Clinical simulation as a teaching methodology allows the student to train and learn technical abilities and/or non-technical abilities. One of the key elements of this teaching methodology is the ...debriefing, which consists of a conversation between several people, in which the participants go over a real or simulated event in order to analyze their actions and reflect on the role that thought processes, psychomotor skills and emotional states can play in maintaining, or improving their performance in the future. The Debriefing Experience Scale allows the experience of students in debriefing to be measured. The objective of this study is to translate the Debriefing Experience Scale (DES) into Spanish and analyze its reliability and validity to measure the experience of nursing students during the debriefing. The study was developed in two phases: One: the adaption of the instrument to Spanish, two: a transversal study carried out in a sample of 290 nursing students. The psychometric properties were analyzed in terms of reliability and construct validity using confirmatory factorial analysis (CFA). Cronbach's alpha was adequate for all the scales and for each one of the dimensions. The confirmatory factorial analysis showed that the 4-dimensional model is acceptable for both scales (experience and opinion). The Spanish version Debriefing Experience Scale questionnaire is useful, valid and reliable for use to measure the debriefing experience of university students in a simulation activity.
The European Higher Education Area (EHEA) recommends the use of new educational methodologies and the evaluation of student satisfaction. Different instruments have been developed in Spain to ...evaluate different aspects such as clinical decisions and teamwork, however no instruments have been found that specifically evaluate student self-confidence and satisfaction during clinical simulation. The aim was to translate the Student Satisfaction and Self-Confidence in Learning Scale (SCLS) questionnaire into Spanish and analyse its reliability and validity and understand the level of satisfaction and self-confidence of nursing students with respect to learning in clinical simulations. The study was carried out in two phases: (1) adaptation of the questionnaire into Spanish. (2) Cross-sectional study in a sample of 489 nursing students. The reliability and exploratory and confirmatory factorial analyses were performed. To analyse the relationship of the scale scores with the socio-demographic variables, the Fisher Student T-test or the ANOVA was used. The scale demonstrated high internal consistency reliability for the total scale and each of its dimensions. Cronbach’s alpha was 0.88 (0.83 to 0.81) for each of the dimensions. The exploratory and confirmatory factor analysis showed that both the one-dimensional and two-dimensional models were acceptable. The results showed average scores above 4 for both dimensions. The SCLS-Spanish translation demonstrated evidence of its validity and reliability for use to understand the level of satisfaction and self-confidence of nursing students in clinical simulation. Clinical simulations help students to increase their levels of confidence and satisfaction, enabling them to face real scenarios in clinical practice.
To assess the incidence and determinants of ICU-acquired muscle weakness (ICUAW) in adult patients with enteral nutrition (EN) during the first 7 days in the ICU and mechanical ventilation for at ...least 48 hours.
A prospective, nationwide, multicentre cohort study in a national ICU network of 80 ICUs. ICU patients receiving invasive mechanical ventilation for at least 48 hours and EN the first 7 days of their ICU stay were included. The primary outcome was incidence of ICUAW. The secondary outcome was analysed, during days 3-7 of ICU stay, the relationship between demographic and clinical data to contribute to the onset of ICUAW, identify whether energy and protein intake can contribute independently to the onset of ICUAW and degree of compliance guidelines for EN.
319 patients were studied from 69 ICUs in our country. The incidence of ICUAW was 153/222 (68.9%; 95% CI 62.5%-74.7%). Patients without ICUAW showed higher levels of active mobility (p = 0.018). The logistic regression analysis showed no effect on energy or protein intake on the onset of ICUAW. Overfeeding was observed on a significant proportion of patient-days, while more overfeeding (as per US guidelines) was found among patients with obesity than those without (42.9% vs 12.5%; p<0.001). Protein intake was deficient (as per US/European guidelines) during ICU days 3-7.
The incidence of ICUAW was high in this patient cohort. Early mobility was associated with a lower incidence of ICUAW. Significant overfeeding and deficient protein intake were observed. However, energy and protein intake alone were insufficient to explain ICUAW onset.
Low mobility, high incidence of ICUAW and low protein intake suggest the need to train, update and involve ICU professionals in nutritional care and the need for early mobilization of ICU patients.
The Educational Practices Questionnaire is an instrument for assessing students perceptions of best educational practices in simulation. As for other countries, in Spain, it is necessary to have ...validated rubrics to measure the effects of simulation. The objective of this study was to carry out a translation and cultural adaptation of the Educational Practices Questionnaire into Spanish and analyze its reliability and validity. The study was carried out in two phases: (1) adaptation of the questionnaire into Spanish. (2) Cross-sectional study in a sample of 626 nursing students. Psychometric properties were analyzed in terms of reliability and construct validity by confirmatory and exploratory factor analysis. The exploratory and confirmatory factor analyses showed that the one-dimensional model is acceptable for both scales (presence and importance). The results show that the participants' scores can be calculated and interpreted for the general factor and also for the four subscales. Cronbach's alpha and the Omega Index were also suitable for all the scales and for each of the dimensions. The Educational Practices Questionnaire is a simple and easy-to-administer tool to measure how nursing degree students perceive the presence and importance of best educational practices.
Anaemia is a common issue in patients who are admitted to intensive care units and worsens their condition throughout the stay due to the extraction of blood for diagnostic purposes. It is also ...well-known that an important amount of the carbon dioxide produced by health services is likely attributable to blood donation, testing and manufacture, storage or distribution of blood components. This must be taken into account to perform nursing interventions consistent with the idea of sustainable health care. In this regard, within patient blood management bundles, with the objective of minimizing the use of blood products, it is recommended to use blood-sparing techniques: small volume tubes (SVT) or closed-blood sampling devices (CBSD). Published studies before 2014 (excepting two more recent ones) have shown that by themselves, both techniques reduce drawn volume but do not decrease haemoglobin reduction and/or need of transfusion. Given the lack of cost-effectiveness studies, it may be easier to implement the use of CBSD as it does not require prior consensus on the discard volume or adaptations in the processing of laboratory tests, as is the case with SVT.
Interprofessional teamwork training of nursing undergraduates is essential to improving healthcare. The absence of clear role definitions and poor interprofessional communications have been listed as ...the main reasons behind abandonment of the profession by recently graduated nurses.
The aim of this parallel randomized clinical trial was to evaluate the impact of Situation-Background-Assessment-Recommendation (SBAR) role-play training on interprofessional teamwork skills (role-related and communication-related) and non-technical skills (patient assessment, patient intervention, patient safety, and critical thinking).
The intervention group were taught teamwork skills, role and task assignment skills, and use of the SBAR worksheet in a 1-hour role-play training session, while the control group received conventional lecture-based training. Teamwork and non-technical skills were then assessed in high-fidelity simulation scenarios using the KidSIM Team Performance Scale (teamwork skills) and the Clinical Simulation Evaluation Tool (non-technical skills). Cohen's d (d) was used to examine effect size differences.
Compared to the control group, the intervention group improved in 4 teamwork items – ‘verbalize out loud’ (p < 0.001, d = 0.99), ‘paraphrase’ (p < 0.001, d = 0.77), ‘cross-monitoring’ (p < 0.001, d = 0.72), and ‘role clarity’ (p = 0.002, d = 0.66) – and in a single non-technical skill (patient intervention: p = 0.004, d = 0.66), while also reporting greater confidence in performing patient assessments (p = 0.02, d = 0.56).
Role-play and SBAR training for undergraduate nurses improved patient intervention, enhanced information sharing in an interprofessional team, and raised awareness of their own and other team members' roles.
•Role-playing in SBAR improves the interventions of students on a simulated patient.•Simulations enabled students to develop competence in teamwork.•A better communication and teamwork performance correlates with an enhancement in the Patient Assessment & decision-making.
Purpose
To compare skills acquired by undergraduate nursing students enrolled in a medical‐surgical course. To compare skills demonstrated by students with no previous clinical practice ...(undergraduates) and nurses with clinical experience enrolled in continuing professional education (CPE).
Design
In a nonrandomized clinical trial, 101 undergraduates enrolled in the “Adult Patients 1” course were assigned to the traditional lecture and discussion (n = 66) or lecture and discussion plus case‐based learning (n = 35) arm of the study; 59 CPE nurses constituted a comparison group to assess the effects of previous clinical experience on learning outcomes.
Methods
Scores on an objective structured clinical examination (OSCE), using a human patient simulator and cases validated by the National League for Nursing, were compared for the undergraduate control and intervention groups, and for CPE nurses (Student's t test).
Findings
Controls scored lower than the intervention group on patient assessment (6.3 ± 2.3 vs 7.5 ± 1.4, p = .04, mean difference, ‐1.2 95% confidence interval (CI) ‐2.4 to ‐0.03) but the intervention group did not differ from CPE nurses (7.5 ± 1.4 vs 8.8 ± 1.5, p = .06, mean difference, ‐1.3 95% CI ‐2.6 to 0.04). The CPE nurses committed more “rules‐based errors” than did undergraduates, specifically patient identifications (77.2% vs 55%, p = .7) and checking allergies before administering medication (68.2% vs 60%, p = .1).
Conclusions
The intervention group developed better patient assessment skills than the control group. Case‐based learning helps to standardize the process, which can contribute to quality and consistency in practice: It is essential to correctly identify a problem in order to treat it. Clinical experience of CPE nurses was not associated with better adherence to safety protocols.
Clinical Relevance
Case‐based learning improves the patient assessment skills of undergraduate nursing students, thereby preparing them for clinical practice.
Many interprofessional education programs are being designed to help students improve their collaborative practice. Traditionally, the evaluation of these programs is focused on attitudes, knowledge ...and skills, but according to some authors, the evaluation of these activities should be expanded to include the evaluation of the development of an interprofessional identity. The Interprofessional Socialization and Valuing Scale (ISVS) is a self-report tool used to measure interprofessional socialization, but it has not been validated with Spanish students. In this study, the tool was translated into Spanish and administered to a sample of 645 undergraduate students. The data were analyzed to estimate structural validity, internal consistency and convergent validity. Regarding the structural validity, our data supported the unidimensional model found in the English version of the ISVS-21 (normed chi-square = 2.3, RMSEA = 0.045, SRMR = 0.087, CFI = 0.963 and TLI = 0.969). The internal consistency reliability of the scale was adequate, Cronbach α = 0.913 95% CI 0.903, 0.923. The Spanish version of the ISVS-21 shows adequate psychometric properties in terms of the construct validity (structural validity and convergent validity) and internal consistency of its scores. This study provides the Spanish-speaking population with an adaptation of the only instrument that has been specifically developed to assess interprofessional socialization.
This column shares the best evidence‐based strategies and innovative ideas on how to facilitate the learning of EBP principles and processes by clinicians as well as nursing and interprofessional ...students. Guidelines for submission are available at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1741‐6787
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