Background: Advance directives allow patients to put in writing the type of health care they want if they are unable to make decisions due to their medical condition. Purpose: The purpose of this study was to determine if there were differences in senior nursing students’ knowledge, attitudes, and confidence based on when the information is positioned in the curriculum. Theoretical: Social cognitive learning theory and Zimmerman’s self-regulation model provided the theoretical framework. Methods: This study reflected a non-experimental, exploratory design, with a convenience sample of senior nursing students from 2 different nursing programs in central Illinois. One program offers advance directive education in the first year and the other program offers the information in the second year. A total of 131 students participated in the study that used subscales of the Knowledge, Attitudinal, Experiential Survey on Advance Directives. Results: The group that received the information the second year rated themselves as having more confidence with advance directives. However, both groups scored low in the area of knowledge of advance directives, the Patient Self-Determination Act, and Illinois law. Students who reported higher knowledge levels had higher attitudes about end-of-life care. There was no difference in attitudes between the two groups. Conclusion: The results of this study highlight the need to review nursing curricula specifically relating to end-of-life care content and its placement in the curriculum.

A review was made of research concerning medical students, nursing students, physicians and nurses with special focus on the physician-nurse relationship. Research was carried out to investigate medical and nursing students' concepts of self, ideal self (as physician/nurse), typical work partner and ideal work partner.

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The problem investigated by the researcher relates to the development of critical thinking knowledge and skill in nursing students. Traditional approaches to educating nursing students have been used in the past to educate nursing students, but newly licensed registered nurses still have difficulty with critical thinking knowledge and skills. The principal investigator evaluated the use of an alternative method of teaching learning to foster and develop critical thinking knowledge and skills. One suggestion for teaching learning methods is the use of human patient simulation. A pretest/posttest experimental design was used to investigate critical thinking knowledge and skills after using human patient simulation in second semester nursing students. Nursing students from a northern California university were approached to participate in the study in the fall of 2011 and spring of 2012. The WGCTA Form D and the Lasater Clinical Judgment Rubric were used as a method to determine any changes in critical thinking knowledge and skills. No simulation. This study adds to the body of knowledge relating to the use of human patient simulation.

Empathy is the foundation of caring in the nursing profession. It is critical to an effective patient-nurse relationship and impacts decision-making in nursing care. This study aimed to investigate the impact of virtual simulation on nursing students’ empathy and the relationships of empathy to their demographic characteristics. A randomized pretest and posttest control group design was employed in the study with 140 participants from twelve undergraduate nursing programs across Canada. A virtual simulation scenario was created by the author regarding a patient with substance overuse in an acute care setting. Standardized patients were employed to portray the virtual characters to enhance realism and immersive experience. The participants in the control group reviewed a text-based case study, which consisted of an identical storyline of the virtual simulation scenario, while those in the intervention group experienced the virtual simulation activity. The Kiersma-Chen Empathy Scale-Revised (KCES-R), Substance Abuse Attitude Survey (SAAS), and a demographic survey consisting of age, gender, personal, family, and learning experiences related to substance overuse, were used in the study. The results indicated empathy was significantly increased after the learning activities in both groups, but nonsignificantly different between the participants in the text-based case study and virtual simulation groups before and after the learning activities. Meanwhile, the participants’ attitudes toward substance overuse did not change significantly after their learning activities. All demographic characteristics were nonsignificantly correlated to the participants’ empathy as well. However, the participants’ empathy toward the patients with substance overuse was significantly associated with their attitude toward substance overuse. This study is one of the few studies that employed virtual simulation to promote nursing students’ empathy. Although the study did not demonstrate a significant difference between the text-based case study and virtual simulation groups after the learning activities, it supports that virtual simulation is effective for promoting empathy in nursing education as a text-based application. Future studies will be needed to explore different virtual simulation designs and to determine how individual characteristics influence the cognitive process of perspective-taking in promoting empathy.

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Objectives The purpose of this study was to examine the influences of spiritual well-being and parenting styles on USA nursing students’ psychological well-being and suicidal ideation. Methods This was a cross sectional, descriptive research design. The structured questionnaires were used to do the data collection. There were 404 nursing students were recruited from a Midwest University in the USA. The mean age was 24.53 (SD = 6.14). There were 53 Male (13.1%) and 351 Female (86.9%). The SPSS 28th version was used to do the data analysis. The descriptive data analysis, Pearson Correlation, and Step-wise Multiple Regressions were used to solve the research questions. Results Total score of spiritual well-being, faith/belief, life and self-responsibility, and life satisfaction/ self- actualization had statistically significant positive relationships with nursing students’ psychological well- being. Total score of spiritual well-being, faith/belief, life and self-responsibility, and life satisfaction/ self- actualization had statistically significant reverse relationships with nursing students’ suicidal ideation. Their parents’ rearing attitude: child monitor, inductive reasoning, communication, positive reinforcement, involvement, and the total scores of positive rearing attitude had statistically significant positive relationships with nursing students’ psychological well-being. Their parents’ rearing attitude: communication, positive reinforcement, and the total scores of positive rearing attitude had statistically significant reverse relationships with nursing students’ suicide ideation. Their parents’ harsh discipline and the total scores of negative rearing attitude had statistically significant positive relationships with nursing students’ suicide ideation. Discussion In this study, life satisfaction/self-actualization, life/self-responsibility, positive reinforcement, and faith/belief were the significant predictors of nursing students’ psychological well-being. Total scores of spiritual well-being and positive reinforcement were significant predictors of nursing students’ suicidal ideation. Higher score of total scores of spiritual well-being and positive reinforcement were found to predict decreasing nursing students’ suicidal ideation.

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