University of Central Florida College of Nursing

Background Public Health Nurses (PHN) provide vital care to the community. There is a growing need to utilize checklists to ensure competencies are met for prelicensure nursing students; however, there are minimal public health resources with validated checklists to meet the requirements of accrediting bodies. Method Experts in public health validated a competency-based checklist that was mapped to the Essentials and public health competencies. Results A 26-item Simulated Public Health Competency Checklist was validated in a simulated environment with prelicensure nursing students. Conclusions The instrument can be used to demonstrate competency requirements and promote public health nursing in curricula.

CONTEXT:Multimodality therapy for locally advanced rectal cancer (LARC) is lengthy, complex, and overwhelming for patients to navigate. We developed "PATHWAYS," an informational and supportive care intervention tailored to patients initiating multimodality therapy for LARC. OBJECTIVES:We sought to assess the feasibility and acceptability of PATHWAYS, and to refine the intervention based on patient feedback. METHODS:We conducted a pilot randomized controlled trial among patients initiating multimodality therapy for LARC. We randomized participants 1:1 to receive PATHWAYS (an educational guide plus four behavioral coaching sessions) or enhanced usual care (a curated list of online resources). Participants completed questionnaires at baseline, six, and 12 weeks, and in-depth interviews at six and 12 weeks to elicit feedback on study participation. The primary outcome was feasibility (60% of eligible patients enroll; 60% of PATHWAYS participants complete the intervention). The secondary outcome was acceptability (80% of PATHWAYS participants report satisfaction using the Client Satisfaction Questionnaire-8). RESULTS:Among 34 eligible patients approached, 20 (59%) enrolled (mean age 56.8 years, 50% women, 75% non-Hispanic White). Of the 10 patients randomized to PATHWAYS, nine (90%) completed the intervention, all (100%) of whom found the intervention acceptable. In qualitative interviews, participants reported using the PATHWAYS guide to enhance knowledge and the coaching sessions to make learning more manageable and tailored to their needs. CONCLUSION:In this pilot randomized controlled trial, we demonstrated high engagement and acceptability of a novel supportive care intervention for patients with LARC. Study results will guide refinements to the PATHWAYS intervention and future study procedures.

This qualitative exploratory study aimed to learn clinicians' perspectives on Pre-exposure Prophylaxis (PrEP) initiation, the HIV risk assessment process, perceived barriers to PrEP implementation, and how a potential electronic health record (EHR)-based PrEP clinical decision support tool can help improve their practices. Using purposive sampling, we recruited 15 clinicians with experience in PrEP practices for the three remote focus groups held between October 2021 and November 2021 using a semi-structured discussion guide. The focus groups were audio-recorded, transcribed, and analyzed in NVivo using thematic analysis. Five themes emerged from the qualitative analysis: (1) PrEP initiation is a joint effort between patients and clinicians; (2) Patient-clinician conversations are key for identifying PrEP candidates; (3) EHRs are helpful but insufficient for identifying PrEP candidates; (4) Patient, clinician, and system-level barriers deter PrEP implementation; and (5) Adopting technological innovations in health care can improve PrEP prescribing. Our analysis suggests that implementing effective communication strategies and behavioral interventions can improve PrEP awareness and reduce barriers in patient-clinician discussions of sexual history and substance use.

INTRODUCTION:Caring is a transpersonal concept within the context of the expression from clinical practitioners or researchers to an individual, family, community and policy development. The connections between human health outcomes and the environment are profoundly relevant in harmful algal bloom (HAB) research. Nurses are responsible for integrating science and environmental health into nursing education, research and practice for collaboration, community engagement and policy changes to address patient needs and mitigate adverse environmental changes and health impacts. A theoretical framework is required to guide this work. DESIGN:An analysis of the Bureaucratic Caring Theory (BCT). BCT is a holographic theory that harmonises a dialectical synthesis of thesis (spiritual-ethical) and antithesis (bureaucracy) into a broader meaning of truth or symbiosis. RESULTS:BCT supports (1) co-creation of improved conditions for the community, (2) fostering self-consciousness and an understanding of health to existing Physical, Educational, Legal, Technological, Educational, Economic and Political dimensions unified by Spiritual-cultural meaning and (3) the study of existing theories and models to communicate community member needs and the response of the nursing profession. DISCUSSION:A theoretical framework was needed to guide practice, education, and research in HAB Human Health Outcomes research. The underpinning of HAB research with BCT aligns with nursing practice, nursing education and nursing research with interprofessional scientists and has significant health care implications. CONCLUSION:We propose the application of BCT which identifies the seven dimensions of the theory and the 8th central dimension of spiritual-ethical caring to enhance continued scientific inquiry, increased attention to environmental health education, and knowledgeable, caring practice to improve the health and well-being of individuals, families, communities, and the impact of environmental health policy development.

Background: Nurse practitioner (NP) students may lack confidence in diagnostic planning skills. As programs move toward competency-based education, virtual simulation (VS) offers an opportunity to assess core competencies related to clinical reasoning (CR) in a structured, learner-centered format. The aim was to explore how VS can be used to evaluate core competencies for advanced practice nurses. Methods: This multisite study included 74 primary-care-focused NP students across three universities. Institutional review board approval at all universities was attained. Participants completed two VS scenarios. Simulations were conducted using standardized prebriefing and debriefing processes. Data collected included clinical and diagnostic reasoning, diagnostic confidence, time on task, and student perception of effectiveness. Results: Time spent in VS was not associated with CR scores. Confidence in diagnosis remained unchanged regardless of diagnostic accuracy. Data suggests that the order in which scenarios occurred was less impactful than the content difficulty. Students perceived the VSs as effective. Conclusion: VS offers a reliable and scalable strategy for evaluating NP learner competencies related to CR. Simulations can align with multiple competencies. (c) 2026 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc.