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.

Improvement in Patient Mobility Following Short-Term Rehabilitation in Skilled Nursing Facilities

Background: Mobility in older adults can be impaired after acute illness or hospitalization, and the level of severity can be used as a predictor of one’s ability to return to independent living. Patients are often referred to skilled nursing facilities in hopes of improving their mobility. We wanted to prove that rehabilitative services at Skilled Nursing Facilities improve overall outcomes. Methods: We conducted a retrospective analysis of data from 4612 patients admitted for short-term rehabilitation in a large nursing home chain in California. Our aim was to determine whether patients’ mobility scores, as measured by rehabilitative staff, significantly improved by time of discharge compared to their scores at admission. Mobility scores were rated from 1 to 6, with 1 being the most dependent on aid and 6 being the most independent, over a variety of tasks at admission and compared to scores at discharge. Pearson’s correlations were performed to determine if there were significant relationships in the data: the Pearson’s correlation coefficient was used to describe the relationships between patient admission to a skilled nursing facility and medical improvement upon discharge. Results: The study demonstrated a statistically significant improvement in patients’ mobility scores upon discharge, with Medicare insured patients showing on average 57% improvement and Managed Care insured patients showing on average 59% improvement. Additionally, admission scores appeared to be predictive of the patient’s outcome at discharge. Conclusions: The values and consistency of improvement support the use of acute rehabilitative services in skilled nursing facilities. An equation can be formulated that evaluates patients’ estimated mobility statuses upon discharge from facilities based on their conditions on their arrivals. With this, new interventions can be studied and compared to the current standard of care by using these measurements. They can determine if further improvements can be made to increase patient outcomes.

Improvement of Activities of Daily Living (ADL) for Patients Treated in Skilled Nursing Facilities (SNFs)

Background: Self-care tasks or activities of daily living (ADL)’s performance are often disrupted after an older adult sustains an injury or illness, which can be a determining factor for discharge placement after hospitalization, or it can determine the level of assistance required after discharge from a skilled nursing facility (SNF). We believe that comprehensive rehabilitation can improve a patient’s overall functioning during their short term stay in SNFs. The purpose of this study is to determine if an individual’s level of independence improved after admission to a skilled nursing facility and procurement of rehabilitation services. Methods: This study retrospectively reviewed 4612 nursing home patients in California who underwent rehabilitative services at skilled nursing facilities to determine how the patients responded to their environments, therapy interventions, and any other additional supportive measures. The records of patients who were admitted for short-term rehabilitation were reviewed in a blinded fashion, looking specifically at Section GG of the Minimum Data Set (MDS). Self-Care Section GG scores recorded by rehabilitative staff provide objective data and measure patients’ levels of assistance that were required. Each activity is scored from 1, being completely dependent, to 6, being entirely independent, with varying levels of assistance with scores in between. The admission scores versus the discharge scores can be compared to determine if a patient improved their level of functioning upon discharge. Results: Utilizing the Pearson’s correlation coefficient, a strong correlation of improvement in ADL performance on Section GG between the admission and discharge scores was identified, implying significant improvement in functional independence upon discharge. The average percent improvement for Managed Care patients was ~35.4% and ~39.4% for Medicare patients. Conclusions: The results support the benefits of rehabilitation services in skilled nursing facilities, and the data suggests that admission scores can be used as a predictive tool for functional outcomes.

Defining soft skills in nursing:a concept analysis

Objective:To define soft skills in nursing.Methods:This is a concept analysis using the Walker and Avant approach.Multiple electronic databases in the English language including CINAHL,Science Direct,MEDLINE on EBSCOhost,and Scopus were consulted.Results:Soft skills in nursing include the intrapersonal attributes,interpersonal skills,and creativity of the nurse,which,when combined with professionalism,teamwork,and effective communication skills,improve the quality of nursing care and client satisfaction.Conclusions:Although hard and soft skills are compatible and synergetic,soft skills are to be prioritized for the success of nursing care in the healthcare industry.This concept analysis adds to the body of knowledge by identifying the attributes of soft skills in nursing and revealing that a good nurse needs more than just good grades to be successful.

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.

A Study on the Work Process-Based Practical Training Model for Basic Nursing Skills in Vocational Colleges

Objective:To explore and analyze the work process-based practical training teaching model for basic nursing skills in vocational colleges and its implementation effects.Methods:A total of 82 nursing students from our school were selected for the study,which was conducted from April 2023 to April 2024.Using a random number table method,the students were divided into an observation group and a control group,each with 41 students.The control group received conventional practical training teaching,while the observation group followed the work process-based practical training model for basic nursing skills.The assessment scores and teaching satisfaction of the two groups were compared.Results:The comparison of assessment scores showed that the observation group performed significantly better than the control group(P<0.05).The comparison of teaching satisfaction also indicated that the observation group had significantly higher satisfaction than the control group(P<0.05).Conclusion:The work process-based practical training teaching model for basic nursing skills in vocational colleges can improve students’assessment scores and enhance teaching satisfaction,demonstrating its value for wider application.

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. .

Observation of the Effect of Video Assessment Method on the Operation Skills of Individual Nurses

Objective:To explore the application effect of video assessment method in clinical nurses’nursing operation skills.Method:To select 58 nurses who participated in the individual soldier standard in the children’s hospital in 2019 and 2020 as the research objects,among which the nurses who participated in the individual soldier standard in 2019 were the nurses who participated in the individual soldier standard in 2019 and 2020.A total of 29 people in the first batch were set as the control group,using traditional assessment methods.In 2020,the second batch of 29 nurses who participated in the individual soldier standard reached the experimental group.Using the video assessment method,there was no significant difference in general information between the two groups(P>0.05).After the assessment,the scores,coping with work pressure,and proactiveness of the two groups of research subjects were compared.Results:The experimental group’s nursing operation assessment scores,coping with work pressure,and proactiveness were significantly better than those of the control group,the difference was statistically significant(P<0.05).Conclusion:The application of the video assessment method improves the passing rate of nurses’operational skills examination,enhances nurses’initiative in learning,reduces examination pressure,and can be accurately,timely,and safely applied to clinical nursing work,which is worthy of study and promotion.

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.

Research on the Reform and Practice of “Basic Nursing Skills Practice” Course Assessment

Objective: “Basic Nursing Skills Practice” is a key course connecting classroom and clinical teaching in nursing specialty teaching. Nursing practice ability is one of the core abilities of nurse practitioners. Therefore, the teaching quality of this course is directly related to the quality of nursing work. To improve the teaching quality of practical course, the assessment reform of the “Basic Nursing Skills Practice” course was carried out among the nursing undergraduates to explore a reasonable and fair assessment mechanism. Method: In the assessment of “Basic Nursing Skills Practice” course, the assessment included individual skill operation assessment, virtual simulation assessment and team comprehensive skill assessment. The assessment proportion was adjusted from 100% for the final examination to 50% for the middle and final examinations respectively. The assessment method was changed from individual skills assessment at the end of the term to a combination of individual skills assessment at the midterm and virtual simulation assessment and team skills assessment at the end of the term. The method has changed from summative evaluation to a combination of formative evaluation and summative evaluation, and self-made questionnaire was used to investigate the effect. Results: After implementing the assessment reform, 86.84% of the students were satisfied with the assessment reform, and the percentage of students with scores above 80 reached 100%. The highest score is 93.0, while the lowest score is 83.0, and the average score was 88.0. Conclusions: High satisfaction of students with basic nursing skills examination reform promoted the learning effectiveness and professional emotions, cultivated comprehensive quality and ability, promoted the realization of talent training objectives.

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.

Application of a hospital–community–family trinity rehabilitation nursing model combined with motor imagery therapy in patients with cerebral infarction

BACKGROUND Rehabilitation nursing is considered an indispensable part of the cerebral infarction treatment system.The hospital–community–family trinity rehabilitation nursing model can provide continuous nursing services across hospitals,communities,and families for patients.AIM To explore the application of a hospital–community–family rehabilitation nursing model combined with motor imagery therapy in patients with cerebral infarction.METHODS From January 2021 to December 2021,88 patients with cerebral infarction were divided into a study(n=44)and a control(n=44)group using a simple random number table.The control group received routine nursing and motor imagery therapy.The study group was given hospital–community–family trinity rehabilitation nursing based on the control group.Motor function(FMA),balance ability(BBS),activities of daily living(BI),quality of life(SS-QOL),activation status of the contralateral primary sensorimotor cortical area to the affected side,and nursing satisfaction were evaluated before and after intervention in both groups.RESULTS Before intervention,FMA and BBS were similar(P>0.05).After 6 months’intervention,FMA and BBS were significantly higher in the study than in the control group(both P<0.05).Before intervention,BI and SS-QOL scores were not different between the study and control group(P>0.05).However,after 6months’intervention,BI and SS-QOL were higher in the study than in the control group(P<0.05).Before intervention,activation frequency and volume were similar between the study and the control group(P>0.05).After 6 months’intervention,the activation frequency and volume were higher in the study than in the control group(P<0.05).The reliability,empathy,reactivity,assurance,and tangibles scores for quality of nursing service were higher in the study than in the control group(P<0.05).CONCLUSION Combining a hospital–community–family trinity rehabilitation nursing model and motor imagery therapy enhances the motor function and balance ability of patients with cerebral infarction,improving their quality of life.

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.

Nursing Students’ Experience with Information Literacy Skill

This study examined the searching skills and extent of usage of electronic databases by Nursing, Midwifery and Public Health Nursing students in the University of Health and Allied Science (UHAS). The focus was on forty (40) level 300 students drawn from a universe of two hundred and forty six (246) of the School of Public Health (SPH). The study used quantitative method approach and the survey instruments were questionnaire, interview and observation. The data collected were analyzed and classified into the following themes: usefulness, extent of use, determinants of use of e-databases, searching skills, and main drawbacks of learning information literacy skills (ILS). Although all the respondents strongly agreed that e-databases are indispensable for academic and professional practice, findings revealed that majority of them have low quality of searching skills and that accounts for the sparse use of the e-databases. This positive association is proven by Pearson’s chi square test (0.000). The study also established that students’ attitude, academic loads and methodology of teaching were the challenges hindering the acquisition of ILS of students. As a consequence, the study recommends that Academic librarians should intensify their education on e-databases, the development of research guides and encourages stronger collaboration with faculty members in the teaching of ILS so that student nurses would be more adept in searching for information to enhanced scholarship and professional practice.

Teaching Reform of “Nursing of Traditional Chinese Medicine” Course Based on OBE Concept

Traditional Chinese medicine(TCM)nursing is one of the important disciplines in TCM.It is based on TCM theory and combined with modern nursing theory and technology,aiming to provide comprehensive and individualized nursing services.With the changes in the medical environment and the continuous improvement of people’s health needs,the teaching of TCM nursing is facing new challenges and opportunities.This paper aims to discuss the teaching reform of TCM nursing course based on the concept of outcome-based education(OBE)or student-centered teaching.The significance of this study is to provide theoretical basis and practical guidance for the teaching reform of TCM nursing course,and to promote the development and progress of TCM nursing education.Through the teaching reform based on OBE concept,we can better cultivate TCM nursing talents with innovative spirit and practical skills,and contribute to the development of TCM.

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.

Philosophizing in skilled nursing care: Must or nice?

To become a professional nurse requires that nurses learn to think in a right way. Thinker nurses strive to be clear, accurate, logical, complete, precise and faire in their practice and manner. In other words, a thinker nurse is a philosopher who has the ability of reasoning, critical and reflective thinking. In many investigations, the role of critical or reflective thinking is explored, but in this review article, we are trying to introduce a comprehensive concept that involves all these elements of thinking skills. It is philosophizing.

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.

Nurses'critical thinking disposition and professional commitment:a cross-sectional study

Objective:High-quality and successful nursing care delivery in a variety of situations requires critical thinking training and professional commitment.The present study aimed to investigate critical thinking disposition,professional commitment,and the relationship between these 2 variables among nurses.Methods:As a result of stratified random sampling,201 nurses were enrolled in the present cross-sectional study.Data were gathered using a socio-demographic form,the Critical Thinking Disposition Inventory(CTDI),and the Nurses'Professional Commitment Scale(NPCS).Results:Although the critical thinking disposition scores were at a moderate level(115.70±13.55),the mean score for professional commitment was high(91.37±11.77).A positive correlation was found between critical thinking disposition and professional commitment(r=0.67,P=0.001).Conclusions:Nursing managers are urged to employ strategies to enhance nurses'critical thinking disposition and professional commitment.