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Purpose: The social determinants of health (SDOH) include factors such as poverty, lack of access to health care, educational barriers, stigma, and racism which can contribute to health disparities and inequities. Minorities, rural communities, and underserved populations are disproportionately affected by SDOH. Nursing students must become aware of the SDOH in order to provide high-quality, holistic, patient-centered care to patients and their families. The purpose of this study was to determine the impact of a case-based workshop on undergraduate and graduate nursing students' knowledge and attitudes about the social determinants of health. Sample: Bachelor of Science in Nursing (BSN), Family Nurse Practitioner (FNP), and Psychiatric Mental Health Nurse Practitioner (PMHNP) students from a public, liberal arts university in the rural, southeastern United States participated in the project. Method: Demographic information and survey data were obtained from participating undergraduate and graduate nursing students to assess the impact of a case-based SDOH workshop on their knowledge and attitudes about the SDOH. Findings: Five of the nine scored survey items had statistically significant differences in pre- and post-survey ranked scores. Increased student response scores were noted on items about SDOH knowledge and attitudes, including awareness of SDOH and vulnerable populations, knowledge of how social determinants and economic factors influence health, and confidence with working with vulnerable populations in the future. Four themes were apparent from analysis of the three open-ended questions: Awareness of Resources, Social Worker Perspective, Awareness of Social Determinants of Health, and Importance of Empathy. Conclusions: It is important for nurses in rural areas to understand the influence of social determinants on population and individual health when caring for and treating vulnerable patients so that they can provide more holistic care to patients and can address health disparities. [ABSTRACT FROM AUTHOR]

Grit and resilience are related but separate concepts. Grit is a long-term commitment toward goals, and it impacts student success and academic achievement. Resilience is the ability of students to recover from stress. Both are important factors in nursing students. This descriptive study included surveys measuring demographics, grit, and resilience among two cohorts of senior nursing students in their last semester and explored challenges and difficulties experienced during the COVID-19 pandemic. The mean grit score for all students was 4.0 (0.52) and the mean resilience score was 3.63 (0.73). Directed content analysis of the ten open-ended survey questions revealed three themes: Impact on Education, Personal Impact, and Coping Mechanisms. Grit and resilience are important factors that can contribute to success in nursing programs and as graduate nurses in the healthcare settings. [ABSTRACT FROM AUTHOR]

Background: Tweet-format narratives have been used in medical education to capture student experiences. However, there is a lack of research on tweet-format narratives during experiential learning in nursing education. Purpose: The purpose of this project was to explore the usefulness of tweet-format narratives to capture nursing student experiences and to elicit reflection during a service-learning trip. Methods: Eight bachelor of science in nursing (BSN) students participated in a service-learning experience to Appalachia. A grounded theory approach with three data collection methods was used to determine the usefulness of tweet-format narratives to facilitate student reflection during the event. A free closed text-messaging app was used to house tweet-format narratives. A focus group session and post-survey were conducted at the conclusion of the trip. Emergent themes from each data collection method were compared and modified using iterative techniques and constant comparison analysis until the data were saturated. Results: Focus group responses were reflective in nature and included student elaboration about content themes that were previously identified by the tweet-based narratives. Modification of themes resulted in six final themes of improved skills, cultural competence, patient interaction, socioeconomic factors and health, landscape/clinic setting, and impactful shared experiences. Conclusions: It is important for nursing students to reflect on their experiences during service-learning immersion trips, especially as they relate to underserved rural populations and their unique healthcare scenarios. With the growth of social media, more nursing students are accustomed to communicating in a short, text-based format. The tweet-format narratives in the free closed text-messaging app allowed students to reflect on their experiences through open-ended comments and to communicate with other members of the group. Short text-based narratives can be an effective narrative medicine technique for nursing students participating in service-learning trips in rural areas. [ABSTRACT FROM AUTHOR]

Background: Prior research studies on the predictors of success in nurse practitioner programs have not focused on students in rural areas. Purpose: The purpose of this study was to examine factors that influence student success in a rural nurse practitioner program in the Southeastern United States. Methods: Admission data from family nurse practitioner students at a rural university were obtained from a secured drive and transcribed into an Excel spreadsheet. Bivariate analysis using independent t-tests for continuous variables and chi-square tests for categorical variables was conducted to determine group differences between successful and unsuccessful students by demographic and education factors. Results: A total of 84 students were enrolled in the family nurse practitioner program, including 70 (83.3%) females and 14 (16.7%) males. Student demographics included 15 (17.9%) African American, 67 (79.8%) Caucasian, one (1.2%) American Indian or Alaska Native, and one (1.2%) Asian, with 67 (80%) residing in the local rural Pee Dee Region. Of the 84 students, 49 (58.3%) successfully completed the program and 35 (41.6%) were unsuccessful and either withdrew or were dismissed. African American students had decreased rates of program enrollment and completion compared to Caucasian students, with only 3 (20%) of the 15 enrolled students successfully completing the program. Conclusions: Identification and examination of sociodemographic and education factors influencing student success in southeastern rural nurse practitioner programs may improve overall program completion rates, facilitate program success for minority students, and increase the diversity of the nurse practitioner workforce. [ABSTRACT FROM AUTHOR]

Background: Collaborative testing is an educational strategy that allows students to work in teams when completing an examination. Method: Twenty-eight family nurse practitioner students took four course examinations individually and collaboratively. Five comprehensive questions were included on the fourth examination. A survey was administered at the end of the course, with permission. Results: All collaborative test scores were higher than the traditional test scores (traditional mean range = 80.78 [8.53] to 84.07 [7.41], collaborative mean range = 93.54 [3.77] to 94.07 [2.80], all p values < .001). Students did not demonstrate significant changes in mean scores for cumulative content on test four. Directed content analysis revealed four themes: Enhanced Understanding of Content, Collaboration With Classmates, Socialization, and Improved Grades. Conclusion: In graduate nursing education, collaborative testing may be an effective strategy to improve teamwork and communication skills, enrich relationships, and enhance critical thinking. [ABSTRACT FROM AUTHOR]

Simulation helps to prepare prelicensure nursing students for practice by providing opportunities to perform clinical skills and make decisions in a safe environment. The integration of nursing knowledge, skills, and decision-making abilities during simulated unfolding case-study scenarios may enhance student self-confidence and foster clinical judgement skills. The purpose of this study was to assess the impact of simulation using unfolding case-study scenarios on undergraduate nursing students' self-confidence in pediatric nursing knowledge, skills, and clinical judgment/decision-making abilities. This mixed methods study included a pre- and post-survey design to evaluate undergraduate nursing students' confidence in pediatric nursing knowledge, skills, and decision-making abilities after participation in both an instructor-led (guided) and a student-led (decision-making) simulation involving unfolding case-study scenarios. Friedman's ANOVA analyses revealed that all 16-items demonstrated statistically significant differences between the three measured responses (pre-simulation and both post-simulation surveys). Post-hoc Wilcoxon signed-rank tests revealed statistically significant differences in student ratings pre-simulation and post-instructor-led (guided) experience for all 16-scored items. The qualitative themes identified were perception of experience, pediatric nursing care, assimilation of knowledge, and critical thinking. Unfolding case-study simulation experiences positively impact the learning, self-confidence, and clinical judgement of undergraduate nursing students. [ABSTRACT FROM AUTHOR]

Telehealth is an expanding modality of providing care. In 2018, the National Organization of Nurse Practitioner Faculties (NONPF) released a white paper encouraging the inclusion of telehealth into nurse practitioner education. It is important for nursing students to gain experience with telehealth so that they are prepared to provide care via telehealth. The purpose of this project was to evaluate the impact of incorporating telehealth simulation into objective structured clinical examinations (OSCEs) in the family nurse practitioner (FNP) and bachelor of science in nursing (BSN) programs. This study was conducted at a public, liberal arts university in a rural area of the Southeast United States. The FNP and BSN students participated in this study. The FNP program is a hybrid master's degree program, which has a two-year plan of study. The BSN program is a traditional campus-based program, which includes two years of upper-division nursing courses. This mixed-methods study included a pre- and post-survey design utilizing both quantitative and qualitative measures to evaluate undergraduate and graduate nursing students understanding of and comfort with telehealth and their perceptions of a simulated intradisciplinary telehealth OCSE experience. Students' telehealth knowledge, skills, and confidence were improved after the telehealth OSCE experience. Directed content analysis of the responses revealed three themes: increased knowledge of telehealth, technical difficulties, and teamwork/communication. It is beneficial for both undergraduate and family nurse practitioner students to have exposure to telehealth in their respective curriculums. [ABSTRACT FROM AUTHOR]