Background and objective: Nurses frequently report insufficient preparation to provide high-quality end-of-life (EOL) care, despite an increasing number of patients requiring comfort-focused interventions. At a community hospital in Connecticut, formal EOL education is limited to a specialty unit, resulting in newly graduated nurses on other inpatient units caring for patients at the end of life without standardized training. The purpose of this evidence-based practice project was to evaluate the impact of integrating the End-of-Life Nursing Education Consortium (ELNEC) curriculum into a new graduate nurse residency program on nurses’ self-perceived knowledge of caring for patients receiving comfort measures. Methods: A single-group, quasi-experimental pretest-posttest design was used. New graduate nurses on inpatient medical units completed the End-of-Life Care Questionnaire (EOL-Q) before and after completing the online ELNEC course. Descriptive statistics and Wilcoxon signed-rank test were used to analyze changes in self-perceived knowledge. Results: Eight nurses completed the post-intervention assessment. Median scores increased across all four EOL-Q factors and across the knowledge, attitude, and management subdomains. Statistically significant improvements were observed in advance care planning (p = .035), symptom management (p = .030), emotional and spiritual support (p = .022), knowledge (p = .022), attitude (p = .035), and management (p = .021). Communication and continuity of care improved but did not reach statistical significance (p = .055). Conclusions: Findings suggest that integrating the ELNEC curriculum into a new graduate nurse residency program may improve nurses’ self-perceived knowledge and attitudes related to end-of-life care. Given the small sample size, single-site setting, and unmatched pretest–posttest design, findings should be interpreted as preliminary.
Background and objective: New graduate nurses frequently report gaps in confidence, self-efficacy, and readiness for high-acuity pediatric practice, largely due to limited exposure to critical care environments during prelicensure education. Specialty electives may offer an upstream strategy to strengthen preparation and support pediatric workforce development. This evaluation examined the impact of a pediatric acute–chronic critical care elective on prelicensure nursing students’ confidence, self-efficacy, and perceived readiness for high-acuity pediatric practice. Methods: A pre–post quality improvement design was used to evaluate a 12 week elective within an accelerated prelicensure program. Seventeen Likert scale items measured confidence, self-efficacy, and perceived readiness across pediatric critical care domains. Wilcoxon signed rank tests and effect sizes (r) were used to assess changes. Qualitative reflections from journals and discussion boards were analyzed using thematic content analysis to contextualize quantitative findings. Results: Eighteen students completed matched surveys. Statistically significant improvements were observed across all 17 domains, with large effect sizes (r = .588–.940). The greatest gains occurred in ventilator management (107.5%), pediatric emergency/code preparedness (76.5%), and recognition of pediatric shock (63.2%). Qualitative themes demonstrated increased confidence, strengthened self-efficacy, and clearer career trajectories. Students described greater decisiveness in high-acuity situations, improved application of structured communication frameworks, and the value of mentorship from pediatric and neonatal critical care nurses. Conclusions: Participation in the pediatric critical care elective was associated with meaningful improvements in students’ confidence, self-efficacy, and perceived readiness for high-acuity pediatric practice. Findings support specialty focused electives as feasible, scalable strategies to enhance practice readiness and contribute to pediatric workforce development.
Procrastination is a common problem in academic contexts, affecting students' performance. To address this problem, the current research investigated its prevalence and factors among postgraduate diploma students. A cross-sectional design and a self-administered online questionnaire were used at the Higher Institute of Health Specialities. The study included all postgraduate diploma students in higher institute programmes. Data were analysed using SPSS Statistics. Findings showed that many Post Graduate Diploma students exhibited above-average levels of procrastination, especially on challenging tasks. Students were willing to reduce procrastination. Key factors included fear of failure, low motivation, task overload, and social influences. Factor analysis identified three main dimensions: risk-taking, fear of failure, and laziness. No significant link was found between procrastination and demographic variables.
Background and objective: Nursing interns frequently experience psychological distress during clinical training, which may negatively affect learning outcomes and professional development. Traditional dual-mentor models provide important educational support but often lack continuous monitoring of interns’ psychological status. This study aimed to develop and evaluate an AI-enabled dual-mentor psychological support closed-loop system and to examine its effects on nursing interns’ clinical skills, emotional exhaustion, and internship satisfaction. Methods: A quasi-experimental pretest–posttest control group design was adopted. A total of 200 nursing interns from a vocational college in Zhejiang Province, China, were assigned to an experimental group (n = 100) or a control group (n = 100) using cluster sampling. The experimental group received an AI-enabled dual-mentor psychological support intervention in addition to routine internship supervision for one semester, while the control group received routine dual-mentor supervision only. Outcomes included clinical skills performance, emotional exhaustion (MBI-GS), and internship satisfaction. Data were analyzed using paired t-tests, chi-square tests, and analysis of covariance (ANCOVA). Results: The proportion of interns achieving excellent clinical skills performance was significantly higher in the experimental group than in the control group (28.0% vs. 11.0%, χ2 = 9.82, p = .002). After controlling for baseline scores, the experimental group reported significantly lower posttest emotional exhaustion (F = 25.34, p < .001) and significantly higher internship satisfaction than the control group (F = 18.56, p = .008). Conclusions: The AI-enabled dual-mentor psychological support closed-loop system effectively improves nursing interns' clinical skills, reduces emotional exhaustion, and enhances internship satisfaction. The system was particularly effective in identifying early signs of psychological distress and facilitating timely, tiered interventions, serving as a supportive tool that enhances—rather than replaces—the established dual-mentor framework.
Background and objective: In 2020, the College of Nursing quickly transitioned to online learning for students in response to the COVID-19 pandemic. It was reported that the pandemic exacerbated student failures due to the quick change to online learning and environmental conditions, changes in program location, and external stressors. Thus, the research team wanted to understand if this transition affected students’ success. The objective of the study was to understand how students defined academic success while completing a Bachelor of Science in Nursing program. Methods: A qualitative descriptive design was used with undergraduate nursing students (n = 14) through interviews over a three-month period. Data were analyzed thematically. Results: Three themes emerged from the interviews: a) Students’ Perspectives of Success, b) Students’ Experiences of In-Person Learning, and c) Students’ Experiences of Online Learning Results. Conclusions: This qualitative descriptive study aimed to explore how undergraduate nursing students conceptualized academic success and navigated online learning during the pandemic, centering students’ experiences. Findings suggest that academic success is not dependent on instructional modality, but rather on students’ access to structured resources, autonomy, and opportunities for meaningful peer and faculty engagement, and their ability to apply knowledge and understand course content.
Objective: Undergraduate nursing research and data analysis courses are foundational to evidence-based practice yet are frequently perceived as abstract and disconnected from clinical care. This study describes an instructional redesign that transitioned from an exam-centered model to a writing-intensive, guided learning approach to improve engagement, critical thinking, and clinical relevance. Methods: A structured pedagogical redesign incorporated writing-intensive assessment, guided skeletal notes, unfolding case studies, and interactive learning tools within a concept-based undergraduate nursing curriculum. A pre–post descriptive design was used to compare course-based assessment scores (analysis, application, and critical thinking) across multiple semesters. Qualitative data from student course evaluations were analyzed to assess perceived engagement, clarity, and relevance to nursing practice. Results: Following implementation, analysis and application scores increased by approximately 7%, while course-based measures of critical thinking improved by 6%. Continued refinement of the instructional approach was associated with sustained improvements, with analysis and application averages reaching 95%–98% in subsequent semesters. Student evaluations further indicated increased engagement, improved clarity of content, enhanced relevance to nursing practice, and greater confidence in applying evidence-based concepts. Conclusions: Writing-intensive, scaffolded instructional strategies grounded in learning science and concept-based education was associated with improvements in course-based measures of critical thinking and professional identity formation in undergraduate nursing education.
Objective: Workplace violence is an ongoing concern in healthcare settings. Patient-initiated violence toward healthcare workers impacts employees physically and emotionally and may affect the quality of care delivered to patients. Healthcare organizations must promote safety through appropriate policies, procedures, and educational practices. The purpose of the study was to examine potential gaps in education and preparedness to manage violent patient situations and to evaluate whether workplace violence training is associated with the prevalence of patient-initiated violence. Methods: A cross-sectional correlational design was used, including a survey with Likert-type items and open-ended questions. The survey was distributed via snowball sampling through social media and professional email listservs. Two hundred fifty-six respondents from the United States participated in the study. Quantitative data were analyzed using chi-square tests and exploratory logistic regression, and qualitative responses were analyzed to identify common themes. Results: More than half of the respondents (66.01%) reported experiencing patient-initiated violence within the past six months. Although 82% of participants reported completing workplace violence training, no statistically significant association was observed between training and the prevalence of patient-initiated violence. Exploratory multivariate analysis adjusting for years of experience, clinical setting, and employment status yielded similar findings. Clinical setting was a significant predictor of violence exposure, indicating variability across practice environments. Qualitative responses highlighted concerns regarding training adequacy, frequency, organizational support, and emphasized the need for changes in hospital policy, procedures, and unit-level environments. Conclusions: Patient-initiated violence toward healthcare workers remains a significant issue in healthcare. Findings from this study suggest that training alone may be insufficient to reduce violence exposure and that organizational and environmental factors play a critical role. Interventions such as enhanced scenario-based training, implementation of de-escalation teams, and stronger enforcement of policies and procedures at the organizational level may better support healthcare workers in recognizing and managing escalating situations.
Background and objective: Despite increasing diversity within nursing programs, educators often report feeling underprepared to teach multilingual students. Self-efficacy is essential in shaping inclusive learning environments that promote academic success and retention. This project aimed to enhance nurse educators’ self-efficacy in teaching multilingual students through a targeted educational intervention. Methods: A one-hour faculty development session was implemented at an associate degree nursing program, utilizing evidence-based teaching strategies, inclusive classroom practices, and culturally responsive communication approaches. A single-group pretest–posttest educational intervention design was used. Changes in self-efficacy were measured using the revised Self Efficacy Toward Teaching Inventory for Nurse Educators (SETTI-NE). Results: Twenty-three educators participated. Self-efficacy significantly improved following the intervention (t(22) = 7.64, p < .001), with mean scores increasing from 34.22 (SD = 8.93) to 45.91 (SD = 5.49), representing a mean difference of 11.69 points (95% CI, 8.48–14.90) and a large effect size (Cohen's d = 1.59). Conclusions: Focused faculty development interventions can improve educators’ preparedness to teach multilingual students and support inclusive educational practices. These findings support faculty development initiatives that align with Domains 1, 3, 5, and 10 of the AACN Essentials by strengthening educator competence in inclusive, evidence-based instruction.
Background: A structural gap persists between foundational nursing education and the rapidly evolving technological landscape of clinical incontinence care in Japan. Increasing product differentiation requires healthcare professionals to exercise situational product selection, while undergraduate curricula often lag behind technological innovation. In addition, the diversification of the healthcare workforce introduces further complexity in interpreting locally optimized product logic. This report describes the development and evaluation of an academia–industry collaborative recurrent education program designed to address these structural challenges. Methods: The program was co-developed by university faculty and an industry product development team. Theoretical sessions addressed skin pH dynamics, barrier protection mechanisms, and cleansing principles relevant to incontinence-associated dermatitis. Practical sessions incorporated visualization-based comparative demonstrations, in which simulated stool and urine were simultaneously applied to different absorbent products to externalize structural differences in absorption patterns and surface moisture conditions. The program was delivered in two separate in-person sessions at different venues in Niigata, Japan, in March 2025, with a total of 34 nursing and caregiving professionals participating across both sites, including one foreign care worker. Results: Among respondents (n = 25), 88% reported acquisition of new knowledge and 92% recognized practical applicability. Qualitative feedback emphasized the value of hands-on visualization and expressed intentions to disseminate updated knowledge within clinical workplaces. Conclusions: Academia–industry collaborative recurrent education may function as an adaptive interface between foundational curricula and accelerating clinical innovation. Beyond individual skill acquisition, such programs have the potential to support shared clinical reasoning across diverse professionals and contribute to regional healthcare quality assurance in technologically advancing care systems.
Objective: Advanced ovarian cancer is often diagnosed at stages IIIB–IV, with frequent recurrence and poor prognosis despite standard treatment. Poly(ADP-ribose) polymerase (PARP) inhibitors are available as maintenance therapies; nonetheless, evidence on patient experiences remains limited. This study clarified patient experiences during maintenance therapy with PARP inhibitors and identified nursing support implications. Methods: We used a descriptive qualitative design. Three women with advanced ovarian cancer (40s–70s; FIGO stage IIIB–IIIC; two with recurrence) attending an outpatient clinic were recruited. Semi-structured interviews were conducted up to five times within 6 months after therapy initiation (total, 531 min), and medical records were reviewed. Transcripts were analyzed using the KJ method. Results: Seven categories were identified. Patients described PARP inhibitors as “a talisman-like treatment” that provided reassurance and enabled them to navigate daily life despite concerns about heredity and financial burden; they valued “the support of family, colleagues, and healthcare providers” and wished “to live by trusting in PARP inhibitors even under uncertainty.” They reported “symptom observation and daily management” as self-care strategies and expressed “fear of cancer and harsh treatments,” “conflicts in regaining self-identity,” and a strong need “for a place to consult about symptoms, costs, and continuation of therapy.” Conclusions: Patients balanced reassurance and uncertainty, supported by treatment efficacy and social relationships, but challenged by fear, financial strain, and identity loss. Nurses should assess these experiences and provide individualized consultations addressing symptoms, economic concerns, and genetic issues. Early, continuous consultation and strengthened multidisciplinary collaboration are essential to sustain treatment and improve quality of life.
Pre-licensure nursing students enrolled in remediation often experience diminished academic self-efficacy and elevated stress, increasing risk for attrition. This descriptive correlational pilot study examined the feasibility and preliminary outcomes of embedding a structured self-care and self-efficacy intervention within a 6–8-week remediation course. Guided by Bandura’s Social Cognitive Theory and principles of metacognitive regulation, the intervention integrated evidence-based learning strategies, time management instruction, stress regulation techniques, and structured reflective journaling. Six students completed pre- and post-intervention assessments using the General Self-Efficacy Scale (GSES). Mean self-efficacy scores increased from 4.28 (SD = 0.31) to 4.62 (SD = 0.38), and internal consistency reliability improved (α = .78 to α = .90). The Wilcoxon signed-rank test was not statistically significant (p = .156). Qualitative analysis identified themes of active strategy adoption, improved planning behaviors, and enhanced academic confidence. Although limited by sample size, findings provide preliminary support for the feasibility of a theory-informed remediation model and suggest potential value in strengthening academic self-efficacy and adaptive learning behaviors among pre-licensure nursing students.
Objective: Fostering connections in online learning is essential for student success. The liquid syllabus is a student-centered course outline shared in a digital format to engage students. The goal of this study was to implement a liquid syllabus in two online, asynchronous nursing courses to explore the effectiveness of the liquid syllabus on course humanization. Methods: Faculty implemented the liquid syllabus and measured perceptions using a Likert survey and one qualitative question based on humanizing online learning experiences. Results: The students' overall perception was positive toward the liquid syllabus with all means greater than 3.8 on a scale from 1-5. Students stated ease of use, feelings of improved preparedness, and feelings of trust toward the instructor. Considerations for timing and connection emerged. Conclusions: The liquid syllabus can be an effective tool to engage online learners, enhance course preparedness, limit anxiety and potentially foster connection.
Background and objectives: Technology literacy is emerging as a competence to support clinical decision-making, documentation, and communication. However, while curricula for nursing students emphasize technological competencies, clinical education fails to support nursing students' understanding of technology in clinical practice. To address this gap, we developed a workshop for nursing students in clinical placement. The objective of this study was to evaluate of a workshop-based educational intervention designed to strengthen nursing students’ technology literacy and clinical decision-making. Methods: Design: A single group, post-intervention, descriptive design was applied to evaluate nursing students' learning outcomes. The workshop was structured in two parts. Part one focused on everyday technologies in nursing care guided by the TEKU model. Part two focused on future technologies such as AI and remote monitoring, using cases supported by The Pedagogical Reflection model or “The House” in clinical decision-making. To evaluate learning outcomes, a post-workshop questionnaire was completed. Results: Of 112 respondents, 77% (n = 86) had previously attended teaching in technology literacy during their studies, 20% (n = 22) had not, and 4% (n = 4) were unsure. As for self-reported technology literacy post-workshop (n = 82), 62% (n = 51) reported a high or very high understanding, 37% (n = 30) reported moderate, and 1% (n = 1) reported low understanding. Furthermore, 89% (n = 97) reported improved clinical decision-making when encountering new technologies to a moderate 54% (n = 59), high 29% (n = 32), or a very high degree of 6% (n = 6), and 11% reported low (n = 10) or very low (n = 2). Open-ended responses highlighted that reflection and case-based group work were valuable in supporting critical thinking in assessing technology. Discussion and conclusions: The results indicate that authentic and case-based learning activities are effective to support nursing students’ technology literacy and critical thinking and may address the gap between curricular requirements and clinical practice. However, a single group design might limit generalizability. A practice-oriented workshop approach is effective to strengthen nursing students’ technology literacy and support clinical decisions.
Background and objective: Nurses are at a higher risk for depression compared to the general public, thus requiring regular screening for depression. It remains unclear if a self-assessment screening tool may be recommended. The objective of this study was to compare a self-administered screening tool versus a clinician-guided interview. Methods: Twenty-five nurses completed BDI-II and the SCID-5-RV. We used descriptive statistics and Pearson correlation for analyses. Results: BDI-II identified 44% as screening positive for depression, and SCID-5-RV identified 40.0%. Conclusions: Self-administered tools like BDI-II may be cost-effective for screening, while clinical interviews remain the diagnostic gold standard. Future research should focus on improving screening accuracy.
Background: In the ever-changing health care field, a solid foundation of assessing clients is imperative. The standard method of performance based head-to-toe is limited in assessing students critical thinking and clinical judgement. An escape room utilizes innovative methods through gamification allowing students a collaborative approach to traditional learning strategies. The objectives were to promoting engagement, enhance teamwork, critical thinking and clinical judgment during performance-based checkoffs. Methods: The process for the escape room was determined by the purpose, and objectives. The steps included designing the escape room, writing the scenario, formulating the clues and puzzles. Results: A health assessment escape room was an effective modality fostering collaboration and student engagement during the final performance check-off. This innovation was well received based on evaluations and input by students and facility. Conclusions: A health assessment escape room enhances clinical judgement during performance checkoffs.
Background: Tiered grading practices that use letter, percentage, and numerical systems to express learner achievement of course outcomes are entrenched in nursing education programs. Despite their prevalence, these approaches present notable issues, including limited actionable feedback, challenges in fostering transferable practice competencies, and inconsistencies among evaluators. These concerns highlight the need for alternative assessment practices by educators that better support student learning and achievement of course outcomes. Methods: A fourth-year online nursing course was redesigned by the course instructor to employ specifications grading, an objective-driven, mastery-based assessment model. The implementation strategies and subsequent course revisions are documented and investigated following the highlights from the design. Discussion: The main challenges encountered by the instructor during the implementation phase included adapting new course structures to the existing ones, clarifying learner expectations, and supporting learners in transitioning to a new assessment framework. Revision opportunities helped improve transparency, alignment with learning outcomes, and learner engagement. Conclusions: Specifications grading demonstrates potential as a viable alternative assessment to traditional systems. Considering the novelty of this approach, recommendations and lessons learned are provided to guide educators considering similar approaches.
Background and objective: Nursing faculty experience high levels of stress and burnout, yet few wellness interventions tailored to this population have been evaluated. This study examined the feasibility and impact of an 8-week group stretching program on burnout, physical activity, and well-being among academic nursing faculty. Methods: Twenty-one faculty at Nevada State University completed pre-intervention surveys, with 12 completed post-intervention surveys. A mixed-methods design included the Maslach Burnout Inventory, International Physical Activity Questionnaire, and open-ended qualitative questions. Wilcoxon Signed-Rank Tests assessed quantitative changes; thematic analysis examined qualitative data. Results: Quantitative analyses showed no significant changes in burnout or physical activity. Qualitative findings revealed reductions in perceived stress, enhanced mindfulness, improved job satisfaction, and strengthened social connection. Conclusions: Brief, group-based wellness activities foster psychological and social benefits that may precede measurable reductions in burnout. Integrating such interventions into faculty workdays can promote resilience and well-being despite time constraints.
Background/Objective: Simulation is utilized in nursing programs to develop critical thinking skills during a high-risk scenario in a low-risk environment. Limited research exists regarding interprofessional simulation involving graduate and undergraduate nursing students. This project aimed to explore the impact of interprofessional simulation on graduate and undergraduate nursing students, focusing on realism, role identification, collaboration, communication, delegation, teamwork, and confidence. Methods: The sample population included 35 Student Registered Nurse Anesthetists (SRNAs) and 148 Bachelor of Science in Nursing Students (BSNs). Students participated in an Obstetric Emergency and Neonatal Emergency Simulation. Upon completion of the simulations, a survey was administered consisting of 17 questions, using a 5-point Likert scale. Results: Survey results revealed that students strongly agreed that working in an interprofessional format enabled them to identify roles and responsibilities. Statistically significant differences were found (p < .05) between the BSN and SRNA students in the following areas: motivated learning, realism, identifying roles, promoting teamwork, and effective communication. A statistically significant difference was found between the students' pre-test and post-test scores, indicating that students were more confident to participate in the interprofessional simulation. Conclusions: The results of this project support the implementation of interprofessional simulation in curriculum development to promote communication, teamwork, role identification, and confidence. Interprofessional simulations provide a safe space for students to explore delegation and role development without time constraints that could result in patient injury.
Objective: To evaluate the impact of an educational intervention aimed at improving knowledge and clinical understanding for emergency nursing professionals who care for patients following suicide attempts. Methods: A quasi-experimental before-and-after study was conducted in Brazil in 2024 with 130 nursing professionals who were allocated to an intervention group (n = 25) that received a structured, interactive educational program or to an active control group (n = 105) that received written educational materials. Knowledge related to suicide attempts was assessed using a 14-item instrument administered before and after the interventions. Paired comparisons were performed using parametric or nonparametric tests based on data distribution, and effect sizes were calculated to estimate the magnitude of change. Results: The intervention group showed statistically significant improvements in misconceptions related to suicide myths, religiosity, and stigma, with effect sizes ranging from negligible (p = -.01) to high (p = .90). The active control group showed negligible or small effects across all items (\textit{p} < .20), with not statistically significant pre-post differences. Conclusions: The intervention group demonstrated improvements in several domains related to misconceptions, stigma, and clinical understanding of suicide attempts, with effect sizes ranging from negligible to high (p = -.01 to .90). Largest effects were observed in items addressing suicide myths and moral or religious beliefs. In contrast, the active control group showed predominantly negligible or small effects (p < .20), with not statistically significant pre-post differences across most items. Items related to institutional safety procedures showed minimal change in both groups.
Clinical reasoning is a core competency in nursing practice, yet its effective teaching faces challenges such as time constraints, limited resources, and insufficient individualized instruction. The rapid advancement of conversational artificial intelligence (CAI) in recent years offers new possibilities for innovating nursing education models. This scoping review aims to systematically map the current application of CAI in nursing clinical reasoning education, delineate its specific roles, analyze the educational opportunities it presents, and identify the main challenges and future directions. By synthesizing existing evidence, this review seeks to provide an evidence-based reference for educators, technology developers, and policymakers to promote the effective and responsible integration of this technology into nursing education. It also offers practical guidance for the application of conversational AI in clinical nursing teaching such as outpatient nursing training.
