However,due to the heterogeneity and bias risk,a large sample and high-quality studies are needed in future to confirm its effectiveness.

The Effect of Simulation-Based Training on Nursing Students’ Communication Skill, Self-Efficacy and Clinical Competence for Nursing Practice

Background: Simulation-based training is a new strategy in teaching that gives the students good opportunities to learn and apply what they learn in nursing care safely. Aim: This study conducted to evaluate the effects of simulation-based training on nursing students’ communication skill, self-efficacy and clinical competence in practice. Subjects and Methods: Quiz-experimental design was used in this study (pre-posttest intervention), it was carried out on 100 nursing students first semester in 2019 using low and high-fidelity simulators. This study was carried out at College of Applied Medical Sciences-Bshia University. Data Collection: demographic data, communication skill, self-efficacy and clinical competence questionnaires. Analysis is done by SPSS version 20 software. Results: Participants who received the simulation-based training, showed statistical significant improvement in communication skill, self-efficacy, and clinical competence scores after participation in the simulation program (t = &#8722;32.64, p = 0.001;t = &#8722;19.9, p = 0.001;16.4, p = 0.001). Also, there are significant relation between gender and clinical competency (t = 2.768, p Conclusion: Simulation-based training in medical courses is effective in enhancing communication skill, self-efficacy and clinical competence. Multiple-patient simulations as a teaching-learning strategy in the nursing curriculum are highly recommended.

Clinical Supervision and Non-Technical Professional Development Skills in the Context of Patient Safety—The Views of Nurse Specialist Students

The aim of the study was to evaluate nurse specialist students’ views of clinical supervision (CS) and its influence on their professional competence development. An additional aim was to interpret the results and link them to non-technical skills and Patient Safety (PS) topics. The research question was: What are the benefits of clinical supervision focusing on non-technical skills in the area of PS? A cross-sectional study of 46 nurse specialist students was conducted by means of questionnaires and exploratory factor analysis. Factors that influenced the nurse specialist students’ competencies were: interpersonal, professional and communication skills in addition to awareness of ethical skills, the importance of teamwork and the benefit of involving patients and their family members in safe care. The results were linked to non-technical skills and PS competencies. Clinical supervision is crucial for the development of non-technical skills and PS competencies among nurse specialist students. However, finding time to reflect and learn from the supervision was reported to be a problem. Over half of the students stated they did not have enough time for supervision. Thus, there is a potential for quality improvement. We recommend that universities should provide formal educational programmes for supervisors focusing on the professional development of students, especially in the area of non-technical skills. In conclusion, CS should be prioritised by management and clinical leaders as it enhances PS.

Effect of simulation-based teaching on nursing skill performance: a systematic review and meta-analysis

Objective:To summarize and produce aggregated evidence on the effect of simulation-based teaching on skill performance in the nursing profession.Simulation is an active learning strategy involving the use of various resources to assimilate the real situation.It enables learners to improve their skills and knowledge in a coordinated environment.Methods:Systematic literature search of original research ar ticles was carried out through Google Scholar,Medline,and Cochrane Cumulative Index to Nursing and Allied Health Literature(CINAHL)databases.Studies conducted on simulation-based teaching and skill performance among nursing students or clinical nursing staff from 2010 to 2019,and published in the English language,were included in this study.Methodological quality was assessed by Joanna Briggs Institute,and the risk of bias was also assessed by Cochrane risk of bias and the risk of bias assessment tool for non-randomized studies(ROBINS-I)checklists.Results:Initially,638 titles were obtained from 3 sources,and 24 original studies with 2209 study par ticipants were taken for the final analysis.Of the total studies,14(58.3%)used single group prep post design,7(29.1%)used high fidelity simulator(HFS),and 7(29.1%)used a virtual simulator(VS).Twenty(83.3%)studies reported improved skill performance following simulation-based teaching.Simulation-based teaching improves skill performance among types of groups(single or double),study regions,high fidelity(HF),low fidelity(LF),and standard patient(SP)users.But the effect over virtual and medium fidelity simulators was not statistically significant.Overall,simulation-based teaching improves the skill performance score among the experimental group(d=1.01,95%confidence interval[CI][0.69–1.33],Z=6.18,P<0.01,93.9%).Significant heterogeneity and publication bias were observed during the pooled analysis.Conclusions:Simulation did improve skill performance among the intervention groups,but the conclusion is uncer tain due to the significant heterogeneity.The large extent of difference among original research has necessitated the development of well-defined assessment methods for skills and standardized simulation set-up for proper assessment of their effects.

Relationship between Reflective Practice Skills and Volume of Writing in a Reflective Journal

Background: According to the diversification of the health needs and the expansion of health disparities, public health nurses need to improve their practical capabilities, starting from basic education in graduate and undergraduate courses. And Reflective Practice with using reflective journal is one way of improving practical capabilities. The purpose of this study was to investigate the relationship between the volume of reflective journal and the quality of progress in the reflective cycle. Methods: The participants in this study were 20 junior students majoring in public health nursing (hereinafter “PHN students”) at a university in the Chugoku area, Japan. We asked the participants to answer the questions on Reflective Practice Skills (RPS) composed of six criteria corresponding to the six questions of Gibbs on the reflective cycle before and after they started writing RJ. The volume of reflective writing was measured by the number of characters written by the PHN students in RJ of the reflective practice for three months. The study plan was approved by the Ethics Committee for Nursing Study, Okayama University. Results: Although the average total RPS score showed a change of about 3 points as a result of the 3-month RJ writing exercise, no correlation was observed between the RPS score and the RJ writing volume (r = 0.175). However, we did observe a moderately positive correlation between the RPS score and the RJ writing volume with regard to Items 5 and 6 (r = 0.475 and r = 0.444, respectively). Conclusion: This study indicated that detailed RJ writing helps to complete the reflective cycle all the way to theorization and action planning, and that the volume of writing may serve as a criterion for qualitative evaluation.

BOPPPS融合线上线下教学在护生关怀性专科操作教学中的应用

目的探讨BOPPPS融合线上线下教学在护生关怀性专科操作教学中的应用效果。方法将102名血管外科实习的护理本科生按照实习时间分为对照组50名,观察组52名。对照组采用常规教学方式,观察组采用BOPPPS融合线上线下教学开展关怀性专科操作教学。入科时及出科时采用关怀能力评价量表、学习积极主动性量表对两组护生进行调查,出科时进行操作技能考核,同时调查观察组护生对教学模式的评价。结果出科时观察组人文关怀能力、学习积极主动性评分及操作考核成绩显著高于对照组(均P<0.05),84.62%~96.15%观察组护生对BOPPPS融合线上线下教学持肯定态度。结论BOPPPS融合线上线下教学应用于护生关怀性专科操作教学,可调动护生学习积极主动性,有效提高护生的操作考核成绩和人文关怀能力。

实习护生遭受医院工作场所语言暴力现状及影响因素分析

目的:调查实习护理专业学生(护生)遭受医院工作场所语言暴力的现状,并分析其影响因素。方法:应用方便抽样法选取2021年12月—2023年1月在湖南省衡阳市、常德市、湘潭市共5所三级综合医院实习的713名护生作为研究对象,使用一般资料调查表、语言暴力问卷、护生临床沟通能力测评量表、情绪智力量表进行问卷调查。结果:年龄、是否为单亲家庭、是否担任学生干部、他人情绪管理、敏锐倾听是实习护生遭受语言暴力的影响因素,共解释总变异的57.28%。结论:实习护生是医院工作场所遭受语言暴力的高风险人群,医学院校教育者及医院管理者应当关注语言暴力的重要影响因素,制订有针对性的干预措施帮助实习护生预防和应对语言暴力的发生。

创伤救护技能模拟训练在医院护生临床实践教学中的应用与效果评价

目的分析创伤救护技能模拟训练在医院护生临床实践教学中的应用效果。方法选择2021年9月至2022年9月在本院实习的护生32名,其中16名为传统带教培训(对照组),16名为创伤救护技能模拟训练培训(观察组),两组均培训3个月。对比两组护生救护能力(理论知识、操作技能、实践综合能力);对比两组对培训反馈情况(是否可提高创伤救护技能练习兴趣、是否贴合临床、是否增加救护时信心、是否提高综合救护能力、是否提高团队协助意识、是否增加与患者沟通能力等);对比两组抢救成功率。结果培训前两组救护能力无差异,培训后救护能力均明显提升,观察组理论知识、操作技能、实践综合能力评分均高于对照组(P<0.05);针对两组反馈情况可知,观察组100%护生均肯定此教学模式可提高对创伤救护技能训练的兴趣,认为此训练模式可贴合临床、增加救护时信心、提高综合救护能力、提高团队协助意识、增加与患者沟通能力者均达85%以上,而对照组患者上述项目认同率均在80%以下(P<0.05);观察组抢救成功率为100%,对照组为68.75%,观察组抢救成功率高于对照组(P<0.05)。结论通过创伤救护技能模拟训练,可以提高护生的救护技能水平,增强其学习的积极性和团队协作能力,并且能够提高抢救的成功率。

基于创客教育理念的CDIO模式构建与应用研究——以急诊实习护生技能培训为例

“构思-设计-实现-运作”(Conceive-Design-Implement-Operate,CDIO)模式是一种系统的工程教育模式,教学者可以从不同的专业角度设计理论与实践相结合的灵活的培训方法。基于此,文章在创客教育理论的支持下,构建了基于创客教育理念的CDIO模式。之后,文章选取青岛市某三甲医院77名实习护生为研究对象。其中对照组38人,实行“教师示教+学生练习”教学模式,试验组39人,实行基于创客教育理念的CDIO模式的急诊技能培训教学模式,收集相关数据,发现对照组实习后和实习前自主学习能力得分的差值为(5.39±51.31)、批判性思维能力得分的差值为(4.08±104.18)、创造力倾向水平得分的差值为(1.05±23.69)、一般自我效能感得分的差值为(2.29±9.70),试验组实习后和实习前自主学习能力得分的差值为(32.69±15.63)、批判性思维能力得分的差值为(59.77±32.16)、创造力倾向水平得分的差值为(22.31±7.55)、一般自我效能感得分的差值为(7.21±6.50),试验组得分差值高于对照组,实习后试验组实践技能操作考核成绩得分(92.15±1.13)高于对照组的(86.09±1.99),均P<0.001,从而验证了该模式在急诊实习护生技能培训中的应用效果。

护理硕士研究生反思能力与沟通能力的相关性

目的:评估护理硕士研究生的反思能力和沟通能力的相关性。方法:以62名护理硕士研究生为研究对象,采用学习者能力增强反思量表、突发坏消息沟通能力量表(BAS)和SPIKES问卷进行调查。结果:护理硕士研究生反思能力得分为(2.64±1.10)分,反思能力与沟通能力呈正相关;回归分析显示,反思及反思能力中的解释注意对护理硕士研究生的沟通能力有影响(P<0.05)。结论:护理硕士研究生反思能力与沟通能力有关,高水平反思能力可以提高沟通能力。

以岗位核心胜任力为导向的实习护生临床路径教学模式的研究

目的探讨以岗位核心胜任力为导向的实习护生临床路径教学模式的教学效果。方法选取2021年8月—2022年1月在盘锦辽油宝石花医院实习的60名护理专业大专学生作为研究对象,随机分为试验组和对照组,每组30名。试验组实习护生通过以岗位核心胜任力为导向的临床路径教学模式教学,对照组通过传统教学模式教学。对2组实习护生在实习前后的教学效果进行比较。结果实习前,2组理论成绩、护理操作成绩及岗位胜任力在各维度上的得分比较,差异无统计学意义(P>0.05)。实习后,2组得分均高于实习前(P<0.05);试验组理论及操作成绩分别为(93.37±2.35)分、(87.97±3.12)分,高于对照组的(89.60±2.94)分、(84.90±3.24)分,岗位胜任力在各维度上的得分均高于对照组(P<0.05)。结论基于岗位胜任力的新型人才培养模式可以有效提高实习护生的理论成绩、技能操作成绩和护理岗位胜任力。

临床实习护生护患沟通能力现状及培养方式研究——以温州医科大学护理专业为例

文章以温州医科大学护理专业学生护患沟通能力特征为切入点,分析当前护生医患沟通现状中出现的具体问题和影响因素,从而提出有针对性的对策和建议。以“护理专业学生护患沟通能力评价量表”为测量工具,对2020届211名实习护生进行调查并分析。影响护生沟通能力因素有多种,在临床沟通能力各维度中,收集信息得分相较其他五个维度较好,得分最低的两个维度是计划和准备、获得以及理解病人的观点。当前本科实习护生护患沟通能力有待进一步提升。

高职在校护生基础护理技能操作风险调查与分析

目的探讨高职在校护生基础护理技能操作避险需求及其影响因素,为降低职业暴露风险提供依据。方法采用随机整群抽样法,利用问卷星对某高职院校386名在校护生进行基础护理技能操作风险问卷调查。结果护生基础护理技能操作风险问卷得分处于较低水平,个别条目得分较高。是否接受过护理安全职业防护教育、是否有8个月的医院实习经历、是否有医院见习经历等是基础护理技能操作风险的主要影响因素。结论高职院校应加强医校合作,积极探索形式多样、内容丰富的职业防护教育课程,开展适合不同阶段高职护生的职业防护教育,创建安全的实践环境。

启发式临床医学教学模式对实习护士专业技能水平及教学质量的影响

目的:探讨启发式临床医学教学模式(PCMC)对实习护士专业技能水平及教学质量的影响。方法:选取2022年9月—2023年7月闽西职业技术学院护理专业实习护士92例作为研究对象,随机分为常规组与PCMC组,各46例。常规组采用传统讲授式教学,PCMC组采用PCMC教学模式。比较两组成绩考核结果、护理能力考核评分、解决问题能力、教学质量。结果:PCMC组理论知识考核成绩、操作技能考核成绩均高于常规组,差异有统计学意义(P<0.05);干预后,两组发现问题、紧急应对、解决问题、团队协作评分升高,PCMC组高于常规组,差异有统计学意义(P<0.05);干预后,两组理性问题解决、正性问题解决评分升高,回避风格、冲动/疏忽风格、负性问题定向评分降低,PCMC组理性问题解决、正性问题解决评分高于常规组,回避风格、冲动/疏忽风格、负性问题定向评分低于常规组,差异有统计学意义(P<0.05);PCMC组思考积极性、课堂专注度、内容掌握度、临床思维、合作交流评分高于常规组,差异有统计学意义(P<0.05)。结论:PCMC教学模式可提高实习护士理论知识与操作技能,优化其专科护理能力与解决问题能力,提高教学质量。