Abstract BACKGROUND US Latines face many challenges and barriers that lead to inequalities in their health care. Failure to include specific Latine culture in health education intensifies this issue. Diverse teaching strategies are needed to address Latine culture in nursing education. METHOD A convenience sample of prelicensure baccalaureate students who completed an overseas cultural program (OCP) was evaluated to determine changes in cultural competence. A convergent mixed-methods design was used. Students’ journal entries, a focus group, and the Transcultural Self-Efficacy Tool were analyzed. RESULTS Statistically significant quantitative responses to changes were seen in pre- versus posttest data. Qualitative data gathered from journal entries and a focus group supported quantitative findings. CONCLUSION Including nursing students in a service-learning OCP improves cultural sensitivity and competency. Using data integration from qualitative and quantitative sources reinforced findings. As such, giving students a service-learning opportunity is a viable option to improve cultural care of Latines.

Beyond the bedside: Exploring the impact of simulation and performance-based learning on nursing students' competence in geriatric care.

Nursing graduates reported feeling unprepared to address migrants' mental health needs. Immersive virtual reality offers an innovative approach to enhance therapeutic communication, cultural competence, and humility. This study examined the acceptability of a virtual reality simulation focused on migrants with mental health challenges and its impact on students' attitudes and cultural competence. A multi-phase sequential mixed methods design was used: phase 1 involved intervention development through an integrative review and a participatory approach; phase 2 employed a one-group pre-quasi-experimental and post-quasi-experimental design; phase 3 employed an interpretive description. Students found the simulation highly acceptable, reporting significant improvements in cultural competence and modest reductions in stigma. Qualitative findings revealed 4 themes: interacting with virtual reality technology; bridging educational gaps; shifting perspectives and practice; and navigating care through lived experiences. Virtual reality shows promise for strengthening mental health nursing education and practice by addressing gaps in clinical placements and traditional teaching. Future research should expand content, improve usability and realism, assess long-term impacts, and support faculty training.

BackgroundSpiritual care is a vital component of holistic nursing and midwifery. This study aimed to assess nursing and midwifery students’ perceived competence in spiritual care and to examine the predictive roles of two key constructs: professional self-efficacy (encompassing care, support, and professional situations) and professional identity (self-image, social modeling, retention benefits and turnover risks, social comparison and self-reflection, and independence of career choice).MethodsThis cross-sectional study was conducted from September 2024 to January 2025 among 201 undergraduate nursing and midwifery students who had completed at least two semesters and had begun clinical internships, ensuring exposure to both theoretical education and practical training. Participants completed a demographic questionnaire that included personal and educational characteristics, as well as selected items such as clinical work experience and previous training in spiritual care. They also completed the Iranian Scale for Assessment of Nurses’ Competencies in Spiritual Care, the Nursing Profession Self-Efficacy Scale, and the Professional Identity Scale for Nursing Students. Data were analyzed using t-tests, ANOVA, Pearson correlation, and multiple regression.ResultsA significant positive correlation was observed between spiritual care competence and both self-efficacy (r = 0.547, p < 0.001) and professional identity (r = 0.369, p < 0.001). Regression analysis revealed that professional self-efficacy (β = 0.475, p < 0.001), professional identity (β = 0.148, p = 0.022), prior training in spiritual care (β = 0.145, p = 0.017), and independence of career choice (β = 0.124, p = 0.037) were key predictors, explaining 37% of the variance.ConclusionThe findings suggest that students’ self-perceived ability to provide spiritual care is associated with their confidence, professional identity, and prior training. Incorporating comprehensive spiritual care training into curricula can enhance students’ confidence and skills, thereby better preparing them for holistic clinical practice.Clinical trial numberNot applicable.

Introduction The worldwide increase of overweight and obesity has become a serious concern and impacts all ages and people of every class. The World Health Organization (WHO) reports an increase of overweight youngsters due to change of lifestyles, eating habits and a decrease in exercise. Academic pressure, poor eating, and inactivity make university students a particularly high-risk group to gain overweight status. In Ghana, the burden of overweight and obesity has been increasing, with evidence suggesting a growing prevalence among young adults, including tertiary students. However, very little information is available to understand the implications of overweight and obesity on health for nursing and midwifery students who are the future health practitioners. Understanding the implications of overweight and obesity for this group is very important, as it will impact their health behaviours, and, in turn, their ability to adopt a healthy lifestyle, and, to influence health behaviours in the community. This study therefore sought to determine the prevalence of overweight and obesity and examined the associated factors among undergraduate nursing and midwifery students in the Northern Region of Ghana. Method An institutional-based study with a cross-sectional design was employed with quantitative approach. This study was conducted among undergraduate nursing and midwifery students of University for Development Studies (UDS) on Tamale Campus. The study employed a probability sampling technique and sampled 422 students from all the department under School of Nursing and Midwifery. Bivariate analysis was conducted to test the relationship between the dependent variable (prevalence of overweight/obesity) and the independent variables with a confidence interval of 95% (p=0.05). Results The study showed that 30.3% of students were 25 years or younger, and while 69.4% had a normal weight, about 30.6% were overweight or obese. Specifically, 25.5% were overweight and 5.1% were obese. Age, level of study, and marital status were all significantly associated with students’ nutritional status, whereas place of residence showed no significant relationship. Further analysis revealed that age, level of study, and marital status were also significant predictors of overweight and obesity. Notably, students aged 36–40 years were almost four times more likely to develop overweight or obesity compared to those aged 25 years and below (AOR = 3.912, 95%CI: 1.798 to 8.512, p = 0.001). Conclusion The study revealed that although most nursing and midwifery students maintained a normal weight, a considerable proportion were overweight or obese. This highlights the need for targeted interventions to address weight-related health risks among undergraduate nursing and midwifery students. It is recommended that universities implement regular nutrition and lifestyle education programmes, focusing particularly on older students and those at higher levels of study, to promote healthy habits and reduce the risk of overweight and obesity.

Background: Seventy percent of hospital admissions require a peripheral intravenous catheter (PIVC) and there is a shortage of skilled inserters. In some countries, undergraduate nursing and midwifery programs teach PIVC insertion, however, in Australia, this is typically limited to simulated PIVC insertion, without hospital-based PIVC insertion experience. We aimed to achieve nursing and midwifery undergraduate clinical competence in PIVC insertion by including hospital-based training. Objectives: To understand 1) the experience of undergraduate nurse/midwife students who received hospital-based training to achieve PIVC insertion competency; and 2) the impact of the training on nurses/midwives' future PIVC insertion practice. Study design and methods: Final year students completed a 5-day clinical placement with a hospital vascular access surveillance and education service. Semi-structured interviews occurred at the completion of the placement. A brief cross-sectional survey 12 months later questioned the impact of this training on their subsequent practice as registered nurses/midwives. Interviews were analysed using Braun and Clarke’s six phases of inductive thematic analysis to detail participants’ experiences and beliefs. Survey data was described descriptively and barriers and enablers to clinical competency were explored. Results: A total of 19 students participated in the clinical placement between March and September 2022 with 16 achieving clinical competency. Eleven students were interviewed. Key themes developed include: 1) clinical PIVC training for undergraduate nurse-midwives builds knowledge, skills, and confidence; 2) mixed mode clinical placement learning builds on undergraduate university training; and 3) barriers and enablers to clinical competency. At 12 months, 60% of participants were employer-certified as PIVC competent and had performed the procedure as a graduate nurse or midwife. Conclusions: Clinical placement with hospital-based vascular access services can enable undergraduate student nurses and midwives to develop PIVC competency. The study highlights the critical role of clinical placements in better preparing nursing and midwifery students for the demands of contemporary healthcare practice.

Background/Objectives: Sex trafficking is a form of modern-day slavery still present in our societies. Health professionals are in a key position to identify and support victims, but adequate training is required. The aim of this study was to analyze the impact of a structured educational intervention on knowledge, perceived professional role, and attitudes toward sex trafficking of women among undergraduate nursing students at the University of Seville, Spain. Methods: A cluster randomized pilot educational trial with a pre-test–post-test control group design and one-year follow-up was conducted. A two-hour educational session addressed key concepts related to sex trafficking, health professionals’ responsibilities, and survivor support. Knowledge and attitudes were assessed at baseline, immediately after the intervention, and at one-year follow-up. Results: 199 students participated. Significant post-intervention improvements were observed in knowledge and attitudes, with sustained impact after one year despite some knowledge decay. Conclusions: This pilot educational intervention appears to improve knowledge and attitudes toward sex trafficking among undergraduate nursing students and may represent a useful strategy for sensitizing and training future health professionals in this area.

BACKGROUND: Needle stick injuries (NSIs) are common occupational hazards among healthcare workers, particularly student nurses, posing a risk of exposure to blood-borne pathogens such as Hepatitis B, Hepatitis C, and HIV. OBJECTIVE: This study aimed to assess the prevalence, knowledge, and practices related to NSIs among student nurses during clinical training. METHODS: A descriptive cross-sectional study was conducted among 88 undergraduate student nurses at Liaquat College of Nursing, Jamshoro. Participants were recruited using convenience sampling. Data were collected through a structured, self-administered questionnaire covering demographics, NSI experience, knowledge, and safety practices. Data were analyzed using SPSS version 26. Descriptive statistics were calculated, and associations between demographic variables and NSI knowledge were examined using the Chi-square test, with significance set at p ≤ 0.05. RESULTS: Among participants, 47.7% reported experiencing NSIs, mostly during medication administration (43.2%) and cannulation (44.3%). Patient movement (39.8%) and needle recapping (34.1%) were the main causes. Most students had high knowledge of NSI definitions and immediate post-exposure actions (90.9%), but knowledge was lower regarding sharps disposal (21.6%), blood-borne pathogens (35.2%), and sharps container capacity (39.8%). Although 59.1% reported injuries occurring, only 45.5% cleaned the site with antiseptics, and 29.5% received post-exposure prophylaxis. Higher knowledge was significantly associated with year of study (p = 0.028), clinical training on needle/sharp handling (p = 0.012), and Hepatitis B vaccination status (p = 0.042).

Nearly a quarter of children worldwide have a parent with mental illness, with impacts on the entire family. Healthcare practitioners can help address the needs of these children and families through family-focused practice. The aim for this proof-of-concept evaluation was to assess the effectiveness and feasibility of a newly developed learning module on the family-focused EASE© (Engage, Assess, Support, Educate) framework, in an undergraduate nursing program. Changes in students' knowledge and confidence in family-focused practice were assessed as well as their overall views of the learning module. A pre/post-online survey was administered to students immediately prior to and 1 week following module delivery. Pre-surveys were completed by 805 students, with 556 (69%) completing post-surveys. Students reported significantly greater knowledge and confidence in working with families and using EASE©. Those who read the pre-reading and had prior experience of working in a mental health service had significantly greater levels of knowledge and confidence. Students with prior experience of working in family services also reported significantly more knowledge. In respect to feasibility, most students (85%) were satisfied with the module. In open-ended responses (n = 168), students described the EASE© framework as easy to understand and important to building confidence in family-focused practice. They acknowledged their limited understandings of child and family needs where parents have mental illness and made recommendations for further development of the module. The findings indicate potential for wider implementation of the EASE© family-focused module across undergraduate healthcare disciplines and development of attendant learning resources for healthcare practitioners.

Cardiopulmonary resuscitation (CPR) is a vital skill for healthcare professionals, crucial in life-saving situations. More than 80% of cardiac arrest cases occur out of hospital. As the demand for competent CPR practitioners grows, the effectiveness of training methods becomes increasingly important, especially for undergraduate students preparing to enter the healthcare field. The primary objective of our study is to investigate the effectiveness of simulation-based teaching methods and by integrating innovative technologies, such as the OMNI2 simulator, to enhance practitioners’ performance and to improve the precision and objectivity of CPR instruction. A cohort of 144 undergraduate students from the Nursing School Department of the National Kapodistrian University of Athens participated in an 8 h Basic Life Support Seminar. It consisted of a 5 h theoretical instruction followed by 3 h of practical training using the OMNI2 simulator. Each student was tasked to identify cardiac arrest and to perform two cycles of CPR according to the 2021 guidelines. Metrics, including total session time, cycles performed, compression-to-ventilation ratio, compression depth, compressions and ventilations per minute, full recoil, peak inspiratory pressure, and ventilation duration, were measured and compared against the simulator’s preset targets. Statistically significant differences (p &lt; 0.05) were observed for all outcomes. In conclusion, while simulation-based teaching has conventionally been proven effective for CPR proficiency, real-time data collected in this study reveal a disparity between anticipated and actual performance. Our research underscores the necessity of refining instructional methods to enhance skill acquisition, potentially leading to improved patient outcomes in the future.

Clinical setting belongingness and development of perceived practice readiness in prelicensure nursing students: A scoping review.

The research employs corpus linguistics to examine lexico-grammatical characteristics in research abstracts authored by undergraduate nursing, medicine, and allied health students at the University of Health and Allied Sciences in Ho, Ghana. A corpus of 150 research abstracts was extracted, of which 96 excerpts were examined for the occurrence of lexico-grammatical features — tense patterns, hedges, boosters, nominalization, technical nouns, and passive voice. The analysis focused on qualitatively determining the frequency of lexico-grammatical features in the research abstracts and quantitatively presenting them as a percentage in a table. The study found the dominant use of the present tense (68%), hedges (75%), and boosters (65%) in the introduction steps, the simple past tense (55%) and the passive voice (100%) in the method steps, the present perfect tense in the statement step (60%), nominalization in the conclusion (42%), method (33%) and introduction (25%) steps, while technical nouns were replete in the conclusion (47%), introduction (30%), and method (23%) steps. The study concludes that steps in the rhetorical moves of research abstracts written by UHAS students were replete with three tense patterns — the simple present, simple past, and present perfect tenses, and other lexico-grammatical devices—hedges, boosters, nominalization, technical nouns, and the passive voice. This paper recommends that English for Academic Purposes course teachers in Ghanaian and global universities teach students the necessary skills to effectively write tense patterns and other lexico-grammar devices in research abstracts.

Social media addiction is a growing concern among undergraduates, with nursing students particularly vulnerable as their stressful academic and clinical context may promote excessive use, impaired sleep, and higher depression risk. Therefore, we aimed to evaluate whether sleep disturbance mediates the association between problematic social media use and symptoms of depression among nursing students in Mexico. We conducted a multicenter, cross-sectional, analytical study using a random sample of 638 nursing students from three Mexican public universities. Between August and December 2024, participants completed validated scales for social media addiction, sleep quality, and depression. Counterfactual causal mediation analysis was performed using logistic regression with robust errors. Sleep disturbance affected 51.7% of students, and 27.5% reported depression. Social media addiction showed a dose-response association with both outcomes. Mediation analysis revealed a total effect on depression (OR = 2.19; 95% CI = 1.45-3.30) and an indirect effect via sleep disturbance (OR = 1.22; 95% CI = 1.01-1.38), explaining 31.4% of the effect. Sleep disturbance partially mediates this association. Interventions addressing digital behavior and sleep hygiene may improve mental health in nursing students.

Introduction: this study focuses on the undergraduate Nursing program at a public higher education institution in the interior of Amazonas, Brazil. Specifically, it explores how education is addressed in the training of nurses and the conceptions held by faculty members regarding this topic. Objective: to investigate how education for teaching practice is incorporated into the training of nurses, according to professors in an undergraduate Nursing program. Method: this exploratory and descriptive study employed a qualitative approach and was conducted with nine nursing professors at a public higher education institution in Amazonas. Data were collected through semi-structured interviews designed to explore how teacher training is integrated into the educational practice of nurses. The data were analyzed using thematic content analysis. Results: teaching development is a continuous process; however, pedagogical gaps hinder the integration of nurses into teaching roles. Participation in tutoring programs during undergraduate studies was identified as a predictor for choosing an academic career. There's a need for pedagogical training and specific qualifications that address the teaching practice of nursing educators. Conclusion: experiences during undergraduate studies, such as tutoring, prove to be strong predictors for pursuing a teaching career. However, as nursing is traditionally a care-oriented profession, it doesn't adequately prepare professionals for academic roles, resulting in pedagogical gaps within nursing education programs.

Background: It is essential to establish sustainability practice in the university environment, this can be evolved through raising the positive attitudes among university students especially among undergraduate health and medical sciences students for being future responsible citizens. Objective: to assess the attitudes of medical and nursing undergraduate university students in Babylon university, Iraq. Methods : this was a cross-sectional comparative study conducted on convenient samples of undergraduate nursing and medical students in Babylon university (nursing and Hammurabi medical colleges) during the period October 2024, through January 2025, data collection was done through a self-filled pre-determined and validated questionnaire adopted from other studies , this approach included the demographic characteristics and questions related to students beliefs about sustainable development goals mainly (environment, economy, society and education), differences of attitudes between the two group were assessed using t independent statistical test. Results: Total of 302 students from both schools were enrolled in this study, males are predominant among medical students, more than half of the study sample were rural dwellers. There was a significant correlation for attitudes toward sustainable development goals (SDGs) as perceived by nursing and medical students across the four dimensions: environment, economy, society, and education. Overall, the results highlight that attitude toward SDGs are interrelated, with stronger correlations observed in the economy and society dimensions for both groups. The high mean score in the societal dimension in this study indicates that both nursing and medical students place significant importance on societal well-being and equity. Conclusion: both groups share a common positive attitude regarding economic dimension, nursing students had higher attitudes score in education dimension. Contents about SDGs strategy should be introduced in the college curricula, further large-scale analytic studies are strongly requested.

Introduction: Across the globe, healthcare systems are experiencing rapid transformation, driven by advances in technology, increasing patient acuity, and evolving professional standards [1]. These shifts have elevated the expectations placed on newly graduated nurses, particularly in their ability to demonstrate critical thinking and clinical judgment. This shift has highlighted the need for innovation in clinical education. Recognizing these challenges, a Faculty of Nursing in Canada saw the opportunity to fundamentally reimagine its approach to clinical education through the intentional development and implementation of an innovative simulation program. The goal was to transition from sparse, ad hoc use of simulation to the comprehensive use of high-quality multimodal simulation to promote clinical judgment and critical thinking. Methods: A simulation program was developed and integrated across the undergraduate nursing curriculum. The program incorporates three simulation modalities: in-person simulation, immersive virtual reality simulation, and screen-based virtual simulation. Informed by the International Nursing Association for Clinical Simulation and Learning’s Healthcare Standards of Best Practice [2], the design is grounded in progressive complexity, aiming to create coherent and scaffolded learning experiences. The faculty engaged in detailed curriculum planning to support the development of consistent simulation experiences throughout all program years. Collaboration and iterative feedback informed implementation. Results: The completed program provides students with over 100 simulation experiences throughout the undergraduate curriculum. These simulations expose learners to diverse clinical contexts mirroring global health priorities and challenges. The program’s standardized design has fostered faculty development and enhanced alignment across courses, promoting a more cohesive and integrated clinical curriculum. Discussion: This initiative offers a replicable model for institutions seeking to modernize nursing education and better prepare students for the complexities of contemporary healthcare. The deliberate integration of multimodal simulation into the undergraduate nursing curriculum has transformed clinical education at this institution. Ethics Statement: As the submitting author, I can confirm that all relevant ethical standards of research and dissemination have been met. Additionally, I can confirm that the necessary ethical approval has been obtained, where applicable

Introduction: Increasingly adopted in healthcare education for their ability to engage learners, develop teamwork and critical thinking skills, escape rooms are defined as ‘live-action, team-based games where players discover clues, solve puzzles, and accomplish tasks in one or more rooms in order to accomplish a specific goal’ [1]. The literature suggests that escape rooms have the potential to engage learners[2,3]. Our simulation team, consisting of academic and simulation technicians, created a virtual escape room using IntuifaceTM software for our immersive learning environment. This interactive touchscreen experience allowed nursing students to practice critical thinking, communication, and teamwork as they navigated a virtual patient’s home, consisting of a linear storyline of puzzles within a 40-minute limit. These were focused on wound assessment and management. Methods: This learning experience involved groups of up to 12 students, structured with rotating participation of 5-6 active learners, and 5-6 active observers who contributed suggestions and insights. Solving the sequential puzzles demanded effective teamwork, clear communication, and the application of knowledge relevant to the scenario’s phases: history taking, information gathering, the correct utilization of wound assessment tools, and the selection of appropriate wound dressings. A simulation technician facilitated the technical operation, while an academic facilitator guided the in-experience discussions and debriefing to enhance learning. Results: Feedback was collected from participants at the end of each session via a QR code. A total of 6 sessions were delivered in 1 day. 65 students took part, with 31 completing the evaluation form (response rate of 47.7%). Overall, student feedback indicated a positive learning experience and participants reported high levels of enjoyment and engagement with the activities, with evidence of perceptions of successful teamwork and communication. Additionally, at least one student noted the development of valuable skills such as critical thinking and problem-solving. The unique and fun nature of the session appears to have contributed to this learning opportunity, see Figure 1. Discussion: The feedback identified a potential area for improvement which was highlighted by “more time and guidance”, suggesting that some students may have felt pressed for time, or required additional support to fully benefit from the activities. This warrants consideration in future session planning to ensure adequate time allocation and appropriate levels of guidance are provided to accommodate all learners. Despite this point for potential enhancement, the feedback suggests the learning experience was innovative and well-received by the participating students, and will be embedded in future nursing curricula. Ethics Statement: As the submitting author, I can confirm that all relevant ethical standards of research and dissemination have been met. Additionally, I can confirm that the necessary ethical approval has been obtained, where applicable.

Introduction: A multi-patient simulation involving patients with acute health challenges was co-created by nursing faculty at the University of New Brunswick, Canada. The integration of this simulation occurred during the 2023 Fall term. Presented findings are focussed on data collected in the 2024 Fall term as research leads obtained ethical approval prior to this second offering. Although simulation-based experiences (SBEs) are well established as effective tools in building capacity in health care programs [1], the use of multi-patient simulations in support of skills such as clinical judgement and time management remain underexplored. The National Council State Boards of Nursing’s Clinical Judgement Measurement Model (CJMM)[2] helped frame learning objectives while INASCL standards were adhered to in the design of this simulation [3]. The purpose of this presentation is to share key findings and recommendations for a study exploring student perceptions of this multi-patient SBE. Methods: A mixed-methods approach was used in this study. Quantitative data were collected using pre- (n=70) and post-(n=60) simulation quizzes, with questions aligned to learning objectives. These quizzes assessed students’ knowledge and clinical judgement before and after the simulation. Qualitative data were collected through two focus groups (n=7) which included an exploration of students’ perceptions of elements impacting their ability to meet learning objectives. Quantitative data were analysed using descriptive statistics. Content analysis was used to identify key concepts which were organized into categories. Results: Quiz responses between subgroups of students were compared – students were either enrolled in the BN program through a bridging model or entered through a four-year pathway. All students scored poorly on questions involving teamwork and scope of practice considerations. In contrast, students who entered the BN program through the bridging model scored significantly higher on time management. Content analysis of focus group data revealed key categories: 1) knowing what to expect and what is expected of me; 2) realism as a performance factor; and; 3) acknowledging the impact of past experience. Discussion: Findings from this study offer insights into how senior nursing students experience and respond to a multi-patient simulation. Relationships between previous clinical experience, preparation, perceived realism, and the link to performance have implications for simulation design and teaching and learning strategies beyond a simulation context. A limitation of this study is the focus group participants included only students enrolled in the four-year pathway. Ethics Statement: As the submitting author, I can confirm that all relevant ethical standards of research and dissemination have been met. Additionally, I can confirm that the necessary ethical approval has been obtained, where applicable.

Cross-cultural adaptation and validation of the "AprendeLact" questionnaire to Portuguese.

Minimum exam averages are an essential component to ensuring academic rigor and subsequent licensure in nursing education, yet there is scant evidence to support such practices. Using a descriptive correlational design, nursing faculty at a medium-sized program in the Northeast explored the relationship between establishing a 77% (C+) minimum exam average requirement for the program and licensure exam passage rates between the 2023 cohort intervention group and the 2022 cohort control group. The implementation of an exam average threshold per course produced a statistically significant effect on the National Council Licensure Examination (NCLEX-RN) pass rate (z = -3.481, p < .001) and provided support for the 77% (C+) examination threshold. A minimum exam average policy may relieve faculty of the moral distress associated with course failures, while also safeguarding academic rigor within the undergraduate program and promoting NCLEX-RN readiness and success.