Critical Assessment Skills Research Articles

Gambling habits and Probability Judgements in a Bayesian Task Environment.

Little is known about how gamblers form probability assessments. This paper reports on a preregistered study that administered an incentivized Bayesian choice task to n = 465 self-reported gamblers and non-gamblers. The task elicits subjective probability assessments and allows one to estimate the degree to which distinct information sources are weighted in forming probability assessments. Our data failed to support our main hypotheses that experienced online gamblers would be more accurate than non-gamblers in estimating probabilities, that gamblers experienced in games of skill (e.g., poker) would be more accurate than gamblers experienced only in non-skill games (e.g., slots), that accuracy would differ by sex, or that information sources would be weighted differently across different participant groups. Exploratory analysis, however, revealed that gambling frequency predicted lower Bayesian accuracy, while cognitive reflection predicted higher accuracy. The decline in accuracy linked to self-reported gambling frequency was stronger for female participants. Decision modeling estimated a decreased weight place on new evidence (over base rate odds) for those participant groups who showed decreased accuracy, which suggests that a proper incorporation of new information is important for probability assessments. Our results link online gambling frequency to worse performance in the critical probability assessment skills that should benefit gambling success (i.e., in skill-based games). Additional research is needed to better understand the mechanism linking reported gambling frequency to probability assessment accuracy.

The Real Experience of Lay Responders Performing Cardiopulmonary Resuscitation: A Synthesis of Qualitative Evidence.

To synthesize qualitative evidence on the experience of lay responders performing cardiopulmonary resuscitation (CPR). Qualitative evidence synthesis was performed using the Thomas and Harden method. The PubMed, Cochrane Library, Web of Science, OVID Medline, Embase, CINAHL, CNKI, and WanFang databases were systematically searched. The quality of the research was assessed by the Critical Assessment Skills Program Tool (CASP). A total of 5,610 studies were identified, and 9 studies were included in the analysis. Four analytical themes were generated: emotional ambivalence before CPR, psychological tolerance during CPR, perceived experience after CPR, and enhancing psychological resilience. Lay responders face complicated psychological experience during CPR, which may be susceptible to psychological effects such as "loss aversion," "bystander effects" and "knowledge curse." In addition to the timely retraining of CPR, lay responders should be instructed to manage psychological distress and improve psychological resilience. More importantly, the psychological sequelae may be long-lasting, requiring ongoing psychological intervention and follow-up based on valuing transdisciplinarity across endeavours.

Pain Management in Cognitively Impaired Older Adults.

Pain identification and management in cognitively impaired older adults, especially those with major neurocognitive disorder, are challenging because of communication barriers and health care providers who are unaccustomed to the patient's baseline behavioral and psychological conditions. Appropriately distinguishing pain-associated behaviors separate from dementia, utilizing effective assessment tools, and administering proper interventions and medications to treat pain promptly for this population need to be considered. Nurses play critical roles in implementing various evidence-based assessment tools to assess pain and choosing appropriate pain management interventions by training and supporting other nurses to use these assessment tools and develop their critical assessment skills to quickly identify pain and evaluate pain management interventions.

Barriers to People with HIV in Accessing Work: Systematic Review

Problems that are often experienced by PLHIV are health, social, and economic problems. In addition, in everyday life, PLHIV experience problems in caring for themselves, meeting their social, economic, and psychological needs. PLHIV in accessing work are often hampered because of the stigma and discrimination they get and because of health factors that are easily exhausted. This research aims to find out the obstacles of PLHIV in accessing work. Systematic reviews were identified in four electronic databases published from 2016 to 2021. The quality of the reviewed studies was checked using the Critical Assessment Skills Program. The data were extracted by researchers and analyzed using thematic analysis. This review includes twelve eligible studies. The review found that stigma, support, environment and empowerment were the solutions and obstacles for PLHIV in accessing work. By providing support, there is no stigma, a good environment and empowering PLHIV can improve the quality of life and meet the primary needs of PLHIV. Barriers to accessing work experienced by PLHIV can be controlled through environmental empowerment by forming a support group.

The Refinement of the Diabetic Wound Assessment Learning Tool: A Novel Tool to Assess Competence in Diabetic Wound Assessment and Management

Diabetic foot wounds, a devastating complication of diabetes, are a major burden on patients and the healthcare system. Training in skills to address such wounds is critical. To support competency-based training of critical wound assessment skills, we developed a Diabetic Wound Assessment Learning Tool (DiWALT). While the original tool demonstrated excellent generalizability (generalizability coefficient of 0.871) and reliability (Phi coefficient of 0.866), based on feedback from raters, its utility was noted to be limited by its lengthy nature (23 items). In this study, we aimed to use item-analysis metrics to refine and shorten the assessment tool and examine validity evidence of the abbreviated versions for workplace-based assessment. In phase 1, data from the DiWALT initial validation study was reanalyzed to ascertain redundant items, and items with poor psychometric performance. We conducted item-total/overall score correlations, discriminative index calculations and a generalizability study. Based on these data, we shortened the DiWALT. Four raters were recruited and conducted 60 video-based simulated assessments using the refined tool. In phase 2, the tool was shortened again using results from phase I. Subsequently, 4 raters conducted 60 video-based simulated assessments using this abbreviated version. A generalizability study was conducted for each phase to assess the reliability of each refinement. Based on discriminative index, item-total correlation and generalizability, the DiWALT was initially shortened to 16 items. Analysis of the 60 assessments conducted with this version yielded a generalizability coefficient of 0.87 and a Phi coefficient of 0.75. Based on these results, the tool was abbreviated to 5 items, one for each DiWALT subscale, making it feasible for use as a short workplace-based assessment. Analysis of the second 60 assessments using the 5-item version revealed a generalizability coefficient of 0.90 and a Phi coefficient of 0.86. We were able to refine the DiWALT in a data-driven manner and improve its generalizability as well as its utility. Of note, we found that the 5-item DiWALT performed superiorly to both the 23- and 16-item tools. This was unexpected; decreasing the number of testing items is expected to result in poorer reliability metrics because any error in scoring is amplified. These results likely reflect how the abbreviated DiWALT functioned superiorly from a rater cognition perspective as fewer assessment items have been shown to decrease the intrinsic cognitive load on raters, improving rater performance.

Designing a Collaborative Model for Problem Identification in Public Policy-Making in the Field of Protection of Citizen's Rights

The aim of the current research is to providing a participatory model for Cognition of issue in public policy (study in the field of protection of citizenship rights). This research is applied in terms of its purpose, in terms of the nature of the research, it is a mixed method and exploratory research, in terms of data collection and descriptive implementation, it is a survey research and in terms of time period, it is cross-sectional. The statistical population of the qualitative part included two parts. The first part included the published scientific works related to the keywords defined regarding the main subject of this research and according to the input criteria and after screening, 65 scientific documents were examined. The second part also included academic and organizational experts according to the research entry criteria, based on the purposeful non-probability sampling method, finally 24 experts were considered according to the principle of saturation. The statistical population in the quantitative part included all the clients to the ministries, organizations and government institutions, the center for public monitoring and the handling of public complaints of the General Inspection Organization, the Islamic Council and the Islamic city and village councils, based on the Cochran formula for unknown communities, the number 385 people were selected as a statistical sample and finally 391 questionnaires were collected that could be used. The sampling method used in this section is a non-probability quota method of a disproportionate type. The data collection tool in the qualitative part was systematic literature review in the first part and semi-structured interviews in the second part. In the quantitative part, there was a questionnaire. It should be noted that the validity and reliability of the tools were confirmed in both qualitative and quantitative sections. In the qualitative part and in the meta-composite part, the Critical Assessment Skills Program (CASP) tool was used for validity and Cohen's kappa was used to measure reliability. In the theme analysis part, Goba and Lincoln's model was used to measure validity and reliability. The method of data analysis in the qualitative section and in the systematic literature review section was meta-composite method and in the interview section, thematic analysis was used, and MAXQDA-V20 software was used for data analysis. In the quantitative part, the analysis included descriptive and inferential statistics (sample t-test and confirmatory factor analysis) which was done through SPSS and SmartPLS software. The findings of this research showed that the model includes 6 dimensions, 20 components and 167 indicators. The identified dimensions and components are: 1) Informing, 2) Involvement, 3) support, 4) Consultation and Survey, 5) Partnership, 6) Citizenship Control and Power. Finally, the validity of this model was examined, which had good validity.

Development and assessment of an online virtual orthodontic curriculum.

Due to break space and time limits, an entirely new online curriculum of orthodontic education with online evaluation system has been structured and developed in the dental school, based on virtual reality simulation. At Nanjing Medical University, a new online orthodontic curriculum with programmatic assessment process was constructed and implemented based on competency-based education (CBE). It was consisted of the online orthodontic theoretical lectures based on the National Open Online Course "Orthodontics," the online journal club via the online "flipped classroom," and the online orthodontic pre-clinical training via the virtual learning network platform. In order to evaluate this curriculum, 94 Year 4 dental students took part to complete the online orthodontic curriculum. The mean total score of all the students was 91.99, and the element scores of the online theoretical lectures, journal club, virtual pre-clinical training, and online final examination were respectively 96.83, 79.49, 96.00, and 87.02, which showed a good performance. According to the student feedback toward this curriculum via the online questionnaire, nearly 98% of the students showed agreement or strong agreement that the online orthodontic curriculum has enhanced their orthodontic theoretical understanding and orthodontic practical ability. As a student-centered CBE, this online orthodontic curriculum with online evaluation system could provide both orthodontic theory and practice teaching for all the dental students at all times and places based on the online virtual mode, which enriched learners' critical thinking, problem solving, and assessment skills.

Improving Physical Assessment and Clinical Judgment Skills without Increasing Content in a Prelicensure Nursing Health Assessment Course.

One hundred twenty-six assessment skills are taught in prelicensure nursing health assessment courses, yet 30 skills are used on a routine basis in practice. New nurses struggle to apply their acquired knowledge in clinical settings. Method: A literature review was completed. Based on the results, a first semester health assessment course in a southeastern accelerated baccalaureate nursing program was redesigned. Lectures and skills labs were adjusted to focus on the most critical assessment skills. To foster critical thinking and clinical judgement, a health assessment post conference was added where students completed concept maps, system specific case studies, nursing priority setting, and patient teaching plans. Results: Outcome surveys were completed by second semester faculty. Prior to course adjustments, 33 percent of students did not meet the benchmark. Following course changes, all students met or exceeded the benchmark. Conclusion: Focusing on critical assessment skills will increase student nurses’ ability to deliver safe patient care.

Mobilizing PACU Nurses to Provide Critical Care during the Covid-19 Pandemic

Background InformationIn March 2020, a New York State mandate required our institution place a moratorium on elective surgery for an unknown period of time to ensure adequate Covid-19 surge hospital bed availability. This resulted in extremely low patient volumes for perioperative services. Conversely, critical care was experiencing an influx of patient volume and acuity, necessitating additional nursing support.Objectives of ProjectOur aim was to bolster the hospital's critical care service line by pooling available nursing resources. The perioperative and critical care leadership teams further identified this initiative as an opportunity to strengthen relationships between nurses that share a common skill set.Process of ImplementationHospital command center meetings to address surge bed capacity reinforced the partnership between perioperative and critical care services. Team nursing models were reviewed collaboratively. The PACU nurse manager requested volunteers to staff critical care based on a team model. Five highly experienced PACU RNs and five newer PACU RNs without prior ICU assignments volunteered, with goals to expand knowledge, improve critical assessment skills, and help a service in need. The ten PACU nurse volunteers were assigned into five pairs, consisting of one experienced RN and one newer RN. The five teams of two were consistently matched with their partner, and worked every shift in the ICU as a pair.Statement of Successful PracticeThis collaborative effort between the perioperative and critical care nursing services achieved the goal of providing safe and competent care to a population in dire need during the height of the Covid-19 pandemic. This initiative also strengthened relationships between the services, thereby promoting improved communication and increased efficiency.Implications for Advancing the Practice of Perianesthesia NursingThe future implications of Covid-19 are largely unknown, and this initiative mobilized nursing resources in a systematic fashion to provide necessary specialized care. A framework was established that could be easily replicated, thereby strengthening our ability to collaboratively approach emergency preparedness moving forward.

The Use of Interpreters in Medical Education: A Narrative Literature Review

This paper presents the results of a narrative literature review on the use of interpreters in medical education. A careful search strategy was based on keywords and inclusion and exclusion criteria, and used the databases PubMed, Medline Ovid, Google Scholar, Scopus, CINAHL, and EBSCO. The search strategy resulted in 20 articles, which reflected the research aim and were reviewed on the basis of an interpretive approach. They were then critically appraised in accordance with the “critical assessment skills programme” guidelines. Results showed that the use of interpreters in medical education as part of the curriculum is scarce, but students have been trained in how to work with interpreters when interviewing patients to fully develop their skills. The study highlights the importance of integrating the use of interpreters in medical curricula, proposes a framework for achieving this, and suggests pertinent research questions for enriching cultural competence.

North-South surgical training partnerships: a systematic review.

Fostering the success of surgical trainees from low- and middle-income countries (LMICs) plausibly addresses the existing workforce deficit in a sustainable manner, but it is unclear whether and how these trainees are targeted as strategic learners for educational exchanges. The purpose of this review was to assess the quality and outcomes of existing literature on exchanges of surgical trainees between high-income countries (HICs) and LMICs. We conducted a systematic review of reported instances of surgical training exchanges between HICs and LMICs. After database searching, 2 independent reviewers evaluated titles, abstracts and manuscripts. Selected studies were critically appraised with the use the Critical Assessment Skills Programme Qualitative Checklist and analyzed for trainee level, institutions, countries and subspecialties, as well as reported outcomes of the exchange. Twenty-eight reports met the inclusion criteria and were analyzed. Most publications (18 [64%]) detailed North-to-South exchanges; 1 exchange was bidirectional. General surgery was the most common discipline identified, with 9 other subspecialties described involving learners at all phases of training. Reports were generally of good quality, although outcomes were reported variably, and most authors failed to acknowledge the ethical implications of their study. The articles identified described a variety of surgical exchanges across disciplines, learner types and host/home countries. Few of the exchanges prioritized the learning of surgical trainees from LMICs. There is an increasing need to formalize these exchanges via clear goals and objectives, as well as to prioritize the proper matching of educational goals with local clinical needs. V - Evidence from systematic reviews of descriptive and qualitative studies.

Approaching grief and death in family members of patients with COVID-19: Narrative review

ObjetivoRealizar una síntesis de la evidencia disponible para establecer recomendaciones sobre el abordaje del duelo y la muerte en familiares de pacientes con COVID-19, así como ofrecer recursos sustitutivos de los rituales y procedimientos necesarios con el fin de favorecer duelos funcionales y prevenir duelos complicados.MétodoSe realizó búsqueda bibliográfica en bases de datos MEDLINE, EMBASE, SCIENCEDIRECT, WOS, CINAHL y CUIDEN, utilizando términos MeSH (family, patient, isolation hospitals, grief, death, ceremonial behavior, self care, affects y social networking) con su ecuación booleana correspondiente. Los artículos seleccionados se sometieron a una lectura crítica a través del Critical Apraisal Skill Programme en español.ResultadosSe encontraron 560 artículos atingentes; tras aplicar los criterios de selección 13 estudios se incluyeron en el análisis, de los cuales 8 eran revisiones sistemáticas, 3 estudios cualitativos, un estudio piloto prospectivo transversal y una guía clínica, que permitieron identificar estrategias para el abordaje del duelo y la muerte atendiendo a este momento de excepcionalidad de la COVID-19, incidiendo en el manejo competencial de los profesionales sanitarios en apoyo emocional y en el acompañamiento, así como en el seguimiento durante todo el proceso y en la comunicación con la familia.ConclusiónEn el proceso final de la vida en tiempos de la COVID-19 los profesionales sanitarios deben trabajar despedidas, los ritos fúnebres alternativos, la atención espiritual y el afrontamiento precoz que permitirán a su vez la prevención del duelo complicado.

Advocating migrant and minority health in Bulgaria through an innovative education subject

Abstract Introduction Migrants and ethnic minorities often face serious inequities concerning their access to good quality health services. The Statement by the European Public Health Association on migration, ethnicity and health addresses the need of supporting public health policy makers by providing education courses. The objectives of the teaching course “Migrant and minority health”, established in Medical University-Pleven in Bulgaria as optional additional subject, is to extend the specific knowledge of students (bachelors and masters of public health) and to develop competencies and skills of future public health practitioners and policy makers. Results The unique for Bulgaria course consists of 15 academic hours of the curriculum and ends with an electronically based test. Teaching methods include lectures, seminars and individual practical assignment and stresses on practice rather than theory. The training advocates migrant and minority health by presenting: the most important migrant’s social and health problems; impact of migrants’ health status on public health; the organization of healthcare in the recipient countries of migrants. The lecture course provides information for the main challenges facing healthcare professionals and the health system regarding the health of the migrants and main minorities groups, in particular the Roma as a predominantly ethnic minority in Bulgaria and Europe. The result of exam until now is good in 42.8% of students, very good in 14.2% and excellent in 42.8%. The curse enable public health professionals to acquire knowledge regarding to the international situation, critical assessment skills and the ability to implement appropriate strategies to address specific health problems. Conclusions The training meets the needs of in-depth knowledge of public health specialists in relation to the medical and social problems of migrants and minorities in Bulgaria. The positive experience gives ground to include it as part of basic curricula. Key messages The subject “Migrant and minority health” enhances student’s competencies as public health practitioners. Knowledge and skills are relevant to the EUPHA Statement on migration, ethnicity and health. By the subject “Migrant and minority health” public health practitioners may work to establish friendly health system with good quality of health services for migrants and Roma population in Bulgaria.

Family nurse practitioner students' perceptions of readiness and transition into advanced practice.

Utilizing skills identified in previous research on successful role transition, this study evaluated the relationship between a strategically designed practicum course and the readiness for role transition to family nurse practitioner (FNP) in graduate nursing students. A mixed methods approach evaluated pre- and post-participation survey data for the FNP role preparedness in graduate nursing students in a strategically designed practicum course. The survey addressed 22 skills associated with readiness for role transitionand had three open-ended questions to collect narrative student perceptions. Mann-Whitney U tests revealed readiness for the FNP role increased from pre to post-participation in the course for 19 out of 22 skills with significant increases (P < 0.05) for one skill and marginally significant increases (P < 0.10) for three skills. Qualitative findings yielded an overall sense of readiness in students for novice FNP roles. A well-designed practicum course that reviews prior knowledge gained through the program and reinforces critical thinking, assessment, and decision-making skills facilitates role transition from registered nurse to novice FNP.

Exploring patients' experiences of the whiplash injury-recovery process - a meta-synthesis.

PurposeThe aim of this study was to conduct a meta-synthesis to analyze qualitative research findings and thereby understand patients’ experiences of whiplash-associated disorders (WAD) and the injury-recovery process.Materials and methodsA qualitative meta-synthesis, which is an interpretive integration of existing qualitative findings, was performed. The databases PubMed, PsychINFO, Scopus, and Web of Science were searched. The Critical Assessment Skills Programme was used to assess the quality of the included studies.ResultsFour studies were included. The synthesis resulted in several codes, 6 categories, and 3 themes (distancing from normalcy, self-efficacy in controlling the life situation after the injury, and readjustment and acceptance) that described the participants’ pain beliefs, their WAD-related life situation and their future expectations and acceptance. Changes in self-image were difficult to cope with and likely led to perceived stigmatization. Struggling with feelings of loss of control appeared to lead to low confidence and insecurity. Focusing on increasing knowledge and understanding the pain and its consequences were believed to lead to better strategies for handling the situation. Furthermore, recapturing life roles, including returning to work, was challenging, but an optimistic outlook reinforced symptom improvements and contributed to feelings of happiness.ConclusionThe results of the present study provide a comprehensive understanding of patients’ complex, multifaceted experiences of WAD, and the injury-recovery process. The findings can guide us in the development of new ways to evaluate and manage WAD. The results also indicate that a more patient-centered approach is needed to determine the depth and breadth of each patient’s problems.

Using Reflective Practice to Support Management Student Learning: Three Brief Assignments

Reflective practice supports critical thinking and assessment skills through analyzing one’s own life experiences, and the role of reflection in learning has been long recognized. However, drawbacks of many reflective practice assignments are their broad scope and lengthy written requirements. I propose that the reflection process is robust enough to support management student learning through short written tasks as well. Three examples of brief reflective assignments are presented suitable for management educators teaching undergraduate, graduate, or non-credit learners: (1) writing an organizational story, (2) a reflection about learning from adversity, and (3) a goal-oriented personal change. Learning outcomes and student responses have been positive, and the assignments have also been an insightful teaching experience for the instructor.

Nursing Student Perceptions of Standardized Patient Use in Health Assessment

BackgroundPeer physical examinations (PPEs) are often used to teach health assessment (HA) skills in undergraduate nursing education; however, the use of standardized patients (SPs) has been shown to have a greater impact on cognitive, affective, and psychomotor learning. MethodSurvey results from students who completed their HA final head-to-toe assessment evaluation using PPEs versus SPs were compared in this mixed-method descriptive study. ResultsStudents who used SPs indicated their assessment required more critical thinking and less memorization compared with those who used PPEs for their HA final head-to-toe assessment evaluation (p < .05). ConclusionThe use of SPs and case-based scenarios is an innovative teaching modality that can improve undergraduate nursing students' critical thinking and assessment skills.

Board #134 - Research AbstractThe Effect of Hybrid Learning with Nuring Students’ Clinical Competency

Hypothesis In most nursing curricula, simulation and PBL (problem-based learning) are used solely and separately as teaching and learning tools. Nurse educators should facilitate complex clinical experiences and utilize more complex and mixed education strategies to enhance nursing students’ clinical reasoning in order to improve the comprehensiveness and accuracy of nursing students’ clinical judgment. In the present study, simulation is combined with PBL as a hybrid framework or a learning strategy including lectures, discussion using problem-based learning modules, self-directed learning, and real situation practice with human patient simulators [HPS] (Lee et al., 2009). Moreover, there is no research in pediatric nursing literature that examines the effect of hybrid learning with combined simulation and problem-based learning. Hence, the purpose of this study is to test students’ clinical competency to assess the effectiveness of the combined teaching method. Methods The bronchiolitis module in the present study was designed based on the PBL and Simulation Model Framework (Barrows and Tamblyn, 1980; Jeffries, 2005). The Hybrid learning combining simulation with PBL was used to assess clinical competency including knowledge, confidence, and students’ satisfaction. This is a comparison study with three education modalities: PBL group (experimental group 1, E1), simulation with PBL group (experimental group 2, E2), and control group (C). We used descriptive, paired t-test statistics, one-way ANOVA, and post-hoc test (Duncan test) for data analysis using SPSS version 18.0 program. A convenient sample of 195 senior nursing students from three nursing schools located in Seoul and Chuncheon, South Korea participated in this study from Sep 1st to Dec 10th, 2013. Results There were no statistically significant differences between the groups in prior simulation experiences (χ2=.396, p=.529), and baseline knowledge (7.80±1.11 versus 7.79±1.99, t=.020, p=.984). There were significant difference in the mean score of knowledge difference (post-pre) among E1 (1.42±2.49), E2 (1.77±2.11), and C (0.44±2.74) (F=14.718, p<.001). There were significant difference in the mean score of confidence among E1 (3.69±0.30), E2 (3.57±0.33), and C (3.38±0.44) (F=12.693, p<.001). There were significant differences in the mean satisfaction total score among E1 (4.67±0.39), E2 (4.17±0.53), and C (3.48±0.62) (F=93.471, p<.001). Conclusion This result could provide a much-need template or starting point for educators who desire to introduce simulation combined with PBL as a teaching-learning strategy in pediatric nursing courses. It is also necessary to monitor the effectiveness of combined simulation with PBL education. New approaches and strategies combined simulation with PBL for teaching critical thinking, clinical assessment, effective communication, and technical skills will be required to meet the demands of the new roles and responsibilities faced by nurse educators and their students.

Effectiveness of interactive discussion group in suicide risk assessment among general nurses in Taiwan: A randomized controlled trial

The evidence of suicide prevention training for nurses is scarce. Strategies to enhance general nurses' ability in suicide risk assessment are critical to develop effective training programs in general medical settings. This study was aimed to examine the effectiveness of an interactive discussion group in a suicide prevention training program for general nurses. In this randomized study with two groups of pre-post study design, the sample was recruited from the Medical, Surgical, and Emergency/Intensive Care Sectors of a 2000-bed general hospital via stratified randomization. Among the 111 nurses, 57 participants randomly assigned to the control group received a two-hour baseline suicide gatekeeper lecture, and 54 participants assigning to the experimental group received an additional five-hour group discussion about suicide risk assessment skills. Using a case vignette, the nurses discussed and assessed suicide risk factors specified in a 10-item Chinese SAD PERSONS Scale during a group discussion intervention. The findings revealed that the nurses achieved significant and consistent improvements of risk identification and assessment after the intervention without influencing their mental health status for assessing suicide risks. The result suggested an effective approach of interactive group discussion for facilitating critical thinking and learning suicide risk assessment skills among general nurses.

Identifying essential infection control competencies for newly graduated nurses: a three-phase study in Australia and Taiwan

Healthcare- and hospital-acquired infection increases patients' morbidity and mortality and increases healthcare costs. Infection prevention and control is a high priority for medical professionals in healthcare settings. To identify essential infection prevention and control competencies for newly graduated nurses. Three phases of research were designed: phase I, Instrument development, which was undertaken from January to May 2008; phase II, Expert panel identification, for which 122 experts were recruited, each nominated by presidents of infection control bodies and heads of nursing schools in Australia (N = 60) and Taiwan (N = 62); and phase III, Delphi surveys, which were conducted in three rounds simultaneously in Australia and Taiwan between July 2008 and May 2009. Ninety-three experts returned the first questionnaire. Response rates of 76.2%, 91.4% and 94.1% were achieved in rounds I, II and III, respectively. Eighty experts participated in all three rounds. Overall, 81 items reached consensus, including seven in the competency area of basic microbiology, 12 in hand hygiene, 30 in standard precautions and additional precautions, 12 in personal protective equipment, nine in cleaning, disinfection and sterilization and 11 in critical assessment skills. The majority of experts (N = 49; 75.4%) agreed that infection control competency levels of newly graduated nurses were inadequate. Eighty-one items of infection prevention and control specific to newly graduated nurses were identified by consensus between expert panellists from Taiwan and Australia. Baseline data from this study may help to develop undergraduate nursing curricula to facilitate nurses' clinical application of infection control principles.