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Aim The study aimed to evaluate the effectiveness of the collaborative teaching of a multi- disciplinary team on the introductory online radiology session for the Master of Nursing students. Background The teaching method for basic radiology reading for the Master of Nursing program was delivered via a 4-hour didactic face-to-face lesson and was ineffective as evidenced by the students' feedback and evaluation. Therefore, a multi-disciplinary team consisting of nursing, medical and radiology staff developed a 4-week online radiology session to enhance knowledge, attitudes and confidence of the Master of Nursing students in interpreting basic chest radiographs, abdominal radiographs and computed tomographic brain scans. Methods A quasi-experimental study design using pre-test and post-test was adopted. The effectiveness of the online radiology session was evaluated on the students' knowledge, attitudes, and confidence. Forty Master of Nursing program students completed the pre-test and post-test questionnaires (response rate 74%) and responded to the open-ended questions in the post-test. IBM-SPSS was used to analyse the quantitative data and quantifying qualitative data technique was used to analyse the qualitative data. Results The participants demonstrated an improvement in knowledge and confidence mean scores of the post-test compared to pre-test. There was improved self-rated proficiency in reading and interpreting a film radiograph but no difference in the way they perceived the importance of radiological investigations vis-a-vis the physical examination and routine laboratory testing. Quantifying quantitative data technique showed that majority of participants appreciated the learning process as it could be done at their own pace and the lectures could be replayed again. However, participants hoped for improved interaction with the tutor during learning and the use of real-life cases in the scenarios. Conclusion Collaborative teaching using an online radiology session shows promise over a traditional didactic method of teaching but requires further refinement in terms of participant interaction and the use of case examples.

Aim The aims of this study were to explore year two nursing students' perceptions toward critical thinking and clinical reasoning and to identify the barriers faced by the students in developing critical thinking and clinical reasoning. Background Critical thinking and clinical reasoning are core competencies emphasized in nursing practices. Nursing students are required to develop and practice these skills throughout their nursing programs to graduate as competent nurses. However, recent studies still report a lack of critical thinking and clinical reasoning in nursing students and fresh graduates. Hence, it is important to recognize the perceptions of nursing students and the barriers that they face in developing critical thinking and clinical reasoning skills. Methods An exploratory descriptive qualitative study design was adopted. Twenty nursing students were recruited from a university in Singapore. Individual face-to-face interviews, using semi-structured questions and an interview guide, were conducted in the academic year 2018/2019. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to analyze the data. Results Seven themes were emerged, namely: 1) essentials for nursing practices, 2) linking theory to practice, 3) individual thought process, 4) stimulating strategies, 5) classroom environment, 6) clinical environment, and 7) students' attributes. Nursing students perceived critical thinking and clinical reasoning as essential for nursing practices and described these skills as linking theory to practice. Strategies such as simulation, case studies, real clinical experiences, and guidance from clinical instructors/preceptors were found to stimulate critical thinking and clinical reasoning for the students. Barriers to developing critical thinking included classroom environments, such teaching methods and student-to-tutor ratios, ward environments/cultures, and students' attributes/attitudes toward learning. Conclusion The findings provided areas for improvement in the current nursing education and practices to better support nursing students in developing critical thinking and clinical reasoning skills.

The Institute of Medicine (IOM) and the Health Information Technology Act (2009) in America had recommended that electronic health records (EHRs) should be fully adopted by 2014. This has urged educational institutions to prepare healthcare professionals to be competent in using electronic health records (EHRs) while they are in schools. To equip nursing students with competency in using EHRs, an electronic health record for nursing education (EHRNE) has been developed and integrated it into nursing curricula. The purposes of the study were to investigate the factors influencing nursing students' acceptance of the EHRs in nursing education using the extended Technology Acceptance Model with self-efficacy as a conceptual framework. The study is a descriptive study design using self-reported questionnaires with 212 student participants. The IBM SPSS and AMOS 22.0 were used to analyze the data. The results showed that attitude toward using the EHRNE was the most influential factor on students' acceptance. The preliminary findings suggested that to enhance the students' acceptance of the EHRNE, cultivation of a positive attitude toward using this EHR as well as increasing the perceived usefulness is very important. Also, the study's framework could be used in guiding learning health informatics and be applied to nursing students.

This paper outlines preliminary research of an innovative software program that enables the use of an electronic health record in a nursing education curriculum. The software application program is called EHRNE, which stands for Electronic Heath Record for Nursing Education. The aim of EHRNE is to enhance student's learning of health informatics when they are working in the simulation laboratory. Integrating EHRNE into the nursing curriculum exposes students to electronic health records before they go into the workplace. A qualitative study was conducted using focus group interviews of nine nursing students. Nursing students' perceptions of using the EHRNE application were explored. The interviews were audio-taped and transcribed verbatim. The data was analyzed following the Colaizzi (1978) guideline. Four main categories that related to the EHRNE application were identified from the interviews: functionality, data management, timing and complexity, and accessibility. The analysis of the data revealed advantages and limitations of using EHRNE in the classroom setting. Integrating the EHRNE program into the curriculum will promote students' awareness of electronic documentation and enhance students' learning in the simulation laboratory. Preliminary findings suggested that before integrating the EHRNE program into the nursing curriculum, educational sessions for both students and faculty outlining the software's purpose, advantages, and limitations were needed. Following the educational sessions, further investigation of students' perceptions and learning using the EHRNE program is recommended.

The use of standardized patients for simulation-based learning was integrated into the Master of Nursing curriculum in the 2012-2013 academic year. The study aimed to explore the Master of Nursing students' experiences with and perceptions of using standardized patients in simulations, and to identify the students' learning needs in preparing to become advanced practice nurses. The study adopted an exploratory descriptive qualitative design, using a focus group interview. The study was conducted at a university in Singapore. Seven Master of Nursing students who were enrolled in the Acute Care Track of Master of Nursing program in the 2012-2013 academic year participated in the study. The data were gathered at the end of the first semester. Content analysis was used to analyze the data. Three main categories - usefulness, clinical limitations, and realism - were identified in the study. The results revealed that the students felt using standardized patients was useful and realistic for developing skills in history taking, communication, and responding to an emergency situation. On the other hand, they found that the standardized patients were limited in providing critical signs and symptoms of case scenarios. To meet the learning objectives, future development and integration of standardized patients in the Master of Nursing curriculum might need to be considered along with the use of a high-fidelity simulator. This can be an alternative strategy to fill the gaps in each method. Obviously, using standardized patients for simulation-based learning has added value to the students' learning experiences. It is highly recommended that future studies explore the impact of using standardized patients on students' performance in clinical settings.

Preparing nursing students for making the transition to graduate nurse is crucial for entry into practice. Final year student nurses at the National University of Singapore (NUS) are required to undergo a consolidated clinical practice to prepare them for their transition to graduate nurse.To describe the development, implementation and evaluation of a simulation program known as SIMulated Professional Learning Environment (SIMPLE) in preparing the final year student nurses for their clinical practicum in transition to graduate nurse practice.A set of simulation features and best practices were used as conceptual framework to develop and implement the simulation program. 94 final year student nurses participated in the 15-hour SIMPLE program that incorporated multiple simulation scenarios based on actual ward clinical practices. Pre and post-tests were conducted to assess the students' preparedness for their clinical practice in transition to graduate nurse practice. The students also completed a satisfaction questionnaire and open questions to evaluate their simulation experiences.The student nurses demonstrated a significant improvement (t=12.06, p0.01) on post-test score (mean=117.21, SD=15.17) from pre-test score (mean=97.86, SD=15.08) for their perceived preparedness towards their clinical practicum in transition to graduate nurse practice. They were highly satisfied with their simulation learning. Themes emerged from the comments on the most valuable aspects of the SIMPLE program and ways to improve the program.The study provided evidences on the effectiveness of the SIMPLE program in enhancing the students' preparedness for their transition to graduate nurse practice. A key success of the SIMPLE program was the used of simulation strategy and the involvement of practicing nurses that closely linked the students with the realities of current nursing practice to prepare them for the role of staff nurses.