搜索结果：The Journal of nursing education

•The National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity calls for a series of policy reforms to unleash the potential of nurses to play greater roles in advancing health equity.•The report recommends that the systems that educate, pay and employ nurses: 1) permanently remove barriers to care; 2) value their contributions; 3) prepare nurses to tackle health equity; and 4) diversify the workforce. The need to fully support nurses is interwoven throughout the report.•All nurses should work in partnership with others to advance the nine major report recommendations. The National Academy of Medicine's long-anticipated report, The Future of Nursing 2020–2030: Charting a Path to Achieve Health Equity, offers an aspirational vision: the achievement of health equity in the United States built on strengthened nursing capacity, diversity, and expertise (Wakefield, 2021Wakefield M. Federally qualified health centers and related primary care workforce issues.Jama. 2021; 325: 1145-1146Crossref PubMed Scopus (10) Google Scholar). Released in May 2021, the report arrives at a critical moment for the profession. Many nurses are burned out, exhausted, and have experienced moral injury from caring for an unrelenting stream of patients with COVID-19. The pandemic has laid bare and further exacerbated long-existing health inequities. School closings during the pandemic similarly exacerbated educational disparities, and poor treatment of Black, Indigenous, and other people of color by police spotlighted inequities in law enforcement. Collectively, these inequities have resulted in renewed calls to dismantle structural, cultural, and interpersonal racism, including within nursing. This new report provides a roadmap for how the nursing profession can contribute its expertise to create a fairer, more just and healthier world. The report is the second collaboration between the Robert Wood Johnson Foundation (RWJF) and the National Academy of Medicine (NAM) on the future of nursing. The first report, released in 2010, re-conceptualized the role of nurses in transforming the healthcare system (Shalala et al., 2011Shalala D. Bolton L.B. Bleich M.R. Brennan T. Campbell R. Devlin L. The future of nursing: Leading change, advancing health. 10. The National Academy Press, Washington DC2011: 12956https://www.nap.edu/catalog/12956/the-future-of-nursing-leading-change-advancing-healthGoogle Scholar). RWJF and AARP formed The Future of Nursing: Campaign for Action, a nationwide initiative to advance the report recommendations. Over the past decade, the nursing field strengthened nursing education, advanced practice, promoted leadership, and increased workforce diversity. In doing so, the nursing field has built – and is continuing to build – its capacity to provide high-quality care to more Americans. As nursing built its capacity and as the evidence increasingly linked inequities to poorer health status, it became clear that nurses could do more to build healthier communities and advance equity. Nurses are the most trusted profession and the first point of contact for most people seeking health care. They are bridge builders and collaborators who engage and connect with people, communities, and organizations to promote health and well-being (Pittman, 2019Pittman, P. (2019,. March 12). Activating nursing to address the unmet needs of the 21st century: Background paper for the NAM Committee on Nursing 2030.Robert Wood Johnson Foundation. Available at: https://publichealth.gwu.edu/sites/default/files/downloads/HPM/Activating%20Nursing %20To%20Address%20Unmet%20Needs%20In%20The %2021st%20Century.pdfGoogle Scholar). Their expertise could be better used to combat the many shortcomings of the U.S. health system. The United States spends $3.5 trillion each year on health care (CMS, 2020) more than any other country in the world but ranks last compared with other high-income countries on equity, access to care, health care outcomes, and administrative efficiency (Schneider et al., 2021Schneider, E. et al.,(2021, August)) Mirror, Mirror 2021 — Reflecting Poorly: Health Care in the U.S. compared to other high-income countries (Commonwealth Fund). https://doi.org/10.26099/01dv-h208.Google Scholar). Life expectancy, infant mortality and maternal mortality are worse in the United States compared with other high-income nations. Disparities in health care access and outcomes related to race, income, geography and other social and environmental factors are also common. RWJF has long believed that nurses have enormous potential for tackling the shortcomings of health and health care in the United States and in 2019 asked the NAM to form a committee tasked with charting a path for the nursing profession to create a culture of health, reduce health disparities, and improve the health and well-being of the nation. As the committee was well into the process of reviewing evidence and preparing to write the report, the pandemic took hold across the country and shined a light on the nation's rampant health inequities. The committee delayed the report to incorporate the major lessons from the pandemic: its disproportionate and devastating toll on poor and marginalized populations that could largely be attributed to persistent health disparities; the need to fully support nurses; and better prepare the workforce for future disasters. Released in May 2021, the report called for a series of policy reforms to unleash the potential of nurses to play greater roles in advancing health equity. The report recommends that the systems that educate, pay, and employ nurses: (1) permanently remove barriers to care; (2) value their contributions; (3) prepare nurses to tackle health equity; and (4) diversify the workforce. The report underscores that prioritizing nurse well-being is paramount to advancing the recommendations. In addition, the report calls on national nursing organizations to develop a shared agenda for addressing the social determinants of health and achieving health equity. Finally, the committee prioritized research needs to build the evidence base to support nurses in advancing health equity. Each of these areas is discussed below. Far too often in the United States, people do not see a health care provider when they need one. Nearly 30 million people are uninsured in the United States, and roughly 40 million have health plans that leave them potentially underinsured (Collins et al., August 2020Collins, Sara R., Gunja, Munira Z., & Aboulafia, Gabriella N. (2020). U.S. Health insurance coverage in 2020: A looming crisis in affordability — findings from the Commonwealth Fund Biennial Health Insurance Survey, 2020.Commonwealth Fund. https://doi.org/10.26099/6aj3-n655.Google Scholar). In addition, timely access to health care is undermined due to the inability to pay; geographic inaccessibility to services and providers, particularly in rural and underserved urban areas; lack of health literacy; and fundamental mistrust of the health care system and providers. Research demonstrates that delays in obtaining care can lead people to experience worse symptoms and disease progression (Man et al., 2018Man R.X.G. Lack D.A. Wyatt C.E. Murray V. The effect of natural disasters on cancer care: A systematic review.The Lancet Oncology. 2018; 19: e482-e499https://doi.org/10.1016/S1470-2045(18)30412-1Abstract Full Text Full Text PDF PubMed Scopus (41) Google Scholar). Nurses can help to explicitly address these gaps in access to care. For example, about 70% to 80% of advanced-practice nurses work in primary care, including in pediatrics, adult practice, gerontology, and nurse midwifery. While the primary care nurse practitioner field has grown, the number of physicians entering primary care has stagnated or declined (Barnes et al., 2018Barnes H. Richards M.R. McHugh M.D. Martsolf G. Rural and nonrural primary care physician practices increasingly rely on nurse practitioners.Health Affairs. 2018; 37: 908-914https://doi.org/10.1377/hlthaff.2017.1158Crossref PubMed Scopus (127) Google Scholar; Barnes et al., 2018Xue Y. Ye Y. Brewer C. Spetz J. Impact of state nurse practitioner scope-of-practice regulation on health care delivery: Systematic review.Nursing outlook. 2016; 64: 71-85https://doi.org/10.1377/hlthaff.2017.1158Crossref PubMed Scopus (117) Google Scholar). Care provided by nurse practitioners has been found to be comparable to the care provided by physicians, according to numerous studies (Perloff et al., 2019Perloff J. Clarke S. DesRoches C.M. O'Reilly-Jacob M. Buerhaus P. Association of state-level restrictions in nurse practitioner scope of practice with the quality of primary care provided to Medicare beneficiaries.Medical Care Research and Review. 2019; 76: 597-626Crossref PubMed Scopus (24) Google Scholar; Yang et al., 2020Yang B.K. Johantgen M.E. Trinkoff A.M. Idzik S.R. Wince J. Tomlinson C. State Nurse Practitioner practice regulations and US health care delivery outcomes: A systematic review.Medical Care Research and Review. 2021; 78: 183-196https://doi.org/10.1177/1077558719901216Crossref PubMed Scopus (32) Google Scholar). They are less expensive to employ than physicians and are more likely to care for vulnerable populations, including those in rural areas (Perloff et al., 2016Perloff J. DesRoches C.M. Buerhaus P. Comparing the cost of care provided to Medicare beneficiaries assigned to primary care nurse practitioners and physicians.Health Services Research. 2016; 51: 1407-1423Crossref PubMed Scopus (83) Google Scholar). However, the ability of nurses to expand access to care is limited by state and federal laws, institutional barriers, and restrictive health systems policies that prohibit them from working to the full extent of their education and training (Wakefield et al., 2021Wakefield M.K. Williams D.R. Le Menestrel S. Flaubert J.L. 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While the advent of Covid-19 has required nurse faculty be innovative, flexible, nimble and agile, there have been challenges. For example, faculty have had to move in-person classes online, conceptualise and offer alternative clinical experiences, and re-define how student performance is evaluated and graded. When we look back on this experience, what will faculty have learned from these experiences, and what are possible changes arising from these learnings? The move to online education has required faculty make changes to examination procedures and grading practices while implementing strategies to foster student engagement (Jackson et al., 2020). Many institutions have moved to a pass/fail rather than a letter grading system. Some institutions have offered students limited choices of how they wish to be graded. For example, at the University of California—Berkeley, decided the default for all class will be pass/fail. However, students have the option to select a letter grade instead (A's for all? Universities debate how to grade during a pandemic, 2020). Moreover, in many parts of the world, the move to providing education in an online format has highlighted several issues associated with online learning. First, faculty must be clear about the difference between what many are doing—offering education in an emergency distance learning format—and robust online education. While many academic institutions, and nursing programs, may have embraced online education and have well developed plans about how to offer robust online programs, COVID-19 has propelled many faculty to offer online education in the absence of “well-considered, durable learning plans” (Gardner, 2020, p. 21). Emergency remote teaching is “a temporary shift of instructional delivery to an alternate delivery mode due to crisis circumstances” (Hodges, Moore, Lockee, Trust, & Bond, 2020, np). More thoughtful, systematic approaches will be needed to make the transition to online teaching and learning successful and permanent. Second, online education has made very visible disparity issues that affect students’ ability to learn and be successful. For example, students restricted to home may not have access to the Internet or Wi-Fi; students in rural areas may not have access to the broadband width necessary to access more sophisticated learning materials such as videos or voice-over PowerPoint© presentations; irrespective of geographic location, students may not have access to laptops and computers at home. Such limitations call for increased faculty sensitivity as they implement online education. Rethinking presentation of online information in a low-fidelity format is one solution to address some of these issues. But doing so requires thought and intentional planning. However, both these activities require time—a privilege not accorded during the pandemic. The challenge to provide relevant clinical experiences has resulted in an increased use of simulation, telehealth and virtual reality while being sensitive to regulatory requirements stipulated by state or country boards of nursing. Although these resources are available, nurse faculty have been challenged by availability of resources—not all academic institutions have needed technology—and be regulatory requirements. Fortunately, some regulatory bodies have altered the percentage of direct patient care student contact hours consequent to COVID-19. For example, the California State Board of Nursing decreased the direct patient care clinical hour requirement for students in obstetrics, paediatrics and mental health/psychiatric course from 75% to 50% and increased the accepted percent of clinical practice from 25% to 50% (State of California, Department of Consumer Affairs, 2020) https://www.dca.ca.gov/licensees/clinical_hours_guidance.pdf. Such flexibility makes possible timely student graduation. In addition, organisations such as the Society for Simulation in Healthcare (https://www.ssih.org/) have been offering numerous strategies including how to use high-fidelity manikins to provide meaningful clinical learning experiences. Planning meaningful clinical learning experiences has been challenging, and in some instances, fraught with ethical dilemmas. While some clinical agencies have supported continuing to have students in their agencies, others have not. Moreover, faculty and educational administrators have questioned how nursing students could be sent to a facility that may not be able to provide them with adequate personal protective equipment (PPE), or how faculty whose average was 59, many of whom had underlying health issues, could be asked to supervise these students, all this despite please from healthcare facilities for help. A typical first response to the COVID-19 experience may be to add or reinforce content about infectious diseases to the curriculum. In fact, this is what the American Association of Colleges of Nursing (2020) has suggested: Minimally, topics such as surveillance and detection, isolation, quarantine, and containment, and proper handwashing, cough and respiratory etiquette should be addressed (https://www.aacnnursing.org/Portals/42/AcademicNursing/pdf/Considerations-for-COVID19-Nursing-Schools.pdf). However, adding content to an already overloaded curriculum will not be the solution to preparing nurses for a future in which events such as Covid-19 become more common, given the number of new and lethal viruses that have surfaced since the beginning of the 21st century. Rather nurse faculty need to be deliberate in determining what content is taught—an undertaking that has challenged faculty for years. There is no better time to re-envision what constitutes core content for entry-level (prelicensure) students and what strategies best help them learn than the present. To paraphrase the WHO State of the World's Nursing (2020), focus of nurse preparation should be on delivering primary care, “ensuring quality of care and patient safety, preventing and controlling infections, and combating antimicrobial resistance” (p. 12). Curricula need to be explicit about the nurse's role in “health promotion, health literacy and management of noncommunicable diseases” (p. 13). Preparing nurses for their critical role managing epidemics should be an integral part of the curriculum, irrespective of educational level (undergraduate or graduate). Emphasis on population health should be strengthened. Given implementation of student engagement activities such as the flipped classroom has had limited success, the need for future healthcare workers to be well prepared to care for an increasing aging population and those with mental health issues, and advances in the neuroscience of learning, the possibility exists that current curricula, and teaching and learning practices are not adequate. Perhaps the time is now to reconsider what constitutes critical information and competencies for entry-level nurses. It is possible, given societal healthcare needs, that content considered critical decades ago is no longer relevant OR cannot be learned in the current time frame. These possibilities lead to two responses: decrease or change the focus of content included in the education of nurses OR increase the time to completion. The former seems more appealing than the latter. That said what information could be removed? What information could be expanded? For example, although care of mothers, infants and children is considered essential undergraduate knowledge in most countries, one could argue that this information is more specialised and warrants being offered at the postgraduate level. Doing so would provide room for inclusion of more comprehensive information about critical care nursing, noncommunicable diseases, social determinants of health, infectious diseases and the nurse's role in planetary health in the curriculum. Perhaps this is the time to revisit what constitutes a generalist nurse prepared at the undergraduate level. It is time to move from a focus on content to a focus on competency-based education (Barton, Murray, & Spurlock, 2020). Competencies “provide the structure and process for performance and assessment ‘…’the intended outcome” (Giddens, 2020, p. 124). A focus on competency-based education could accelerate the production of nurses, provide increased flexibility in terms of content taught and help address current criticisms by many clinical practice colleagues about new graduate nurses’ inability to think critically. The International Confederation of Midwives’, 2019 Essential Competencies for Midwifery Practice is an example of how integrated statements convey expectations, including necessary knowledge, skills and behaviours to produce an educated midwife. In many parts of the world, it takes three to four years to educate a nurse. Often content relevant to the discipline is offered in the final two years of the curriculum (Very common in the United States). However, given evidence from neuroscience of teaching and learning (Ambrose, Bridges, DiPiertro, Lovett, & Norman, 2010), distributing disciplinary content overall years of the curriculum may provide students the opportunity and time to process and practice what they are learning. Such a practice is not common in many parts of the world. The structure of the academic semester may need to change (McMurtrie, 2020). For example, as is common in many online nursing programs, courses are offered in 7-week segments. Perhaps there is rationale for offering select courses in even less time. Although this option may be appealing, the challenge in any practice discipline is to assure students have the opportunity to practice what they have learned in class in the clinical setting. While regulatory bodies have stipulated hours of clinical practice, for example the Nursing and Midwifery Board of Ireland (NMBI) has stipulated the minimum number of theoretical (1,533) and clinical hours (2,300) required in order to register to practice in the country and the North Carolina State Board of Nursing has stipulated 120 hr of focused client care experience in the final year of registered nurse curricula, there is no evidence to date to support the range of stipulated clinical hours (Bowling, Cooper, Kellish, Kubin, & Smith, 2018). Adopting competencies and examining alternative evaluation methods such as objective structured clinical examinations (Kolivand, Esfandyari, & Heydarpor, 2020; Walsh, Bailey, & Koren, 2009) may be one approach to providing evidence to determine the number of clinical hours necessary for registration or licensure. Irrespective of changes are made or not made, it is imperative that nurse faculty systematically research student outcomes based on modifications made during the pandemic. Such information will help faculty be ready for the next pandemic. However, of utmost importance is that research efforts be rigorous and ethically developed (Barton et al., 2020). Lastly, those of us who are responsible for educating future nurses must continue to reinforce the essential contribution nurses make to the health of society. Given the life-threatening experiences demonstrated by caring for COVID-19 patients, students who may have considered nursing as a career may no longer entertain the possibility. Nurse faculty must assure students they will be provided an education that prepares them to be knowledgeable caregivers. To do less would be a travesty and would threaten the future supply of nurses—a supply that will continue to be sorely needed.

Introduction: The Corona virus (COVID-19) pandemic caused, among others, the need for colleges and universities managers around the world to reinvent new ways of providing education preserving its good quality at the same time. With the new ordinances of the Ministry of Education and Health, all courses can use remote methodologies for the continuity on the current school year. With new challenges and paradigms emerging from this methodological proposal: provide for the user the feeling of immersion, of being in the class room, from the navigation and interaction in this virtual environment, at the same time that the educator, respecting the educational principles and the pedagogical approach that he believes, does not transform this moment into a simple distance education. Objective: to describe the state of the art on nursing education and the challenges of using remote technologies in the time of Corona virus pandemic. Methods: this is a reflective study based on secondary sources of literature relevant to the theme, considering articles from national and international journals and recent productions on education, health training, remote technologies, COVId-19 and public health. Results: it is evident that experiencing the effects of the corona virus pandemic (COVID-19) in the health educational sector, especially in the field of nursing, goes beyond a structural reorganization of courses. It implies change attitude of managers, teachers and students to reformulate educational practices (sometimes with traditional tools), with innovative practices preserving a methodology that provides to the student criticality reflection, dialogue, bonding and interaction; elements that are part of a training aimed at transformation, empowerment and not just the transmission of knowledge. In this context, the COVID-19 pandemic caused paradigm shifts perhaps not yet overcome by health science institutions , because when they perceived themselves within a reality that generated changes in the political, economic, cultural and social aspects at a global level, they had to reinvent and insert new ways of teaching in their work process; they had to discuss different educational approaches and, given the needs to readjust health teaching methods, they inserted remote technologies as essential tools to meet the real need for continuity of classes in non-face-to-face model. For many, it is a challenge, as it currently permeates a reflection on the attention of distance learning in the field of nursing and other courses in the health area. However, as it opened up to discussions about new ways of teaching mediated by innovation, it can be said that this will be one of the greatest impact of the pandemic in benefit the education: the contribution of new information and communication technologies in the teaching-learning process for training in health, as well as the reflection on distance education and its concepts, differentiating it from the concepts of remote methodology and the use of technologies. Conclusion: In nursing education, the discussion related to the use of remote technologies in the classroom has always been a point of debate. However, with the need to include these tools for the continuity of classes in the non-face-to-face model resulting from the social isolation strategy motivated by the pandemic of COVID-19, it can provide an opportunity to have a new look on the subject and perhaps there is an opportunity to expand the debate on the use of remote methodologies in health education, seeking a reflection on their interaction with the other teaching methods already implemented.

This research focused on the use of writing to increase reflection and problem solving in the clinical setting. Two groups of associate degree students provided clinical care and maintained journals, answering a series of focused questions. One group of students worked as individuals in the clinical setting; the other consisted of students working in pairs. There were significant differences between levels of reflection of students who worked in pairs and those who were not paired. Three major themes were found in students' journals: emotions, connections between theory and practice, and learning.

According to the outcomes-based education and training system of education (OBET) in the country and the South African Nursing Council, education should focus on "creating" reflective learners and practitioners. This article seeks to determine the effectiveness of reflective journal writing in promoting the reflective thinking of learners in clinical nursing education and to validate the guidelines described in a bigger study on how to facilitate reflective thinking using reflective journal writing. A qualitative, contextual, explorative, descriptive research design was used to determine the learners' perceptions on whether reflective journal writing did promote their higher-level thinking skills during the six-month placement in a psychiatric clinical practice using the reflective diaries. From a population of seventeen fourth-year students, six volunteered to participate in a focus group interview. The data was analysed by means of the descriptive method of open coding of Tesch (in Creswell, 1994:154-156). Positive and negative results from the perceptions of the participants and a literature review served as a basis for deducing and describing guidelines for the effective use of reflective journal writing in promoting reflective thinking in clinical nursing education. The positive perception was the development of problem-solving skills attained through reflection by using analytical critical thinking, synthesis and the evaluation of situations. Self-evaluation leading to intellectual growth and self-awareness indicated a positive perception. Negative perceptions were that reflective journal writing is time consuming, content based with a lack of clear expectations from the teacher, and distrust of students about the information written. Guba's model of ensuring trustworthiness in qualitative research as described in Krefting (1991:215-222) was employed. It is concluded that reflective journal writing in clinical nursing education does promote reflective thinking and learning. The use of the developed guidelines will minimise the negative perceptions. It is recommended that the guidelines be used in basic training at all levels of training to attain the objective of nursing education and training, which is to produce a critical, analytical thinker through reflection to improve practice.

The flipped classroom has generated considerable interest in nursing education in the last few years, especially in higher education in China. However, research to date has been insufficient to confirm the effectiveness of the flipped classroom approach. Since most of the Chinese studies are published in Chinese journals, they may not be easily accessible to international researchers. Therefore, this meta-analysis aimed to review the effectiveness of a flipped classroom in nursing education both in English and Chinese databases. The aim of the present study was to identify the robust available evidence about the effectiveness of flipped classrooms in nursing education through a systematic review and meta-analysis. A systematic search of English databases, including PubMed, EMBASE, Science Director, CINAHL and Google Scholar, and Chinese databases, including Chinese National Knowledge Infrastructure (CNKI), WanFang Data, VIP Information and Chinese Biomedical Literature (CMB), were conducted to identify peer-reviewed studies that met the inclusion criteria. Two reviewers independently performed study identification with Endnote X7 software and used Excel to extract data. The risk of bias in the included studies was assessed with Cochrane Collaboration's risk of bias tool, and a meta-analysis was conducted using RevMan 5.3 software following the guidelines proposed by PRISMA reporting standards with the protocol register No. CRD42016041826. A total of 29 studies were included in systematic review. There was a significant post-intervention improvement in academic performance both in knowledge with a pooled random-effects standardized mean difference of 1.13 and skills with a pooled random-effects standardized mean difference (SMD) of 1.68. Students' self-learning abilities were also improved with a pooled random-effects SMD of 1.51 compared with traditional lecture. In the subgroup analysis, we found that the effect sizes had high fidelity in terms of nursing degrees and research settings. There was a high rating of flipped classroom pedagogy from teaching evaluations, study satisfaction, study attitude and improvement in critical thinking and problem-solving skills. These results indicated that a flipped classroom might help nursing students improve in knowledge, skills, attitudes, self-learning, study satisfaction, critical thinking and problem-solving skills. We recommend adopting this approach for nursing education reform. There is a call for robust empirical research and unification of appraisal standards for further support of the effectiveness of the flipped classroom. Furthermore, a meta-regression analysis is also recommended to explore the sources of heterogeneity in included studies.

BACKGROUND: Educational meetings are widely used for continuing medical education. Previous reviews found that interactive workshops resulted in moderately large improvements in professional practice, whereas didactic sessions did not. OBJECTIVES: To assess the effects of educational meetings on professional practice and healthcare outcomes. SEARCH STRATEGY: We updated previous searches by searching the Cochrane Effective Practice and Organisation of Care Group Trials Register and pending file, from 1999 to March 2006. SELECTION CRITERIA: Randomised controlled trials of educational meetings that reported an objective measure of professional practice or healthcare outcomes. DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed study quality. Studies with a low or moderate risk of bias and that reported baseline data were included in the primary analysis. They were weighted according to the number of health professionals participating. For each comparison, we calculated the risk difference (RD) for dichotomous outcomes, adjusted for baseline compliance; and for continuous outcomes the percentage change relative to the control group average after the intervention, adjusted for baseline performance. Professional and patient outcomes were analysed separately. We considered 10 factors to explain heterogeneity of effect estimates using weighted meta-regression supplemented by visual analysis of bubble and box plots. MAIN RESULTS: In updating the review, 49 new studies were identified for inclusion. A total of 81 trials involving more than 11,000 health professionals are now included in the review. Based on 30 trials (36 comparisons), the median adjusted RD in compliance with desired practice was 6% (interquartile range 1.8 to 15.9) when any intervention in which educational meetings were a component was compared to no intervention. Educational meetings alone had similar effects (median adjusted RD 6%, interquartile range 2.9 to 15.3; based on 21 comparisons in 19 trials). For continuous outcomes the median adjusted percentage change relative to control was 10% (interquartile range 8 to 32%; 5 trials). For patient outcomes the median adjusted RD in achievement of treatment goals was 3.0 (interquartile range 0.1 to 4.0; 5 trials). Based on univariate meta-regression analyses of the 36 comparisons with dichotomous outcomes for professional practice, higher attendance at the educational meetings was associated with larger adjusted RDs (P < 0.01); mixed interactive and didactic education meetings (median adjusted RD 13.6) were more effective than either didactic meetings (RD 6.9) or interactive meetings (RD 3.0). Educational meetings did not appear to be effective for complex behaviours (adjusted RD -0.3) compared to less complex behaviours; they appeared to be less effective for less serious outcomes (RD 2.9) than for more serious outcomes. AUTHORS' CONCLUSIONS: Educational meetings alone or combined with other interventions, can improve professional practice and healthcare outcomes for the patients. The effect is most likely to be small and similar to other types of continuing medical education, such as audit and feedback, and educational outreach visits. Strategies to increase attendance at educational meetings, using mixed interactive and didactic formats, and focusing on outcomes that are likely to be perceived as serious may increase the effectiveness of educational meetings. Educational meetings alone are not likely to be effective for changing complex behaviours.

BACKGROUND: It is predicted that artificial intelligence (AI) will transform nursing across all domains of nursing practice, including administration, clinical care, education, policy, and research. Increasingly, researchers are exploring the potential influences of AI health technologies (AIHTs) on nursing in general and on nursing education more specifically. However, little emphasis has been placed on synthesizing this body of literature. OBJECTIVE: A scoping review was conducted to summarize the current and predicted influences of AIHTs on nursing education over the next 10 years and beyond. METHODS: This scoping review followed a previously published protocol from April 2020. Using an established scoping review methodology, the databases of MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, PsycINFO, Cochrane Database of Systematic Reviews, Cochrane Central, Education Resources Information Centre, Scopus, Web of Science, and Proquest were searched. In addition to the use of these electronic databases, a targeted website search was performed to access relevant grey literature. Abstracts and full-text studies were independently screened by two reviewers using prespecified inclusion and exclusion criteria. Included literature focused on nursing education and digital health technologies that incorporate AI. Data were charted using a structured form and narratively summarized into categories. RESULTS: A total of 27 articles were identified (20 expository papers, six studies with quantitative or prototyping methods, and one qualitative study). The population included nurses, nurse educators, and nursing students at the entry-to-practice, undergraduate, graduate, and doctoral levels. A variety of AIHTs were discussed, including virtual avatar apps, smart homes, predictive analytics, virtual or augmented reality, and robots. The two key categories derived from the literature were (1) influences of AI on nursing education in academic institutions and (2) influences of AI on nursing education in clinical practice. CONCLUSIONS: Curricular reform is urgently needed within nursing education programs in academic institutions and clinical practice settings to prepare nurses and nursing students to practice safely and efficiently in the age of AI. Additionally, nurse educators need to adopt new and evolving pedagogies that incorporate AI to better support students at all levels of education. Finally, nursing students and practicing nurses must be equipped with the requisite knowledge and skills to effectively assess AIHTs and safely integrate those deemed appropriate to support person-centered compassionate nursing care in practice settings. INTERNATIONAL REGISTERED REPORT IDENTIFIER IRRID: RR2-10.2196/17490.

Background Virtual reality (VR) is the use of computer technology to create an interactive three-dimensional (3D) world, which gives users a sense of spatial presence. In nursing education, VR has been used to help optimize teaching and learning processes. Objective The purpose of this study was to evaluate the effectiveness of VR in nursing education in the areas of knowledge, skills, satisfaction, confidence, and performance time. Methods We conducted a meta-analysis of the effectiveness of VR in nursing education based on the Cochrane methodology. An electronic literature search using the Cochrane Library, Web of Science, PubMed, Embase, and CINAHL (Cumulative Index to Nursing and Allied Health Literature), up to December 2019 was conducted to identify studies that reported the effectiveness of VR on knowledge, skills, satisfaction, confidence, and performance time. The study selection and data extraction were carried out by two independent reviewers. The methodological quality of the selected studies was determined using the Cochrane criteria for risk-of-bias assessment. Results A total of 12 studies, including 821 participants, were selected for the final analysis. We found that VR was more effective than the control conditions in improving knowledge (standard mean difference [SMD]=0.58, 95% CI 0.41-0.75, P&lt;.001, I2=47%). However, there was no difference between VR and the control conditions in skills (SMD=0.01, 95% CI –0.24 to 0.26, P=.93, I2=37%), satisfaction (SMD=0.01, 95% CI –0.79 to 0.80, P=.99, I2=86%), confidence (SMD=0.00, 95% CI –0.28 to 0.27, P=.99, I2=0%), and performance time (SMD=–0.55, 95% CI –2.04 to 0.94, P=.47, I2=97%). Conclusions The results of this study suggest that VR can effectively improve knowledge in nursing education, but it was not more effective than other education methods in areas of skills, satisfaction, confidence, and performance time. Further rigorous studies with a larger sample size are warranted to confirm these results.

BACKGROUND: The increasing availability of technology devices or portable digital assistant devices continues to change the teaching-learning landscape, including technology-supported learning. Portable digital assistants and technology usage have become an integral part of teaching and learning nowadays. Cloud computing, which includes YouTube, Google Apps, Dropbox and Twitter, has become the reality of today's teaching and learning and has noticeably improved higher education, including nursing education. OBJECTIVES: The aim of this integrative literature review was to explore and describe technology usage for teaching and learning in nursing education. METHOD: A five-step integrative review framework by Whittemore and Knafl was used to attain the objective of this study. The authors searched for both empirical and non-empirical articles from EBSCOhost (health information source and health science), ScienceDirect and African Journals Online Library databases to establish what is already known about the keywords. Key terms included in literature search were coronavirus disease 2019 (COVID-19), digital learning, online learning, nursing, teaching and learning, and technology use. RESULTS: Nineteen articles were selected for analysis. The themes that emerged from this review were (1) technology use in nursing education, (2) the manner in which technology is used in nursing education, (3) antecedents for technology use in nursing education, (4) advantages of technology use in nursing education, (5) disadvantages of technology use in nursing education and (6) technology use in nursing education amidst COVID-19. CONCLUSION: Technology in nursing education is used in both clinical and classroom teaching to complement learning. However, there is still a gap in its acceptance despite its upward trend.Contribution: The findings of this study contribute to the body of knowledge on the phenomenon of technology use for teaching and learning in nursing education.

AIM: To discuss the actual public image of nurses and other factors that influence the development of nurses' self-concept and professional identity. BACKGROUND: Nurses have become healthcare professionals in their own right who possess a great deal of knowledge. However, the public does not always value the skills and competences nurses have acquired through education and innovation. DESIGN: Discussion paper. DATA SOURCES: We identified 1216 relevant studies by searching MEDLINE, CINAHL and PsycINFO databases in the period 1997-2010. Finally, 18 studies met our inclusion criteria. DISCUSSION: The included studies show that the actual public image of nursing is diverse and incongruous. This image is partly self-created by nurses due to their invisibility and their lack of public discourse. Nurses derive their self-concept and professional identity from their public image, work environment, work values, education and traditional social and cultural values. IMPLICATIONS FOR NURSING: Nurses should work harder to communicate their professionalism to the public. Social media like the Internet and YouTube can be used to show the public what they really do. CONCLUSION: To improve their public image and to obtain a stronger position in healthcare organizations, nurses need to increase their visibility. This could be realized by ongoing education and a challenging work environment that encourages nurses to stand up for themselves. Furthermore, nurses should make better use of strategic positions, such as case manager, nurse educator or clinical nurse specialist and use their professionalism to show the public what their work really entails.

BACKGROUND: Simulation-based nursing education is an increasingly popular pedagogical approach. It provides students with opportunities to practice their clinical and decision-making skills through various real-life situational experiences. However, simulation approaches fall along a continuum ranging from low-fidelity to high-fidelity simulation. The purpose of this study was to determine the effect size of simulation-based educational interventions in nursing and compare effect sizes according to the fidelity level of the simulators through a meta-analysis. METHOD: This study explores the quantitative evidence published in the electronic databases EBSCO, Medline, ScienceDirect, ERIC, RISS, and the National Assembly Library of Korea database. Using a search strategy including the search terms "nursing," "simulation," "human patient," and "simulator," we identified 2279 potentially relevant articles. Forty studies met the inclusion criteria and were retained in the analysis. RESULTS: This meta-analysis showed that simulation-based nursing education was effective in various learning domains, with a pooled random-effects standardized mean difference of 0.70. Subgroup analysis revealed that effect sizes were larger for high-fidelity simulation (0.86), medium-fidelity simulation (1.03), and standardized patients (0.86) than they were for low-fidelity and hybrid simulations. In terms of cognitive outcomes, the effect size was the largest for high-fidelity simulation (0.50). Regarding affective outcome, high-fidelity simulation (0.80) and standardized patients (0.73) had the largest effect sizes. CONCLUSIONS: These results suggest that simulation-based nursing educational interventions have strong educational effects, with particularly large effects in the psychomotor domain. Since the effect is not proportional to fidelity level, it is important to use a variety of educational interventions to meet all of the educational goals.

ChatGPT is the world’s most advanced chatbot thus far. Unlike other chatbots, it can create impressive prose within seconds, and it has created much hype and doomsday predictions when it comes to student assessment in higher education and a host of other matters. ChatGPT is a state-of-the-art language model (a variant of OpenAI’s Generative Pretrained Transformer (GPT) language model) designed to generate text that can be indistinguishable from text written by humans. It can engage in conversation with users in a seemingly natural and intuitive way. In this article, we briefly tell the story of OpenAI, the organisation behind ChatGPT. We highlight the fundamental change from a not-for-profit organisation to a commercial business model. In terms of our methods, we conducted an extensive literature review and experimented with this artificial intelligence (AI) software. Our literature review shows our review to be amongst the first peer-reviewed academic journal articles to explore ChatGPT and its relevance for higher education (especially assessment, learning and teaching). After a description of ChatGPT’s functionality and a summary of its strengths and limitations, we focus on the technology’s implications for higher education and discuss what is the future of learning, teaching and assessment in higher education in the context of AI chatbots such as ChatGPT. We position ChatGPT in the context of current Artificial Intelligence in Education (AIEd) research, discuss student-facing, teacher-facing and system-facing applications, and analyse opportunities and threats. We conclude the article with recommendations for students, teachers and higher education institutions. Many of them focus on assessment.

BACKGROUND: This literature review on nursing journal clubs evaluates the efficacy of the teaching strategy within the clinical setting. METHOD: Peer-reviewed articles were retrieved using an online journal database. Inclusion criteria incorporated information on efficacy of the teaching strategy, evidence-based practices, and continuing education as they related to nursing journal club initiatives. RESULTS: The literature cited numerous benefits and proved to be in favor of nursing journal clubs. The most common benefits found were nurses remaining abreast of current research, skill development in reading and critically appraising research, and incorporation of evidenice-based practices to patient care. Due to the self-motivated and voluntary nature of this teaching strategy, a limitation commonly identified was lack of participation, and further research on this limitation often was suggested. CONCLUSION: Nursing journal clubs proved to be an effective teaching strategy; a finding that remains consistent with the medical pioneers of the movement.

Sir William Osler organized a journal club at McGill University in 1875, and several authors suggest that journal clubs were found in certain European countries (in particular, Germany and England) prior to that time. The evolution and development of the journal club, however, has not been recorded in the medical literature. Through personal communications and interviews with senior clinicians and historians, I have traced the history of the journal club as an educational modality. In the early 1900s in Germany, journal clubs were routinely found in departments of medicine and medical schools. From 1917-1975, journal clubs evolved into a forum for continuing medical education. Recently, journal clubs have been designed to teach critical appraisal skills to physicians-in-training. Journal clubs are currently found in the fields of medicine, surgery, psychiatry, nursing, pharmacy, obstetrics and gynaecology, paediatrics and geriatric social service. This powerful educational tool has played an active role in medical education for over a century. The journal club should be more formally incorporated into the medical educational curriculum.

ChatGPT is an artificial intelligence (AI)-based conversational large language model (LLM). The potential applications of LLMs in health care education, research, and practice could be promising if the associated valid concerns are proactively examined and addressed. The current systematic review aimed to investigate the utility of ChatGPT in health care education, research, and practice and to highlight its potential limitations. Using the PRIMSA guidelines, a systematic search was conducted to retrieve English records in PubMed/MEDLINE and Google Scholar (published research or preprints) that examined ChatGPT in the context of health care education, research, or practice. A total of 60 records were eligible for inclusion. Benefits of ChatGPT were cited in 51/60 (85.0%) records and included: (1) improved scientific writing and enhancing research equity and versatility; (2) utility in health care research (efficient analysis of datasets, code generation, literature reviews, saving time to focus on experimental design, and drug discovery and development); (3) benefits in health care practice (streamlining the workflow, cost saving, documentation, personalized medicine, and improved health literacy); and (4) benefits in health care education including improved personalized learning and the focus on critical thinking and problem-based learning. Concerns regarding ChatGPT use were stated in 58/60 (96.7%) records including ethical, copyright, transparency, and legal issues, the risk of bias, plagiarism, lack of originality, inaccurate content with risk of hallucination, limited knowledge, incorrect citations, cybersecurity issues, and risk of infodemics. The promising applications of ChatGPT can induce paradigm shifts in health care education, research, and practice. However, the embrace of this AI chatbot should be conducted with extreme caution considering its potential limitations. As it currently stands, ChatGPT does not qualify to be listed as an author in scientific articles unless the ICMJE/COPE guidelines are revised or amended. An initiative involving all stakeholders in health care education, research, and practice is urgently needed. This will help to set a code of ethics to guide the responsible use of ChatGPT among other LLMs in health care and academia.

BACKGROUND: Emotional labour has been widely accepted in the literature as part of nursing work, however the contribution of emotional intelligence in the nursing context requires further study. AIM: This paper aims to present an analysis of the literature on emotional intelligence and emotional labour, and consider the value of emotional intelligence to nursing. METHOD: A literature search was undertaken using the CINAHL and MEDLINE databases. Search terms used were 'emotions', 'intelligence', 'emotions and intelligence' and 'emotional labour'. A hand-search of relevant journals and significant references added to the data. RESULTS: Emotional intelligence plays an important part in forming successful human relationships. Emotional labour is important in establishing therapeutic nurse-patient relationships but carries the risk of 'burnout' if prolonged or intense. To prevent this, nurses need to adopt strategies to protect their health. The potential value of emotional intelligence in this emotional work is an issue that still needs to be explored. CONCLUSIONS: Analysis of the literature suggests that the modern demands of nursing draw on the skills of emotional intelligence to meet the needs of direct patient care and co-operative negotiations with the multidisciplinary team. The significance of this needs to be recognized in nurse education. The link between emotional intelligence and emotional labour is a fruitful area for further research. The potential benefits of gaining a better understanding of how these concepts interact is largely conjecture until we have more evidence. The prospect that there may be advantages to both nurses and patients is a motivating factor for future researchers.

AIM: The aim of this study was to report an analysis of the clinical learning environment concept. BACKGROUND: Nursing students are evaluated in clinical learning environments where skills and knowledge are applied to patient care. These environments affect achievement of learning outcomes, and have an impact on preparation for practice and student satisfaction with the nursing profession. Providing clarity of this concept for nursing education will assist in identifying antecedents, attributes and consequences affecting student transition to practice. DESIGN: The clinical learning environment was investigated using Walker and Avant's concept analysis method. DATA SOURCES: A literature search was conducted using WorldCat, MEDLINE and CINAHL databases using the keywords clinical learning environment, clinical environment and clinical education. Articles reviewed were written in English and published in peer-reviewed journals between 1995-2014. METHODS: All data were analysed for recurring themes and terms to determine possible antecedents, attributes and consequences of this concept. RESULTS: The clinical learning environment contains four attribute characteristics affecting student learning experiences. These include: (1) the physical space; (2) psychosocial and interaction factors; (3) the organizational culture and (4) teaching and learning components. These attributes often determine achievement of learning outcomes and student self-confidence. CONCLUSION: With better understanding of attributes comprising the clinical learning environment, nursing education programmes and healthcare agencies can collaborate to create meaningful clinical experiences and enhance student preparation for the professional nurse role.

The ability for nurse educators to improve the empathy skill set of nurses has been the subject of several studies with varied outcomes. The aim of this paper is to review the evidence for empathy education programmes in nursing and make recommendations for future nurse education. A review of CINAHL, Medline, Psych Info and Google Scholar was undertaken using the keywords empathy, person centredness, patient centredness, client centredness, education and nursing. The studies included were required to have measured the effectiveness of empathy training in postgraduate and or undergraduate nurses. The included studies incorporated both qualitative and quantitative methods and were published in peer-reviewed journals. Studies were ranked for level of evidence according to The Joanna Briggs Institute criteria. Seventeen studies from the literature review were found that met the inclusion criteria. Of the 17 studies, 11 reported statistically significant improvements in empathy scores versus six studies that did not. Several variables may affect empathy education that need to be accounted in future studies such as; gender, cultural values and clinical speciality experience. Models of education that show most promise are those that use experiential styles of learning. The studies reviewed demonstrated that it is possible to increase nurses' empathic ability.