<p> Empathetic communication enhances the nurse-patient relationship and improves patient outcomes and needs to be taught and evaluated during simulated clinical experiences. Experience in healthcare education has shown students&rsquo; empathy levels decrease over time. The purpose of this quasi-experimental pretest posttest, study was to compare nursing students&rsquo; empathy levels, self-confidence, and satisfaction with simulation between the use of the high-fidelity manikin simulator (HFMS) and a standardized patient (SP) used during their simulated clinical experience. Kolb&rsquo;s experiential learning theory was used to guide the study through the four phases specific to simulation and learning. Convenience sampling was used to recruit 135 nursing students in the pre-simulation survey; 123 participants completed the post-simulation survey with 64 in the control group (HFMS) and 59 in the experimental group (SP). Data were analyzed using an independent <i>t</i>-test to determine if there were any mean differences between the HFMS and SP groups in terms of empathy, satisfaction, and self-confidence. Empathy was measured using the Jefferson Scale of Empathy-Health Professions Student and the NLN&rsquo;s Satisfaction and Self-Confidence Scales. Results revealed there were no significant difference in students&rsquo; empathy levels, self-confidence, and satisfaction. Positive social change through prioritizing nursing students&rsquo; empathetic communication in patient care may be enhanced in the simulated clinical environment with various approaches. Recommendations for future research are to determine what interventions best develop nursing students&rsquo; empathy, satisfaction, and self-confidence in patient care. </p><p>

<p> Clinical reasoning is the cognitive process and strategies used to understand the significant patient data to identify and diagnose actual or potential problems in order to make competent clinical decisions that will affect patient outcomes (Fonteyn &amp; Ritter, 2000). The purpose of the study was to determine if implementing the Outcome-Present State Test Model of Clinical Reasoning with guided reflection activities was an effective method to improve clinical reasoning skills in senior nursing students at a large southeastern university. The overall research questions involve comparing participants Health Sciences Reasoning Test scores before and after implementation of the OPT Model as clinical paperwork, secondly the experimental group was given a guided reflection activity to complete in conjunction with use of the OPT Model during clinical experience. </p><p> Kolb&rsquo;s Experiential Learning Theory is the theoretical framework used throughout this study. Nursing education has historically blended didactic learning with clinical experiences to transfer knowledge. The OPT offers a frame to organize thoughts and guides the learner to decide what data is important to each patient situation. </p><p> This study reports the findings for 62 senior nursing students that completed the HSRT prior to implementation of the OPT Model and a guided reflection activity. Clinical instructor&rsquo;s scored participants using the Lasater&rsquo;s Clinical Judgment Rubric each week. There were no statistically significant differences between the experimental group and the control group. The only statistically significant difference that was identified was in the Lasater&rsquo;s Clinical Judgment Rubric scores between week one and week 2, and week 3 and week 4.</p><p>

<p> Nurses at a suburban northeastern U.S. community hospital reported that they felt unprepared to effectively respond to a pediatric emergency. Empirical data were not available to identify if this local problem was due to a lack of the nurses&rsquo; self-confidence or if other factors were involved. The purpose of this study was to determine if there were relationships between nurses&rsquo; self-efficacy in pediatric emergencies and their knowledge of pediatric emergency care, as well as their years of clinical experience, nursing education, pediatric life support certification, specialty certification, and caring for pediatric patients. In addition, the research questions guided the investigation to determine if any of the variables could predict nurses&rsquo; self-efficacy in pediatric emergencies. The theoretical framework was based on Bandura&rsquo;s social learning theory, which incorporates the concept of self-efficacy, as well as Zimmerman&rsquo;s self-regulated learning theory. A quantitative correlational design was used with a convenience sample of 37 nurses. Self-efficacy was measured with the General Self-Efficacy Scale and knowledge was quantified using a 32-item researcher-developed instrument. The data were analyzed using multiple regression analysis and correlations. Results showed that none of the variables predicted self-efficacy; however, years of nursing education, pediatric life support certification, and clinical experience were all significantly related to knowledge. Based on the results, a 3-day educational program was developed to address pediatric emergency practice. The results of this study can direct positive social change by informing future nursing education and training efforts in order to improve the medical outcomes of pediatric patients.</p>

<p> Lifelong learning in professional communities is changing to adapt to professions in the anesthesia field with input from the public and various stakeholders. An extensive review on learning styles identified a gap in literature, specifically evidence on sensory learning styles among adult professionals. Changes in Certified Registered Nurse Anesthetist (CRNA) recertification requirements, most importantly the incorporation of an assessment component, prompted the research to address CRNA enhancement methods in learning. The main purpose of the current study was to contribute to the body of literature if a CRNA&rsquo;s knowledge of sensory learning styles mix influences test score achievement. The posttest-only control-group design was utilized, wherein a Sensory Learning Styles Self-Assessment (SLS-SA) instrument was piloted to establish content validity and internal reliability prior to its application with the treatment group. The American Association of Nurse Anesthetists (AANA) Learn&rsquo;s Health and Wellness Module 1 provided the 10-hour posttest, which measured the test score achievement among participants. An analysis of variance (ANOVA) was conducted and yielded a nonsignificant effect of the current study&rsquo;s treatment on test score results among CRNAs. Interaction effects of the CRNAs&rsquo; gender and years of practice were also examined, which produced the same results (e.g., not significant). No effect was established in the current research, however, several research limitations were identified and specific outcomes on an individual participant level were acknowledged, which were recommended to substantiate further research. </p>

<p> Identifying the primary barriers that block initial employment of newly licensed nurses is essential to smooth transition to the workforce. Enrollment in nursing education has increased and schools have added programs, but newly licensed nurses struggle to gain initial employment. This qualitative e-Delphi study solicits feedback from nurse employers through a series of three surveys. The surveys were delivered and returned electronically. They were distributed to 33 volunteer nursing participants who are responsible for hiring and evaluating nurse performance in the workplace. The average response rate was 46%. The identified skill gaps in newly prepared nurses are communication, critical thinking, organization, and professionalism. These skill deficits result in delayed initial employability and prolonged orientation times.</p><p>

Nursings' lack of full professional status based on the criteria of autonomy coupled with the need for a more independent practitioner in today's complex health care system was the basis for this study. A comparison of senior nursing students from different educational programs was undertaken to determine if type of educational preparation was a predictor of professional autonomy. Schutzenhofer's (1988) Nursing Activity Scale (NAS) was used to measure and compare the level of professional autonomy of 306 senior nursing students who were within four weeks of graduation from nine nursing programs across Massachusetts. Further comparisons of students' professed autonomy as a function of demographic variables and students' perceptions of their level of participation in learning were compared. Thirty-six senior level nursing faculty were surveyed for identification of possible relationships between student and faculty scores on these variables. The majority of students surveyed (85%) scored in the high range of the autonomy scale, and the level of nursing education was not a predictor of the students' autonomy level. Variables that correlated with student autonomy levels were marriage, plans for earning an advanced nursing degree and perceived level of participation in learning. However, significant differences were found in student reported autonomy between schools at the associate degree level. Schools at the baccalaureate degree level did not differ significantly from each other. No clear relationship was found between student and faculty scores. More baccalaureate degree students reported their programs as having a more theoretical than practical focus, while the associate degree students perceived a more practical focus to their programs. Seventy-five percent of students from both programs planned to earn advanced nursing degrees. These findings have implications for nursing education. Increased opportunities for students to participate more fully in their educational process may facilitate the internalization of professional autonomy in nursing students. Such opportunities may ultimately provide the health care system with practitioners who possess the professional characteristics necessary for a more autonomous, successful practice.

<p> Nursing programs have embraced distance learning in their curricula, but discussion is ongoing about course assignments and grading criteria to increase examination scores in nursing distance learning courses. Because course examinations are a predictor of success on the postgraduate licensing examination (NCLEX-RN), the purpose of this study was to determine whether differences existed in student examination scores between nursing distance learning courses with and without points aligned to assignments. The theoretical framework was Knowles&rsquo;s theory of andragogy, which highlights adults&rsquo; motivation and self-direction to succeed. The quantitative causal comparative study included a convenience sample of 164 students to compare archival data of 4 examination scores between 2 nursing distance-learning courses. Data analysis included an independent-groups one-tailed <i> t</i> test. No significant differences were found between the 2 courses, suggesting that students do not achieve higher examination scores with course points aligned with course assignments. Nursing administrators and faculty in nursing programs with a distance learning component will benefit from the findings of this study. Findings may be used to draft, revise, and implement assignment criteria and point alignment for nursing distance learning courses. Social change will occur when nursing distance learning faculty use problem-solving and critical thinking assignments, including case studies, discussion boards, group assignments, concept mapping and NCLEX-RN style testing in each nursing distance learning course. Because point alignment to course assignments do not significantly improve examination scores, implementation of problem-solving and critical thinking assignments is necessary to promote student learning and examination success.</p>

<p> This study took place at a Wake Technical Community College, a multi-campus institution in Raleigh, North Carolina. An evaluation of the return on investment in high fidelity simulation used by an associate degree of nursing program was conducted with valid and reliable instruments. The study demonstrated that comparable student outcomes are attainable when traditional clinical study is replaced with high fidelity simulation curriculum. Limited clinical practice space justifies the spread of simulation in college health science programs. North Carolina Administrative Code permits community colleges to replace 25% of traditional clinical with simulation. The lack of research on the cost effectiveness of high fidelity simulation has been cited as a barrier to its diffusion. Sound research demonstrating performance-based and patient-centric outcomes can provide governing bodies with evidence supporting the diffusion of high fidelity education.</p>

<p> The purpose of this study was to increase the knowledge level and change self-reported behavioral intent among a sample of healthcare providers regarding safe sleep messaging. From 1995 through 2015 in New York City, an average of one infant died every week from unsafe sleeping conditions. One agency in New York City experienced four unsafe sleep infant deaths within two months in 2010. In 2011, the city provided case managers with training on infant safety. Before this training, up to six sleep-related infant deaths were reported annually. The following year, one sleep-related infant death occurred. None occurred during the second year subsequent to the training. Current literature demonstrates healthcare providers have considerable influence on safe sleep messaging. This current study utilized a similar educational training designed for healthcare providers working in an urban health facility.</p><p> A single group pre/post-test quasi-experimental design was delivered to 23 participants. The design incorporated an online educational intervention in order to increase healthcare provider&rsquo;s knowledge level and change their self-reported behavioral intent to educate parents and caregivers on the importance of safe sleep practices. Data were gathered at pre-test and post-test to assess changes.</p><p> Final analysis, using a repeated measures general linear model, was carried out on data from the twenty-three participants who returned completed pre- and post-class surveys. There was a statistically significant change in the overall 13-item composite score reflecting knowledge level and change the self-reported behavioral intent from pretest (M=6.13, SD=2.78) to post-test (M=8.78, SD=3.79) at the p &lt;.001 level. These findings support current literature recommendations for healthcare providers to incorporate the safe sleep message into their practice. Nonetheless, supplementary research is needed to conclude whether these results coincide with communities elsewhere and to examine the issues regarding knowledge and behavioral intent regarding safe sleep messaging.</p>

<p> Incivility has infiltrated our institutions of higher learning as well as the world of nursing. All too familiar in nursing is the phrase &ldquo;eating their young,&rdquo; which aptly describes how nurses treat other nurses, even though they should be nurturing and caring professionals. The investigator explored nursing and health science students&rsquo; perceptions of student and faculty uncivil behaviors within the academic environment, seeking the levels and frequency of the problem. Bandura&rsquo;s social learning theory presents a sound theoretical framework for this dissertation. The research methodology consisted of a quantitative descriptive approach. The Incivility in Higher Education-Revised (IHE-R) Survey was used to compare nursing and health science student perceptions of the level and frequency of student and faculty incivility. Descriptive statistics and independent t tests were used to compare the different student perceptions. The study results indicated that perceptions of student behavioral levels were between <i>somewhat </i> and <i>moderately</i> uncivil. Student perceptions of faculty behavioral levels were found to be more <i>moderate</i>. Review of the frequency levels reflected students&rsquo; frequencies to be <i> never</i> as compared with faculty, which indicated a frequency of <i> sometimes</i>. These results indicated that students perceived incivility to not be problematic within their individual programs, although it found faculty behavior levels were more uncivil even when similar behaviors were demonstrated by students. In general, these results were atypical than other results as incivility is found to be a rising problem. Further study is needed to confirm these results. </p><p>