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<p> Simulation based learning (SBL) is pedagogical method poised to innovate nursing educational approaches. Yet, despite a growing body of research into SBL, limited investigation exists regarding assumptions and beliefs that underpin SBL pedagogy. Even though key simulation design characteristics exist, the particular methods nurse educators use to operationalize simulation design characteristics and how these choices are viewed from the perspective of nursing students is unknown. Without understanding what motivates educators to design simulations as they do, it is difficult to interpret the evidence that exists to support chosen methods. Through the exploration of perspectives (points-of-view), underlying beliefs can be uncovered. Educators readily share their points-of-view on simulation design both formally (in literature) and informally (ordinary conversations). These conversations portray the subjectivity surrounding simulation design and become a vehicle for exploration. The purpose of this study was to describe and compare nurse educators' and nursing students' perspectives about operationalizing design characteristics within educational simulations. The National League for Nursing-Jeffries Simulation Framework guided this study by identifying the interaction of teacher, student, and educational practices on the five design characteristics (objectives, student support, problem solving, fidelity, and debriefing). It was from this interaction that perspectives were investigated. A Q-methodological approach was employed to investigate the subjectivity inherent in perspectives. Derived from 392 opinions on simulation design, a 60-statement Q-sample was rank-ordered into a quasi-normal distribution grid by 44 nurse educators and 45 nursing students recruited from two national organizations. Factor analysis and participants' explanations for statement placement contributed to factor interpretation. Factor analysis revealed nurse educators share a common, overriding <i>Facilitate the Discovery</i> perspective about operationalizing simulation design. Two secondary bipolar factors revealed that even though educators share a common perspective, there exist aspects of simulation design held in opposition regarding student role assignment and how far to let students struggle including when and if to stop a simulation. Factor analysis revealed nursing students hold five distinct and uniquely personal perspectives labeled <i>Let Me Show You, Stand By Me, The Agony of Defeat, Let Me Think it Through,</i> and <i> I'm Engaging and So Should You.</i> Second-order factor analysis revealed nurse educators share similar aspects of thinking with four of the five nursing students' perspectives. Results suggest ongoing and sustained educational development along with time for nurse educators to reflect on and clarify their perspective about simulation design is essential. Educators need to emotionally prepare and support nursing students prior to and during simulation activities. Further educational research is needed on how operationalizing simulation design characteristics differ based on a SBL activity with either a formative or a summative purpose.</p>

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

A thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfilment of the requirements of the degree of Doctor of Philosophy Johannesburg, 2017. / Although simulation has been part of health care education for the last 40 years, there appears to be some resistance to embedding the education methodology in both nursing and medical curricula. Possible reasons for this lack of integration could be the educators’ fear of technology, organizational barriers, such as time for integration, and a lack of support for educators wanting to introduce simulation. In South Africa at present, simulation is only being used in pockets at universities and nursing colleges, with no formal contextually relevant training programme in place, specifically for nursing education, despite evidence that simulation improves student’s outcomes and critical thinking. Nurse educators have expressed anxiety and bewilderment and seem uncertain about the use of simulation. The purpose of this study was to develop a best practice simulation programme for nurse educators wanting to use simulation in their undergraduate nursing curricula. A multi-method design within a pragmatic paradigm was used for this study. The process was divided into four phases. Phase one involved data collection, using the National Council of State Board of Nursing (NCSBN) survey: Use of Simulation in Nursing Education (Hayden, 2010), to describe the prevalence and use of simulation in both university and college undergraduate curricula. Phase two consisted of two parts, conducted consecutively: a scoping literature review to determine simulation best practices in nursing and medical education, followed by a Delphi Study to elicit the perceptions of educators in South Africa regarding simulation and best practice. In the scoping literature review the question asked was: What does the literature identify as simulation best practices in nursing and medical education? Four best practices emerged from the literature, namely the importance of debriefing, identifying learner objectives, the integration of simulation into the curriculum and the inclusion of deliberate practice. A Delphi Study was then conducted to elicit the judgement and perceptions of simulation educators, working in the South African context, of the identified best practices. Phase three was the design of a conceptual framework and the development of a constructivist blended learning programme, using the Assessment, Design, Development, Implementation and Evaluation (ADDIE) instructional design method. The goal of the programme was: Participants will be able to apply simulation knowledge and skills to meet the learning needs of their undergraduate nursing students. The four best practices and the National League of Nurses/Jeffries Simulation Framework guided the programme. The resultant programme was developed in seven Modules building towards the completion of a simulation scenario, including planning for the scenario and post simulation debriefing. Phase four was an expert review of the programme, from an e-learning specialist, nurse educators and a simulation expert. Both an expert review guideline for a written report and interviews were used for evaluation and refinement of the programme, prior to the programme being rolled out to nurse educators. Results: Simulation in South African nurse education institutions is predominantly at a task training level and has been developed into complex patient scenarios using higher fidelity simulations. The programme was well received by the experts as relevant to simulation education in South African undergraduate nursing curricula, either in a university or nursing college educational environment. Limitations: The limitations to the study include the small sample sizes in the data collection phases, due to simulation in South Africa being relatively new in nursing education. Universities were predominantly represented in the data collection findings, despite the researcher reaching out to nursing colleges for their perspectives and inputs. There is a dearth of South African simulation literature and none on best education simulation practices in South African Nursing Education Institutions (NEIs), and therefore the researcher relied on international literature in the scoping review. Conclusion: The blended education simulation programme is based on the needs of nurse educators wanting to include simulation in their education environment, based on their resources, and allows them to work through the programme in their own work space and time. / MT2017

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Aims: Empirical evidence demonstrates successful expert nurses appointed as nurse lecturers in higher education find themselves as 'newcomers' to the role and organisation. New nurse lecturers often find their transition to higher education confusing and challenging. Using the conceptual framework of communities of practice, this study aims to provide original research into what induction means for new nurse lecturers, and gain an in-depth understanding of their perceptions and experiences of their induction into working in a multi-sited university. Method: A qualitative research methodology was employed, using the theoretical approach of Interpretive Phenomenological Analysis (IPA) developed by Smith, Flowers, and Larkin (2009). Eight lecturers, with between one to three years' experience as nurse lecturers, were recruited from one university in the North West of England. Purposive sampling was utilised and data was obtained through one-toone semi-structured interviews. Verbatim transcripts were analysed following the principles of IPA. Findings: Three super-ordinate themes emerged (partial transition, dual communities of practice, introduction), along with six sub-ordinate themes (expectations of the nurse educator role, career change, contextual influences, location and culture of sites, tick box exercise, and the limited role of the mentor). New nurse lecturers found transition stressful: key aspects included the culture shock and the career change of adopting their new academic identity. Changing identity from a nurse to an educator, working across the boundaries of both practice and academia, was a struggle, particularly in participants with visiting lecturer experience who had mistakenly perceived this would prepare them for the role. Early role preparation was essential to understanding the different cultures and processes within the university. Formal mentoring supported development of self-confidence, but its value was undermined due to the mentors' workload and lack of understanding of their role, which affected relationship building. Supportive heads of department, and informal mentoring and peer support, were essential in developing new academic identities. Conclusion: This study contributes to practice through the development of an induction framework for new nurse educators. This framework acknowledges the relevance of maintaining a dual community of practice for new nurse educators, in supporting their new identity and their dual continuing professional development. Practical outcomes include: development of an informational resource for new lecturers (including visiting lecturers); development of a community of learning with facilitated workshops and online information resources; development of mentor training and resources for mentors; and mentors being thoughtfully designated by heads of department, with hours attached to their workload for mentoring. A long term online community of practice is needed for new staff to keep in touch and share information. Heads of department need to take ownership of inductions to ensure that their staff feel welcomed and supported in their new environment, with regular evaluation taking place.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Thesis (M.S.)--Boston University

Heart failure (HF) has a global significance for the older population and is the most common reason for hospitalization. Patients with HF can reduce their risk for hospital readmissions and adverse outcomes through self-management of their disease. Nurses are responsible for educating patients about HF self-management; however, nurses at the project site lacked sufficient understanding and confidence to perform adequate HF patient education, creating a gap in practice. This project was guided by Pender's health promotion model and adult learning theory with the goal to increase nurses' knowledge and confidence with the self-management principles of HF. The purpose of this project was to develop an educational program for nurses to increase their knowledge of HF disease management and patient self-management principles. The education program was supported by research literature and recommendations from the Agency for Healthcare Research and Quality, in addition to input from a planning team consisting of 3 nursing leaders from the project site. The planning team provided process evaluation regarding satisfaction with the planning process by completing an anonymous, 10-question, Likert-type survey. Seven project evaluations were completed and all respondents indicated that they agreed or strongly agreed in response to questions regarding the effectiveness of the project, it's planning, and the leader. At the completion of the project, the education program was delivered to the project site, with a plan for later implementation and learner evaluation using assessment tools of HF knowledge and confidence. This project has the potential to achieve positive social change in relation to nurses' commitment to improving patient outcomes through quality initiatives and dedication to the implementation of evidence-based practice, thus, promoting positive patient outcomes.

Vaccinations are important factors in the eradication of most communicable diseases. Tetanus, diphtheria, and pertussis (Tdap) vaccine has been found to decrease the incidence and further spread of pertussis, and even nullify its existence, yet many postpartum mothers opt not to receive the vaccination even if eligible to do so. It was unknown whether clinical nursing staff at the project site had sufficient knowledge about Tdap vaccine to educate postpartum mothers to accept the vaccine. The practice-focused question explored whether an educational program and a toolkit implemented for nursing staff members on the postpartum nursing unit would improve Tdap vaccination rates among postpartum mothers. The health belief model, theory of planned behavior, and social learning theory provided a framework for the project. Evidence obtained from the results of pre- and post-testing of nursing staff on their vaccine-related knowledge and attitudes showed a statistically significant increase in knowledge (z = -3.366, p = .001). Descriptive statistics were used to evaluate the change in Tdap refusal after the education. The use of Tdap vaccine in the postpartum period improved slightly with fewer postpartum mothers refusing the vaccine in the post-education period. Project findings showed that providing Tdap vaccine education to clinical nursing staff could prepare them to teach postpartum mothers about the benefits of Tdap vaccination, which may improve the percentage of postpartum mothers who will accept the vaccine. Higher vaccination rates might contribute to positive social change by decreasing pertussis transmission rates for newborns.