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Effects of a cultural competence education program for nursing students in Taiwan
(2014-11-17)
Session presented on Saturday, July 26, 2014:
Background: Cultural competent care is an essential ability for nursing students in current Taiwanese global context. However, little is known about nursing students' knowledge, ...
Using multicultural role-play to improve end-of-life care education
(2017-07-25)
Purpose: The purpose of the study was to evaluate the effectiveness of an undergraduate End-of-Life education with simulation. In 2012, the World Health Organization (WHO) reported 56 million deaths worldwide. Furthermore, the 2014 Institute of Medicine report Dying in Americacalled for improvements in end-of-life care. Providing dying patients with high-quality family and patient-centered end-of-life care that aligns with the patients’ values and informed preferences poses challenges. One aspect of the problem is nursing curricula and clinical rotations often lack educational opportunities that address such challenges related to end-of-life (EOL) care conversations. As a result, many nurses are uncomfortable or ill prepared to carry out appropriate end-of-life conversations.
Simulation-based education presents a realistic way to practice these skills and provide a safe environment to where mistakes can be made in the absence of patient harm (Founds, Zewe, & Scheuer, 2011). Simulation creates a valuable opportunity for students to have authentic experiential experiences that support the development of technical, cognitive, therapeutic, and psychological skills (Roberts &Greene, 2011). End-of-life care simulation experiences, that include a unique blend of promoting competence with therapeutic communication, cultural competence, medication management, nursing interventions, and empathy, can help to better equip nurses to deal with end-of-life care. Standardized patients (SPs) are instrumental in providing realism in scenarios, but SPs can be costly, and difficult to find. To address this problem, we present an innovative approach that utilizes multicultural arts and sciences students enrolled in a theater course that trains them to be SPs. The SPs were culturally representative thus allowing the nursing students to experience a variety of diverse patient care demands that are common in today’s healthcare.
This approach also utilizes a unique two-phased debriefing process that allows nursing students to experience immediate in-character feedback at the bedside followed by traditional debriefing in a separate area. The traditional debriefing is replete with a debrief and a reflection of the in-character feedback as well as the scenario action. This approach allows students to reflect on the experience as a whole as well as benefit from the “patient” view of their care.
Methods: Students participating in a theater course were trained to play SPs followed with the more specific training to be able to realistically play the family member of a dying patient. This tactic also allowed for the inclusion of cultural considerations to be woven into the end-of-life scenarios. The scenario presented a woman with Non-Hodgkin’s Lymphoma who was brought by the Emergency Medical Services (EMS) to the Emergency Room. The students enter the “scene” to find the SP, playing either the patient’s daughter or son, at the bedside. The major objective of the scenario was for the nursing students to provide therapeutic communication as they managed the care of patient and the family as they navigate the end-of-life process.
During the initially run sessions, SP feedback was given as part of the usual debriefing process, with the SP staying in character. However, upon receiving feedback from the nursing students that this approach was not well received, modifications were made to instead include in-character feedback immediately following the end of scenario action at the bedside. Subsequently this was followed with traditional debriefing in a classroom.
Results: Fifty-six participants completed a mixed method study. The Katherine Frommelt (1991) Attitudes toward Care of the Dying (FATCOD-B) survey was administered at two time points (pre/post). Qualitative research questions with content analysis tapped into the participants’ attitudes related to the end of life educational experience. Responses from the nursing students revealed that receiving feedback from a SP was a new experience and something to which they were not initially receptive. Following the change to the two-phased approach, the nursing students’ opinions of the overall experience was more positive. They felt more aware of the family members’ needs and shifted from a patient-focused care approach toward a family-centered care approach. When asked about their simulation experience, what their thoughts were related to end-of-life, and their feelings related to end of life care, respondents described the scenario as being realistic and a valuable learning opportunity. Participants were also asked “which learning situation had the biggest impact on your thoughts and feelings related to end-of-life care?” Many stated the simulation influenced their thoughts and feelings on end-of-life care; one participant mentioned that when an SP daughter asked “if her mother died” it created a lasting impression.
Conclusion: Preparing to interact with patients and families at the end-of-life requires individuals to be psychologically and physically present in the patient’s care. Using SP students was a novel way to provide a rich learning experience and added realism to an end-of-life simulation experience. Realism was further deepened through the integration of SPs from different cultures and genders, another important element that reflected the influence of culture on end-of-life nursing care. While the approach was generally successful, there are important considerations to heed. Both groups of students must understand each other’s roles, pre-briefing is vital to inform nursing students that the SPs will provide in-character feedback, and immediate bedside in-character SP feedback is received may be better received than having SPs participate in debriefing. Finally, the debriefing should include a discussion of the bedside feedback to give the opportunity for learners to reflect on receiving feedback from the “patient’s” perspective. Creating experiential learning with a multicultural element in simulation is integral toward preparing future nurse for culturally diverse healthcare....
Nursing students behind bars: An innovative pilot project
(2015-01-15)
Session presented on Saturday, September 27, 2014:
Purpose: The prison population is one of the fastest growing populations in the United States (U.S.) The U.S. prison population rose to 16.3% overall from 2000 to 2009, ...
Impact of Cultural and Linguistic Diversity on Success of the First Attempt of the NCLEX-RN
(2017-07-27)
Schools of nursing are struggling with high attrition rates and low NCLEX-RN first time pass rates. Many students identified among those with high attrition rates and low pass rates are culturally and linguistically diverse ...
Reducing test anxiety through mind relaxation
(2017-07-28)
The purpose of this experimental study is to identify the effects of a Tai Chi intervention on nursing students’ test anxiety. Research supports the use of Tai Chi for psychological well-being and stress reduction, ...
Sigma Theta Tau: Beta Rho Chapter a leader in a living and learning community for nursing students
(2015-01-15)
Sessions presented on Thursday, September 25, 2014, Wednesday, September 24, 2014:
A Living and Learning Community (LLC) was established as a collaborative project between the School of Nursing (SON) and university housing. ...
Stress in Baccalaureate Nursing Student
(2015-01-15)
Session presented on Thursday, September 25, 2014: Stress is a phenomenon that everyone experiences in his or her lifetime. Stress can impair both physical and psychological health. Nursing students are no exception to ...
Sleep deprivation and the potential impact on nursing students practice and health
(2016-09-26)
Session presented on Monday, September 19, 2016:
Nursing students are an important part of the overall healthcare team. In addition to the didactic aspect of nursing student education, students also complete required ...
The effects of task characteristics and cognitive loading on clinical examination performance in nursing students
(2017-07-20)
Purpose: The integration and education and practice has received wide attention in the nursing profession. In this regard, the objective structured clinical examination (OSCE) is being increasingly used with students in nursing programs in Taiwan before they enter clinical practice in hospitals. Most studies, however, examine OSCE’s advantage, while few focus on the impact of task characteristics and the relationship between task characteristics, task cognitive loading, and skill performance for the OSCE.The purpose of this study was to examine the task characteristics of and cognitive loading that occurs during OSCE administration among third-year nursing students who are seeking a baccalaureate in nursing and to explore the association between the task characteristics, cognitive loading, and clinical examination performance.
Methods: A correlation study design was employed. A total of 118 nursing students who sat for the clinical examination were recruited. The data were collected in January 2015. Students’ ages ranged from 21 to 31, and the mean age was 21.68 (SD =1.23). The majority of students were female (78.05 %).The measures included task characteristic, task cognitive loading, and skill performance scores. The structural equation modeling (SEM) approach with partial least squares (PLS) was used in the data analysis.
Results: The results of this study indicated that students perceived the top dimensions of the task characteristics of the OSCE was “task significance”. Further, “task identity and feedback from job” and “task autonomy” had a significant negative effect on task cognitive loading (β = -0.14; β = ‑0.18, p < .05), respectively. In contrast, “task variety and significance” had a significant positive effect on cognitive loading (β = 0.20, p < .01), and cognitive loading had a significant negative effect on student’s OSCE performance score (β = -0.25, p < .001).
Conclusion: We found that increased task variety and significance and reduced task autonomy, task identity, and feedback during OSCE were associated with increased task cognitive load, which, in turn, reduces OSCE performance. This study demonstrated that task cognitive loading plays an important role between students’ perceived task characteristics and performance during the OSCE. We suggest that skill examination begin with the presentation of a simple strategy (low element interactivity) and gradually work up to more complex tasks....
A mindfulness-based approach to student self-care
(2017-07-26)
This experimental pilot study explored the effectiveness of an 8 week mindfulness based stress reduction (MBSR) and cognitive behavioral intervention in impacting wellbeing among first semester junior nursing students. ...