Head-to-toe assessment skills are core to nursing practice, but clinical settings often limit opportunities for skill reinforcement and growth. This study synthesized existing literature on continuing education programs on head-to-toe assessment and presents a case study highlighting a successful educational model that enhances nurses' clinical judgment and early detection skills. This narrative review analyzed current literature on head-to-toe assessment continuing education, along with presenting a detailed case study of a voluntary continuing education program implemented within an integrated health care system. The literature shows that structured, experiential learning methods enhance nurses' confidence and assessment skills. The described continuing education program, based on adult learning principles and simulation-based techniques, resulted in improved clinical judgment, increased confidence, and enhanced recognition of patient deterioration among participating nurses. Continuing education programs on comprehensive head-to-toe assessment that use experiential learning methods effectively enhance nursing clinical skills and improve patient safety outcomes. Regular reinforcement of skills through structured continuing education interventions is crucial for maintaining assessment competency across all levels of nursing experience.
Extended reality (XR), encompassing virtual, augmented, and mixed reality, creates immersive educational environments that connect theory with practice, and it is increasingly used in continuing professional development. This scoping review examines current literature on XR technologies for nursing professional development. Literature published between January 2022 and March 2025 was synthesized from the MEDLINE, Scopus, and CINAHL databases. Twenty-five studies met the inclusion criteria, spanning 10 countries, with sample sizes ranging from seven to 1,868 nurses. Virtual reality was the predominant modality (84% of interventions), mostly in hospital settings. Five primary themes emerged: (1) learning outcomes and educational effectiveness, (2) technical and implementation challenges, (3) realism and fidelity considerations, (4) specialized clinical applications, and (5) user experience and engagement. Interventions that used XR improved clinical knowledge, confidence, and procedural skills, with some studies reporting advantages over traditional methods, despite challenges such as cybersickness, infrastructure limits, financial constraints, and limited haptic feedback.
Until spring 2023, nurses in professional development did not have terminal degree options tailored to their needs. In response, The Ohio State University College of Nursing launched the Doctor of Nursing Education (DNE) program with two tracks: academic nurse educator and nursing professional development (NPD). This program addresses the national shortage of doctorally prepared nurse educators and prepares graduates to lead educational change. This article describes the curriculum and leadership focus of the NPD track of the DNE program, aligned with the Association for Nursing Professional Development scope and standards of practice (2022). It highlights four capstone projects implemented by NPD practitioners in health care settings. Students conducted evidence-based, quality improvement, and program evaluation projects that improved clinical teaching, nurse certification, interdisciplinary collaboration, and new graduate nurse mentoring. These NPD projects highlight the transformative impact of the DNE program, illustrating how doctoral education drives meaningful improvements in health care practice across diverse settings.
Gamified learning may offer an accessible, time-efficient, and engaging modality for continuing education for nurses working in an intensive care unit (ICU). This study evaluated the effectiveness of a role-playing video game in improving ICU nurses' knowledge of train-of-four monitoring and assess attitudes toward gamified learning. A single-arm pretest-posttest study was conducted with 17 nurses working in a surgical ICU. Participants completed an eight-item test before and after a 15-minute tablet-based game involving clinical decision-making. The Wilcoxon signed-rank test was used to compare pretest and posttest results. An 11-item postgame survey was used to assess engagement, usability, and the learning experience. Mean scores improved from 3.41 to 7.12 of a possible score of 8 (p < .001). Most nurses found the game engaging (88.2%), easy to use (94.1%), and educationally effective (100%). Participant comments praised its relevance and interactivity. A short, gamified intervention was well received and was associated with improved knowledge of train-of-four monitoring. Gamification may be a valuable tool for the future of clinical education.
Training programs for cardiovascular specialist nurses in China lack standardized evaluation frameworks. This study developed a structured evaluation model based on the Workplace-Based Assessment (WPBA) guided by Miller's Pyramid of clinical competence. A Delphi method was employed, involving 15 cardiovascular nursing education experts who participated in two consultation rounds. Initial evaluation items were derived from literature reviews and expert group discussions. Consensus and content validity were assessed using descriptive statistics and Kendall's coefficient of concordance. Experts achieved strong consensus, validating a comprehensive evaluation model comprising four integrated assessment components: theoretical knowledge examination, Mini-Clinical Evaluation Exercise (Mini-CEX), Direct Observation of Procedural Skills (DOPS), and Case-Based Discussion (CBD). Each assessment aligns with one level of Miller's Pyramid, ensuring a comprehensive evaluation from theoretical knowledge to clinical performance. Consensus analysis demonstrated high expert agreement and consistency across assessment criteria and clinical sites. This structured assessment model addresses existing gaps in advanced nursing education, offering standardized and objective evaluations of trainee competencies. This evaluation framework contributes substantially to advancing nursing education and enhancing cardiovascular health care quality through better trained specialist nurses.
Nurses often face high workloads, limited supervision, and challenging conditions. This study was conducted to assess the competence of clinical nurses and explore driving forces for nursing competence in a mountainous area of Vietnam. A cross-sectional survey was conducted among 356 clinical nurses working at nine district health centers, using a structured self-administered questionnaire. Logistic regression was used to examine factors associated with higher competence. Of the nurses, 67.4% reported good overall competence. The highest rated domains were comprehensive care practice and collaboration with colleagues in patient care. However, notable gaps were noted in patient-centered competencies, especially patient communication and education (62.4%), prioritization of care based on patient needs (70.2%), and medication guidance communication (71.9%). Nurses who reported higher job motivation (odds ratio = 7.9, p < .001) and recent training (odds ratio = 3.6, p < .001) showed notably better competence. These findings highlight critical areas for improvement, particularly in patient-centered communication skills. Targeted training initiatives and strategies to enhance professional motivation are essential interventions to address these competence gaps, thereby improving health care quality and workforce retention in underserved mountainous areas.
Although nursing curricula focus on preparing students for entry to practice, the limited clinical judgment skills of novice and newly hired registered nurses in practice can lead to adverse patient outcomes. This study was conducted to improve clinical judgment skills and perceived confidence in clinical judgment of novice and newly hired nurses. The study used a quasi-experimental, criterion-referenced educational evaluation design. The 90-minute intervention included two simulation encounters lasting 12 to 15 minutes. Participants (n = 152) reported high post-intervention confidence in recognizing cues, prioritizing hypotheses, and executing clinical interventions. Ratings across all domains on the Lasater Clinical Judgment Rubric suggest that simulation-based education, guided by the National Council of State Boards of Nursing Clinical Judgment Measurement Model framework, can be a powerful tool for enhancing clinical judgment. Findings from this study may further validate the use of simulation in both clinical practice and educational settings.
Nutritional support is vital for critically ill patients, especially during infectious disease outbreaks. Intensive care unit (ICU) nurses, as frontline providers, face unique challenges in delivering effective nutritional care. This study explored ICU nurses' experiences in providing nutritional care to patients with infectious diseases in high-risk settings. This study aimed to identify and describe the barriers, processes, and practical experiences associated with providing nutritional support to ICU patients during an infectious disease outbreak. Data were collected through semi-structured interviews and analyzed using content analysis. Trustworthiness was ensured through triangulation, peer debriefing, and member checking. Three themes emerged: Importance of Nutrition, Nutritional Challenges, and Nutritional Support Strategies. Nurses emphasized nutrition's contribution to immunity and clinical stability. Barriers included isolation protocols, feeding complications, workload, and resource limitations. ICU nurses play a critical role in sustaining nutritional care during infectious crises. Their experiences point to the need for stronger support systems and collaboration. Findings support incorporating outbreak-specific nutrition and emotional resilience training into continuing education to better prepare ICU nurses for future challenges.
Trauma training for nurses is essential for quality trauma care. Whereas traditional offline workshops face spatiotemporal limitations, online training models offer a necessary evolution in the information era. A total of 276 trauma nurses from tertiary hospitals in Hubei Province, participating in the China Trauma Care Training-Nurse, were divided into groups participating in a real-time interactive cloud-based workshop (n = 144) and a traditional offline workshop (n = 132) to compare the effectiveness of training and participant satisfaction. No significant differences were found in demographic characteristics, theoretical and practical scores, core competences, teaching atmosphere, learning efficiency, and overall satisfaction (p > .05). However, the nurses in the real-time interactive cloud-based workshop group had higher satisfaction with the teaching format and design (p < .01). The real-time interactive cloud-based workshop sparked interest in learning, created a new learning atmosphere, and achieved equivalent teaching effectiveness and recognition compared with a traditional offline workshop.
This study explored the transition experiences of newly graduated nurses in pediatric clinical practice through the lens of Meleis's Transitions Theory and examined how simulation-based education can support this transition. A qualitative study was conducted using focus group interviews with six novice nurses in a tertiary hospital in South Korea. Data were analyzed using directed content analysis based on Meleis's Transitions Theory. Three major themes emerged: Difficulty Managing Caregivers' Emotions and Building Trust, Limited Age-Specific Communication Skills, and Lack of Exposure to Diverse or Complex Pediatric Conditions. Participants reported that current simulation programs emphasize technical procedures and lack preparation for the emotional and relational aspects of care. Emotional preparedness is a critical yet underdeveloped component of continuing education for novice pediatric nurses. Incorporating emotionally immersive and developmentally diverse simulation scenarios may enhance clinical readiness and support professional identity formation.
The Brilliant at the Basics Leadership Presentation Series represents an output of a strategic collaboration between academic and clinical partners that addresses the gap between theoretical leadership education and practical application in health care settings. In response to evolving post-pandemic challenges and changing organizational needs, this initiative delivered an enhanced 8-month program focused on developing core leadership competencies (e.g., decision-making, conflict resolution, and communication) among nursing and interprofessional leaders that built on the framework of the original series from 2018. Participant feedback reflected overall program satisfaction, and both partners regarded the leadership series as beneficial. This article offers insight for nurses and institutions interested in offering continuing education in leadership development, especially within the academic-practice partnership setting. In addition, this article describes an academic-practice partnership that successfully collaborated in sustaining a much needed up-to-date training program.
This column examines barriers to applying evidence in both undergraduate nursing education and continuing professional development, emphasizing the role of nursing professional development specialists in supporting the use of evidence in practice. Strategies are proposed to strengthen the integration of evidence-based practice across academic and clinical environments to enhance nursing care quality.
Long-term care and home and community care sectors face severe nursing shortages, intensified by COVID-19. Nurse bridging education (NBE) programs may enhance career mobility, professional development, and workforce stability in these sectors. This study explored perceptions of nurse educators, supervisors, and bridging students of the role of NBE programs in recruitment and retention. Interpretive description guided focus groups with educators and supervisors, and individual interviews with students. Thematic analysis was used to interpret the data. Twenty-five participants (4 educators, 6 supervisors, 15 students) contributed. Two themes emerged: (1) Supporting Bridging Students Through Role Transition, and (2) Optimizing Learning Experiences for Working Students. System-level challenges, including funding allocation, limited placements, and wage disparities, constrained recruitment and retention. Findings suggest supervisors can improve retention through mentorship and flexibility, whereas academic-practice partnerships and government investment in placements and wage parity are critical to addressing workforce shortages.
Advance care planning is essential in nursing homes to ensure end-of-life care aligns with residents' values, yet staff often lack the knowledge and confidence to lead these discussions. This study evaluated an advance care planning training program for 37 nursing home staff in Taiwan using a participatory action research design. The 3-month intervention included lectures, videos, role-playing, and biweekly case discussions. Data were collected at four time points (T0-T3). The program led to statistically significant, sustained improvements in advance care planning knowledge and communication confidence across all measurement points. Qualitative findings revealed two themes: enhanced readiness for advance care planning consultations and persistent barriers to implementation. Structured training in advance care planning can strengthen staff capacity for meaningful end-of-life discussions; however, ongoing education and case-based support remain essential to address contextual challenges and maintain communication competence.
This study used a qualitative research design with thematic analysis informed by phenomenological concepts to explore the lived experience of new graduate nurses during their first year of professional practice. The focus was on nurses who were within 1 month of completion of a structured transition program and were working on a clinical unit. Understanding their perceptions of support during this critical period is essential to improving retention and professional satisfaction. Data were collected through surveys of new graduate nurses as they neared the end of the transition program and completed their first year of nursing practice. The study examined their personal experiences and perceptions of support systems and contextual factors that shaped their transition to a professional nursing role. Consistent themes of role strain, emotional stress, and the importance of accessible mentorship emerged. Supportive work environments and structured preceptorships were identified as key elements in easing the transition and improving confidence and competence. The findings suggest that enhanced support strategies during and after a transition program can reduce stress, foster professional growth, and improve nurse retention.
As nurses constantly face increasing work demands, their efforts to engage in their own development can be challenged. Digital storytelling, previously used to support nursing students' reflection on clinical practice, may also hold potential benefits for practicing nurses. This study explored clinical nurses' experiences of reflecting on digital stories created by nursing students as part of a learning activity during clinical practice. The study used an exploratory qualitative design. Data were collected through three semi-structured focus group interviews with nurses on a hospital clinical unit and at a nursing home. Data were analyzed with Granheim and Lundman's (2004) qualitative content analysis. Based on the analysis, students' digital stories (1) provide an oasis for reflection, (2) open learners up to different perspectives, and (3) engage learners from reflection to action. Students' digital stories can be a valuable contribution to continuing education for professional nurses. Further research should focus on long-term strategies for implementing the digital story activity as a part of everyday life on clinical units.
This article explores how nursing professional development (NPD) practitioners can use artificial intelligence (AI) and generative artificial intelligence (Gen AI) across each phase of the ADDIE (Analyze, Design, Develop, Implement, Evaluate) instructional design model to drive timely, personalized, data-driven education that aligns with health care system priorities, boosts learner engagement, and improves outcomes. The authors describe ways to use AI according to the ADDIE framework for NPD education, including the benefts and risks of this technology. Integrating Gen AI within the ADDIE framework positions NPD practitioners as strategic enablers of agile, responsive education. It allows for faster, tailored content development, real-time learner adaptation and evaluation, and alignment of education with organizational performance. Applying Gen AI within the ADDIE framework provides a structured, yet flexible strategy to operationalize innovation. When intentionally integrated within the ADDIE framework, these technologies allow NPD practitioners to assess, design, develop, implement, and evaluate education programs that are agile, scalable, and directly aligned with organizational goals.
Distinguishing between nursing competency and education in clinical health care is multidimensional. The NYU Langone Health Nursing Education and Competency Algorithm (NE-CA) was developed to guide competency identification. A qualitative study was conducted to elicit dialogue through focus groups to identify themes specifically related to use of the NE-CA. The results of this qualitative research include four major themes: algorithm, competency, competency assessment process, and education. Findings from the focus groups support the application of the NE-CA by clinical nurse educators, professional registered nurses, and organizational stakeholders guiding competency and education.
Questions continue to arise as to what exactly Doctor of Nursing Practice (DNP) practitioners are doing differently in practice. The DNP Leaders in Practice Assessment (DNPLPA) Tool was developed for this reason and was the instrument used in this study. Data from a mixed-methods online study of a national sample of 208 practicing DNP nurses are reported. Means are reported, and the Staff Outcomes-based questions had the highest mean, followed closely by the Patient/Population Outcomes questions. Themes were created from the qualitative data that reflected three main categories: Implementation, Dissemination, and Professional Expectations. Exemplars demonstrated the wide range of activities of DNPs in practice today. Data validate that DNP practitioners are making major impacts in practice, education, and service, and through scholarly activities. The DNPLPA Tool collected a wealth of data that adds depth and breadth to the nursing body of DNP practice today.
Use of evidence-based practice (EBP) is imperative to ensure safe patient care; however, literature reveals that nurses identify barriers to developing and implementing EBP, such as lack of knowledge, training, and mentorship. The purpose of this study was to explore the effects of an instructor-led EBP program on nurses' beliefs, implementation self-efficacy, and competency using EBP in a clinical setting. The eight-session program included instruction and interactive activities covering EBP implementation strategies following the Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care. Pre- and post-program survey data were used to evaluate program effectiveness. Statistical analysis of survey responses from 11 participants revealed significant improvements in EBP beliefs and self-perceived competency to engage in EBP. Non-significant improvements were seen in EBP implementation self-efficacy. The findings validate the effectiveness of an intentional, RN-tailored educational initiative in elevating nurses' EBP beliefs, competency, and implementation self-efficacy.