Investigation on the Current Status and Effects of Online Course Learning for Nursing Students

[Objectives]To explore the current situation and effects of online learning from the perspective of students,as well as the learning dynamics,and to explore the online teaching methods.It is possible to put forward relevant suggestions for the problems presented by online teaching,find effective teaching methods,and explore appropriate online teaching methods.[Methods]The nursing students of the 2020,2021,and 2022 grades of Chengde Nursing Vocational College were selected as the research subjects.A self-made questionnaire survey method was adopted.The questionnaire had 5 items and 44 questions:3 questions on personal information,9 questions on the teacher level,12 ques-tions on the student level,7 questions on the technical level,and 13 questions on online learning satisfaction.[Results]In the process of on-line teaching,the cooperation between family and school can be carried out to give full play to the important role of family supervision in online learning and other education,which is conducive to maintaining the discipline of online courses on the Internet,increasing the online learning effect of students,and avoiding the temptation of the Internet to the greatest extent.In the process,we should increase students'self-control in online learning,help students shape realistic goals,and thus improve the effect of online learning.Technical level:increase information-based teaching,enrich teaching content,and introduce virtual simulation software to simulate clinical operations,so as to increase students’interest and enthusiasm in learning.[Conclusions]This study is expected to provide a certain reference for the smooth and efficient development of online teaching and online learning skills.

Evaluating the influence of a structured nursing protocol on targeted outcomes in rheumatoid arthritis patients

Objective:Rheumatoid arthritis(RA)requires comprehensive management.Structured nursing protocols may enhance outcomes,but evidence is limited.This study evaluated the effect of a structured nursing protocol on RA outcomes.Materials and Methods:In this one-group pre-post study,30 Egyptian RA patients completed assessments before and after a 12-week nursing protocol comprising education,psychosocial support,and self-management promotion.Assessments included clinical evaluation of joint counts,erythrocyte sedimentation rate(ESR),and C-reactive protein(CRP)and patient-reported Arthritis Self-Efficacy Scale(ASES),Health Assessment Questionnaire(HAQ),Visual Analog Scale(VAS)for pain,and Hospital Anxiety and Depression Scale(HADS).Results:The study demonstrated significant improvements in both clinical-and patient-reported outcomes.Joint count decreased from 18.4±4.2 to 14.2±3.8(P<0.001),ESR from 30.1±6.8 mm/h to 25.5±6.8 mm/h(P<0.01),and CRP levels from 15.2±3.6 mg/L to 11.8±2.9 mg/L(P<0.01)postintervention.Patient-reported outcomes showed a marked increase in ASES score from 140±25 to 170±30(P<0.001)and reductions in HAQ from 1.6±0.4 to 1.3±0.3(P<0.01),VAS pain score from 7.8±1.7 to 6.2±1.2(P<0.001),and HADS anxiety and depression scores from 11±3 to 8±2(P<0.05)and 10±2 to 7±1(P<0.05),respectively.Conclusion:A structured nursing protocol significantly improved clinical disease activity,physical functioning,pain,self-efficacy,and emotional well-being in RA patients.A multifaceted nursing intervention appears beneficial for optimizing RA outcomes.

Effectiveness of simulation-based learning regarding management of post-COVID complications in terms of knowledge,clinical decision-making ability,and self-efficacy among nursing students:A quasi-experimental study

Objective:To assess the effectiveness of simulation-based learning regarding the management of post-COVID complications in terms of knowledge,clinical decision-making ability,and self-efficacy among nursing students.Methods:This was a quasi-experimental study conducted among 1152nd-year nursing students.The participants were selected by a simple random sampling technique.The participants were divided into an experimental(n=56)and a comparison group(n=59)by a random table method.Data were analyzed using descriptive and inferential statistics with SPSS version 20.Results:There were significant differences in mean post-test knowledge scores(P=0.03)and mean post-test self-efficacy scores(P=0.001)between the experimental and the comparison groups while the difference in mean post-test clinical decision-making ability scores between the two groups was non-significant(P=0.07).A positive correlation was found between knowledge and clinical decision-making ability in pre-test(P=0.03)and in post-test(P<0.001)and a non-significant correlation was found between pre-test knowledge and self-efficacy score(P=0.52)among the experimental group.Conclusions:Simulation-based learning regarding the management of post-COVID complications is effective among nursing students.Simulation labs should be established in health care settings where simulation training can be provided for updating the knowledge,clinical decision-making ability,and self-efficacy of nursing personnel during program installment and continuous nursing education.

Knowledge, Attitude, and Practice toward Coronavirus (Covid-19) among Laboratory & Nursing Students of Hadhramout University, in Mukalla City, Yemen

Background: As future healthcare providers, nursing students must have high-quality knowledge and be able to respond to rapid changes in any situation, such as the pandemic Covid-19. The condition of these students reflects the readiness of nursing students to face the increasing cases in the country. Since December 2019, coronavirus (Covid-19), a novel infectious disease that emerged, has spread worldwide, and the World Health Organization (WHO) has declared that the infection is a “pandemic” and no country or region can be considered safe. The World Health Organization declared the novel coronavirus a global health emergency (pandemic) on January 30, 2020. The novel coronavirus is a highly contagious disease, and the current outbreak has affected a large portion of the population around the world. Public health and social interventions play a critical role in reducing the number of infections and deaths until the vaccine is available to all. Objective: To determine the knowledge, attitude, and practice toward Coronavirus (Covid-19) among Laboratory & Nursing students of Hadhramout University, in Mukalla City, Yemen. Methods: This was a descriptive cross-sectional. Stratified random sampling is used in sample selection to ensure that laboratory and nursing students total of 130 (70, 60) were included in the study. The sample was randomly selected from one hundred students, 50 laboratory students, and 50 nursing students studying at Hadhramout College. Time of study from October to December 2021. Results: The statistical analysis of data collected in this study showed that the awareness of coronavirus knowledge was high, as indicated by the percentage of correct answers. 78% of the nursing students obtained the highest percentage of knowledge about coronavirus, while more than 75% of the laboratory students, relied on social media as their main source of Covid-19 information. The College of Nursing students got the highest percentage of resource information about the Coronavirus 44%. Also we reported negative attitudes in general among nursing students and laboratory students at Hadhramout University, with 31% and 35% of nursing students and laboratory students respectively. On the other hands, we noted that (39%) of nursing students received a greater percentage of practice about Coronavirus than (37%) of laboratory students. So, they had a negative practice in general. Conclusion: The present study shows that knowledge about coronavirus is high, but attitudes and practices toward coronavirus (Covid-19) among laboratory and nursing students at Hadhramout University in Mukalla, Yemen, are generally negative.

Nitrate reduction capacity of the oral microbiota is impaired in periodontitis:potential implications for systemic nitric oxide availability

The reduction of nitrate to nitrite by the oral microbiota has been proposed to be important for oral health and results in nitric oxide formation that can improve cardiometabolic conditions. Studies of bacterial composition in subgingival plaque suggest that nitrate-reducing bacteria are associated with periodontal health, but the impact of periodontitis on nitrate-reducing capacity(NRC)and, therefore, nitric oxide availability has not been evaluated. The current study aimed to evaluate how periodontitis affects the NRC of the oral microbiota. First, 16S rRNA sequencing data from five different countries were analyzed, revealing that nitratereducing bacteria were significantly lower in subgingival plaque of periodontitis patients compared with healthy individuals(P < 0.05 in all five datasets with n = 20–82 samples per dataset). Secondly, subgingival plaque, saliva, and plasma samples were obtained from 42 periodontitis patients before and after periodontal treatment. The oral NRC was determined in vitro by incubating saliva with 8 mmol/L nitrate(a concentration found in saliva after nitrate-rich vegetable intake) and compared with the NRC of 15healthy individuals. Salivary NRC was found to be diminished in periodontal patients before treatment(P < 0.05) but recovered to healthy levels 90 days post-treatment. Additionally, the subgingival levels of nitrate-reducing bacteria increased after treatment and correlated negatively with periodontitis-associated bacteria(P < 0.01). No significant effect of periodontal treatment on the baseline saliva and plasma nitrate and nitrite levels was found, indicating that differences in the NRC may only be revealed after nitrate intake. Our results suggest that an impaired NRC in periodontitis could limit dietary nitrate-derived nitric oxide levels, and the effect on systemic health should be explored in future studies.

案例教学法结合虚拟仿真技术在助产实验课程中的应用效果研究

目的探讨案例教学法结合虚拟仿真技术在助产实验课程中的应用效果。 方法采用类实验研究设计,于2020年9月至2022年1月,从桂林医学院护理学院助产专业选取2018级和2019级两个班级共135名学生为研究对象,2019级为干预组(n=59),2018级为对照组(n=76)。干预组在传统实验教学的基础上,采用案例教学法结合虚拟仿真技术,课程包括正常分娩(6学时)异常分娩(6学时)脐带脱垂(2学时)、新生儿窒息与复苏(4学时)4部分内容;对照组学生采用传统实验教学。采用课程成绩、自主学习能力问卷、教学满意度问卷进行调查,比较两组学生的教学效果。结果课程结束后,干预组学生的个人操作能力(90.88±2. 14比89.24土3.15),团队操作能力(90.97±2.33比81.28±5.45)和案例分析能力(88.64±3.19比86.70±2.56)均高于对照组(P<0.01)。课程干预前,两组学生自主学习能力得分比较,差异无统计学意义;课程实施后,干预组学生自主学习能力得分(94.78±6.59比88.12±8.36)及各维度得分均高于对照组(P<0.05)。超过94%的干预组学生认为案例教学法结合虚拟仿真技术有效提高了他们自主学习热情、独立思考、团队协作及沟通等综合能力。结论在助产实验课程中应用案例教学法结合虚拟仿真技术,可有效提高学生课程成绩、自主学习能力及综合能力,并得到学生的认可。

Transcultural adaptation of Odia version of health-related kidney disease and quality of life-36 instrument

Objective:The study objective was to translate,validate,and test the reliability of the original kidney disease and quality of life-36(KDQOL-36^(TM))instruments in Odia.Materials and Methods:A cross-sectional design with a purposive sampling technique was used.According to RAND Corporation guidelines,initially,the items of the KDQOL-36^(TM)questionnaires were translated into Odia by two independent,bilingual,professional translators,and then back-translated to English,followed by tryout and field testing.The experts validated the KDQOL-36^(TM)instrument review committee for review related to kidney health conditions.The tool was implemented among 180 patients undergoing“maintenance”hemodialysis.The following tests evaluated reliability and validity:test-retest reliability with Cronbach’s alpha correlation(stability),(reliability)internal consistency,and contents validity index.Results:The Cronbach’s alpha value and intraclass correlation coefficient(ICC)score of all five domains,namely“physical component summary,mental component summary(MCS),the burden of kidney disease,symptoms and problems of kidney disease,and effects of kidney disease”of both KDQOL-36^(TM)English and Odia(KDQOL-36-E^(TM)and KDQOL-36-O^(TM))version,recommended excellent homogeneity.A high positive correlation(r=0.998)was found between the Odia version of KDQOL-36^(TM)and the English version KDQOL-36^(TM)questionnaire.The ICC score ranges from 0.889 to 0.997 at a 95%confidence interval for test-retest reliability,and Cronbach’s alpha was 0.832.Conclusion:This study explores the Odia version of KDQOL-36^(TM)psychometric properties,depicted at an acceptable level of internal consistency.The KDQOL-36-O^(TM)instrument is a valid and reliable tool for assessing the kidney disease-related quality of life in Odia-speaking hemodialysis patients.

Efficacy and safety of B-ultrasound-guided radiofrequency ablation in the treatment of primary liver cancer: Systematic review and metaanalysis

BACKGROUND Primary liver cancer is one of the most lethal malignancies in the world.Tradi-tional treatment methods have limitations in terms of efficacy and safety.Ra-diofrequency ablation(RFA)guided by B-ultrasound,as a minimally invasive treatment,has attracted increasing attention in the treatment of primary liver cancer in recent years.AIM To study the efficacy and safety of RFA were compared with those of traditional surgery(TS)for treating small liver cancer.METHODS At least 2 people were required to search domestic and foreign public databases,including foreign databases such as EMBASE,PubMed and the Cochrane Library,and Chinese databases such as the China National Knowledge Infrastructure database,China Biomedical Literature database,Wanfang database and VIP database.Controlled trials of RFA vs conventional surgery for small liver cancer were retrieved from January 2008 to January 2023.They were screened and eva-luated according to the quality evaluation criteria in the Cochrane Handbook of Systematic Reviews.The meta-analysis was performed using RevMan 5.3 soft-ware.RESULTS A total of 10 studies were included in this study,including 1503 patients in the RFA group and 1657 patients in the surgery group.The results of the meta-ana-lysis showed that there was no significant difference in 1-year overall survival between the two groups(P>0.05),while the 3-year and 5-year overall survival rates and 1-year,3-year and 5-year tumor-free survival rates in the surgery group were greater than those in the RFA group(P<0.05).In terms of complications,the incidence of complications in the RFA group was lower than that in the surgery group(P<0.05).CONCLUSION In terms of long-term survival,TS is better than RFA for small liver cancer patients.However,RFA has fewer complications and is safer.

Effectiveness of structured teaching program on knowledge and attitude toward foot care

Objective:The study was aimed to assess the knowledge and attitude toward foot care and evaluate the effectiveness of structured teaching program(STP)on the knowledge and attitude of patients with diabetes mellitus regarding foot care.Materials and Methods:A preexperimental research design was used in this study,which was conducted in medical-surgical wards of a secondary hospital in Northeast India,Nagaland.A total of 30 subjects were recruited by consecutive sampling technique.A closed-ended structured questionnaire and 5-point Likert scale was used to assess knowledge and attitude toward foot care.A STP was administered after which posttest was done after 24 h.Results:The majority(86.6%)of the participants in the pretest had inadequate knowledge and 80%had negative attitudes toward foot care.After STP,70%had moderately adequate knowledge and 53.3%had a positive attitude regarding foot care.The structured teaching program was effective in improving the knowledge and attitude at P<0.01 which is highly significant and there was a significant association between the pretest level knowledge and duration of diabetes at P<0.01.Conclusion:STP was effective in enhancing the level of knowledge and attitude toward foot care among diabetic inpatients.This type of interaction can be organized at regular intervals to reinforce knowledge and attitude toward foot care among inpatients.

SOX11 as a potential prognostic biomarker in hepatocellular carcinoma linked to immune infiltration and ferroptosis

Objective:SOX11 is expressed in numerous malignancies,including hepatocellular carcinomas(HCC),but its oncogenic function has not been elucidated.Here,we performed a comprehensive bioinformatics analysis of the Liver Hepatocellular Carcinoma(LIHC)dataset to investigate the function of SOX11 in tumorgenesis.Methods:SOX11 expression data from The Cancer Genome Atlas(TCGA)and Gene Expression Omnibus(GEO)were validated by immunohistochemistry(IHC).Co-expression,differential expression,and functional analyses utilized TCGA-LIHC,Timer 2.0,Metascape,GTEx,and LinkedOmics databases.Associations with immune infiltration,ferroptosis,and immune checkpoint genes were assessed.Genetic changes were explored via CBioPortal.Logistic regression,receiver operating characteristic curve(ROC),Kaplan-Meier analysis,and nomogram modeling evaluated associations with HCC clinicopathological features.SOX11’s impact on proliferation and migration was studied in HepG2 and HuH7 cell lines.Results:SOX11 was significantly elevated in HCC tumors compared to controls.SOX11-associated genes exhibited differential expression in pathways involving extracellular membrane ion channels.Significant associations were found between SOX11 levels,immune infiltration,ferroptosis,and immune checkpoint genes in HCC tissue.SOX11 levels correlated with HCC stage,histologic grade,and tumor status,and independently predicted overall and disease-specific survival.SOX11 expression effectively distinguished between tumor and normal liver tissue.Spearman correlations highlighted a significant relationship between SOX11 and ferroptosis-associated genes.Decreased SOX11 levels in HepG2 and HuH7 cells resulted in reduced proliferation and migration.Conclusions:SOX11 was found to represent a promising biomarker within HCC diagnosis and prognosis together with being a possible drug-target.

Disruption of sleep patterns among secondary school adolescents

Objectives:This study aims to assess sleep disorders among secondary school adolescents and explore the relationship between sociodemographic factors(age,gender,household income,and sleep duration)and the occurrence of these disorders.Methods:A quantitative,descriptive,cross-sectional study,was conducted from November 20th,2022,to May 25th,2023,involving 200 secondary school students selected through convenience sampling.Data collection utilized a structured questionnaire divided into sociodemographic and sleep disorder sections.Validity was ensured by a panel of ten experts,and reliability was confirmed using Cronbach’s Alpha(0.77).Statistical analysis employed SPSS version 26.Results:Findings revealed that a majority of participants(70.5%)had low-level sleep disorders,followed by moderate disorders represented(29%).Significant associations were found between sleep disorders and gender(P=0.000),economic status for family(P=0.020),and nightly sleep duration(P=0.016).However,no significant relationship was observed between sleep disorders and family structure or age(P>0.05).Conclusions:The study highlights that most secondary school students experience mild sleep disorders,followed by moderate disorders.Notably,gender,income,and sleep duration showed significant correlations with sleep disorders.

护士心理负荷的影响因素:一项潜在剖面分析

目的采用潜在剖面分析的方法探讨临床护理人员心理负荷现状及其影响因素。方法于2023年3月-7月,以便利抽样法采用人口学资料调查表、领悟社会支持量表、简易应对方式问卷和NASA-任务负荷指数量表对我国5所三级医院的526名临床护士进行问卷调查。分别使用Mplus 7.3和SPSS 24.0软件进行潜在剖面分析和多元logistic回归分析,探讨心理负荷不同潜在剖面的影响因素。结果护理人员心理负荷总分为(69.57±16.93)分,可分为“低心理负荷-高自评”组(n=70,13.3%)、“中心理负荷”组(n=273,51.9%)和“高心理负荷-低自评”组(n=183,34.8%)3个潜在类型。在“高心理负荷-低自评”亚组中,工作年限≥5年、无子女、月收入≥6000元、健康状况差、近1年未接受过心理培训和遭受过工作场所暴力的护士比例高于其他亚组,组间差异具有统计学意义(P<0.05)。此外,logistic回归分析显示,与较高的心理负荷伴随的是消极的应对方式和较低的领悟社会支持。结论护士工作心理负荷可分为3个潜在类型。月收入、健康状况、心理培训、工作场所暴力、消极应对方式和领悟社会支持是心理负荷的影响因素。

Eruptive xanthomas in a patient with severe hypertriglyceridemia:A case report

BACKGROUND Xanthomatosis,a metabolic disorder causing yellow growths(xanthomas),poses challenges in lipid metabolism.This case study introduces the first documented instance within China's Yi population,emphasizing the need to explore dietary habits and treatment strategies tailored to this specific community.CASE SUMMARY Xanthomatosis is a metabolic disorder where lipid metabolism goes awry,resulting in the development of yellowish growths called xanthomas.A male patient,47 years of age,from China's Yi population,who is obese,visited our dermatology clinic complaining of widespread,non-painful rashes that have been present for two weeks.The patient works as a chef and has a diet that frequently includes oily and greasy foods.This case represents the initial documentation of xanthomatosis within the Yi population in China,offering a theoretical foundation for understanding dietary patterns and treatment options specific to the Yi community.CONCLUSION The first report of xanthomatosis in the Yi population in China lays a theoretical foundation for understanding Yi dietary patterns and treatment.

Breast cancer awareness in reproductive women in the low-and middle-income countries:a scoping review

Objective:This study aimed to assess breast cancer(BC)awareness among reproductive women in low-and middle-income countries(LMICs),identify influencing factors,and propose feasible interventions or programs.Methods:We followed a 5-step process using a modified version of Arksey and O’Malley framework methodology.A comprehensive search was conducted on the Embase,PubMed,and CINAHL electronic databases for literature published within 10 years(from 2012 to 2022).Results:Thirty-three papers published between 2012 and 2020,spanning 18 countries,were included.Of these,45.6%described a good level of knowledge,while 24.2%reported that women at reproductive ages had good awareness.Twelve influencing factors were identified in 3 categories:socio-demographic(family history,personal history,marital status,age,religion,income status,living place,and occupation),personal(self-efficacy,education,and perceived level),and external(advertisements promoting awareness).Educational programs were recommended in most(>72%)of the included studies.Conclusions:While most studies reported high levels of knowledge and awareness,some found low prevalence among certain groups.Factors affecting knowledge and awareness were classified into socio-demographic,personal,and external categories,with socio-demographic factors such as age,education,income,and marital status being the most frequently cited.The studies recommended implementing educational programs,health prevention strategies,and social interventions to increase BC knowledge and awareness.

Comparison of Clinical Thinking Ability in Nursing Students of Different Grades

Objective： This study investigated and compared the clinical thinking ability of undergraduate nursing students of different grades, and searched for influencing factors of clinical thinking ability of nursing undergraduate students. Methods： The convenience sampling method was used to select the Subject of the study. In total, 180 third-year, fourth-year, and fifth-year nursing undergraduate students were enrolled in this study. A self-designed scale of clinical thinking ability was used to collect the data. SPSS17.0 was used to analyze the data. Results： The average scores of clinical thinking ability of undergraduate nursing students were 68.14±9.13. In addition, 71.1% of the students have a higher level of clinical thinking ability, and only 7.2% of the students have the best level. The ANOVA test showed that the fourth-year students had the highest scores（72.96±8.64）, and the third-year students had the lowest scores（62.35±8.09）, which indicated a significant difference in the scores of the three groups（ F= 26. 79, P〈0.05）. Multiple linear regression analysis indicated that the frequency of academic activities and the frequency of department rounds were significantly correlated to clinical thinking ability（P〈0.05）. Conclusion： We must pay attention to the changes and influencing factors of clinical thinking ability of nursing undergraduate students. Thus, traditional teaching methods need to evolve and be revised to host the capacity of clinical practice most effectively and, eventually, promote the development of clinical thinking ability of nursing undergraduate students.

The effectiveness of shared clinical teaching in nursing

Aim: Clinical learning is a critical component of a nursing curriculum.Student satisfaction in clinical environment is crucial to foster a positive learning experience.Faculty shortages have made clinical teaching more challenging;as such,alternate models of clinical teaching must be explored by nursing programs.The purpose of this study was to measure the perception of student satisfaction in regard tothe effectiveness of shared clinical teaching in nursing.Methods: Utilizing Chan's Clinical Learning Environment Inventory (CLEI),this quantitative comparative study examined nursing students' preferred and actual clinical learning environment.The CLEI contains 42 questions in six subscales: Individualization,Innovation,Involvement,Personalization,Task Orientation,and Satisfaction in both the actual and preferred clinical learning environment.The sample consisted of 202 nursing students in two groups: the first group had 91 students who experienced shared clinical teaching with two faculty,whereas the second group had 111 students who experienced the traditional,single faculty model.The results were analyzed using independent sample T-tests.Results: The preferred learning environment was rated highest in all six subscales.Scores of the Satisfaction subscale and the Innovation subscale for Actual Learning Environment,and the score of the Innovation subscale for Preferred Learning Environment of students experiencing shared clinical teaching with two faculty were higher than the scores of students experiencing traditional,single faculty model,with statistically significance (P< 0.05).Conclusion: The results indicated students preferred the shared clinical teaching model with two faculty over the single faculty model.Nursing programs can utilize this model and apply these results to develop and maintain quality clinical teaching.

Effectiveness of flipped classrooms in nursing education: Systematic review and meta-analysis

Background: The flipped classroom has generated considerable interest in nursing education in the last few years, especially in higher education in China. However, research to date has been insufficient to confirm the effectiveness of the flipped classroom approach. Since most of the Chinese studies are published in Chinese journals, they may not be easily accessible to international researchers. Therefore,this meta-analysis aimed to review the effectiveness of a flipped classroom in nursing education both in English and Chinese databases.Objective: The aim of the present study was to identify the robust available evidence about the effectiveness of flipped classrooms in nursing education through a systematic review and meta-analysis.Methods: A systematic search of English databases, including PubMed, EMBASE, Science Director,CINAHL and Google Scholar, and Chinese databases, including Chinese National Knowledge Infrastructure(CNKI), WanFang Data, VIP Information and Chinese Biomedical Literature(CMB), were conducted to identify peer-reviewed studies that met the inclusion criteria. Two reviewers independently performed study identification with Endnote X7 software and used Excel to extract data. The risk of bias in the included studies was assessed with Cochrane Collaboration's risk of bias tool, and a meta-analysis was conducted using RevMan 5.3 software following the guidelines proposed by PRISMA reporting standards with the protocol register No. CRD42016041826.Results: A total of 29 studies were included in systematic review. There was a significant postintervention improvement in academic performance both in knowledge with a pooled random-effects standardized mean difference of 1.13 and skills with a pooled random-effects standardized mean difference(SMD) of 1.68. Students' self-learning abilities were also improved with a pooled random-effects SMD of 1.51 compared with traditional lecture. In the subgroup analysis, we found that the effect sizes had high fidelity in terms of nursing degrees and research settings. There was a high rating of flipped classroom pedagogy from teaching evaluations, study satisfaction, study attitude and improvement in critical thinking and problem-solving skills.Conclusions: These results indicated that a flipped classroom might help nursing students improve in knowledge, skills, attitudes, self-learning, study satisfaction, critical thinking and problem-solving skills.We recommend adopting this approach for nursing education reform. There is a call for robust empirical research and unification of appraisal standards for further support of the effectiveness of the flipped classroom. Furthermore, a meta-regression analysis is also recommended to explore the sources of heterogeneity in included studies.

Comparison of Nursing Education among Different Countries

After reviewing Chinese and foreign language literature published in recent years, this study analyzed nursing education in China and other countries and China in terms of basic nursing education and training, curriculum and teaching contents, teaching materials, and teaching methods and evaluated the characteristics of nursing education andcontinuing education, etc., to draw experience and lessons from successful foreign nursing education programs and to provide examples for nursing education reform in our country.

Barriers in performing physical assessment among nursing students:An integrative review

Objectives:This study aimed to identify barriers in performing physical assessments among nursing students through integrative review study.Methods:The literature were searched in Medline,CINAHL,ScienceDirect,Web of Science,ProQuest,and Taylor&Francis Online using the descriptors barrier,physical assessment,nursing student et al.Only English-language and peer-reviewed journal articles were included,and there were no year restrictions.Results:Twelve articles were selected for review.Two aspects were extracted:the barriers included personal challenges,challenges related to nursing education,challenges related to clinical practice;establishing competency-based education learning as a method to reduce physical assessment barriers.Student competencies and experiences were influenced by various factors that collectively hindered their successful performance of physical assessments.Conclusions:The review findings provide valuable insights into the complex issues involved in the performance of physical assessments and guidance for improvement in practice.A collaborative effort should be made to address the issues often faced by nursing students in performing routine physical assessments.Also,more constructive and competency-based teaching methods should be integrated into academic and clinical settings.

A Comparison of the Sexual Knowledge, Attitudes, and Behaviors of Korean College Students Studying in Korea and in the United States

The number of Korean students enrolling in universities overseas is rapidly growing. However, these populations are underrepresented in sexuality related research, despite the possibility of sexually risky behavior in overseas university students. We examined the sexual knowledge, attitudes, and behaviors of university students in Korea and studying in the United States. Data were collected—131 Korean students in Korea and in the US using a web-based self-report questionnaire system. Students in the US showed greater total sexual knowledge than students studied in Korea. There were differences in the sexual knowledge, attitude and behaviors according to general characteristics between both groups. Although students in the USA had a higher level of sexual knowledge, both students in the USA and in Korea had a low level of sexual knowledge overall.