Traditional Clinical Experiences Research Articles

Improving Adolescent Psychosocial Assessment through Standardized Patient Simulation: An Interdisciplinary Quality Improvement Initiative.

Adolescent suicide and mental illness have increased at alarming rates. Healthcare professionals report a lack of skill and confidence in obtaining adolescent histories and managing confidential care due to limited training in residency. Nursing professional development practitioners face challenges of adequately preparing interdisciplinary healthcare providers to assess, identify, and intervene at all points of contact with adolescents. To increase the confidence in clinical communication skills and clinical competency, and to increase the number of social work referrals related to modifiable risk factors for adolescent patients, a Texas pediatric tertiary care center utilized standardized patient (SP) methodology to supplement traditional clinical experiences with communication-focused education based on the Home, Education, Eating, Activities, Drugs, Sexuality, Suicidality, and Safety (HEEADSSS) interviewing. This quality improvement (QI) pilot demonstrated the benefits of utilizing standardized patient methodology in communication-focused education based on the HEEADSSS interviewing. Following the SP simulations, confidence in clinical communication skills increased by 13%, clinical competency in performing comprehensive psychosocial interviews increased by 11%, use of HEEADSSS increased by 64%, and social work referrals increased by 89%. This interdisciplinary SP interviewing simulation pilot was beneficial in improving the 36 physician and nursing residents' ability to conduct psychosocial assessments for risk factors of suicidality among adolescents.

A Cost-Utility Analysis Comparing Traditional Clinical, Manikin-Based Simulation, and Screen-Based Virtual Simulation Activities.

Simulation activities are used increasingly in nursing education to augment or replace traditional clinical experiences. Educators and regulators are called on to make evidence-based decisions about the use of limited clinical and simulation resources. This cost-utility analysis addresses the final aim of a study comparing cognitive learning, patient care performance, and self-perceptions of how well learning needs were met among students who were exposed to 4 hours of traditional clinical experience, 2 hours of manikin-based simulation, or 2 hours of screen-based virtual simulation. The costs of each activity were calculated and divided by a composite measure of the utility of each activity. The cost-utilities for 4 hours of traditional clinical experience, 2 hours of manikin-based simulation, and 2 hours of screen-based virtual simulation were $0.15, $0.62, and $0.38, respectively, in U.S. dollars per unit of utility. The data provide evidence for educators and administrators to make effective and efficient use of limited resources to prepare nurses for practice. [J Nurs Educ. 2024;63(2):79-85.].

Mechanism of Yixishu lotion in the treatment of vaginitis based on network pharmacology combined with experimental validation: an experimental research study

Objective: Yixishu lotion (YXSL) originates from the summary of traditional Chinese medicine clinical experience and constantly improves in practice in clinical validation of the exact efficacy of traditional Chinese medicine prescription. To explore the mechanism of YXSL in treating vaginitis and the potential mechanisms based on network pharmacology and experimental verification. Methods: The active components and drug-related targets of YXSL were retrieved from the TCMSP (Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform) database, and the target was predicted by the UniProt database. Searching for genes related to ‘vaginitis’ disease in the GeneCards database, a total of 2581 drug targets were obtained. The interaction between proteins (PPI – protein–protein interaction) relationship was obtained by STRING database and visualized by Cytoscape software. Finally, the ‘Bioconductor’ installation package in R software was used to analyze the GO (Gene Ontology) and KEGG (Kyoto Encyclopedia of Genes and Genomes) pathways of the target. Results: In this study, by the method of network pharmacology, the key active components of YXSL were flavonoids such as quercetin, apigenin, kaempferol, luteolin, β-sitosterol; the main core proteins included MAPK14, TP53, FGF2, ESR1, MAPK3, MAPK1, VEGFA, JUN, IL-6, and the KEGG pathway was mainly involved in MAPK pathway, Th17 pathway, Malaria, TNF pathway, and other signaling pathways. Animal experiments showed that the clinical symptoms and vaginal tissue lesions of the YXSL group and the fluconazole group were improved, and the levels of TNF-α (tumor necrosis factor alpha), IL-6 (interleukin-6), MDA (malondialdehyde), SOD (superoxide dismutase), IL-4, and IFN-γ (interferon-γ) in vaginal tissue and serum were better than the model group. Conclusion: YXSL may achieve its therapeutic effect on vaginitis by reducing the inflammatory response, improving oxidative stress response, and improving body immunity, and it provides a theoretical basis for further research on its pharmacodynamic material basis and mechanism of action.

Effectiveness of Screen-Based Simulation as a Strategy to Improve Nurse Practitioner Students' Access to Electronic Health Records in Clinical Education.

Learning to use electronic health records is essential for family nurse practitioner students to inform practice and clinical decision-making. Limited access to electronic health records during clinical training can lead to suboptimal use. Academic programs often rely on healthcare organizations to provide opportunities for students to learn electronic health record skills. However, clinical experiences are highly individualized, and students may not have access to electronic health records. Alternatives are needed to develop this critical competency. This study compared self-reported ratings regarding comfort and access to electronic health record documentation between students who participated in screen-based simulation and students who completed traditional clinical experiences with a preceptor during the last 70 hours of clinical training in one family nurse practitioner program. There was a significant difference in electronic health record access between students who participated in simulated versus traditional clinical experiences (P = .002). There were no significant differences in ratings of comfort using electronic health records between groups. Both groups reported limited access to electronic health records in the first 500 hours of clinical experience. However, students who participated in screen-based simulation reported a quarter-fold increase in electronic health record access during their last 70 hours of clinical training.

Evolving Approaches to Meet Clinical Hours for Undergraduate Nursing Students during COVID-19.

The COVID-19 pandemic challenged all healthcare professionals to re-think how patient care is provided. Faculty in nursing schools faced similar challenges in offering adequate clinical hours to nursing students, because of the limited availability of clinical placements. A faculty in one school of nursing introduced virtual simulation resources to supplement in-person clinical hours. The faculty developed a revised clinical curriculum for students that included weekly objectives and deliverables for virtual simulations. The Simulation Effectiveness Tool-Modified (SET-M) was utilized to evaluate the effectiveness of the virtual simulations. 130 students (88.4%) completed the post-implementation survey. After using the virtual simulations, 50% of the students reported feeling confident in providing interventions that foster patient safety. Furthermore, students reported a sound understanding of disease pathophysiology (60%) and medications (53.8%). The qualitative data indicated that students found the virtual simulations beneficial and a safe learning environment. Pre-pandemic virtual simulations were not used by this school of nursing to replace the traditional in-person clinical experiences. However, the pandemic demonstrated that the utilization of innovative virtual simulations are effective methods for student learning to augment traditional clinical experiences.

Determining a common understanding of interprofessional competencies for pre-registration health professionals in Aotearoa New Zealand: A Delphi study.

There is growing awareness that factors such as the growing incidence of co-morbidity and increasing complexity of patient health needs cannot be addressed by health professionals practicing in isolation. Given this, there is an increasing emphasis on preparing students in health-related programs for effective interprofessional practice. Less clear, however, are the specific skills and clinical or learning opportunities necessary for students to develop effectiveness in interprofessional practice. These factors drove a team associated with a tertiary health education provider in Hamilton, New Zealand to transform traditional clinical student experiences in the form of an interprofessional student-assisted clinic. The clinic was intended, in part, to provide students with opportunities to learn and experience interprofessionalism in practice but was hampered by limited information available regarding the specific skill requirements necessary for students in New Zealand to learn in this context. In this Delphi study, we synthesize national expert opinion on student competency indicators necessary for effective interprofessional practice. The resultant set of indicators is presented and opportunities for application and further research discussed. The paper offers guidance to others seeking to innovate health curricula, develop novel service-oriented learning experiences for students, and foster interprofessional practice competence in the future health workforce.

Comparison of Flex vs. residential clinical education program outcomes: physical therapy students’ self-efficacy, confidence, and clinical competence

Purpose: Alternative flexible (Flex) path Doctor of Physical Therapy (DPT) programs may have an emerging footprint. The differences between Flex and traditional residential DPT program clinical experience outcomes remain unknown. The purpose of this study was to evaluate Flex and residential DPT students’ clinical reasoning self-efficacy, confidence with treating, and Clinical Performance Instrument (CPI) clinical reasoning and summative scores during clinical experiences. Methods: A descriptive and exploratory cross-sectional survey was used with a voluntary convenience sample of 211 university DPT students during Fall 2020 full-time clinical experiences. Descriptive and inferential statistics evaluated differences in Flex and residential DPT program students’ (1) Physical Therapist Self-Efficacy (PTSE) scale scores, (2) confidence with treating initial and subsequent same-patient visits, and (3) final CPI clinical reasoning and summative scores during clinical experiences. Results: Mean PTSE scores were significantly lower for Flex (x̄ = 14.2) compared to residential DPT students (x̄ = 15.2) (P < 0.05). No significant student differences were found in (1) Flex (x̄ = 2.1) and residential (x̄ = 2.2) confidence with treating at the initial visit (P = 0.59), (2) Flex (x̄ = 2.8) and residential (x̄ = 3.0) confidence with treating subsequent same-patient visits (P = 0.15), and (3) Flex (x̄ = 15.8) and residential (x̄ = 16.5) CPI clinical reasoning (P = 0.17), and (4) Flex (x̄ = 16.1) and residential (x̄ = 16.7) CPI summative scores (P = 0.21). Conclusion: Clinical reasoning self-efficacy among Flex DPT students was lower, but there was no difference in CPI clinical reasoning or summative results between Flex and residential DPT students. In the university investigated, the Flex distance learning DPT program curriculum appeared effective in preparing students’ clinical reasoning readiness for the available full-time clinical experiences. We recommend academic institutions consider expanding Flex entry-level DPT program availability options because the outcomes were comparable. Additional flex entry programs may help address the underrepresentation of nontraditional students in entry-level DPT programs and societal demands for physical therapy services.

Ontology characterization, enrichment analysis, and similarity calculation-based evaluation of disease-syndrome-formula associations by applying SoFDA.

Clinical symptom-based diagnosis and therapy play a crucial role in personalized medicine and drug discovery. The syndromes, distinctive groups of clinical symptoms summarized by traditional Chinese medicine (TCM) theories and clinical experiences, are used as the core diagnostic criteria and therapeutic guidance in TCM. However, there is still a lack of standardized data, information, and intrinsic molecular basis to help TCM syndromes better classify diseases and guide tailored medications. To address this problem, we built the first integrated web platform, SoFDA (http://www.tcmip.cn/Syndrome/front/), with a curated ontology of 319 TCM syndromes, 8045 diseases, and 1359 TCM herbal formulas and their relationships with genes, diseases, and formulas. This platform proposed an association measurement by calculating Jaccard/Cosine similarities between TCM syndromes and their related biomedical entities with case and control validations. On this basis, the SoFDA platform enables biomedical and pharmaceutical scientists to rank and filter the most promising associations for disease diagnosis and tailored interventions. Conversely, the targeted gene sets and symptom sets can also be associated with TCM syndromes, formulas, and diseases for function illustration. Notably, SoFDA explores the multi-way associations among diseases, TCM syndromes, symptom genes, herbal formulas, drug targets, and pathways in heterogeneous biomedical networks with lots of customization. The protocol here implements all the analyses above using the SoFDA platform. Collectively, SoFDA may provide insights into the biological basis of disease-specific TCM syndromes and the underlying molecular mechanisms, as well as a tailored treatment for single or multiple symptoms within a syndrome.

Contributing to Evidence-Based Regulatory Decisions: A Comparison of Traditional Clinical Experience, Mannequin-Based Simulation, and Screen-Based Virtual Simulation

<h3>Background</h3> Boards of nursing need empirical evidence to guide the regulation of simulation in nursing education and to make decisions about how simulation should count toward required clinical hours. <h3>Purpose</h3> The purposes of this study were to (a) compare cognitive learning and patient care performance outcomes between prelicensure nursing students who participated in 4 hours of traditional clinical experience, 2 hours of mannequin-based simulation, or 2 hours of screen-based virtual simulation and (b) examine students' self-perceptions about the efficacy of each experiential learning activity. <h3>Methods</h3> Participants were randomly assigned to one of three groups: 4 hours of traditional clinical experience, 2 hours of mannequin-based simulation, or 2 hours of screen-based virtual simulation. After completing their first experiential learning activity and posttest assessments, participants completed the two experiential learning activities they were not originally assigned as well as a survey regarding their self-perceptions about the effectiveness of each activity. Learning and patient care performance scores were compared between groups. <h3>Results</h3> There was no significant difference in cognitive learning outcomes between groups. On the measure of patient care performance, students who were randomized to the mannequin-based simulation group performed as well as or significantly better than students who were randomized to the other two groups. Overall, students reported that screen-based virtual simulation was the least effective of the three experiential learning activities in meeting their learning needs. <h3>Conclusion</h3> Additional research is needed to make the most effective and efficient use of our resources for experiential learning in nursing education.

From the Frontlines to the Future: Emergency Department Nurses' Advice During the COVID-19 Pandemic

Nurse educators are challenged to bridge the gap between academia and the health care environment to provide nursing students with the knowledge and skills to ensure their readiness to practice. With limited traditional clinical experiences, many new graduate nurses begin their careers in high-stress environments such as emergency departments. A convenience sample of 66 emergency department nurses completed two qualitative survey questions related to their experiences working with new graduate nurses during the coronavirus disease 2019 (COVID-19) pandemic. Respondents reported lack of clinical skills was the biggest weakness observed in new graduate nurses. Four themes were identified: protection and unpreparedness, thirst for knowledge, burnout, and support and self-care; these themes built the foundation for the overarching theme of resilience. Nurse faculty must be able to support students' transition into a rapidly changing health care environment. Student preparation should focus on skill building, communication, self-care strategies, and resilience. [J Nurs Educ. 2022;61(12):711-715.].

Replacing community clinical hours with an antepartum simulation-based experience.

Community and population health is an essential part of pre-licensure nursing education. Securing community clinical sites for large cohorts of nursing students is challenging. Individual community sites in nursing specialty areas, such as women's health, limit the number of students, making it difficult to provide a consistent clinical experience for all students. The literature shows simulation is an effective alternative to traditional clinical hours. This article describes a pilot simulation-based antepartum experience in the community setting. This simulation-based experience replaced the clinical hours for a previous traditional clinical experience in the community setting, for which students were only able to observe and not interact. The objectives were to allow students to be engaged in communication, patient education, and anticipatory guidance with a live patient. Faculty at a large southeastern university created an antepartum simulation-based clinical experience focused on important elements of obstetrics and maternal health assessment utilizing standardized patients. Student responses from the post-simulation survey showed 96% strongly agreed they were more confident in communicating with clients. Faculty concluded this simulation-based experience is an effective alternative to traditional community clinical experiences in the antepartum setting.

Increasing Critical Thinking Opportunities Through Post-Conference Simulation in a Pediatric Baccalaureate Nursing Course.

Traditional clinical experiences offer opportunities for nursing students to practice critical thinking. However, there are many limitations to planning these clinical experiences. The purpose of this educational activity is to incorporate post-conference simulation with traditional clinical to allow undergraduate nursing students expanded opportunities for enhancing critical thinking. The faculty created high-acuity simulation scenarios, which included a child experiencing respiratory, hematologic, neurological, or cardiovascular complications. After participating in the activity, students completed evaluation and reported increased confidence and preparedness to identify, think critically, and intervene in high-acuity situations.

A Qualitative Study of Preclinical Medical Students Randomized to Patient-Partnered vs Traditional Clinical Experiences.

Longitudinal patient-partnered experiences may promote medical student empathy, but evaluation of such programs is limited. The aim of this study was to compare areas of learning among first-year medical students randomized to a patient-centered track (PCT) or traditional track (TT) longitudinal clinical experience. PCT students (n=24) were paired with 2 patients and a physician to participate in their patients' care across multiple settings. TT students (n=56) were paired with a physician preceptor and participated in caring for a variety of patients in a single setting. This qualitative study used a phenomenological approach to template analysis, examining and comparing student reflective essays for areas of learning. Three domains of learning emerged: 1) Focus of learning (biomedical, patient-centered); 2) Roles and relationships (clinical skills, relationship-building, teaching from preceptor and patients); and 3) Context of care (health systems science, interprofessional care). PCT students described patient-centered learning, relationship-building, and patients' role as teachers. In contrast, TT students emphasized biomedical learning, clinical skills development, and teaching from physician preceptors. Longitudinal patient-partnered clinical experiences provide rich opportunities for preclinical students to cultivate empathy and develop patient-centered values.

COVID-19 Pandemic: Effects of Replacing Clinical Hours With Virtual Simulation in BSN Prelicensure Nursing Education.

At the onset of the COVID-19 pandemic, many academic institutions suspended in-person instruction and clinical experiences. Virtual simulation played an essential role in providing alternatives. The current study used faculty and student surveys, along with standardized exit exams and NCLEX-RN® pass rates, to determine the effect of using virtual simulation instead of traditional hospital clinical experiences during the final semester of a prelicensure BSN program. Results indicated a small decrease in exit exam scores compared to those who completed the traditional clinical experience and no significant relationship between NCLEX-RN pass/fail rates.

Integrated metabolism, network pharmacology, and pharmacokinetics to explore the exposure differences of the pharmacodynamic material basis in vivo caused by different extraction methods for Saussurea involucrata

Ethnopharmacological relevanceSaussurea involucrata Kar.et Kir. (S.I.) has long been used as a precious national medicine and clinically proven to be an effective treatment for rheumatoid arthritis (RA) and cardiovascular diseases. In clinical practice, two extraction methods of S.I., including water decoction and alcohol extraction, are prescribed to treat the same conditions. Nevertheless, no study has been performed on the exposure differences of the pharmacodynamic material basis in vivo caused by different extraction methods. Aim of the studyBased on the integrated strategy of metabolism, network pharmacology, and pharmacokinetics, we aimed to reveal exposure differences in pharmacodynamic substances caused by different extraction methods. Materials and methodsUltra-high-performance liquid chromatography-high-resolution mass spectrometry (UPLC-HRMS) was employed to identify the chemical constituents of S.I. extracts and the metabolites in vivo after administration. Based on the analysis of prototype components in vivo, the major exposure active constituents, potential therapeutic targets and possible pharmacological mechanisms in RA treatment were investigated using network pharmacological analysis. Seven critical active components, including quercetin, hispidulin, apigenin, chlorogenic acid, arctigenin, syringin, and umbelliferone, were quantitatively compared between the alcohol, and aqueous extraction methods, which had been confirmed by the reference substance. ResultsThe chemical comparison demonstrated that the types of chemicals in the two extracts were identical, mainly flavonoids, phenylpropanoids, coumarins, lignins, sesquiterpene lactones, and others, but the contents of the primary constituents in the aqueous extract were lower than those of the alcohol extract. A total of 30 prototype components and 174 metabolites were analyzed and identified in rat plasma, urine, fecal, and bile samples. Twenty-three prototype components were analyzed by network pharmacology, and seven critical active components were selected as representative markers for the pharmacokinetic study. Pharmacokinetic studies had shown that the Tmax values of apigenin, hispidulin, chlorogenic acid, arctigenin, and syringin after the oral administration of the alcohol extract were lower than those after the oral administration of the aqueous extract, and the above components in the alcohol extract could increase the absorption. Compared with the aqueous extract group, the Tmax and T1/2 of quercetin and umbelliferone were longer; it was suggested that alcohol extraction might have a slow-release and long-term effect on these two components. The relative bioavailability of apigenin, hispidulin, quercetin, chlorogenic acid, and umbelliferone in the alcohol extract group were higher than those in the aqueous extract group, which was consistent with the traditional clinical experience that alcohol extract could improve the efficacy of S.I. ConclusionsThe major exposure active constituents in vivo were screened. The representative components that could be used in pharmacokinetics were determined by integrating network pharmacology and metabolism studies. The critical active compounds were quantitatively compared between the alcohol and aqueous extraction methods. This study clarified that flavonoids, coumarin, and phenylpropanoids might be the primary material basis that caused the exposure differences between aqueous and alcoholic extracts from S.I.. This research aimed to provide the basis of metabolism in vivo for further studying these pharmacodynamic differences.

Impact of Student Debt on Decisions of Terminal Clinical Education Experiences in Physical Therapist Education

Purpose: Student debt is of growing concern in physical therapy and other health professions in the United States. This study explored the extent to which finances and other factors influenced student decision making when applying to and selecting terminal clinical education experiences. Methods: An online survey was developed and distributed to 250 recent graduates of a Doctor of Physical Therapy Program (2016-19). A logistic regression model was used to determine the relationship between respondents’ reported student debt and other factors when choosing a nontraditional model (the yearlong internship model (YLI)/residency model) or the traditional 4-month model. A 5-point Likert scale was used to rate the level of importance for each factor. Results: Seventy-six participants, across four cohorts completed the survey, representing a 30.4% response rate. The logistic regression model found that student debt did not significantly predict whether a student was likely to choose the nontraditional model over the traditional shorter terminal clinical experience; however, age and relationship status were found to be significant predictors of preference for length of experience. Based on aggregate mean data, the most important decision-making criterion in deciding the terminal clinical experience was patient population, followed by the culture of the clinic, then geographic location, and type of clinical setting. The criterion with the lowest aggregate mean was peer (within cohort) competition followed by student debt. A comparison of means found two decision-making criteria significantly reduced from the point of application to the commitment decision: saving money and interprofessional opportunities. Both decision-making criteria became less important for students when deciding on their terminal clinical experience as compared to when they were applying for the terminal clinical experience approximately 3 months earlier. Conclusions / Recommendations: Student debt was not an important factor in selecting the terminal clinical education experience and did not predict whether a student would apply to or select the YLI model rather than the shorter, traditional option. Instead, students considered multiple factors when selecting their terminal experience. Healthcare education programs may want to consider these factors in recruitment of clinical sites, student advising, and/or student placements related to the terminal clinical education experience.

Exploring Ganweikang Tablet as a Candidate Drug for NAFLD Through Network Pharmacology Analysis and Experimental Validation.

Nonalcoholic fatty liver disease (NAFLD) is defined as liver disease in which more than 5% of hepatocytes are steatotic with little or no alcohol consumption. NAFLD includes benign nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). Importantly, NASH is an advanced progression of NAFL and is characterized by steatosis, hepatocyte ballooning, lobular inflammation, and fibrosis. However, to date, no drugs specifically targeting NAFLD have been approved by the FDA. Therefore, a new drug or strategy for NAFLD treatment is necessary. However, the pathogenesis of NAFLD is complex and no single-target drugs have achieved the desired results. Noticeably, traditional Chinese medicine formulations are a complex system with multiple components, multiple targets, and synergistic effects between components. The Ganweikang tablet is a compound formula based on traditional Chinese medicine theory and clinical experience. In this study, network pharmacology analysis indicates Ganweikang tablet as a candidate for NAFLD treatment. Furthermore, we evaluated the therapeutic effects of Ganweikang tablet on the NAFL and NASH and tried to clarify the underlying molecular mechanisms in animal models and cell experiments. As expected, Ganweikang tablet was found to improve NAFL and NASH by modulating inflammation, apoptosis, and fatty acid oxidation by inhibiting NFκB, caspase-8, and activating PPARα, which not only indicates that Ganweikang tablet as a drug candidate but also provides a theoretical basis of Ganweikang tablet for the treatment of NAFL and NASH.

Doctor of Physical Therapy students’ clinical reasoning readiness and confidence treating with telehealth: a United States survey

Purpose: Telehealth has an emerging footprint on entry-level physical therapy programs. Students’ readiness for clinical reasoning with virtual versus traditional face-to-face treatment remains unknown. The purpose of this study was to evaluate Doctor of Physical Therapy (DPT) students’ preparedness for clinical experiences with and without telehealth. Methods: A descriptive and exploratory cross-sectional survey was employed, with a voluntary convenience sample of 211 second- and third-year university DPT students during Fall 2020 clinical experiences. Descriptive and inferential statistics evaluated differences in DPT students’ (1) Physical Therapist Self-Efficacy (PTSE) scale scores, (2) confidence with treating initial and subsequent same-patient visits, and (3) final Clinical Performance Instrument (CPI) clinical reasoning and summative scores during clinical experiences with and without telehealth. Results: Telehealth availability was 40.3%, with 16.6% of DPT students reporting participation. Most students reported being comfortable (39.3%) or neutral (32.2%) using telehealth. DPT students’ confidence level using telehealth to treat was 74% on initial and 97% on subsequent same-patient visits. Mean PTSE scores were significantly lower during clinical experiences with telehealth (13.1) compared to traditional experiences (15.1) (P &lt;.001) and for integrated (second-year) (14.1) compared to terminal (third-year) clinical experiences (15.5) (P &lt;.001). For traditional experiences, weak positive associations were demonstrated between PTSE and CPI scores. There were no significant differences for CPI scores between telehealth and traditional experiences. Conclusion: While entry-level DPT programs continue to establish best practice for telehealth education, current trends in academic curriculum seem to prepare students’ clinical reasoning readiness for clinical experiences. The PTSE could be used to identify outlier students requiring additional mentoring during traditional and telehealth clinical experiences.

Simulation: An active learning pedagogy for an undergraduate nursing leadership course.

Interpretive pedagogy with simulation encourages students to consider multiple perspectives contextually leading students to think deeper in a shared learning environment. Clinical sites were lacking in a senior nursing leadership and management course and necessitated the adaptation of traditional clinical teaching methodologies. Low-fidelity simulation was used as an active learning strategy to fulfill clinical hours. Comparing student groups' pretest mean scores were not significant (p = .610; 95% confidence interval [CI][-0.95, 0.12]). Comparatively, the student groups' posttest scores ranging between 87% and 90%, respectively, were also not statistical significance (p = .136, 95% CI [-0.95, 0.12]). Students were positive about their experience. They appreciated the opportunity to practice what they learned in the classroom in a safe environment. As a result, simulation in a senior nursing leadership course can be successfully used as an alternative to traditional clinical experiences and fulfill clinical hour requirements.

A call to reform undergraduate nursing clinical placements

A call to reform undergraduate nursing clinical placements