Surgical Nursing Research Articles

The effect of virtual reality glasses on reducing pain during chest tube removal

<b>Background:</b> The studies that generally investigate the effectiveness of pharmacological and non-pharmacological methods in reducing chest tube removal related pain are remarkable. However, new studies need to expand the use of virtual reality glasses and evaluate its effectiveness.<br /> <b>Aim</b>: This study aims to determine the effect of distraction with virtual reality glasses on pain during chest tube removal in patients undergoing tube thoracostomy.<br /> <b>Material and methods:</b> This quasi-experimental study with a pre-test post-test control group design was performed with the participation of 40 patients. The patients in the intervention group (n=20) watched the video with virtual reality glasses throughout procedure. Pain measurements were evaluated before, during, and after chest tube removal. The patients in the control group (n=20) received standard care.<br /> <b>Results:</b> In the intervention group, it was revealed that the pre-procedure pain score decreased compared to the pain score obtained during the procedure (p=0.002). After the chest tube removal procedure, a statistically significant decrease was observed in pain score in favor of the intervention group. In the intervention group, the pre-procedure pain score was found to decrease statistically significantly in the measurement at the 10th min of the procedure (p=0.000). The pain score of the intervention group 10 min after the chest tube removal procedure was lower than that of the control group (1.80 vs 2.95 and p=0.028).<br /> <b>Conclusion:</b> The virtual reality glasses assisted chest tube removal procedure can help reduce pain. Surgical nurses should benefit from the use of virtual reality glasses for pain control.

Pediatric Surgical Nurses as Advocates for Immigrant Latinx Children

AbstractLatinx children represent over a quarter of the child population in the United States and are cared for by pediatric nurses in various settings across the care continuum. In the clinical setting, medical interpretation resources help pediatric nurses interact with their patients and their families, yet significant barriers to therapeutic communication remain. A case study will illustrate critical points for nurses to consider as they strive to provide the best care for their Latinx pediatric patients and their families. Although most support resources are community based, nurses who better understand the social and legal implications of immigration support higher levels of advocacy at the bedside.

Pain-related fear among adult patients undergoing open-heart surgery: an interpretative phenomenological analysis

Background One of the sources of anxiety and fear among patients undergoing open-heart surgery is the possibility of experiencing pain, such as sternotomy-related chest pain. Giving them the chance to express their feelings about the potential pain may be effective in reducing their anxiety and may support their coping strategies. Objectives To examine pain-related fear among patients undergoing open-heart surgery and to understand the underlying reasons of their fears. Methods A qualitative interview based on Heidegger’s interpretative phenomenological approach was conducted adhering to the COREQ guidelines. Sixteen patients who were undergoing open-heart surgery in the following day were interviewed at the cardiovascular surgery ward of a university hospital. The organization and mapping of the qualitative data was done by using ATLAS.ti 8.0. Results The patients who were afraid of experiencing pain after surgery seemed to be more concerned about open-heart surgery itself (such as pain from sternotomy and chest tubes) and the possibility of prolongation of postoperative pain. To cope with these fears, the patients employed a variety of social and self-coping strategies. Trusting the healthcare team, having a high pain tolerance, and having personal thoughts that take precedence over pain-related fear were the key factors explaining not being afraid of experiencing pain. Conclusions This study provides a deeper understanding of the underlying reasons and the needs of patients in controlling their pain-related fears before open-heart surgery. Trusting the healthcare professionals is one of the main factors for patients to control their pain-related fears. To develop a supportive sense of trust and to help patients in controlling their pain-related fears, surgical nurses must dedicate enough time for understanding patients’ concerns while planning their nursing care plans. Future studies may focus on exploring the role of nursing interventions and multidisciplinary team approaches on the management of preoperative pain-related fear.

Determination of Surgical Nurses’ Compliance with Isolation Precautions

Introduction: Patients are impacted by healthcare-associated infections. The aim of the study is to determine the compliance status of surgical nurses to isolation precautions. Methods: This research is a descriptive and cross-sectional research. The research was carried out between July and September 2022 in two training and research hospitals, with the participation of 215 surgical nurses. Face-to-face interviews were used to collect the research data using the Nurse Information Form and the scale. Results: The mean score of the Scale of Compliance with Isolation Precautions was determined as 53.38 ± 4.45 over 18–90 points. Upon comparing the total mean scores of surgical nurses on the scale by gender, the compliance of female surgical nurses with isolation precautions was found to be higher compared to male surgical nurses (p < 0.05). Conclusion: The compliance of the surgical nurses participating in the study with isolation precautions was determined to be moderate. The compliance of surgical nurses with isolation precautions should be increased.

A Study of Medical Surgical Nurses Leaders' Evidence-Based Practice Attributes: Critical Implications for Practice.

The purpose of this study was to determine medical-surgical nurse leaders' evidence-based practice (EBP) attributes, perceived barriers to EBP, and whether there were differences in leaders' EBP competencies and EBP implementation by demographic and organizational factors. Leaders are crucial to the development of cultures that support EBP implementation, but little is known about medical-surgical nurse leaders' capacity to perform this aspect of their role. A cross-sectional design using survey methodology was used. The survey contained demographic/work setting questions and 3 instruments to measure EBP beliefs, implementation, and competencies. Senior leaders self-reported higher EBP attributes compared with nurses in other roles; nurses with an MSN or higher reported greater frequency of EBP implementation. A regression revealed that EBP competencies, EBP beliefs, having a DNP degree, and working in an Academy of Medical-Surgical Nurses Premier Recognition In the Specialty of Med-surg unit or a Pathway to Excellence® organization had significant, positive effects on EBP implementation scores (R2 = 0.37). Findings demonstrate there is a range of EBP beliefs and competencies, and barriers to EBP among medical-surgical nurse leaders. Because medical-surgical nursing is the largest acute care practice specialty in the United States and many other countries, leaders fully integrating EBP into their practice would be a substantial contribution to advancing EBP in healthcare.

Investigation of the effects of personalized oral care methods in oral and maxillofacial surgical nursing.

Investigation of the effects of personalized oral care methods in oral and maxillofacial surgical nursing.

Burnout Levels in Nurses and Associated Factors during the COVID-19 Pandemic-A Cross-Sectional Study.

Previous studies have shown that sudden changes in the nature of nursing work and their work environment related to the COVID-19 pandemic have affected the professional experience of nurses, and consequently led to an increase in professional burnout in this professional group. Thus, the aim of the study was to measure occupational burnout among nurses working during the COVID-19 pandemic in Poland. A cross-sectional study was conducted with pediatric and surgery female nurses (N = 110, mean age 51 ± 6.92) from the Provincial Specialist Hospital in Włocławek, Poland. The participants completed the Link Burnout Questionnaire (LBQ) and the Socio-Demographic Questionnaire (SDQ). The data were analyzed using Spearman's rank correlation and Mann-Whitney U test. The study showed that high burnout affected 6.4% of nurses. The level of professional burnout for the subscales of psychophysical exhaustion, relationship deterioration, professional inefficacy and disappointment was 28.2%, 26.4%, 11.8% and 13%, respectively (mean score: 19.85 ± 6.51, 18.03 ± 5.15, 13.74 ± 4.07 and 17.61 ± 5.85, respectively). The results show that surgical nurses were statistically more likely to experience professional burnout. In sum, burnout among nurses has become a serious problem, especially considering the COVID-19 pandemic, which is why it is so important to continue research in this area. Hospital management needs to take urgent action to address the systemic and professional issues that contribute to the suboptimal mental health of nurses.

Investigation and Analysis of the Implementation Status of Enhanced Recovery After Surgery in the Context of Precision Nursing in Xinjiang

To investigate the current status of surgical nurses' implementation of enhanced recovery after surgery (ERAS) concepts in the context of precision nursing in Xinjiang and to provide a basis for the development of precision nursing of ERAS. By way of convenience sampling, surgical nurses from 8 tertiary-care hospitals were involved in a survey on their ERAS implementation status in March and April 2023 and the results were collected by online questionnaire. A total of 985 valid questionnaires were collected. Out of the 8 hospitals covered in the survey, the orthopedics departments of 7 hospitals have implemented ERAS concepts, accounting for 87.50%. The average score for the ERAS Knowledge, Attitude, and Practice Questionnaire among the surgical nurses was (182.98±17.69), of which, the average score for ERAS knowledge was (13.08±1.51), the average score for ERAS attitude was (88.75±8.30), and the average score for ERAS practice was (81.15±11.96). A total of 61.02% of the surgical nurses implemented ERAS pathways that concentrated on 4-6 pathways, with the prevention of postoperative ileus after surgery being the most commonly implemented pathway, accounting for 498 (50.56%) surgical nurses. A total of 78.48% of the nurses considered work overload to be the most important obstacle to implementing ERAS in the context of precision nursing. Poor multidisciplinary team collaboration and poor awareness of implementation among the nurses ranked the second and the third, accounting for 74.92% and 71.57%, respectively, of the surgical nurses. ERAS has won the approval of surgical nurses in Xinjiang, but it is still not widely implemented in all surgical fields. In addition, the quantity and quality of ERAS pathways implemented still need to be further improved. The development of ERAS in the context of precision nursing remains a long-term challenge.

Medical and surgical nurses' approach to patient pressure injury prevention education: An integrative review.

Identify and synthesise the published literature on the approaches and practices nurses use during the delivery of pressure injury prevention (PIP) education to hospitalised medical and surgical patients. An integrated review. Whitmore and Knaff's (2005) five-stage methodology guided this review: (1) research problem identification; (2) literature search; (3) data evaluation; (4) data analysis; and (5) results. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (2020) Statement was followed. The quality of included studies was assessed using the Mixed Method Appraisal Tool (2018). Extracted data were analysed using inductive content analysis. Journal publication dates from 1992 to 2022. Systematic searches of CINAHL (Cumulative Index of Nursing and Allied Health Literature) complete, Embase, PsycINFO (via Ovid) and Scopus databases were undertaken. A total of 3892 articles were initially identified, four quantitative and two qualitative studies were included. Articles were published between 2013 and 2022.Two themes were identified: responsibility and workplace culture determine nurses' approach to PIP education delivery; and nurses tailor education strategies to address challenges and opportunities for PIP education delivery. Nurses require resources to facilitate approaches to PIP education with medical and surgical patients. In the absence of clear instruction to support nurses' practice, PIP education for patients is at best delivered in an informal and ad hoc manner. Nurses require accessible education resources to enable them to tailor the content and frequency of PIP education to patients in med-surg settings. No patient or public contribution.

Surgical Nurses' Perceptions of Strategies to Enhance Pain Management Proficiency: A Qualitative Study.

To describe surgical nurses' strategies for enhancing their pain management proficiency. A qualitative design was used to conduct the study. The participants were forty surgical nurses who had at least six years of nursing experience in caring for patients with pain. They responded to open-ended questions based on a review of the policy documents concerning the main elements of the pain management programme to be implemented by surgical nurses. Three key themes emerged from the surgical nurses' suggested strategies: partnering, disrupting, and becoming familiar with pain management competency concerns. Surgical nurses' strategies in acute and chronic pain management nursing units included solving patients' problems and promoting and enhancing pain strategies to address health challenges in organisations. The themes presented in the results include enhancing pain management in nursing competencies. State-of-the-art healthcare technologies are being applied to pain management. Surgical nurses' strategies should improve the quality of nursing care, especially post-surgery recovery time. It is recommended to engage patients, their families, and multidisciplinary care teams in other healthcare fields.

Surgical nurse experience with adverse events - a descriptive qualitative study

Aim: To explore the experience of surgical nurses with adverse events. Design: A descriptive qualitative study. Methods: Data were collected between August 2021 and February 2022 using semi-structured interviews. Participants were nurses (n = 10) working in surgical care units in a teaching hospital in the Slovak Republic. The interviews were recorded on an audio recorder and transcribed verbatim. Data were analyzed using thematic analysis. Results: Two main themes were identified: Adverse events in the surgical workplace and Preventive strategies aimed at reducing adverse events. Several subthemes specified themes and reflected the nurse’s experience with adverse events in surgical settings. Conclusion: Surgical workplaces are at risk of adverse events due to the number of surgical procedures. Given that most adverse events are preventable and systemic factors are responsible for their occurrence, we recommend implementing risk management, including active identification of patients at risk, teamwork support, management of missing resources, adjustment of the environment, and creation of a positive patient safety culture.

Facilitators and Barriers to Nurses Screening for Frailty in Acute Care in a Provincial Health-Care System: a Survey Study Guided by the Theoretical Domains Framework.

Older adults living with frailty represent the largest population of hospitalized patients in Canada, but they do not always receive the quality of care needed. Nurses are well-positioned to screen for frailty, but current frailty screening practices are poorly understood. A cross-sectional survey study was conducted over a six-week period with nurses from Alberta, Canada working in acute care with older adults. Demographics were descriptively reported. Frailty screening methods were quantified on 5-point frequency scales, reported descriptively and compared by practice area using linear regression. The top-five mean scores from a 43-item, 6-point Likert-type questionnaire based on the Theoretical Domains Framework were compared by practice area. Frailty screening by clinical impression was "usually" used (median = 4, IQR = 4-5), while tools were "rarely" used (median = 2, IQR = 1-3). Medical and/or surgical nursing had higher general frailty screening tool use (β = 0.81, r = .31, p < .001), but no significant (p > .05) differences for using clinical impression, or preference of screening method. The top facilitator was the disbelief that frailty screening negatively impacts relationships with older adults. The top barrier was belief that conducting frailty screening was routine. Nursing practice area influenced frailty screening beliefs. There is an opportunity to implement frailty screening tools into the nursing practice of Alberta' nurses working in acute care. Frailty screening tools that become routine have greater likelihood for utilization. Nursing practice areas may have unique situations that require tailored approached to tool implementation.

The Effect of Burnout and Moral Sensitivity Levels of Surgical Unit Nurses on Job Satisfaction

This study was carried out to determine the effect of burnout and moral sensitivity levels of surgical unit nurses on their job satisfaction. A descriptive and correlational design study. The population consisted of 268 nurses working in health institutions in the Eastern Black Sea Region of Turkey. The data were collected online between 1 and 30 April, 2022 using a sociodemographic data form, the Maslach Burnout Inventory, the Minnesota Job Satisfaction Scale, and the Moral Sensitivity Scale. Pearson correlation analysis and logistic regression analysis were used to evaluate the data. The nurses' moral sensitivity scale mean score was 105.2 ± 18.8, and the Minnesota job satisfaction scale mean score was 3.3 ± 0.7. The participants' mean emotional exhaustion score was 25.4 ± 7.3, the depersonalization score average was 15.7 ± 4.6, and the personal accomplishment mean score was 20.5 ± 6.7. The factors affecting the job satisfaction of nurses were found to be moral sensitivity, personal accomplishment, and satisfaction with the unit they worked. Nurses had high levels of burnout due to emotional exhaustion, one of the subdimensions of burnout, and moderate levels of burnout due to depersonalization and personal accomplishment. The moral sensitivity and job satisfaction of nurses are moderate. As the nurses' accomplishment and ethical sensitivity levels increased and their emotional exhaustion levels decreased, their job satisfaction levels increased.

MLuq Protocol: A Proposal for the Immobilization of the White Weapon, Preservation of DNA Traces, and Its Chain of Custody.

Unprecedentedly, this article presents a useful management protocol for the workers in emergency situations assisting victims of white weapon aggressions with a dual innovation. It could presage a possible advance in the healthcare management of these patients and support important repercussions in the legal field when this type of wound is inflicted due to an aggression. The MLuq protocol has been agreed by consensus in a multidisciplinary manner including experts belonging to the state security forces (judicial and scientific Police), to the healthcare area (surgical nursing, emergency medicine, general cardiothoracic and digestive surgery, and the legal and forensic medicine area), to the legal system (a jurist specialized in the area), and to the academic sphere. It is the first paper to propose purse string sutures as a weapon immobilization technique, as well as a set of actions designed to obtain biological traces of legal interest and to preserve the chain of custody. Therefore, it is a useful tool for the health and legal personnel, and especially for the victims.

Occupational Burnout among Nursing Professionals: A Comparative Analysis of 1103 Polish Female Nurses across Different Hospital Settings

Burnout is common in public trust professions that help people, particularly in healthcare. Professional burnout is a psychological syndrome of emotional exhaustion, depersonalization, and a lowered sense of personal achievement in individuals who work with other people. Research has also shown that occupational burnout can result from the incompetence of employees. This study aimed to examine the occupational burnout and coping strategies among nurses working in different hospital settings. A study group consisted of 1103 Polish female nurses working in non-invasive, intensive care, and surgical units. The following validated tools were used: the Maslach Burnout Inventory (MBI) and the Mini-COPE questionnaire. The largest contribution in occupational burnout was depersonalization (mean score of 51.57) and, to a lesser extent, emotional exhaustion (mean score of 47). The smallest impact was recorded for job satisfaction (mean score of 28.76). Nurses in surgical departments were younger, less burned out, and dealt with stress better than nurses in non-invasive and intensive care units. Nurses in non-invasive wards were the most burned out among the study sample. Nurses in intensive care experienced the least satisfaction from work. In conclusion, professional burnout in nurses depends on the hospital settings, and this specification should be considered in recognizing this problem among nurses. Considering coping strategies, the results suggest a need for tailored coping interventions and support programs specifically designed for nurses working in high-stress environments such as the intensive care unit and non-invasive ward. Given that surgical nurses demonstrated better coping strategies, there is an opportunity to share their best practices with nurses in the intensive care unit and non-invasive ward. In the long-term perspective, investing in the well-being of healthcare workers can lead to a more sustainable healthcare system. By reducing turnover rates and improving the quality of care, sustainable practices can improve the efficiency and effectiveness of healthcare systems.

Otolaryngology resident familiarity with surgical instruments and preoperative setup: A pilot study

ObjectiveThis study was designed to determine otolaryngology (ORL) residents' ability to prepare the operating room independently for ORL surgical cases and their familiarity with ORL surgical instruments and related equipment. MethodsA 24-question, one-time, anonymous survey was distributed to otolaryngology-head and neck surgery program directors for distribution among their residents in the United States in November 2022. Residents in every post-graduate year were surveyed. Spearman's ranked correlation and Mann-Whitney U test were used. ResultsThe response rate among program directors was 9.5 % (11/116 programs), while the response rate among residents was 51.5 % (88/171 residents). A total of 88 survey responses were completed. 61 % of ORL residents who responded were able to name most instruments used in surgical cases. The most recognized surgical instruments by ORL residents were microdebrider (99 %) and alligator forceps (98 %); the least recognized were bellucci micro scissors (72 %) and pituitary forceps (52 %); and all instruments except the microdebrider showed significantly increased recognition with increasing post graduate training year (PGY), p ≤ 0.05. ORL residents were most able to set up independently the electrocautery (77 %) and laryngoscope suspension (73 %), while they were least able to set up the robot laser (6.8 %) and coblator (26 %) independently. All instruments showed significant positive correlations with increasing PGY; the strongest correlation was found in laryngoscope suspension, r = 0.74. 48 % of ORL residents reported that there were times when surgical techs and nurses were not available. Only 54 % of ORL residents reported being able to set up instruments when alone in the operating room, including 77.8 % of PGY-5 residents. Only 8 % of residents reported receiving education related to surgical instruments from their residency program, while 85 % thought that ORL residencies should have courses or educational materials about surgical instruments. ConclusionORL residents' familiarity with surgical instruments and preoperative setup improved throughout their training. However, specific instruments had much lower recognition than others and a lower ability for independent setup. Nearly half of ORL residents reported being unable to set up surgical instruments in the absence of surgical staff. Implementation of surgical instrument education may improve these deficiencies.

The Knowledge, Practices, and Perceptions of Surgical Nurses Concerning Spirituality and Spiritual Care

PurposeThe purpose of this descriptive study was to describe the knowledge, practices and perceptions of nurses concerning spirituality and spiritual care. DesignA descriptive study. MethodsThe study was performed with 142 surgical nurses working in three public hospitals in a city in Turkey. A “Personal Information Form” and the “Spirituality and Spiritual Care Grading Scale” were used for data collection. The data were analysed on SPSS 25.0 software. FindingsWhile 77.5% of the nurses reported having heard about the concepts of spirituality and spiritual care, 17.6% reported having received instruction concerning spirituality and spiritual care during their initial nursing education and 19.0% after graduation. In addition, 78.2% provided spiritual care in the clinics where they worked, 40.5% reported that patients were given religious support and 37.8% stated that patients were given the opportunity to be involved in their own care. The nurses’ total mean spirituality and spiritual care grading scale score was 57.6±5.6. A statistically significant difference was determined in mean scale scores between nurses who had and had not heard about the concepts of spirituality and spiritual care (P=0.049) and between those who practiced and did not practice spiritual care in the clinics where they worked (P=0.018). ConclusionsThe majority of surgical nurses had heard about the concepts of spirituality and spiritual care but had not been exposed to them during their initial nursing education. However, the majority practiced spiritual care in their clinics, and their perception levels were above average.

Discussion-based interprofessional education: A positive step toward promoting shared understanding between surgical residents and nurses

ABSTRACT Interprofessional education during medical training may improve communication by promoting collaboration and the development of shared mental models between professions. We implemented a novel discussion-based intervention for surgical residents and nurses to promote mutual understanding of workflows and communication practices. General surgery residents and inpatient nurses from our institution were recruited to participate. Surveys and paging data were collected prior to and following the intervention. Surveys contained original questions and validated subscales. Interventions involved facilitated discussions about workflows, perceptions of urgency, and technology preferences. Discussions were recorded and transcribed for qualitative content analysis. Pre and post-intervention survey responses were compared with descriptive sample statistics. Group characteristics were compared using Fisher’s exact tests. Eleven intervention groups were conducted (2–6 participants per group) (n = 38). Discussions achieved three aims: Information-Sharing (learning about each other’s workflows and preferences), 2) Interpersonal Relationship-Building (establishing rapport and fostering empathy) and 3) Interventional Brainstorming (discussing strategies to mitigate communication challenges). Post-intervention surveys revealed improved nurse-reported grasp of resident schedules and tailoring of communication methods based on workflow understanding; however, communication best practices remain limited by organizational and technological constraints. Systems-level changes must be prioritized to allow intentions toward collegial communication to thrive.

Subspecialty nurses as an essential ingredient for modern vascular service

Surgical PracticeAccepted Articles EDUCATION Subspecialty Nurses as Essential Ingredient for Modern Vascular Service Yiu Che Chan, Corresponding Author Yiu Che Chan [email protected] orcid.org/0000-0003-3764-3782 Division of Vascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, SAR, China Author Correspondence Dr. Yiu Che CHAN MB BS BSc MD FRCS(England) FRCS(General Surgery) FCSHK, Associate Professor, Division of Vascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, South Wing, 14 Floor K Block, Queen Mary Hospital, Pokfulam Road, Hong Kong. Tel: +852-2255-4969, FAX: +852-2255-4967, Email: [email protected]Search for more papers by this authorPo-Ching Chan, Po-Ching Chan Division of Vascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, SAR, ChinaSearch for more papers by this authorPui-Yan Paine Kong, Pui-Yan Paine Kong Division of Vascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, SAR, ChinaSearch for more papers by this authorYee-Ming Tse, Yee-Ming Tse Division of Vascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, SAR, ChinaSearch for more papers by this authorStephen W. K. Cheng, Stephen W. K. Cheng Division of Vascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, SAR, ChinaSearch for more papers by this author Yiu Che Chan, Corresponding Author Yiu Che Chan [email protected] orcid.org/0000-0003-3764-3782 Division of Vascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, SAR, China Author Correspondence Dr. Yiu Che CHAN MB BS BSc MD FRCS(England) FRCS(General Surgery) FCSHK, Associate Professor, Division of Vascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, South Wing, 14 Floor K Block, Queen Mary Hospital, Pokfulam Road, Hong Kong. Tel: +852-2255-4969, FAX: +852-2255-4967, Email: [email protected]Search for more papers by this authorPo-Ching Chan, Po-Ching Chan Division of Vascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, SAR, ChinaSearch for more papers by this authorPui-Yan Paine Kong, Pui-Yan Paine Kong Division of Vascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, SAR, ChinaSearch for more papers by this authorYee-Ming Tse, Yee-Ming Tse Division of Vascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, SAR, ChinaSearch for more papers by this authorStephen W. K. Cheng, Stephen W. K. Cheng Division of Vascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, SAR, ChinaSearch for more papers by this author First published: 25 April 2023 https://doi.org/10.1111/1744-1633.12625 This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/1744-1633.12625. AboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Accepted ArticlesAccepted, unedited articles published online and citable. The final edited and typeset version of record will appear in the future. RelatedInformation

Effects of BOPPPS combined with TBL in surgical nursing for nursing undergraduates: a mixed-method study

BackgroundSurgical Nursing is a core subject for nursing undergraduates that requires active and effective learning strategies to cultivate students’ autonomous learning competencies and critical thinking. The effects of BOPPPS (Bridge-in, Objectives, Pretest, Participatory Learning, Post-test and Summary) model combined with team-based learning (TBL) have rarely been explored in Surgical Nursing courses.ObjectiveTo explore the effects of BOPPPS combined with TBL in Surgical Nursing for nursing undergraduates.MethodsA mixed research method of quasi-experimental study design and descriptive qualitative research was used. The control group included 27 nursing undergraduates who had finished the Surgical Nursing course using traditional learning. The experimental group included 36 nursing undergraduates were enrolled in to receive the Surgical Nursing course in the teaching mode of BOPPPS combined with TBL. The quantitative data of students’ Surgical Nursing final scores, autonomous learning competencies and critical thinking ability of the two groups were collected and compared by t-test. Qualitative results were obtained through semi-structured interviews and data were analyzed by thematic analysis method.ResultsCompared with the traditional learning mode, BOPPPS combined with TBL significantly improved nursing students’ final examination scores, autonomous learning competencies and critical thinking ability (p < 0.05). Qualitative results from 14 undergraduate nursing students’ interviews were summarized into five themes: (1) stimulating learning interest; (2) improving autonomous learning ability; (3) improving the sense of teamwork; (4) exercising critical thinking; and (5) suggestions for improvement.ConclusionsThe combination of BOPPPS and TBL positively impacted nursing students by improving their autonomous learning competencies and critical thinking ability. The study suggests BOPPPS combined with TBL learning as an effective, alternative learning mode.