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Objective: Wound care is an important component of nursing care, consuming a significant amount of working hours. Literature reports the existence of many barriers to evidence-based wound care and that nursing students have an increasing need for education in this field. While blended learning activities have shown some benefits in learning outcomes, dedicated wound care modules within baccalaureate nursing courses occur infrequently. The aim of this study was to facilitate an increase in confidence and knowledge of evidence-based wound care in third-year baccalaureate nursing students., Method: In this descriptive pre-post research design, a dedicated wound care module within a baccalaureate nursing course (using a constructivist learning approach) was offered to students in a university in Australia. Pre- and post-implementation surveys were completed (2018-2020). Due to a small number of matching participants, only descriptive statistics were calculated for all variables., Results: A total of 276 students were invited to respond to the survey and 41 responded initially, 35 responded post the wound care module, and 26 responded to the survey after six months. Positive outcomes were noted in increased levels of confidence in the student nurses' ability to assess, manage and prevent wounds; as well as to apply evidence-based practice and change management following the educational wound care module within the baccalaureate nursing course., Conclusion: Implementation of a dedicated wound care module within a baccalaureate nursing course in this sample of third-year students fostered a positive change in the knowledge of evidence-based wound management, assessment and prevention. Education of the next generation of registered nurses in this valuable area of practice is an important part of baccalaureate nursing education.

The purpose of this systematic literature review of quantitative findings was to examine the effectiveness of educational interventions to improve gerontological knowledge, attitudes, and willingness to work with older people in baccalaureate nursing students. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a systematic literature search was conducted in five databases. Quality assessment was conducted using the Mixed-Methods Appraisal Tool. Based on inclusion and exclusion criteria, 41 papers were included in the review. The overall quality of studies included was moderate. The interventions were classified as education content, simulation or immersion experiences, clinical placement, or a combination of these pedagogical approaches. Majority of studies demonstrated improvement in knowledge and attitudes but there was a limited change in willingness to work with older people. There is insufficient evidence to make recommendations for the most effective educational intervention for enhancing bachelor of nursing students' willingness to engage in gerontological care., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Aim: To explore the benefit and engagement of undergraduate students' use of H5P interactive books for student learning., Design: An evaluation study of technology enabled learning for first year undergraduate Bachelor of Midwifery students in Australia., Methods: Students were invited to complete an online evaluation survey of their use and engagement with H5P interactive books. The survey included the long form User Engagement Scale which has four subscales of focused attention, aesthetic appeal, reward factor and perceived usability scored on a 5-point Likert scale. Content analysis was used to analyse the text comments given to five open text questions., Results: There were 21 students who completed the survey. There was a high overall User Engagement Scale score of 73.1 % with aesthetic appeal and reward factor being the highest scoring subscales. The content analysis showed students found the interactive books engaging and easy to navigate. Areas for improvement identified were not including a large amount of content and providing downloadable content., Conclusions: This study demonstrates the valuable and engaging use of H5P Interactive Books for undergraduate students in higher education. Students who used H5P Interactive Books identified their ease of use, organised layout and engaging format., Competing Interests: Declaration of Competing Interest The authors have no competing interests to declare., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Global and national frameworks for midwifery education recognise and prioritise the provision of midwifery continuity of care. Previous studies report that learning is enhanced when students have professional experience placements within these models, however there remains wide variation in midwifery students' access to placements within these models in Australia., Aim: To evaluate Bachelor of Midwifery students' experiences in midwifery continuity of care models within two local health districts in New South Wales, Australia., Method: A mixed methods design was used: qualitative data collected through interviews, and quantitative data collected via an online survey using the Midwifery Student Evaluation of Practice (MidSTEP) tool. Thematic analysis of qualitative data and descriptive analysis of quantitative data was undertaken., Results: Sixteen students responded, four students were interviewed, and 12 students completed the survey. The MidSTEP mean scores for all sub-scales rated above 3.0/4.0. Participants rated 'work across the full scope of midwifery practice' and five out of eight subscales of Philosophy of Midwifery Practice at 100 %. 'Experiences prepare me to be a change agent for maternity service reform' rated the lowest (67 %). Three qualitative themes emerged: care versus carer model; learning experience; and future career as a caseload midwife., Conclusion: A mixed method approach using a validated tool to measure student experiences, contributes to the evidence that students value professional experience placements within midwifery continuity of care models. Currently this is not an option for all midwifery students and as midwifery continuity of care models expand, these findings will inform further implementation of student professional experience placement within these models., Competing Interests: Declaration of Competing Interest All authors declare that there is no actual or potential conflict of interest, including financial and personal relationships with people or organisations, within 12months of beginning the submitted work that could inappropriately influence (bias) our work., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Newly graduated nurses' lack of professional competence is associated with inadequate preparation during their clinical placement as nursing students. Clinical placement is a critical stage in the development of nursing students' professional preparedness. However, research on the trajectory of nursing students' professional preparedness during clinical placement has not yielded findings with the same specificity., Objectives: The aim of this study is to estimate differences in professional preparedness levels at different clinical placement stages, to identify distinct patterns of professional preparedness trajectories during clinical placement, and to evaluate predictors of these trajectory group memberships., Design: A quantitative longitudinal study., Settings: Participants were recruited on a voluntary basis using convenience sampling at a tertiary hospital in Nanning, China., Participants: 224 senior nursing students were initially invited to participate in the study. A total of 178 nursing students successfully completed the follow-up assessments at baseline, as well as at 1 month, 4 months, and 8 months into their clinical placement., Methods: Participants completed four online surveys, during which their professional preparedness level was measured using the Perceived Professional Preparedness questionnaire for senior nursing students. Professional preparedness scores at different time points were compared using one-way repeated measures ANOVA and latent growth model. Group-based trajectory model was applied to identify professional preparedness trajectories. Multiple logistic regression was adopted to determine the predictors of trajectory group memberships., Results: The entire sample of Senior nursing students experienced a significant increase in professional preparedness during clinical placement. The best-fitting group-based trajectory model delineated three distinct trajectories: low-slowly increase trajectory (27.53 % of sample), moderate-rapidly increase trajectory (47.19 % of sample) and a high-stably increase trajectory (25.28 % of sample). Male, good and excellent academic performance, and very high degree of professional interest are the predictors of the moderate-rapidly increase trajectory. While male, good and excellent academic performance, high and very high degree of professional interest and participating in medical-related part-time employment are the predictors of the high-stable increase trajectory., Conclusions: Senior nursing students exhibit different levels of professional preparedness throughout their clinical placement. Simultaneously, three different trajectories were identified among the sample of nursing students. Therefore, in future research, greater attention should be directed towards the professional preparedness levels of nursing students with different trajectories, and early identification and targeted interventions should be prioritized., Competing Interests: Declaration of competing interest The authors had no conflicts of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Nurse education is critical for preparing student nurses for clinical practice, but the transition to clinical settings poses numerous challenges. A standardized scale to assess student nurses' adjustment in the clinical area is lacking in the Philippines., Objective: This paper described the development and evaluation of the Clinical Adjustment Scale for Student Nurses (CAS-SN)., Design: An exploratory sequential research design., Settings: Nursing schools in three government owned universities in the Philippines., Methods: Expert panels and field pretesting established content and face validity. Inter-item and inter-total correlations and Cronbach's α were used to assess the reliability of the scale. Construct validity was evaluated using exploratory factor analysis (EFA). Criterion validity was evaluated with established measures., Results: The CAS-SN comprises 15 items across three subscales: (1) Professional Growth and Interpersonal Engagement, (2) Clinical Competence and Confidence, and (3) Coping and Support Strategies Reliability was excellent and the validity was satisfactory, with significant correlations with academic adjustment, psychological distress, and dropout intention., Conclusion: The CAS-SN was found to be a valid and a reliable for assessing student nurses' clinical adjustment., Implications for Nurse Education: The CAS-SN provides a structured framework to assess and monitor student nurses' clinical adaptation, enhancing our understanding of their competence, resilience, and professional identity development. Its integration into nurse education programs can significantly improve the assessment of clinical learning experiences and contribute to better student learning outcomes., Competing Interests: Declaration of competing interest The author declares no conflict of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Expert modeling videos (EMVs) have shown promise in improving students' performance in simulation. However, research evaluating the impact of EMVs is limited to major performance areas, lacking exploration into specific student competency behaviors., Purpose: This study evaluated the effect of an EMV intervention on undergraduate nursing students' behavioral competencies as measured by the Creighton Competency Evaluation Instrument (CCEI)., Methods: Using a quasi-experimental pragmatic evaluation design, students in a medical surgical nursing course (n = 160) viewed either an expert model demonstration video (experimental) or expert model discussion video (control). Students' behavioral competencies were measured and compared between groups using the CCEI., Results: Students who viewed an expert model demonstration video performed at a higher level of competency in 11 of the 18 CCEI behaviors., Conclusion: Using EMVs in nursing simulation may improve students' ability to achieve clinical competency in nursing specific behaviors., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Understanding the link between plantar force, pressure, and foot discomfort is important for nursing students' well-being, given the prevalence of foot and ankle musculoskeletal disorders among nurses. Assessing these factors can inform tailored self-care interventions, supporting holistic nursing education., Purpose: To assess the plantar force and pressure distribution of third-year nursing students at baseline and after 5 months of exposure to a clinical setting., Methods: A prospective cohort study in a Portuguese nursing school measured changes in podiatric profile at 5 months, including peak pressure, maximum force, and contact area., Results: Elevated mean peak pressure in the heel correlated positively with maximum force and contact area. Negative correlations were found between the contact area and edema. Peak pressure correlated positively with thigh pain, indicating pressure transfer to metatarsal heads., Conclusions: The findings underscore the importance of integrating ergonomic education into nursing curricula and raising awareness of self-care interventions., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Artificial intelligence technology is among the most significant advancements that provide students with effective learning opportunities in this digital era. Therefore, the National League for Nursing states that it is necessary to reframe the nursing education process., Objective: This study aimed to determine the factors that affect the usefulness and sustainability of artificial intelligence tools used in nursing education., Design: A descriptive cross-sectional study was conducted among. Three models, including the Technological Acceptance Model (TAM), the Information System Success Model (ISSM), and the Online Learning Self-Efficacy (OLSE), were used., Participant: All of fourth- year undergraduate nursing students who were enrolled in nursing department regularly (N = 420), and who respond (n = 204)., Setting: In the nursing department of the health professions faculty at AL-Quds University, in Palestine., Results: Among the 204 students who responded, 9.80 % employed simulation, 5.40 % utilized virtual reality, 19.10 % used Chat GPT, 42.20 % used mobile applications, and 23.50 % utilized PowerPoint AI as part of their learning process. The mean and standard deviation (SD) were computed for key parameters related to the information system success model (AI) (ISSM) (M = 4.52, SD = 1.17). Technology Acceptance Model (TAM) (M = 4.61, SD = 1.16). Online Learning Self-Efficacy (OLSE) (M = 4.55, SD = 1.28)., Conclusion: There is a need to adapt teaching strategies and integrate AI tools as useful learning tools, which have become essential for students to complete their learning activities through enhancing knowledge of the multimodal technological factors that should be taken into consideration while creating AI tools across several domains for universities and developers., Competing Interests: Declaration of competing interest Conflicts of interest/Competing interests not available., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Literature showed that learners' perceived usability and perspective toward a technology application affected their learning experience. Fewer studies have investigated immersive virtual reality (IVR) simulation learning of fundamental nursing skills learning (FNSL)., Purpose: The aim of the study was to explore the perceived usability of IVR simulations for FNSL among first-year nursing students and their perspectives toward this learning modality., Methods: This study used a mixed-methods design with an educational intervention. Sixty-five first-year nursing students participated in 2 IVR simulation procedures in complementary mode. Surveys and focus groups were conducted in the postintervention period., Results: The findings demonstrated students' positive inclinations toward IVR simulation learning. Two areas emerged: using IVR simulation as a complementary modality for FNSL and barriers affecting students' perceived usability toward this technology., Conclusions: With addressing the concerns from students' perceived usability, immersive virtual reality simulation could be a potential complementary modality for FNSL., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc.)

Aim: The aim of this study was to analyze nursing student level of knowledge and understanding of current experiences of Indigenous people within the Canadian health care system to identify curricular gaps that need to be addressed., Background: In response to the 2015 Truth and Reconciliation Commission of Canada, nursing schools have begun incorporating Indigenous health content into curricula. However, few studies about the implementation and effectiveness of this education exist., Method: Students wrote a reflection and engaged with colleagues' reflections after watching a video from the Aboriginal Peoples Television Network. Fifteen reflections were selected using systematic, random sampling to undergo thematic analysis., Results: Two themes were identified: 1) students' understanding of barriers Indigenous populations face when accessing the health care system and 2) students' perceptions of strategies to ensure culturally safe care for Indigenous populations., Conclusion: Analysis of students' learning through a reflection activity can improve the Indigenous health content curriculum., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Aim: The aim of this study was to examine the impact of reverse-role simulation on nursing students' empathy levels toward ethnoculturally diverse patients., Background: Empathy is an essential component of culturally competent care; however, it is often left out of cultural competence education. Enhancing nursing students' cultural empathy may benefit students and patients., Method: The study used a quasi-experimental one-group pretest-posttest design in a private nursing school in the Northeast. The sample consisted of 37 undergraduate nursing students., Results: Pretest and posttest scores were statistically different, indicating a significant increase in the students' ethnocultural empathy, t (36) = -3.20, p = .003., Conclusion: This study supports using reverse-role simulation as an effective teaching strategy to enhance nursing students' empathy toward ethnocultural diverse patients. Placing students in the "shoes" of an ethnoculturally diverse patient can increase their empathy levels and enhance cultural competence education., Competing Interests: The author has declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Background: Escape room simulations are an innovative teaching methodology that may be useful in addressing pediatric-specific content and clinical placement limitations of generalist nursing programs., Problem: This project studied if a pediatric escape room simulation improved students' knowledge and confidence in pediatric nursing to support the development of the pediatric nursing workforce., Approach: A pediatric escape room simulation was developed for a large Midwestern university's prelicensure nursing program. Students completed surveys to assess knowledge and confidence in pediatric nursing. Simulation quality was assessed using the Simulation Learning Effectiveness Inventory., Outcomes: Students' (N = 37) knowledge and confidence in pediatric nursing concepts significantly increased after the simulation. Students responded positively to the simulation and recommended it be included in the undergraduate curriculum., Conclusions: The pediatric escape room simulation offers a promising alternative for students to gain pediatric-specific knowledge and confidence for prelicensure nursing programs in the context of limited pediatric clinical placements., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: In the management of individuals with venous leg ulcers, education serves as a pivotal tool for acquiring knowledge, fostering appropriate attitudes, and promoting best practices. Consequently, assessing knowledge, skills, attitudes, confidence, and commitment becomes essential, necessitating the development of suitable evaluation instruments. Pre- and post-test assessments align with Level 2 of Kirkpatrick's model. Moreover, nurse educators should integrate assessment into the teaching-learning sequences., Aim: To psychometrically validate an instrument designed to assess undergraduate nursing students' knowledge of the aetiology, prevention, and treatment of venous leg ulcers., Design: A multi-phase study was designed to develop the tool and subsequently validate its psychometric properties., Setting(s): The study was conducted at three sites within the University of the Basque Country and one site within the University of Alicante., Participants: A total of 516 students from all four years of the nursing degree program participated., Methods: The construct definition and instrument development were previously published. This article presents the psychometric evaluation, which involved classical item analysis, analysis of psychometric properties according to the Rasch model, differential item functioning analysis, construct validity analysis through hypothesis testing in known groups, and reliability analysis via internal consistency., Results: The results validated the Knowledge on Venous Leg Ulcer Questionnaire, reducing it from 72 initial items to 36 definitive items. It was found to be a valid and reliable instrument, capable of detecting statistically significant differences between known groups. Knowledge scores on a 0-100 scale were found to be 33.1 (SD = 19.5) for the first-second year groups, and 48.3 (SD = 17.5) for the third-fourth year groups, demonstrating a progressive and logical increase in knowledge each year., Conclusions: The Knowledge on Venous Leg Ulcer Questionnaire appears to be a valid and reliable instrument for measuring nursing students' knowledge of venous leg ulcers. However, further research in different contexts is required to confirm these results., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Evidence-based practice (EBP) competency is an expected outcome of baccalaureate education; however, research indicates nursing graduates enter practice with competency gaps., Purpose: The purpose of this study was to explore the challenges accelerated baccalaureate students experience when learning the steps of EBP., Methods: A qualitative, descriptive design was used to identify bottlenecks to student learning., Results: Learning the steps of EBP in an accelerated format was challenging for students. Data analysis revealed 3 types of bottlenecks that stalled learning: cognitive, procedural, and emotional., Conclusions: Faculty build EBP competency by making explicit the steps that help students progress. Scaffolded learning, collaborative partnerships, and reflective practices are recommended to support student learning in accelerated formats., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Self-Regulated Learning (SRL) is key in developing healthcare professionals and lifelong learner. iCARE (internalization of Critical thinking, Assessment, Reflection to Empower learning) model was designed to enhance nursing students' SRL., Aim: This study investigated the effects of iCARE on nursing students' reflective practice, SRL, self-efficacy and skill performance as compared to conventional group reflection., Method: A quasi-experimental exploratory study was employed on 49 final-year nursing students in a tertiary acute hospital. The iCARE group (n = 24) received guided daily reflective journal with weekly feedback while the group reflection group (n = 25) received group reflection. Both were facilitated by clinical instructors. Participants' SRL score, self-efficacy level and skill performance were measured pre- and post- training. End of posting reflective journal between group was compared. Their experience and perception on both facilitation methods were obtained using questionnaires. Quantitative data were summarised and analysed using Chi-Square test and t-test. Theme coding and content analysis were used to analyse the qualitative responses., Results: Compared to group reflection group, the iCARE group reported a statistically significant improvement in SRL score, reflective practice, skill performance and self-efficacy in skill performance after a four-week clinical posting. Participants from both groups perceived that reflection helped them learn from peers and experience, enhanced their performance and motivated them to learn. Three unique themes emerged only from the iCARE group: iCARE helped to developed SRL; application of assessment, planning, implementation and evaluation (APIE) improved clinical reasoning; iCARE improved the use of feedback., Conclusion: The findings demonstrated the effect of the iCARE model in enhancing the development of nursing students' reflective practice, SRL and clinical learning outcomes. The design of iCARE model that embeds SRL instructions, APIE framework and SRL focused feedback can promote cognitive and metacognitive development as well as skill performance., Competing Interests: Declaration of competing interest No conflict of interest has been declared by the authors., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Abstract: This article describes an exemplary collaboration in which a librarian was fully embedded in beginner undergraduate nursing courses in a baccalaureate nursing program. The goal was to increase academic help-seeking behaviors and information literacy skills. Students benefited from the intervention and increasingly demonstrated the use of better sources for their evidence-based practice assignments. Library tutorials were permanently integrated into the courses. A collaborative approach to designing research assignments allowed the librarian and nursing faculty to lay a foundation of information literacy in the nursing program and encourage academic help-seeking behaviors., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Aim: This qualitative study aimed to identify effective retention strategies for Native American nursing students., Background: Native Americans are underrepresented in nursing and health education programs, comprising only 1.3 percent of the nursing workforce in the United States., Method: A basic qualitative design grounded in self-determination theory was used to solicit narrative accounts from 12 Native American nursing students., Results: Semistructured interviews revealed three themes: nursing program experience, methods to enhance persistence, and hindrances to persistence. Social support emerged as a critical factor, with participants emphasizing the significance of cultural awareness activities, safety classes, and celebrations fostering a sense of belonging., Conclusion: The study found that social support, financial aid, and cultural awareness are essential for Native American nursing students to succeed. Limited resources and online learning challenges are barriers that need to be addressed. Tailored support systems, financial assistance, and culturally responsive education can enhance retention and success rates., Competing Interests: The author has declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Background: Adequate professional preparation of nursing undergraduates is conducive to developing health care careers. Deep learning is important for enhancing nursing competencies and the overall quality of students. However, limited research has been conducted to explore deep learning and its associated factors for students in higher nursing education., Objective: To describe the level of deep learning and explore its associated factors among Chinese nursing undergraduates., Design: A cross-sectional study., Setting: This study was conducted at a medical university in Anhui Province, China., Participants: Convenience sampling was used to survey 271 nursing undergraduates between July and September 2023., Methods: The survey included questions about general information, deep learning, and critical thinking disposition. Nonparametric tests were used to distinguish the intergroup differences. Correlations were evaluated using Spearman's rank correlation analysis. Hierarchical multiple regression analysis was performed to determine the influencing factors., Results: The deep learning score of the nursing undergraduates was 3.82 (3.56, 4.00). Hierarchical multiple regression analysis revealed that gender (β = 0.10, P = 0.044), experience as a student leader (β = 0.10, P = 0.049), and critical thinking disposition (β = 0.60, P = 0.000) significantly impacted deep learning. All the variables explained 41.1 % of the total mean score variance for deep learning., Conclusion: Chinese nursing undergraduates showed upper-middle levels of deep learning. Gender, experience as a student leader, and critical thinking disposition were significantly associated factors of deep learning. Nursing educators should provide targeted interventions for deep learning to facilitate the professional competencies of these students., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Metacognition can assist students in improving poor examination (exam) performance. An exam wrapper is a metacognitive tool used to assess a student's thought processes and behavioral patterns during test-taking., Purpose: The purpose of this study was to determine the effect of an exam wrapper tool used during one-to-one exam review sessions with faculty on prelicensure nursing students' subsequent exam performance., Methods: Paired t -tests and repeated measures ANOVA were used to compare undergraduate students' (n = 91) exam scores before and after an exam review session with faculty in which the exam wrapper tool was used., Results: Students who completed a one-to-one exam review session with faculty using the exam wrapper showed significant improvement in subsequent exam scores., Conclusions: Use of an exam wrapper tool as part of a one-to-one exam review session with faculty is a viable way to leverage metacognition to improve student exam performance., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: The current state of nursing education is concerning, with nearly two-thirds of the American Association of Colleges of Nursing (AACN) and Commission of Collegiate Nursing Education (CCNE) -accredited universities reporting that their nursing graduates are ill-prepared to care for the LGBTQIA+ community (Eickhoff, 2021). This lack of training is alarming, given the ongoing reports of LGBTQIA+ healthcare discrimination and the insufficient knowledge of nursing faculty to guide future nurses in caring for this patient population (Hughes et al., 2022)., Aim: Our study sought to address this gap by developing and assessing the effectiveness of an LGBTQIA+ inclusivity training module for Baccalaureate nursing students., Design: We employed a quasi-experimental pretest-posttest design, evaluating nursing students' knowledge and attitudes before and after the LGBTQIA+ inclusivity training., Setting: The study was conducted in a four-year baccalaureate nursing program in the Southern United States., Participants: Junior-level baccalaureate nursing students., Methods: Using a pre-test post-test method, we collected data that included the Gay Affirmative Practice Scale, an LGBTQIA+ knowledge assessment, and a computer-based LGBTQIA+ inclusivity training module., Results: N = 30 students consented and completed all necessary study components. The findings revealed significant improvements in pre-test and post-test GAP and knowledge assessment scores following the LGBTQIA+ Inclusivity Training for baccalaureate nursing students., Conclusions: The results of our study underscore the effectiveness of an LGBTQIA+ computer-based simulation experience for baccalaureate nursing students, marking a significant step towards improving LGBTQIA+ healthcare inclusivity in nursing education., Competing Interests: Declaration of competing interest The authors of this study have no conflicts of interest to report., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Abstract: Student reflection stimulates self-awareness, deep learning, insight into patient care challenges, and professional role development. As such, reflection assignments are an ideal target for revision using language associated with the steps of the clinical judgment measurement model (CJMM) to maximize critical thinking. Tanner's clinical judgment model aligns with the CJMM and underpins the curriculum in many nursing programs. Faculty used the model to update a simulation reflection assignment template, incorporating CJMM language and facilitating improved measurement of clinical judgment. Substantially improved student responses resulted during an initial quality improvement pilot study., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2023 National League for Nursing.)

Abstract: The academic performance of nursing students significantly impacts their ability to deliver quality patient care. This descriptive correlational study investigated the effects of nursing students' locus of control, motivation, and learning strategies on their academic performance in a sample of 515 students. External locus of control was associated with higher scores in extrinsic goal orientation, task value, elaboration, and academic performance. Locus of control, test anxiety, and organization were identified as predictors of academic performance. The study highlights the need for further research on factors affecting academic performance and effective educational interventions., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Objectives: To reveal the effectiveness of didactic architectures and pedagogical strategies to be implemented in nursing curricula to develop and improve Emotional Competencies (EC) in undergraduate nursing students., Design: Systematic review of effectiveness conducted according to Joanna Briggs Institute (JBI) guidelines. We followed the PRISMA statement to guarantee the transparency of the review and the GRADE to report the strength of evidence., Data Sources: Seven databases were searched: MEDLINE, The Cochrane Library, SCOPUS, CINAHL, EMBASE, PsycINFO and ERIC. Grey literature was also searched through the OpenGrey database., Review Methods: Studies focusing on educational programmes and/or activities to develop EC in nursing curricula, published in English or Italian were included. Quality assessment of the studies was evaluated using JBI critical evaluation tools and the Mixed Methods Appraisal Tool (MAAT). Following JBI guidelines, a narrative synthesis was performed., Results: A total of 19 studies from 8 countries were included. The population varied from first to fourth-year students in relation to the duration of the undergraduate nursing program across the various countries. Most of the students were females. The age of the participants ranged between18 and 56 years. The most common pedagogical strategies were simulation, role playing, and face-to-face lessons. In some cases, studies combined two or three pedagogical strategies in the same intervention. The most effective strategy was simulation, which improved EC, compassion, self-awareness, self-efficacy, empathy, critical thinking, clinical practice skills, and teamwork skills. Furthermore, the combination of lessons, simulation, and literature exploration effectively developed communication skills, and improved students' satisfaction., Conclusions: Investing in simulation, role-playing activities, and lessons regarding the importance of EI, empathy and compassion, and the role of an emotionally competent nurse leads to improved nursing care and wellbeing., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Clinical judgment is the hallmark of safe patient care. Nurse educators continue to explore best practices to assist prelicensure nursing students in developing clinical judgment., Purpose: The 3-part purpose of this study was to identify what students learned about themselves related to clinical judgment after viewing their video-recorded high-fidelity simulation scenarios, to assess if video recording is an effective post-debriefing teaching strategy, and to evaluate if the 2021 American Association of Colleges of Nursing (AACN) Domains can be assessed longitudinally., Methods: Qualitative interpretive description study of 37 prelicensure nursing students., Results: Ten codes were derived from 314 excerpts: communication, body language, confidence in self, putting data together, collaboration, leadership, safety, skillfulness, areas of improvement, and growth., Conclusions: Longitudinal data showcased the development of clinical judgment, effectiveness of self-evaluation of video recorded simulations as a teaching strategy, and assessment of 5 AACN Domains., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc.)

Background: Clinical education provides important learning opportunities for students. Finding clinical sites and faculty can be a challenge. Exploring the relationship between the number of clinical practice hours and NCLEX-RN success may be helpful for curriculum development and revision., Purpose: The purpose of this study was to provide descriptive information about clinical education in RN programs and determine if a relationship existed between the number of clinical hours and NCLEX-RN pass rate., Method: A descriptive research design using a survey was sent to over 1000 accredited nursing programs in the United States., Results: One hundred and fourteen surveys were completed. When comparing 2021 NCLEX-RN pass rates with clinical hours, there was a statistically significant difference at the 500 clinical hour interval., Conclusion: Nursing programs can ensure fiduciary responsibility while supporting clinical judgment development and licensure success by reviewing their curriculum and reconsidering the number of clinical hours in their programs., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: The purpose of this mixed-methods study was to examine the relationship between virtual reality simulation (VRS) and student satisfaction and self-confidence in a health assessment laboratory course., Methods: Second-year students (n = 37) completed a postoperative respiratory distress scenario using Elsevier's Simulation Learning System with Virtual Reality. All participants completed the Satisfaction and Self-Confidence in Learning Scale; a subset participated in 1:1 semistructured interviews., Results: Satisfaction and self-confidence scores were strongly correlated. VRS experiences of fidelity, communication confidence and competence, learning with peers, integrated learning and critical thinking, and a safe space to learn were related to students' satisfaction and self-confidence., Conclusions: VRS experiences are correlated with high student satisfaction and self-confidence., Competing Interests: The authors declare that Mamta Shah is an employee of Elsevier, which may be considered as potential conflicts of interest. The authors declare no other conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: Debriefing as a learning activity aims to elevate participants' competence through communicative interaction. This activity is an integral component of any formative simulation. Thus, the primary objective of this study was to explore debriefing as a communicative experience in nursing students within the context of interactive virtual simulation. The secondary objectives were: 1) To investigate the typology of interactions based on participants' discourse and 2) To identify the actions that students use to develop knowledge during debriefing., Method: A qualitative exploratory study design involving six debriefing groups was conducted with 105 s-year nursing students. The debriefing sessions were analyzed following interactive virtual simulations in an in-person setting in the classroom. All sessions were recorded and transcribed verbatim. A mixed (deductive and inductive) content analysis approach was used., Results: A total of 2187 units of meaning were identified and categorized into 3 themes (interaction by participant, interaction by communicative action, and interaction by participant's communicative goal); nine subthemes (facilitator-student, student-student and student-facilitator; declarative - unidirectional, reactive - bidirectional and multidirectional-interactive; individualistic, competitive, and collaborative), and 5 categories (providing information; generating creative solutions; processing critical and deliberative information; positive interdependence and psychosocial relationships)., Conclusion: The students developed knowledge and practical communication skills, particularly reinforcing soft skills through collaborative interactions, predominantly multidirectional-interactive in nature. The facilitator and the interpersonal relationships among the participants fostered a safe and positive environment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Abstract: Most virtual escape rooms are built using Google documents that ask a series of questions; our faculty team wanted to provide a more interactive experience in a large classroom and created a virtual escape room that mimicked the Next Generation NCLEX testing platform. Each room contained a case study with multiple-choice questions. Seventy-three of 98 possible students completed the escape room survey. All recommended this activity to other students, and 91 percent said they preferred the game format more than the lecture format. Virtual escape rooms are interactive, engaging, and can be used successfully to bridge theory to practice., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2023 National League for Nursing.)

Background and Purpose: It has been shown that nurse confidence predicts peripheral intravenous catheter (PIVC) insertion success. However, intravenous cannulation is a challenging skill for entry to practice students. To date, there is no well-validated measure of nursing student self-confidence in learning and performing PIVC insertion. To address this measurement gap, we created and validated the Nursing Student PIVC Insertion Self-Confidence Scale. Methods: This study employed a descriptive, cross-sectional design. Three cohorts of undergraduate entry-to-practice students at a Canadian university were recruited and assessed during their studies. Two hundred eighty-one students completed the scale at the first data collection point and 146 at the second point. The structure of the tool was analyzed by exploratory factor analysis to extract factors and confirmatory factor analysis (CFA) was employed for validation. Results: CFA revealed a three-factor scale (PIVC Cannulation Confidence, PIVC Preparation and Securement Confidence, and PIVC Learning Confidence). It has 15 items with satisfactory goodness of fit indices. Conclusions: The Nursing Student PIVC Insertion Self-Confidence Scale is a valid and reliable scale to measure nursing students' confidence in learning about and performing PIVC insertions., (© Copyright 2024 Springer Publishing Company, LLC.)

Background and Purpose: Nursing students and graduates experience grief when not achieving curricular benchmarks or passing the NCLEX-RN. This study developed the perceptions of academic grief (PAG) instrument for baccalaureate nursing program completers experiencing academic failure. Methods: Content analysis methods generated items and achieved face validity. Focus group interview and experts' judgment of item relevance established content validity. A purposeful sample of registered nurses (RNs) and nursing students ( N = 70) completed the pilot test on the 40-item instrument. Results: The highest ranked items included being disappointed, trying again to prove they could become a nurse, life investment in nursing school, and fear of failing again. The coefficient α was .94. Conclusions: The instrument was developed to measure nursing students' and RNs' academic grief. The PAG showed beginning reliability and validity and needs additional testing., (© Copyright 2024 Springer Publishing Company, LLC.)

Background and Purpose: Nursing student retention is essential to meet workforce demands. Jeffreys' Nursing Student Retention Student Perception Appraisal-Revised (SPA-R1) has been used extensively to understand factors that impact retention. Psychometric testing of the SPA-R1 contributes to greater confidence in the instrument's reliability and validity. Methods: Item response theory and specifically, the single parameter polytomous Rasch model was used as a framework for fit statistic testing and rating scale diagnostics of the SPA-R1. This was a secondary analysis of a convenience sample of undergraduate prelicensure nursing students. The setting for the previous study was virtual, and the study period was 2022. Results: The model item characteristic curves for the 27 items of the SPA-R1 have similar shapes and are clustered in proximity. Overall, there are three clusters of items evident in the Rasch standardized residual contrast. The Rasch scale diagnostics indicated that the scale appropriately monotonically increases. However, there is a greater than 5 logit distance between does not apply and severely restricts, between severely restricts and moderately restricts, and between does not restrict or support and moderately supports. These large threshold distances indicate that additional steps in the scale may be warranted. The items cover the mid-range of the amount of retention perceptions; however, there are no items that represent the highest magnitude of the perceived amount of influence on retention. Conclusions: This study contributes further evidence to support the validity and reliability of the SPA-R1. We recommend adding steps to the scale, removing the does not apply response option, and considering scoring by three domains or clusters., (© Copyright 2024 Springer Publishing Company, LLC.)

Objectives: Chat Generative Pre-Trained Transformer (ChatGPT) is an artificial intelligence-powered language model that can generate a unique outputs, in reponse to a user's textual request. This has raised concerns related to academic integrity in nursing education as students may use the platform to generate original assignment content. Subsequently, the objective of this quality improvement project were to explore and identify effective strategies that educators can use to discern AI-generated papers from student-written submissions., Methods: Four nursing students were requested to submit two versions a Letter to the Editor assignement; one assignment that was written by the student; the other, exclusively generated by ChatGPT-3.5., Results: AI-generated assignments were typically grammatically well-written, but some of the scholarly references used were outdated, incorrectly cited, or at times completely fabricated,. Additionally, the AI-generated assignments lacked detail and depth., Conclusions: Nursing educators should possess an understanding of the capabilities of ChatGPT-like technologies to further enhance nursing students' knowledge development and to ensure academic integrity is upheld., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Objectives: This study reveals the learning gained by Canadian and Rwandan nursing students from a course to enhance cross cultural clinical decision-making skills using a collaborative approach across two countries., Methods: A qualitative descriptive study was conducted using thematic analysis. The study included analysis of end of course reflections of 94 students., Results: Students became more open-minded, curious, strengthening teamwork, increasing their critical thinking, and identifying cross-cultural similarities in practice. They challenged their previous beliefs about others., Conclusions: Students achieved a transformation of previous knowledge and decision-making skills. Results indicate the value of underpinning courses with theories and being open in allowing students to develop their own means to achieve expected learning outcomes., Implications for an International Audience: Creating learning environments designed to stimulate open mindedness and exploration of cultures among students can be achieved through online learning. Providing opportunities for students to learn across other countries about their nursing practices and health systems are critical to understanding how future patients who are immigrants and refugees from other countries differing perspectives to their health care needs., (© 2024 the author(s), published by De Gruyter, Berlin/Boston.)

Background:  Nursing students often experience high anxiety and depression because of the demanding nursing curriculum. This mental strain can harm their academic performance. As a result, nurse educators need to assess how anxiety impacts nursing students' academic achievements., Objectives:  To evaluate and describe the knowledge of counsellors and nurse educators regarding the impact of anxiety-related conditions on nursing students' academic excellence in selected nursing education institutions., Method:  A qualitative descriptive phenomenological design was used to evaluate and describe the perceptions of counsellors and nurse educators about anxiety-related conditions on nursing students' academic excellence. Participants were purposively selected, and semi-structured interviews were utilised to collect data. Four counsellors involved in psychosocial support of nursing students who participated in individual semi-structured interviews, and 20 nurse educators participated in focus group interviews, with 5 participants per group. Data were recorded and transcribed. Transcripts were analysed using Giorgi's (2009) four data analysis steps., Results:  Four themes emerged from data analysis: understanding of anxiety-related conditions, responses to anxiety-related conditions, influences of anxiety-related conditions and support of nursing students with anxiety-related conditions. The findings highlighted the significance of recognising the effects of mental health issues on nursing students., Conclusion:  The study revealed the factors influencing nursing students' responses to and the support provided for anxiety-related conditions affecting their academic performance.Contribution: The importance of prioritising mental health support for nursing students is to ensure they complete their qualifications on time.

Background: Previous studies have reported varying levels of self-directed learning readiness and time management skills among nursing students, and the relationship between these two skills has not been extensively explored. Consequently, this study aimed to assess self-directed learning readiness and its influencing factors, with a specific emphasis on the role of time management skills among nursing students., Methods: This cross-sectional study involved the participation of 110 undergraduate nursing students who were conveniently recruited for the research. The data collection tools included a demographic information form, Fisher's Self-Directed Learning Readiness questionnaire, and the Time Management Inventory developed by Britton and Tesser. The collected data were analyzed using STATA-14 statistical software., Results: The findings revealed that 96.4% of the nursing students demonstrated readiness for self-directed learning. The mean overall score for self-directed learning readiness was 162.3 ± 6.1 out of 200, indicating a relatively high level of readiness. The mean score for time management skills was 98.1 ± 5.0 out of 135, suggesting satisfactory proficiency in this area. In terms of the relationship between self-directed learning readiness and its associated factors, time management skills, academic probation history, grade point average, place of residence, and level of interest in the field of study collectively accounted for 9.2% of the variance in self-directed learning readiness. Among these factors, academic probation history, grade point average, and place of residence emerged as statistically significant predictors (P < 0.05)., Conclusions: The study findings indicate that the level of self-directed learning readiness and time management skills among the nursing students were considered acceptable. Academic probation history, grade point average, and place of residence emerged as significant predictors of self-directed learning readiness. These results highlight the importance of considering students' academic background and living conditions to effectively enhance their level of self-directed learning readiness. Further research is recommended to explore additional factors that may influence self-directed learning readiness among nursing students., (© 2024. The Author(s).)

Aim: To translate and adapt the Nursing Student Academic Resilience Inventory (NSARI) into Chinese and assess its validity and reliability among Chinese nursing students., Background: Nursing students frequently encounter stress during their clinical education and academic resilience is an important skill to help students withstand stress. The NSARI is a valid and reliable tool for assessing the level of academic resilience of nursing students during clinical practice. Currently, there is no valid and reliable measurement tool to assess academic resilience for nursing students in China., Design: A descriptive, methodological and cross-sectional design was used., Method: This study was conducted on 600 nursing students in Northeast China. A socio-demographic form, the Chinese version of the NSARI and the nurse resilience scale were used for data collection between May to November 2023. The exploratory factor analysis and confirmatory factor analysis samples comprised 300 students, respectively, to test the structural validity of the inventory. In addition, internal consistency and invariance analyses were conducted to assess the reliability of the inventory., Results: The Chinese version of NSARI comprises 24 items separated into six dimensions. Exploratory factor analysis extracted six factors, with a cumulative variance contribution rate of 71.908 %. Confirmatory factor analysis showed a satisfactory fit. Cronbach's alpha coefficient for the internal consistency of the total inventory was 0.939 with a test-retest stability reliability value of 0.957., Conclusion: The Chinese version of NSARI is a valid and reliable measurement tool for assessing the level of academic resilience of nursing students during clinical placement., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Aim: To use a grounded theory approach to explore and understand the encounters of undergraduate nursing students with incivility in the clinical setting so that data-informed strategies for addressing this counterproductive behavior could be developed., Background: Nurses are being called upon to fill ever-increasing responsibilities associated with expanding roles in different specialties within healthcare. One issue that has developed in this high-pressure environment is an increase in incivility in the workplace that spills over into the clinical training environment. As a pervasive problem in the healthcare system, its effects on nursing students could compound the nursing shortage by undermining the integrity of nursing education and discouraging individuals from entering the profession. Therefore, it is vital to construct new theories regarding incivility so that this unprofessional practice can be eradicated or reduced. When this is done, there may be a renewed hope for new nursing students to practice their clinical rotations without feeling disrespected, undermined and intimidated. Students should be able to complete clinical rotations without these unnecessary barriers., Design: Qualitative grounded theory using philosophical underpinnings of symbolic interactionism and pragmatism., Methods: A classical grounded theory approach focusing on the Glaserian Model was used to develop an inductively derived theory from the data. Participants were interviewed about their encounters with incivility and then open coding was used to identify recurring concerns on which a model of the effect of these occurrences could be established. The study sample consisted of 32 participants of which 25 were undergraduate nursing students and seven were graduate students who participated in a focus group. Data were collected through face-to-face (in-person and virtual) structured interviews that were audiotaped. These individuals were recruited by flyers posted at varying strategic points on university campuses., Results: Open coding of student responses revealed three significant areas of concern: feelings of being disrespected, intimidated and undermined, from which the Inhibiting Actions Theory emerged., Conclusion: Nursing students' perceptions of incivility and their attitudes and behaviors toward this occurrence culminated in the Inhibiting Actions Theory, which provides a framework for implementing effective policies and personnel training in clinical settings. The hope is that these research findings will be a call to action for introducing systemic changes in the clinical training environment, thereby improving the clinical experiences of nursing students and patients., Competing Interests: Declaration of Competing Interest The author of this publication declares there is no conflict of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Aim: to report a thematic synthesis of students' narratives in free text comments from a national quality survey of Australian nursing degree students' clinical placements., Background: Nursing student evaluation surveys are submitted to the Australian National Placement Evaluation Centre. Students in 36 Australian nursing programs are included., Design: Thematic synthesis of nursing students' narrative comments., Methods: Data were sourced from 10,226 surveys submitted between July and December 2023. From these, the 3640 free text comments were extracted and tabulated to form the sample for synthesis. Three authors conducted a thematic synthesis and all five authors agreed on the findings., Findings: Student's comments generally portrayed a positive learning culture in clinical placement environments. One dominant theme 'Support' was interpreted as giving deeper meaning to students' perceptions of the help and encouragement of placement facility staff. Three subthemes 'Welcoming environment', 'Providing learning opportunities' and 'Teaching strategies' described students' ideas of what elements contribute to learning. Ten ways of teaching were revealed in students' narratives as education activities. Students commonly referred to staff supporters, illustrating that various staff worked to ensure students were supervised during clinical skills practice and that students' learning objectives were addressed., Conclusions: Staff-student relationships are paramount for students' learning and students' narratives revealed perceptions of a generally positive learning environment. The notion of support is implied as vital to nursing students' positive experience of clinical learning during placements. Curriculum designers, university course convenors and placement partners may use the findings identified in this study to ensure academic and placement facility staff are aware of how best to support students. In this way, institutions may narrow the gap between successful and less successful nursing student clinical placements., Competing Interests: Declaration of Competing Interest The researchers declare they have no conflict of interest to declare. This research did not receive financial support from the private or public domains, (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Aim: This study aimed to examine if a cooperative intervention improved outcomes for a simulation-based paediatric nursing course., Background: Fostering cooperative learning can enhance student engagement and improve learning. Simulation-based courses provide nursing students an opportunity to practice and hone nursing skills when hands-on experiences are limited. Providing instruction in cooperative learning could improve course outcomes., Design: A quasi-experimental study with pre-test/post-test assessments., Methods: Third-year nursing students enrolled in an 18-week paediatric simulation-based nursing course were purposively recruited (N = 110). One class (n = 55) received a researcher-developed cooperative learning program, which encouraged student support during class activities and simulations. The second class (control) received usual class instruction and simulations. The efficacy of the intervention was assessed by comparing mean scores at class enrolment (pre-test) and completion (post-test) for self-perceived problem-solving attitude, cooperative learning experience and knowledge of paediatric nursing. Paired t-tests compared pre-test with post-test scores for the two groups. ANCOVA examined differences in mean scores between groups. Correlations between differences in mean pre-test and post-test subscale scores for problem-solving attitude and cooperative learning experience were also examined., Results: There was no significant difference in age or gender between groups. Mean post-test scores on the final exam were significantly higher for students who received the intervention (85.26, 95 % CI 84.19, 86.33) compared with controls (83.61, 95 % CI 82.52, 84.69; F = 4.63, p = 0.034). There were no significant differences in total scores for problem-solving attitude or cooperative learning experience or between groups. For the intervention group, two problem solving subscales were correlated with two cooperative learning subscales: problem solving confidence with learning motivation, respectively (r = 0.302, p = 0.025) and personal control with classroom learning, respectively (r = 0.389, p = 0.003). For the control group, approach-avoidance problem solving was negatively correlated with cooperative learning efficacy (r = -0.343, p = 0.01)., Conclusions: Compared with the control group, nursing students who received the cooperative learning intervention had higher scores for knowledge of paediatric nursing, as well as learning motivation and attitude and problem-solving confidence, suggesting that the researcher-designed intervention facilitated simulation-based learning as well as confidence in problem-solving. Nurse educators could easily integrate the intervention into simulation-based paediatric nursing courses to enhance students' problem-solving abilities., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Aim: To construct a network structure for cognitive emotion regulation among Chinese undergraduate nursing students and identify central nodes and to explore the bridge connections between cognitive emotion regulation strategies and professional identity from the perspective of network analysis., Background: Undergraduate nursing students are currently in a poor psychological condition and cognitive emotion regulation strategies can help them use positive approaches to regulate their emotions. There may be a link between cognitive emotion regulation strategies and professional identity., Design: This was a cross-sectional study that used network analysis., Method: A total of 218 Chinese undergraduate nursing students were selected and surveyed using the Cognitive Emotion Regulation Questionnaire and the Professional Identity Questionnaire. A network analysis model was constructed and the related indices were calculated using R 4.3.0 software., Results: Network analysis showed that the central nodes of undergraduate nursing students' cognitive emotion regulation strategies were positive reappraisal, refocusing on planning and catastrophising; In the bridge network of cognitive emotion strategies and professional identity, professional self-concept, positive reappraisal, benefits of stay and risk of resignation and refocusing on planning were the nodes with the strongest bridge strength., Conclusion: The salient central and bridge nodes can serve as potential targets for interventions aimed at improving the mental health of undergraduate nursing students. Nursing educators must be trained in cognitive emotion regulation and appropriately guided to use positive emotion regulation strategies in their studies and work. Educators should focus on the relation between cognitive emotion regulation and professional identity to improve the mental health of nursing students and stabilise the nursing workforce., Competing Interests: Declaration of Competing Interest I declare that there are no conflicts of interest in relation to the manuscript titled "Centrality and bridge connections between cognitive emotion regulation strategies and professional identity among Chinese undergraduate nursing students: a network analysis" submitted to Nurse Education in Practice. I confirm that the results and interpretations reported in the manuscript are original and have not been plagiarized. I certify that I have read and understand the Nurse Education in Practice conflict of interest policy. I understand that failure to disclose a conflict of interest may result in the manuscript being rejected or retracted. I also certify that I have disclosed any financial or nonfinancial relationships that may be interpreted as constituting a conflict of interest in relation to this manuscript. I understand that this information will be subject to peer review, and I am willing to provide further information or clarification if required. I confirm that I have no known conflicts of interest that would influence the results or interpretation of the data presented in this manuscript, and I understand that failure to disclose a conflict of interest is unethical and may result in sanctions being imposed on me., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Aim: The aim of this study was to explore the perceptions and satisfaction of last-year nursing students with the Self-Learning Methodology in Simulated Environments (MAES©)., Background: As a learning method, clinical simulation uses elements that replicate real clinical practice scenarios and facilitates the acquisition of competencies and learning objectives. Simulations promote critical thinking, knowledge, techniques and teamwork in nursing students. The Self-Learning Methodology in Simulated Environments (MAES©) is a method that integrates problem-based learning with realistic clinical simulation., Design: A cross-sectional mixed-method study implemented a simulation learning method as part of the mandatory nursing training practice; that was registered in Open Science Framework (Registration DOI: https://doi.org/10.17605/OSF.IO/R89PZ)., Methods: Students were invited to complete a cross-sectional questionnaire about satisfaction with the simulation and were asked to participate in an interview about their perceptions on the simulation. All data were collected in December 2023 in a mid-sized southern Spanish university. A total of 69 last-year nursing students were enrolled in the simulation course and were selected using eligibility criteria., Results: Satisfaction measures showed no significant differences across gender, university access, or age (p>0.05 each). However, strong correlations were found between students' preference for the simulation method and perceived effort value (p<0.001 each). Qualitative analysis identified key themes in different stages of simulation (prebriefing, scenario, briefing, debriefing), simulation benefits (learning, usefulness, positive emotions) and challenges (difficulty, realism, time constraints). Despite some realism concerns, overall, students viewed the methodology positively., Conclusions: The findings of this study underscore the vital role of simulation-based learning in nursing education. As the field of nursing continues to evolve, so too must the educational methods we employ, with simulation-based learning standing at the forefront of this transformative journey., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Rapid developments in artificial intelligence have begun to necessitate changes and transformations in nursing education., Objective: This study aimed to evaluate the impact of an artificial intelligence-supported case created in the in-class case analysis lecture for nursing students on students' case management performance and satisfaction., Design: This study was a randomized controlled trial., Method: The study involved 188 third-year nursing students randomly assigned to the AI group (n=94) or the control group (n=94). An information form, case evaluation form, knowledge test and Mentimeter application were used to assess the students' case management performance and nursing diagnoses. The level of satisfaction with the case analysis lecture was evaluated using the VAS scale., Results: The case management performance scores of the students in the artificial intelligence group were significantly higher than those of the control group (p<0.05). There was no statistically significant difference in satisfaction levels between the artificial intelligence (AI) group and the control group (p>0.05)., Conclusions: The study's results indicated that AI-supported cases improved students' case management performance and were as effective as instructor-led cases regarding satisfaction with the case analysis lecture, focus and interest in the case. The integration of artificial intelligence into traditional nursing education curricula is recommended., Clinical Trials Registration Number: https://register., Clinicaltrials: gov; (NCT06443983)., Competing Interests: Declaration of Competing Interest The authors have no conflict of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Aim: To describe undergraduate nursing students' clinical decision-making in post-procedural bleeding scenarios and explore the changes from the first to the final year of their program., Background: Bleeding is a common complication following invasive procedures and its effective management requires nurses to develop strong clinical decision-making competencies. Although nursing education programs typically address bleeding complications, there is a gap in understanding how nursing students make clinical decisions regarding these scenarios. Additionally, little is known about how their approach to bleeding management evolves over the course of their education., Design: Longitudinal mixed-methods study based on the Recognition-Primed Decision Model., Methods: A total of 59 undergraduate students recorded their responses to two clinical decision-making vignettes depicting patients with signs of bleeding post-hip surgery (first year) and cardiac catheterization (final year). Their responses were analyzed using content analysis. The resulting categories capture the cues students noticed, the goals they aimed to achieve, the actions they proposed and their expectations for how the bleeding situations might unfold. Code frequencies showing the most variation between the first and final years were analyzed to explore changes in students' clinical decision-making., Results: Nearly all students focused on two primary categories: 'Bleeding' and 'Instability and Shock.' Fewer students addressed six secondary categories: 'Stress and Concern,' 'Pain,' 'Lifestyle and Social History,' 'Wound Infection,' 'Arrhythmia,' and 'Generalities in Surgery.' Students often concentrated on actions to manage bleeding without further assessing its causes. Changes from the first to the final year included a more focused assessment of instability and shifts in preferred actions., Conclusions: This study reveals that nursing students often prioritize immediate actions to stop bleeding while sometimes overlooking the assessment of underlying causes or broader care goals. It suggests that concept-based learning and reflection on long-term outcomes could improve clinical decision-making in post-procedural care., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper, (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Aim: To explore nursing students' thoughts and feelings about self-injuring during their clinical practicums., Background: Unfamiliar clinical environments pose challenges for nursing students, potentially leading to high levels of stress. When students find it difficult to cope with emotional triggers, some contemplate self-injury. Yet, it is rare to explore nursing students' thoughts and feelings related to self-injury during their clinical practicums., Design: A phenomenological approach was used., Methods: Purposive sampling was used and the participants were drawn from nursing students who graduated from universities in Taiwan. In-depth, semi-structured interviews were conducted from August to November 2023. Data saturation was reached after interviewing 15 participants. Colaizzi's seven steps and NVivo software were used for data analysis., Results: Four themes and 14 subthemes emerged. They were: (1) Sensing an emotional crescendo: participants experienced anxieties about clinical educators, assignments, homework and the clinical practicums and these intensified across time. (2) Physical and mental dysregulation: participants experienced physical discomfort, psychological distress and negative thoughts when subjected to overwhelming pressures during their clinical practicums. (3) Unwholesome self-protective behaviors: participants expressed thoughts of self-injury, engaged in self-injurious behaviors, experienced suicidal ideations and attempted suicide as measures of relieving stress. (4) Compassionate self-protective behaviors: participants coped with stress through emotional voicing, modifying situations to adjust stress, reaching out for help, self-compassion and self-care., Conclusions: Findings raise awareness of the need for clinical educators to demonstrate empathy with nursing students who have thoughts of self-injury during their clinical practicums. Further, it is crucial for them to offer timely guidance on the healing process while simultaneously creating nurturing clinical environments wherein students could flourish and grow., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Aim: The present study was conducted to determine the effect of education provided to first-year nursing students with the escape room game on their learning of parenteral drug administration., Background: The use of escape room games in education supports formal education in providing students with professional knowledge and skills., Design: A randomized controlled study design was used in this study., Method: The current study was conducted with 72 first-year nursing students. Data were collected with the Descriptive Characteristics Questionnaire (DCQ), Parenteral Drug Administration Information Test (PDAIT), Parenteral Drug Administration Sub-Checklists (PDASC) and Game Evaluation Form (GEF) between May and June 2022. The initial knowledge and skills of all students participating in the study were measured after completing the parenteral drug administration theoretical course and laboratory skills course. Students were assigned to the intervention (n=36) and control (n=36) groups by the stratified block randomization method according to their initial knowledge and skill measurements. Unlike the control group, the intervention group played the escape room game once in groups of four. The control group was allowed to work freely in the laboratory during this period. The final knowledge and skills of the intervention and control groups were measured immediately after the intervention. Students' skills were measured with an objective structured clinical examination., Results: It was determined that the post-test knowledge level of the students in the intervention group and their post-test skill mean scores for drug withdrawal from an ampoule, subcutaneous injection administration, intradermal injection administration and intravenous push drug administration were higher than those of the students in the control group (p<0.05). Additionally, Intervention group students evaluated the escape room game positively., Conclusion: This study concluded that the escape room game supported formal education and could be used in teaching parenteral drug administration., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this study., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Aim /objective: To identify strategies nursing students recommend for responding to discrimination in their program., Background: The nursing discipline is rooted in social justice, which is increasingly positioned as practices that seek to enhance equity in health and healthcare. Yet, a growing body of knowledge indicates nursing students experience discrimination by virtue of race, sexual identity, gender identity, ability and mental health in nursing programs. There is a dearth of information that speaks to redressing discrimination in nursing schools, particularly from the perspectives of nursing students., Design: This study reports on the findings of the qualitative portion of a mixed-methods project., Methods: Data were collected via qualitative interviews (n=20) conducted on the Zoom platform. Inclusion criteria included any nursing graduate or undergraduate student enrolled in two institutions in Western Canada. Analysis was guided by a combination of thematic analysis with interpretive description to facilitate the identification of broader themes within the context of relevant disciplinary considerations., Results: Three key themes that represent nursing student perspectives to redress discrimination in their programs were identified: (1) strategies to redress discrimination at the level of the educator/curriculum, (2) strategies to redress discrimination at the structural level and, (3) strategies to support students who have experienced discrimination., Conclusions: Systematic curriculum updates and educator supports to ensure up-to date knowledge and appropriate educator approaches are needed in classroom and clinical settings. The integration of equity-seeking processes at higher levels, e.g. for example, nursing standards of practice, was identified as essential to redress discrimination in education as well in everyday nursing practice. Lastly, a clearly defined reporting pathway was suggested to support students who have been subject to discrimination. Given this is one of the first investigations into student perspectives on redressing discrimination in nursing schools, additional research is needed to evoke meaningful change., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Aim: The aim of this scoping review was to discover literature identifying factors influencing academic motivation in undergraduate nursing students., Background: Nursing students have a heavy academic workload, so self-motivated learning is important for them to succeed in the nursing program. There is a plethora of factors that influence the degree and type of motivation in nursing students. Understanding these factors will assist faculty in providing an environment that fosters motivation., Design: This study was conducted using a scoping review method., Method: This review was completed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). The following databases were searched: 1) CINAHL; 2) ERIC; 3) Education Full Text; 4) ProQuest; and 5) PUBMED. The date was restricted to articles published from 2019 to 2024. Article titles and abstracts were screened for eligibility., Results: A total of 461 articles were screened and 10 studies were identified that met eligibility criteria. The articles consisted of descriptive, cross-sectional and correlational studies. The main themes identified were autonomy, competence, social support and coping. The research questions in this review were answered by explaining how autonomy and competence affect academic motivation, along with other contributing factors., Conclusion: Academic motivation was positively correlated with coping behaviors, social support, competence and autonomy. It is recommended that faculty encourage autonomous activities in the classroom and provide positive feedback to increase student competence and academic motivation., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Aim: This research aimed to evaluate the effect of the psychodrama-based intervention used in the communication course of 2nd year nursing students on their therapeutic communication skills and cognitive flexibility., Background: Psychodrama has been defined as a way of practicing living without being punished for making mistakes. The psychodrama-based interventions can be used as a novel teaching method to improve therapeutic communication skills and cognitive flexibility in education by allowing students to learn from their trials and errors before going into clinical practice and communicating one-on-one with the patient., Design: A single group, pretest-posttest with a follow-up quasi-experimental design was adopted., Method: The participants were a convenience sample of 24 s-year undergraduate nursing students. Students attended a one-day in-a-week psychodrama-based communication course for 14 weeks. The data of the study were collected with the Demographic Information Form, the Therapeutic Communication Skills Scale and the Cognitive Flexibility Inventory. Outcomes were measured on the first day (baseline), at the end of the course and 6 and 12 months after completing the course. Outcomes were analyzed using descriptive and repeated measures analysis of variance, Friedman and Dunn tests., Results: It was determined that the nontherapeutic communication scores were significantly lower at the post-test, 6 months and 12 months than at baseline in participants. Therapeutic-one scores were significantly increased at the post-test compared with baseline in participants. Therapeutic-two scores were significantly increased at 6 months compared with baseline. There was no statistical difference in any measure in the cognitive flexibility inventory., Conclusion: The psychodrama-based intervention in communication course significantly improved nursing students' therapeutic communication skills. It is also recommended to conduct studies with larger samples of nursing students from different institutions and also randomized controlled studies with control groups and qualitative studies. It is recommended to conduct studies evaluating an intervention that includes subheadings more related to cognitive flexibility which is an important nursing competency, as well as new studies that evaluate cognitive flexibility with different measurement tools., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Aim: To develop an evidence-based nursing practice course framework for undergraduate nursing students from a perspective of academic-practice partnerships., Background: Academic-practice partnerships could play a crucial role in bridging theory-practice gap in evidence-based nursing education. However, there is a lack of evidence-based nursing practice course framework for undergraduate nursing students from a perspective of academic-practice partnerships., Design: A Delphi study., Methods: The Delphi study was conducted by literature analysis, qualitative interview and Delphi expert consultation to develop this course framework. 15 and 12 experts were involved in round one and round two of Delphi expert consultation, respectively. The consensus threshold of two-round Delphi expert consultation was described by expert's positive coefficient (≥ 50 %), positive coefficient (≥ 70 %), expert authority coefficient (≥ 0.7), coefficient of variation (<0.25) and full score frequency (>20 %)., Results: The final course framework includes learning objectives (17 items); teaching chapters of theoretical classes (five items); teaching contents (30 items), methods (12 items) and class hours (9 items) of theoretical classes; and the responsibilities of academic teachers (11 items) and clinical teachers (11 items) in practical classes., Conclusion: The course framework developed by this study could provide guidance for evidence-based nursing education of undergraduate nursing students. The effectiveness of this course framework should be verified through further experimental studies in the future., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)