Clinical reasoning is the cognitive process that nurses use to gather and incorporate information into a larger bank of personal knowledge. This incorporated information guides therapeutic actions, and helps determine client care. Since the process guides therapeutic actions regarding client care, failure to use the process effectively leads to poor clinical decision-making, inappropriate actions, or inaction. Because of the criticality of this process, this paper presents an analysis of the literature that reveals the current state of the science of clinical reasoning, identifies gaps in knowledge, and elucidates areas for future research. A systematic review of the databases the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Educational Resources Information Center (ERIC), PsychInfo, the Education Full Text (H.W. Wilson), and PubMed revealed 873 articles on the topic of clinical reasoning. Quality appraisal narrowed the field to 27 pieces of literature. Appendix A gives the State of the Science Coding Sheet used to identify the selections used in this research. Appendix B contains a summary of this literature. Although analysis of this literature shows that three theories exist on how to utilize most effectively the clinical reasoning process presently; a clear consistent definition is lacking. Additional research should focus on closing gaps that exist in defining the process, understanding the process, establishing linkages to non-clinical reasoning processes, and developing measures to both develop and accurately measure clinical reasoning.

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Social media can provide a tool for nursing students, who frequently transition between learning in the classroom and clinical contexts, to consolidate both their formal and informal learning experiences. Furthermore, the majority of baccalaureate nursing students fall within the millennial generation, meaning that they have grown up with computers and other digital tools and likely already use them to share educational resources and maintain contact with their peers. We know little about how health professions outside of Medicine use social media in teaching and learning, especially outside the context of the classroom and assignments. This pragmatic three-phase sequential mixed methods case study explores nursing students’ perceptions of using social media to support their learning and teaching. Phase 1 involves a survey of nursing students at Nipissing University to understand their use of social media for teaching and learning purposes. Phase 2 consists of a digital artifact collection, which involves following nursing students’ social media accounts to see what content they share related to teaching and learning in nursing education. Finally, Phase 3 involves semi-structured interviews to gain a deeper understanding of what motivates nursing students’ decisions to use social media for teaching and learning purposes. Overall, the findings show that nursing students at Nipissing University’s School of Nursing use social media in their formal and informal teaching and learning; they also use it as a ‘third space’ to supplement existing educational and institutional structures. The findings also demonstrate that while nursing students are relatively motivated to use social media in their teaching and learning, issues of quality and reliability of evidence, professionalism, and faculty or program attitudes can influence nursing students’ decisions to use or not to use social media for teaching and learning purposes. Finally, the findings suggest that nursing students share content related to advocacy, health education, and their perceptions and realities of nursing practice. This study contributes practically to the existing conversations regarding teaching and learning, critical inquiry, communication and collaboration, and professionalism in nursing education and practice.

Healthcare teams can implement care initiatives to promote a positive dying experience. However, there is a lack of knowledge related to how best to care for dying patients. Nurses do not receive extensive training in nursing school to care for patients at the end of life, yet most, at some point in their careers, experience the provision of this type of care. It is important to ensure that nurses caring for dying patients have been educated about end-of-life care. The purpose of the quality improvement project was to address the lack of end-of-life care education among critical care nurses in an acute care hospital by implementing and testing the effectiveness of an end-of-life care educational program. Kolcaba's theory of comfort was chosen as the theoretical framework for the project. Registered nurses (n = 34) employed on a critical care unit participated in the one-group pretest/posttest design project. The nurses completed the Healthstream online end-of-life care education, and knowledge improvement was determined through comparison of pretest and posttest scores. Descriptive tests were completed to determine the mean score. The descriptive data analysis and tests showed that participants' level of end-of-life care knowledge improved after they completed the formalized educational program. Participants' scores increased from pretest (68% to 100% correct answers) to posttest (93% to 100% correct answers). The primary populations benefiting from the project are nurses, dying patients, and family members of dying patients. The social change implication of the findings is that if nurses receive education on end-of-life nursing, increased knowledge of appropriate care for dying patients is expected.

The researcher designed this quantitative dissertation research to explore the perceptions of beginning nursing students toward professionalism in nursing, specific to professional values within the context of curriculum delivery for a leadership and management course in one baccalaureate nursing program. In addition, the researcher reviewed the literature for defining characteristics of professionalism in nursing. Adult students admitted to nursing programs today create multi-generational cohorts with prior learning from experiences and academic degrees in other disciplines. Often, content on professionalism in nursing is integrated in a nursing curriculum. However, students in a leadership and management course were unable to state the meaning of professionalism in nursing shortly before graduation. This study focused on professional values based on the nursing code of ethics as one attribute of the complex concept of professionalism. This exploratory study analyzed responses of students prior to beginning nursing courses to the Nurses Professional Values Scale-Revised (NPVS-R) survey. Findings indicated that beginning student perceptions of professionalism in nursing specific to professional values were generally in alignment with nursing standards. Significant findings suggested a lack of alignment to professional standards under the themes of trust, activism, caring and professionalism through autonomous practice, self-regulation, and participation professional activities positively associated to five variables. Recommendations are made for enhancing curriculum design of leadership and management in nursing content to address these areas.

Indiana University-Purdue University Indianapolis (IUPUI) / Simulation is an educational strategy used in prelicensure nursing education that has been demonstrated to effectively replace selected clinical experiences. Simulation experiences may include the use of differing roles including the active participant, who makes decisions during the simulation and the passive observer, who watches the simulation unfold. There is a lack of rigorous research testing whether students in the passive observer role during simulations demonstrate and retain knowledge similarly to those in active participant roles. In addition, differences in knowledge applied to a contextually similar case between those who actively participate and passively observe have not been studied. The purpose of this study was to explore the relationship between nursing student’s roles in simulation and cognitive knowledge demonstration, retention, and application about two contextually similar cases of respiratory distress. An experimental, pretest-multiple posttest, repeated measures study was conducted with a convenience sample of 119 baccalaureate prelicensure nursing students from a large multi-campus Southwestern university. Two knowledge instruments were administered throughout different stages of the simulation and four weeks later. Associations between role in simulation and scores on the knowledge instruments were examined using t-tests and mixed repeated measures-analysis of variance. Of the 59 active participants and 60 observers, there were no significant differences in knowledge demonstrated or retained after simulation, after debriefing, or four weeks later. Additionally, there were no significant differences in knowledge demonstrated when applied to a contextually similar case after debriefing or four weeks later between active participant and observer. Future research is needed to examine these relationships in larger and more diverse samples and different contextual clinical situations in simulation. These results will contribute to the further testing and implementation of using observation as a strategy for teaching and learning with simulation for nursing and health professions education.

Engaging students in class when first-hand experience is not available is challenging. Three teaching strategies, flipped classroom, a guest speaker, and technology, engaged students during a global health class. Students were given a graded preclass assignment, which was used to guide the class session when an expert physician from Zambia joined us using technology. On the day of class, students were engaged and asked questions of the physician related to global health and culture. Combining the three strategies was an innovative and effective way to engage students, with many sharing with faculty that this was their favorite class day.

This study addressed the use of simulation as an adjunct to experiential learning in nursing education. The purpose of this study was to determine the perceived needs of faculty required for successful incorporation of simulation in nursing curricula in associate degree nursing programs in the southern region of the United States. This study further explored experienced nursing faculty perceptions regarding how simulation can enhance or supplement specific components required in nursing curricula. The population was a convenience sample of faculty members teaching in public funded NLNAC accredited associate degree nursing programs in the southern region of the United States. Data were collected using the Barriers to Simulation Utilization scale, a demographic questionnaire, and a researcher developed question exploring the current use and perceived acceptable use of simulation in associate degree education. This study found that associate degree nursing faculty in the southern region of the United States perceive that adopter/innovation and organization/communication factors are facilitators of simulation. Organizational support, adequate training, faculty workload consideration, and the use of a technology or simulation coordinator were identified as factors that may facilitate the use of simulation in associate degree programs. Components of nursing curriculum were identified that could be taught using simulation. The results of this study are consistent with others and add to the body of knowledge related to faculty needs for successful incorporation of simulation in nursing curricula.

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