Undergraduate Nursing Curriculum Research Articles

Assessment of Electronic Health Record Usability with Undergraduate Nursing Students

Health information technology (HIT), and specifically electronic health records (EHR), are recognized as fundamental tools for collecting, storing, retrieving, and monitoring patient care and information. However, few schools of nursing have incorporated theoretical or practical aspects of HIT competencies within the educational curriculum. The purpose of this study was to conduct a usability assessment to explore undergraduate nursing student electronic health record documentation knowledge and skill, using a patient case scenario to inform the development of an informatics-based undergraduate nursing curriculum. Three themes were identified: "Being a Novice User/Practitioner," "Confidentiality and Security," and "Repetition and Practice." Integration of the EHR into nursing curriculum will allow students an EHR apprenticeship with the potential to enhance understanding and skill of nursing processes, documentation, and critical thinking. Findings will also guide teaching and learning strategies that will respond to rising expectations for competency with health information technology.

Basic Life Support:A Call for Reevaluation by Nurse Educators

FORMAL EVALUATION OF THE STUDENT'S NURSING SKILLS IS FUNDAMENTAL TO THE UNDERGRADUATE NURSING CURRICULUM. An exception is basic life support (BLS) skills. The fact that these skills elude formal evaluation is alarming as research demonstrates that nursing students perform BLS skills poorly (Madden, 2006; Moule & Knight, 1997). This author urges that schools of nursing incorporate BLS skill evaluation into the undergraduate curriculum. Typically, schools of nursing require that students certify in BLS, but certification only validates the student's knowledge at one point in time. Following certification, a period of skill and knowledge deterioration takes place that Alspach (2005) attributes to the inability of the brain to form a procedural memory of the task. Students may complete the nursing program with the false notion that they are still competent in BLS. Formal skill evaluation is the accurate appraisal of a skill using techniques that have been tested for reliability and validity. Without formal evaluation of BLS, lack of competence may go unnoticed, and minimal learning may take place. As a nursing student, I had first-hand experience with the deterioration of skills and knowledge. Prior to joining the emergency response team (ERT), I had been through the certification process and considered myself an expert in BLS. However, following formal evaluation by the ERT team, my areas of deficiency were clearly apparent. I was able to remedy my errors and learn from my mistakes. I also worked as a peer mentor in my school's nursing laboratory for the last two years of the nursing program and observed students practicing other nursing skills, but never their BLS skills. As a student and mentor, I can attest that students will not practice a skill unless they know they cannot perform it correctly, or unless the skill is to be evaluated. Since the evaluation of BLS skills is not incorporated into the curriculum and appears to be inconsequential, students do not spend time fine-tuning these skills. But Niemi- Murola, Makinen, and Castren (2007) studied nursing and medical students' attitudes toward cardiopulmonary resuscitation and current practice guidelines and reported that nursing students would have liked to learn more BLS in their prelicensure education. Simulation and monitoring feedback devices are useful tools for maintaining BLS competency. The use of such devices may eliminate questions such as how hard do I push? and how fast should I go? Ackermann (2007) found that nursing students' BLS performance in a mock cardiac arrest scenario using high-fidelity simulation manikins was significantly better than the performance of a control group trained using standard American Heart Association training. …

Adequacy of Wound Education in Undergraduate Nursing Curriculum

The purpose of this study is to evaluate a 2-hour lecture and laboratory class on wound care by a nurse wound specialist. A quantitative, quasi-experimental nonrandomized design was used to measure undergraduate nursing student's knowledge of wound care, prevention, and documentation. Sixty-five undergraduate nursing students in their second year of a 4-year public college participated in the study. Results were compared to 55 undergraduate first year nursing students in a 2-year community college program. Both the intervention and comparison groups received basic instruction on wound care and read a chapter on wound care in a required textbook prior to participating in this study. A pre- and postintervention questionnaire consisting of 10 multiple choice and true/false questions was used to measure wound care knowledge. A comparison cohort study was conducted among 2 groups of nursing students to determine whether students receiving a 2-hour lecture and laboratory class on wound care by a nurse wound specialist retained more knowledge about wound care 2 months following the educational intervention. The intervention was 3-hour lecture and laboratory-based experience delivered by a wound care specialist. The control group completed the questionnaire at the end of the semester and answered questions based on their readings and basic lecture from their nursing program instructors. Intervention group participants had significantly higher scores on 7 of 10 questions as compared to the control group of student nurses. A 2-hour lecture or laboratory intervention improved the nursing student's knowledge of basic evidenced wound care; this improvement persisted for a prolonged period of time (2 months).

Simulation: An effective pedagogical approach for nursing?

Simulation features strongly within the undergraduate nursing curriculum for many Universities. It provides a variety of opportunities for students as they develop their clinical nursing skills. The nursing literature highlights the potential of this approach and the positive opportunities afforded to students in terms of developing competence and confidence. However, much of this literature focuses upon the more operational concerns of simulation. This paper reflects upon the evolution of simulation in nurse education. It considers the theoretical positioning and understanding of simulation as a teaching and learning approach for undergraduate nursing skills development. The work of Vygotsky (1978) and Lave and Wenger (1991) are highlighted in order to begin to explore the theoretical basis of simulation as an effective pedagogical approach for nurse education today, enabling students to learn to be nurses.

TEACHING HEALTH LITERACY IN THE UNDERGRADUATE CURRICULUM:Beyond Traditional Methods

Whether in hospitals, long-term care facilities, clinics, or public health settings, provide care to more than 90 million Americans who struggle to locate, comprehend, and appropriately use health information (Zarcadoolas, Pleasant, & Greer, 2006). Participants in improving health literacy as a public health objective represent all parts of health care arena (Schloman, 2004). In Healthy People 2010, health literacy is defined as the degree to which individuals have capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions (US Department of and Human Services, 2000, section 11, p. 20). The term also refers to ability of individuals to understand, make decisions, and act on spoken, written, and visual health information in order to lower risk and improve health status. Adequate knowledge about health behaviors is considered prerequisite in behavior change (Seligman et al., 2007). National nursing organizations have called for better integration of health literacy content and activities into nursing curriculum. As part of its accreditation criteria, National League for Nursing Accrediting Commission (NLNAC) calls for all levels of undergraduate nursing curriculum to include cultural, ethnic, and socially diverse concepts (2008, Standard 4.4, p. 76). The American Association of Colleges of Nursing, in its Essentials of Baccalaureate Education for Professional Nursing Practice, identifies health literacy as an important content area for baccalaureate programs under Essential VII Clinical Prevention and Population Health (2008, p. 25). Nurse educators recognize need for curricular standards in area of health literacy. Literacy Focus in Curriculum ACTIVE TEACHING STRATEGIES Active strategies that engage students as participants in process of learning serve as models for students to use in teaching patients with low health literacy. For example, teaching students how to role-play using a simple video and audio podcast to model a teaching episode with a patient (peer) and having patient (peer) teach back what has been learned is an effective strategy that incorporates active learning and newer technology. When this strategy is followed by in-depth analysis in a class or seminar, students learn not only from content of podcast, but from analysis of strengths and limitations of teaching method. That knowledge is then transferred to actual teaching situations in clinical setting. Table 1 outlines selected learning objectives, teach ing strategies, and activities in health literacy that can be used in nursing curriculum. CONTENT Speros (2005) suggests that nurses should be educated about health literacy, its prevalence across all segments of society, and its relationship to health (p. 638). According to Speros, long-term consequences of this focus will be who can identify people with low literacy skills and then appropriately adapt patient education methods and materials. Experts offer following content areas for health literacy education: * Definitions of low literacy and health literacy, scope of health literacy problem, at-risk populations, and relationship between health literacy and health outcomes (Bastable, 2008; Schloman, 2004; Speros, 2005; Thobaben, 2007) * Assessment of literacy levels in clients (Bastable, 2008; Cutilli, 2005; Owens & Walden, 2007; Speros, 2005) * Observed client behaviors related to low literacy (Speros, 2005). * Plain language communication (Osborne, 2005; Owens & Walden, 2007; Schloman, 2004) * Interpersonal skills (Thobaben, 2007) * Cultural sensitivity (Andrulis & Brach, 2007; Chang & Kelly, 2007) * Common myths and health literacy (Bastable, 2008) A wide variety of information on health literacy is also available on Internet. …

From novice to expert: using simulators to enhance practical skill

This article reports on the introduction of simulation (using a high fidelity patient simulator) into an undergraduate nursing curriculum in Northern Ireland to develop confidence and proficiency without compromising patient safety. It also reports on how the students perceived the impact of this experience on their clinical practice. The simulation was developed for third-year adult branch nursing students (n=90). Students attended in groups of six for a 4-hour session over a period of 8 days. The students participated in three case scenarios using a high-fidelity patient simulator (HPS). Students' responses showed that the simulation helped them to gain a perspective on the role of a qualified nurse and also enhanced their understanding of the relationship between theory and practice. Students also reported that they valued the experience as a means of highlighting gaps in their knowledge, but it also had given them confidence for future clinical practice.

Nursing Education: The Experience, Attitudes, and Impact of Caring for Dying Patients by Undergraduate Argentinian Nursing Students

There is extensive research documenting serious deficiencies in undergraduate nursing education related to end-of-life care. Many nurses and nursing students have difficulties in dealing with death and report feeling anxious and unprepared to be with patients who are dying. In Argentina, education on palliative care, death, and dying has not been made part of the undergraduate nursing curriculum. We performed a multicenter survey on undergraduate nursing education regarding the care of dying patients at eight schools of nursing in Buenos Aires, Argentina. We enrolled 680 students from first to fifth year. Students acknowledged interacting directly with dying patients. Attitudes toward dying patients were highly positive. Students of the fifth year expressed a less satisfying relationship with their patients than those from the first year; considered it as a less gratifying occupation, and also showed a greater preference for avoiding emotional involvement with those patients. Many of them described in short and very expressive phrases the emotional impact of their encounters with patients facing a life-threatening illness. Students perceived that this issue received more attention in humanistic rather than clinical subjects. Ninety-eight percent of students spontaneously demanded more training in end-of-life care. The interest and desire of undergraduate students to enhance their knowledge and experience in palliative care, demands more specific teaching contents. This suggests that in Argentina, improvements in undergraduate nursing training are urgently needed and would be well received by the students. It could be very useful to consider this topic as part of accreditation standards for nursing programs.

The Evaluation of Simulation in a Baccalaureate Nursing Program

Background A public university acquired 4 high-fidelity simulators for integration into the undergraduate nursing curriculum. The purpose of this study was to assess learning after using the simulators in a laboratory setting in one nursing course. Method Students evaluated 4 simulation experiences for active learning, fidelity, and student satisfaction and confidence. An analysis of variance was completed with SPSS to determine the effectiveness of the simulation experiences. Results The results of the evaluation demonstrate that fidelity is valued by students. Simulations that used role-playing integrated with communication techniques were scored highest by the students. The students were satisfied with the simulation experience and scores of self-confidence increased with every simulation experience. Conclusions Simulation was successfully added to a medical-surgical class to enhance the clinical experience.

Integrating palliative care content into a new undergraduate nursing curriculum: The University of Notre Dame, Australia – Sydney experience

The majority of society's deaths occur in a health care environment. Regardless of whether a death occurs in acute care, hospice, residential aged care or community settings, nurses are the health professionals that will spend the largest proportion of time with the patient who has a terminal condition and their families. As few nurses have specialist palliative care qualifications it is essential that nursing education prepares graduates to achieve the core capabilities required for the delivery of best evidenced based palliative care. This reality makes the integration of palliative care content into the undergraduate nursing curricula an important priority. This paper aims to describe how palliative care content has been embedded throughout the three-year University of Notre Dame Australia, Sydney (UNDA) undergraduate nursing degree. The School of Nursing at the University of Notre Dame Australia, Sydney campus is committed to ensuring that students graduate with the capabilities to deliver appropriate care to people with requiring end-of-life care. The establishment of this new School of Nursing coincided with the release of the 'The Palliative Care Curricula for Undergraduates Program' (PCC4U) learning resources. These resources have been integrated into relevant units across the three-year nursing curricula. The nursing curriculum has been design to supports the integration of palliative care knowledge into clinical practice. The Palliative Care Curricula for Undergraduates Program Learning resources offer engaging palliative care case studies and scenarios for academics to utilise. Adopting an iterative approach where palliative care content is spiralled across multiple units provides opportunities for undergraduate nursing students to sequentially build and consolidate their palliative care capabilities. Developing a new curricular provided an ideal opportunity to integrate and embed palliative care content into the undergraduate nursing degree. The next stage of the curriculum development is to explore inter-professional palliative care education opportunities. Evaluating the palliative care capabilities of our nursing graduates is also an important consideration. This paper provides practical suggestions for integrating palliative care education into an undergraduate nursing curriculum.

일 대학 간호대학생의 시뮬레이션 교육 경험 분석

Purpose: The purpose of this study was to explore experiences among undergraduate nursing students in a high-fidelity simulation education course for a semester. Method: The participants in this study were 10 nursing students in the senior classes and volunteers. Data collection was conducted using a focus group interview for 100 minutes, which was recorded on video tape. Transcribed data was analyzed through qualitative content analysis. Result: The results of this study were deduced as 4 codes and 22 themes. Study participants reported experiences due to the simulation method itself, interaction among peer group and personal experiences during high-fidelity simulation education. Additionally, experiences related to clinical application were examined. The participants indicated positive outcomes such as developing clinical judgment skills and confidence. Conclusion: Overall, the results of this study supported the usability and effectiveness of a high-fidelity simulation education method in undergraduate nursing curriculum. Further studies are needed to provide more reliable and valid educational information.

Integration of Simulation Across the Undergraduate Curriculum: Student and Faculty Perspectives

Background High-fidelity human simulation provides an innovative teaching method for nursing students. Faculty members face challenges related to the integration of this method of teaching within a curriculum. Method The purpose of this study was to implement and integrate the use of high-fidelity human simulation as a teaching and active learning strategy throughout the undergraduate nursing curriculum and evaluate the student and faculty perceptions related to this instructional technology. Kolb's experiential learning theory and Jeffries's Nursing Education Simulation Framework provided the framework for this research project. Creative methods for implementation of simulation in various courses are described. A mixed-methods (survey and focus group) research design was used to measure student and faculty perceptions of this process. Following the simulation experience, students ( N = 151) completed the simulation evaluation survey, and faculty ( N = 6) participated in focus groups to provide insight into the experience. Results/Conclusions Student responses related to the experience were overwhelmingly positive, and while faculty agreed that the use of simulation was beneficial to the achievement of learning objectives, many challenges related to the use of the technology were experienced. This study supports the use of simulation in an undergraduate nursing curriculum and offers suggestions for faculty faced with implementing simulation.

The immediate life support course: implementation into an undergraduate nursing programme

The aim of this paper is to outline how the immediate life support (ILS) course was incorporated into an undergraduate nursing curriculum in a university in Northern Ireland. It also reports on how the students perceived the impact of this course on their clinical practice. The rationale of the course was to develop the student's ability to recognize the acutely ill patient and to determine the relevance of this to clinical practice. Prior to this, the ILS course was only available to qualified nurses, and this paper reports on the first time undergraduate nursing students were provided with an ILS course. The ILS course was delivered to 89 third-year nursing students from the adult branch pathway of the BSc (Hons) programme in Nursing Sciences. Each course was taught to 10-12 students and was completed over eight 7.5 h sessions within a 2-week period. Recognized advanced life support (ALS) instructors, in keeping with the UK Resuscitation Council guidelines, taught the students. Student feedback reported that the ILS course helped them understand what constituted the acutely ill patient and the role of the nurse in managing a deteriorating situation. Students also reported that they valued the experience as highlighting gaps in their knowledge.

Ready for the World: Preparing Nursing Students for Tomorrow

In 2004, a 5-year plan of international and intercultural education was developed by the University of Tennessee, Knoxville (UTK) to help students become ready for the changing world in which they will live. This program is called "Ready for the World." The University of Tennessee College of Nursing in Knoxville has integrated many of the suggestions from this program into the undergraduate nursing curriculum to prepare students for the world by making the world their classroom. Intercultural learning includes both a solid base of knowledge obtained in the classroom and multiple experiences that involve cultural interaction. Experiences begin on UTK's diverse campus and expand to the surrounding city of Knoxville, including interactions with vulnerable populations such as the homeless or elderly persons, then to nearby Appalachian communities, and on to Central America. Many of these experiences are offered for credit in the Community Health Nursing or the Transcultural Nursing courses. The knowledge nursing students acquire and their varied experiences will help them gain cultural competence for their future nursing practice.

Diagnosing the problem: Using a tool to identify pre-registration nursing students’ mathematical ability

Mathematical ability is a skill nurses need to safely administer medicines and fluids to patients (Elliott, M., Joyce, J., 2005. Mapping drug calculation skills in an undergraduate nursing curriculum. Nurse Education in Practice 5, 225–229). However some nurses and nursing students lack mathematical proficiency (Hilton, D.E., 1999. Considering academic qualification in mathematics as an entry requirement for a diploma in nursing programme. Nurse Education Today 19, 543–547). A tool was devised to assess the mathematical abilities of nursing students. This was administered to 304 nursing students in one Higher Education Institution (HEI) in Wales, United Kingdom (UK) on entry to a pre-registration undergraduate nursing course. The students completed a diagnostic mathematics test comprising of 25 non-clinical General Certificate of Secondary Education (GCSE) level multiple choice questions with a pass mark set at 72%. The key findings were that only 19% ( n = 53) of students passed the test. Students appeared to have difficulties with questions involving decimals, SI units, formulae and fractions. The key demographic variable that influenced test scores was previous mathematical qualifications on entry to the course. The tool proved useful in two ways. First, in identifying those students who needed extra tutorial support in mathematics. Second, in identifying those areas of mathematics that presented difficulties for students.

Starting STEPS: Implementation of a Simulation Technology Electronic Informatics Preparatory System

The University of Detroit Mercy (UDM) is currently implementing a unique and innovative clinical practice program that will integrate computerized simulation, an electronic health record, point-of -care handheld health reference and tele-health resources throughout its undergraduate nursing curriculum.

Arts-based inquiry in nursing education

This paper is concerned with the methods, processes, and experiences of using arts-based inquiry within the context of an undergraduate nursing curriculum. Exploration of these phenomena was achieved through an ethnographic study that involved participatory research among twenty second year students as they engaged in a Nursing Humanities option module. The capacity of arts-based approaches in the nursing curriculum to foster inquiry and critical thinking; essential attributes in contemporary nursing, is explored through re-presentation and analysis of student artwork/artmaking processes, contextual discussions and researcher field notes. The challenges encountered in using arts-informed pedagogical approaches within current nursing curricula are made visible and possibilities for integrating aesthetic inquiry into nurse education programmes are discussed.

Acute care teaching in the undergraduate nursing curriculum

To incorporate basic aspects of acute care into the undergraduate nursing programme by providing an opportunity for the development of knowledge and skills in the early recognition and assessment of deteriorating patients on general hospital wards. Acute care initiatives implemented in the hospital setting to improve the identification and management of 'at risk' patients have focused on the provision of education for trained or qualified staff. However, to ensure student nurses are 'fit to practice' at the point of registration, it has been recommended that acute care theory and skills are incorporated into the undergraduate nursing curriculum. PRACTICE DEVELOPMENT INITIATIVE: An 'Integrated Nursing Care' module was incorporated into year 3 of the undergraduate nursing programme to introduce students to acute care theory and practice. Module content focuses on the early detection and management of acute deterioration in patients with respiratory, cardiac, neurological or renal insufficiencies. We used a competency-based framework to ensure the application of theory to practice through the use of group seminars. High-fidelity patient-simulated clinical scenarios were a key feature. The United Kingdom Resuscitation Council Intermediate Life Support course is also an important component of the module. Incorporating the Integrated Nursing Care module into the undergraduate nursing curriculum provides pre-registration students the opportunity to develop their knowledge and skills in acute care. The provision of undergraduate education in care of the acutely ill patient in hospital is essential to improve nurses' competence and confidence in assessing and managing deteriorating patients in general wards at the point of registration.

The objective structured clinical examination (OSCE): Optimising its value in the undergraduate nursing curriculum

This article explores the use of the objective structured clinical examination (OSCE) in undergraduate nursing education. The advantages and limitations of this assessment approach are discussed and various applications of the OSCE are described. Attention is given to the complexities of evaluating some psychosocial competency components. The issues are considered in an endeavour to delineate the competency components, or skill sets, that best lend themselves to assessment by the OSCE. We conclude that OSCEs can be used most effectively in nurse undergraduate curricula to assess safe practice in terms of performance of psychomotor skills, as well as the declarative and schematic knowledge associated with their application. OSCEs should be integrated within a curriculum in conjunction with other relevant student evaluation methods.

O ensino de cuidados críticos/intensivos na formação do enfermeiro: momento para reflexão

Este estudo teve como objetivo re(pensar) a disciplina de cuidados intensivos no currículo de graduação em enfermagem, pontuando aspectos relevantes de sua inserção, considerando a capacitação e a qualificação profissional, a necessidade do mercado de trabalho e uma formação reflexiva e crítica acerca das competências profissionais do enfermeiro, por meio de referencial teórico.

Implementation of Handheld Devices

With the rapid introduction of technology in nursing education, information regarding its implementation in undergraduate curricula is emerging. The authors describe the implementation process used to integrate personal digital assistants into an undergraduate nursing curriculum. Barriers such as potential for device loss, issues related to patient confidentiality, and infection control are addressed.