Prelicensure Nursing Programs Research Articles

End-of-Life Education in a Prelicensure Nursing Program.

The demand for palliative and end-of-life nursing is increasing with the aging US population. The American Association of Colleges of Nursing published recommendations for incorporating palliative and end-of-life care across nursing curriculum to prepare the future workforce. However, recommendations regarding teaching end-of-life content are limited. This project aimed to integrate and evaluate the outcomes of end-of-life education introduced in a prelicensure nursing program. Using a documentary created by the American Nurses Foundation, students had the opportunity to discuss common themes in end-of-life care, practice morgue care in the simulation laboratory, and practice reflective journaling. The students' preevaluations and postevaluations indicated that the educational program significantly increased their confidence in providing end-of-life care and support to patients and families, demonstrating the importance of end-of-life curricula in nursing school.

Student Peer Mentorship in Prelicensure Nursing Programs: A Scoping Review

Student Peer Mentorship in Prelicensure Nursing Programs: A Scoping Review

Virtual Reality Simulation Integration in a Prelicensure Nursing Program: Lessons Learned.

Simulation, whether conducted live or through virtual technologies, provides students with experiential learning by replicating realistic clinical experiences that can develop learner competencies in a safe environment. Virtual reality simulation may provide the same level of effective and engaging experiential learning in a fully immersive learning environment without many of the limitations inherent to traditional live simulation environments, such as simulation equipment and designated labs. While there are vendor-provided resources and a new tool kit covering immersive technology simulation implementation in nursing, a lived example to contextualize the implementation process is missing from the literature. This article discusses the selection and implementation of virtual reality simulations in a nursing undergraduate program and lessons learned in the process. Nurse educators seeking such experiences for their students may benefit from the insights shared in this article.

The Long-Term Transferability of Clinical Judgment Via In-Class Simulations to Nursing Practice: A Qualitative Descriptive Study

BackgroundThe transferability of clinical judgment developed through in-class simulations to clinical practice is understudied. MethodsThis qualitative descriptive study utilized semi-structured interviews to determine to what extent new-to-practice nurses transfer active learning that occurred during observation of in-class simulations during their traditional pre-licensure nursing program to their nursing practice three years later. ResultsThree major themes emerged: cue recognition through visual recall, increased confidence in decision-making, and new cognitive frameworks for nursing practice. ConclusionUsing in-class simulations may improve transferability of clinical judgment through contextualizing student learning and promoting long-term retention as learners transition to practice.

Person-Centered Care and Clinical Judgment: Mapping the AACN Essentials with Simulation in Prelicensure Nursing Programs

The purpose of this article is to describe simulation as a strategy for teaching and mapping the AACN Essentials domain of Person-Centered Care and the concept of clinical judgment with prelicensure nursing students. A validated assessment tool, Lasater clinical judgment Rubric, may be used to evaluate the AACN concept of clinical judgment with simulation. A variety of high-fidelity simulation scenarios, standardized clients, and embedded participants increase realism and student learning. Encompassing a variety of clients across the lifespan, while incorporating cultural diversity in each scenario, offers an opportunity to teach the AACN domain of Person-Centered Care. Evaluating student performance progressively in interactive simulation activities aims to prepare practice-ready nurses.

Specializing Within a Prelicensure Nursing Program: An Innovative Clinical Design.

Traditionally, prelicensure nursing programs aim to give students exposure to several different populations in preparation for becoming a registered nurse. Those who begin a career in a specialty such as pediatrics have often had little exposure and experience with the aptitudes and knowledge needed to be workforce ready. An innovative clinical cohort program was designed to prepare students better to graduate with a strong specialty foundation already established. Following the American Association of Colleges of Nursing recommendation to seek academic-practice partnerships, this cohort model was established between a university and freestanding children's hospital. Students enrolled in this program complete all required didactic and simulation coursework in the traditional curriculum. In addition, they participate in frequent clinical experiences at the children's hospital throughout the entire program. Students graduating from this program have received adequate preparation to graduate, pass NCLEX, and are competent in all necessary general nursing principles. At the same time, they are well versed in pediatric nursing and comfortable caring for this specialty population. Prelicensure students can specialize in pediatrics while meeting all general requirements of a traditional Bachelor of Science in Nursing program. This novel clinical cohort design could serve as a model to change standard programming and better meet the needs of our practice partners. [J Nurs Educ. 2023;62(8):475-478.].

SOS: Survey of Skills in Prelicensure Nursing Programs

A survey of nursing faculty was conducted for this exploratory study on the skills taught in their nursing program, along with the evaluation methods utilized. Students' competence is verified in various forms, including traditional skills checks, peer evaluation, or video recording (Kemery & Morrell, 2020; Sterling-Fox et al., 2020). Other skills may be demonstrated and practiced and not formally validated.

Where Are We Now? A Follow-up Survey on Regulation of Simulation Use in United States Prelicensure Nursing Programs

BackgroundApproval of simulation in substitution of traditional clinical hours increased in nursing programs during the COVID-19 pandemic, yet these temporary and inconsistent between states. Variability and a return to “pre-pandemic” limits on simulation use amplify questions about consistency of learner outcomes. MethodsBoards of Nursing (BONs) of the United States and District of Columbia (DC) were queried to verify accuracy of simulation regulations posted on the International Nursing Association for Clinical Simulation and Learning (INACSL) regulatory map and to identify factors contributing to regulatory changes. ResultsApproximately half of respondents indicated information posted on the INACSL regulatory map is accurate for their state. Almost 30% of respondents indicated information is not accurate. Some states could not confirm accuracy of simulation regulations posted. ConclusionsMany nursing programs expanded the use of simulation during the COVID-19 pandemic. Reverting to “prepandemic” limited simulation use presents a missed opportunity to advance nursing education and align simulation regulation with the growing body of evidence supporting its outcomes.

Exploring the Feasibility of Using Knowledge Surveys to Increase Student Knowledge, Clinical Skills and Assess Student Perceptions

This study explored the feasibility of using knowledge surveys (KSs) in a pre-licensure professional nursing program using cognitive and behavioral outcomes and illustrates how profession-specific competencies can be imbedded into a KS. This study introduces the KS as a potentially useful tool for formative and summative application in nursing education.

Integration of Motivational Interviewing Within Prelicensure Nursing Programs: A National Survey.

Vital to the nurse-patient partnership is the use of active listening and a clear understanding of the patient's health care goals. Motivational Interviewing is an evidence-based, patient-centered communication technique that assists patients in self-identifying and committing to health behavior change. This study explored whether, where, and how Motivational Interviewing is integrated into current prelicensure nursing curricula. An exploratory, descriptive study incorporated a researcher-developed survey. Participants (N = 112) represented 5 types of prelicensure nursing programs from across the United States. Forty-one participants reported using Motivational Interviewing within their program with accreditation being the primary rationale. Seventy-one participants reported not integrating Motivational Interviewing within their program with lack of knowledge being the primary rationale. Further research on optimizing the integration of Motivational Interviewing educational content and practice into all levels and specialty areas of nursing education would help to identify best practices.

Lessons Learned: Implementation of a Concept-Based Curriculum in the Development of a New Prelicensure Nursing Program.

Nursing programs throughout the United States are making changes to curricula to decrease content overload, increase critical thinking and clinical reasoning skills of graduates, and prepare students to care for the complex needs of today's health care consumer. In a student-centered approach, students are no longer passive recipients in the classroom but active learners. A concept-based curriculum is a design focused on a student-centered learning approach. This article provides lessons learned throughout the development and implementation of a concept-based curriculum in a new prelicensure nursing program.

Nursing student and faculty perspectives following involvement in women, children, family scholars pilot program

Background: Mentoring by experienced faculty can provide opportunities for nursing students to grow personally and professionally in their pursuit of establishing a clinical specialty focus. At a Midwest pre-licensure nursing (pre-licensure clinical nurse leader) program, faculty sought to assist students in pursuing knowledge and experiences within the Women, Children, and Family Nursing (WCFN) specialty.Methods: After completing an application process, selected scholars were matched with a faculty mentor to discuss student objectives/goals, project work, and engage in post-program employment opportunities conversations. At program end, both scholar and mentor completed satisfaction surveys.Results: Surveys revealed the WCFN scholar pilot program proved beneficial for both student scholar and faculty mentor. Small program changes would improve the scholar experiences.Conclusions: A WCFN Scholar program provides nursing students’ access to experienced faculty mentors who provide encouragement, assist with problem solving, and offer professional development advice, and networking. Faculty mentors reported personal satisfaction knowing they were supporting new nurse development in the WCFN specialty.

Competent Communication: Use of Video Response Assignments in a Prelicensure Nursing Program.

Competent Communication: Use of Video Response Assignments in a Prelicensure Nursing Program.

Length of Clinical Shift on Quality of Care, Learning Outcomes, and Satisfaction in Prelicensure Nursing Programs

Some schools and nursing care organizations have implemented 12-hour shifts for students' clinical experiences. The aim of this review was to identify how student 12-hour shifts compared to shifts of less than 12 hours influence patient safety, care quality, learning outcomes, and student, faculty, and staff satisfaction. Searches for academic literature using electronic databases resulted in 13 primary research articles covering the period between 1982 and 2018. During longer clinical shifts, no change in patient safety events occurred. Students and clinical staff perceived care quality was maintained or influenced positively. Faculty were undecided or minimally did not believe care quality improved. While students perceived meeting learning outcomes, faculty perceptions were divided. Students were satisfied with longer shifts; however, the satisfaction of faculty and clinical staff was mixed. Within realms of patient safety, care quality, learning outcomes, and student, faculty, and clinical staff satisfaction, research has been insufficient and inconclusive regarding 12-hour student shifts.

Mock Nursing Research and Evidence-Based Practice Conference to Support Learning in Pre-Licensure Nursing Students.

This column shares the best evidence-based strategies and innovative ideas on how to facilitate the learning and implementation of EBP principles and processes by clinicians as well as nursing and interprofessional students. Guidelines for submission are available at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1741-6787 Evidence-based practice (EBP) is an essential element of quality nursing care and education programs. However, nursing students do not seem to grasp the importance of learning EBP, as evidenced by a lack of competency in their clinical roles (Melnyk et al., 2018). Within the seven steps in the EBP process (Table 1), it was found that nursing students’ most needed improvement is with the competencies of “critical appraisal of published research” and “evaluation and synthesis of evidence” (Melnyk, Fineout-Overholt, Stillwell, & Williamson, 2010; Melnyk et al., 2018). One common way to teach critical appraisal skills and evaluation of evidence competencies is through the use of journal clubs (Ahmadi et al., 2012). Journal clubs are educational tools used to foster critical appraisal skills, encourage EBP, and disseminate new findings, typically through discussion of an article (Topf et al., 2017). This teaching strategy has been around since the mid-1800s and has since taken on a number of forms, ranging from face-to-face meetings to interactions via online, social media platforms (Rosenthal & Rosenthal, 2017; Topf et al., 2017). Incorporating the concepts of the journal club, this column will describe an innovating teaching strategy using a live “mock” nursing research and EBP conference in a pre-licensure nursing program. The objectives were to (a) engage students in current nursing research and EBP and (b) develop their critical appraisal and evaluation skills. Whereas traditional journal clubs discuss current, published literature (Topf et al., 2017), the mock conference included presentations on projects currently in process by PhD and DNP students. The mock conference took place during the EBP course in a pre-licensure nursing program halfway through the semester. The beginning of the semester was spent providing an overview of the EBP process using the Iowa Model of EBP as a guide (Buckwalter et al., 2017). As an integral component of EBP, much didactic time was spent reviewing non-research and research methodologies and how to critically appraise articles. Standard critical appraisal tools that also include clear descriptions and directions on how to assess an article’s level and quality were used to further guide students (Dearholt & Dang, 2012). The concepts of validity, reliability, and applicability of evidence were discussed in didactic lectures, and examples were provided by the course faculty. Course faculty served as the moderator for the conference. Each presenter had 15 min to discuss their project, with time allotted for questions. Presenters were at various stages in their projects, ranging from beginning protocol development to finalized results, with a variety of methodologies and topics presented. Brochures with presenters’ biographies and evaluation forms were distributed to students. Within the brochures, students were asked to rate presentations on a 5-point Likert scale of 1 (poor) to 5 (excellent). This provided students with experience in evaluating speakers, a component of real nursing conferences. Evaluations were provided to the presenters for feedback. To improve the students’ critical appraisal and evaluation skills, students were asked to (a) identify the methodology used, (b) describe the overall purpose, (c) describe the population and setting, and (d) describe how outcomes were measured. Lastly, students were asked to rate the overall mock conference on the same 5-point Likert scale. I thought this was super interesting and a great way to solidify some of the research concepts we have been learning! It gave us examples in what we are studying, while giving students a chance to practice presentations on their research. Great collaboration! This was a great experience. As a student interested in research, this mock conference sparked further interest into future work. The presenters’ enthusiasm for their work is contagious! This conference was helpful in demonstrating multiple facets of ‘real-world’ application of research and EBP. PhD and DNP students commented that they appreciated the opportunity to practice presenting their projects and that it gave them confidence and helpful feedback for the future. The mock conference, a new twist on the journal club, was a mutually beneficial activity that improved pre-licensure students’ critical appraisal and evaluation skills and provided a forum for PhD and DNP students to practice presenting their project. Based off of feedback from the first mock conference, a PhD and DNP student panel was added where pre-licensure students could ask questions about the two doctoral programs. Future conferences may expand to add faculty and clinicians from the health system, as well as poster presentations.

Current State of International Clinical Experiences in US Prelicensure Nursing Programs.

The study purpose was to describe current international clinical experience (ICE) practices in RN prelicensure programs in the United States. There is interest in ICE to fulfill the goal of preparing global citizens; however, lack of evidence on developing, implementing, and evaluating best practices for ICE limits the enactment of this approach. An electronic survey was completed by 900 deans and/or directors of diploma, associate, bachelor's, accelerated bachelor's, and master's-entry RN prelicensure programs. Respondents (n = 241, 27 percent) indicated their programs included ICE. Across programs, ICE occurred most often in community health courses. The predominant reason for offering ICE was alignment with the institutional mission and vision. Wide variability exists in methods used to implement ICE for credit toward the nursing major. There is a need to continue to assess and disseminate best practices in implementing ICE to accomplish the goal of global health engagement.

Regulation of Simulation Use in United States Prelicensure Nursing Programs

BackgroundSimulation usage has proliferated throughout nursing education. Although nursing programs have sought integration of simulation to substitute traditional clinical learning hours, the variability of regulations between states raises questions about consistency of learner outcomes. MethodsThe Boards of Nursing (BONs) of the United States and the District of Columbia were queried by internet, phone, and email to discover regulations and guidelines for the use of simulation in nursing education. ResultsMore than half of the BONs reported regulations for simulation use, but they varied greatly. Some had regulations defining a percentage of traditional clinical hours that could be replaced with simulation. A few BONs specified an equivalent ratio of hours between simulation and clinical, but most did not. Some BONs described requirements for simulation instructors, but few provided specific criteria. ConclusionsThis search revealed great variability in how BONs are defining and regulating the use of simulation in prelicensure nursing education including the amount of traditional clinical hours that can be replaced with simulation. Because a description of measured learning that occurs during traditional clinical learning hours is lacking, inconsistency in regulation will persist.

Simulation Activity and Inter-Professional Education in Pre-Licensure Nursing Programs in New Jersey: A 3 Year Trend Analysis

This three-year descriptive study describes variations of academic requirements, simulation activity, and inter-professional education in diploma, associate, and baccalaureate schools of nursing in New Jersey. The sample represents 32,978 students from 2013–2016. A total of 10,717 qualified student applicants were not offered admission to a NJ nursing program and these reasons included lack of qualified faculty and budgeted faculty positions, limited classroom space, and lack of clinical space.

Survey of Simulation Use in Prelicensure Nursing Programs: Changes and Advancements, 2010–2017

The rise of simulation in nursing education programs is due to technological advancements and limitations in the number of clinical placements available for students. Building off the National Council of State Boards of Nursing's National Simulation Study, this evaluative follow-up study sought to update the current simulation landscape in prelicensure programs, compare results between 2017 and 2010, and determine the impact of the National Simulation Study and and National Council of State Boards of Nursing's National Simulation Guidelines. Results of a survey sent to all prelicensure nursing education programs in the U.S. indicate high-fidelity simulation use in undergraduate courses increased substantially during the 7-year period, and computer-based simulation use decreased for all courses except for psychiatric/mental health nursing. Most nursing programs substitute simulation for clinical hours using a 1:1 ratio of simulation to clinical hours. The National Simulation Study and the Simulation Guidelines have a definite impact on how simulation is being employed. Knowledge of the study and guidelines seem widespread, and half of the programs indicated they adopted at least some of the simulation guidelines. Boards of nursing should remain vigilant and ensure that debriefing is occurring and that faculty receive formal training in programming the mannequins and running the scenarios.

Conceptual Model for Predicting Academic Success in Prelicensure Nursing Programs Through Expanded Cognitive Aptitude Assessment.

Attrition from prelicensure nursing programs is a serious issue with implications for students, nursing programs, and the nursing workforce. Academic failure due to insufficient cognitive aptitude often contributes to this problematic attrition rate. Thus, cognitive aptitude could be included in admission criteria, as a predictor of academic success and a strategy to minimize attrition. Currently, admissions practices are often incomplete and lack standardization for measuring cognitive aptitude. The Nursing Cognitive Aptitude Model (NCAM) presented in this article is an innovative conceptual model to guide educators in expanding current admissions processes. The NCAM model depicts the cognitive domains involved in student academic success including current scholastic knowledge, previous academic performance, and critical-thinking ability. Together, these three domains predict student academic success and are a useful reference for the admissions process.