Ruth Donnelly Corcoran Research Award

Project Title: Effect of race on cultural humility following simulation telehealth case scenarios among second-degree nursing students: RCT

Abstract: The registered nursing workforce in the U.S. is 80.6% white, yet 40% of the population identify as people of color. Nursing educators have always been tasked with preparing nurses to care for patients from cultures different than their own. Unfortunately, this discrepancy has led to threats of bias and unequitable health outcomes among racial minority populations. Although case studies have long been used to effectively educate nursing students, there is an ongoing debate about whether to include race in a case study’s demographics. Race may be omitted for fear of stereotyping or included for fear of promoting colorblindness. We propose to conduct a randomized controlled trial to measure the difference in self-reported cultural humility among second-degree nursing students completing two video telehealth case studies where race, age, and sex of a standardized patient (SP) is known (intervention group) versus audio telehealth case studies where only age and sex are known (control group). Our exploratory aim adds in a second, more objective measure of cultural humility. The SP’s will score each student on a cultural humility subscale. We aim to determine the correlation between baseline implicit bias and observed cultural humility following both the video and audio telehealth case studies. Our study aligns with the National League for Nursing’s research priority to “evaluate innovative teaching and learning strategies and emergent technologies”, as we aspire to advance the science of nursing education through innovative simulation technology to ultimately assist nurse educators as they design future case studies to promote health equity.

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Dorothy Otto Research Award

Project Title: Deliberate Practice of Critical Nursing Skills and Assessment of Competencies: A Multi-Site Study

Abstract:  Purpose:  To investigate the impact of deliberate practice on a) medication administration, b) handoff report, and c) interruption management skills. Significance: Newly graduated registered nurses (NGRNs) are expected to enter complex healthcare environments competent in core, critical nursing skills. However, recent evidence demonstrates that less than 10% of NGRNs demonstrate acceptable competency for a novice nurse. Students and NGRNS attribute lack of skill competencies to a lack of practice with skills during their educational preparation. In addition, interruptions are pervasive during core nursing skills and associated with increased errors. Ideally, nursing students would learn and practice strategies to manage interruptions, yet interruptions are seldom included in nursing curricula. Methods: A multi-site, repeated measures, multi-method study will be conducted with prelicensure nursing students across two semesters. Participants will engage in deliberate practice of medication administration and interruption management during both study semesters. In the second study semester, students will also participate in deliberate practice of handoff report. Outcomes to be investigated include a) medication errors and safety procedures, b) handoff quality and accuracy, and c) interruption management. Implications: Deliberate practice of nursing skills has the potential to develop skill competencies. Findings can be used to guide educational methods that aim to improve nursing students’ attainment of competencies and safety of patient care. NLN Priority in Nursing Education Research: This study aligns with NLN Priority 1: Build the science of nursing education through the generation and translation of innovative teaching and learning strategies.

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Nancy Langston Research Award

Abstract: Increasingly reduced and restrictive pediatric clinical experiences have been an ongoing issue threatening nursing education. Deliberate, planned experiences have been shown to enhance nursing students’ development of pattern recognition and understanding of context and significance. This project embodies the NLN research priorities for nursing education specific to the generation of innovative teaching strategies reflecting best practices for clinical education in alignment with the National Council of State Boards of Nursing (NCSBN) Clinical Judgment Measurement Model (CJMM). This project will develop three unfolding pediatric simulations using computer-based Artificial Intelligence (AI) to standardize virtual clinical experiences as a substitute for traditional acute care clinical hours. By educating nursing students using virtual unfolding simulated patients (VIPs) equipped with AI, students will receive planned experience with deliberate practice designed to enhance their clinical judgment, decision making, and problem-solving abilities. The aim of this project is to generate virtual patients able to communicate using AI to prepare prelicensure nursing students to deliver high quality individualized nursing care. The purpose of this study is to compare the outcomes of students participating in unfolding case simulations incorporating AI to students participating in unfolding case simulations without AI technology. Faculty will evaluate student competencies using the Creighton Competency Evaluation Instrument during an end-of-semester high-fidelity simulation. Students will rate their confidence and satisfaction using the Student Satisfaction and Self-Confidence in Learning tool. Knowledge will be compared using course exam grades and final exam HESI grades. Communication and cultural awareness will be measured with the Global Interprofessional Therapeutic Communication Scale©.

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Edmund J.Y. Pajarillo Research Award

Abstract:  Simulation-based learning in nursing education enhances clinical competence, knowledge, and self-confidence. However, more simulation scenarios are needed to address social determinants of health (SDOH) with culturally diverse patients to ensure patient and student safety. This study aimed to develop and validate new simulation scenarios focused on SDOH with culturally diverse patients. It also aimed to assess the impact of these scenarios on cultural awareness and SDOH knowledge in standardized patient and manikin-based simulations. The study involved senior nursing students in a single-blind quasi-experimental pretest-posttest trial. Simulation scenarios were created following a literature review and input from instructors and students. Validity and reliability were ensured through expert input. The study occurred at a public university, with participants assigned to standardized patient and manikin-based simulation groups. Simulation-based interventions significantly improved cultural awareness scores for both simulation types, as measured by the Cultural Awareness Scale (CAS). The two groups had no significant differences in CAS and SDOH Knowledge Survey scores after the intervention. In conclusion, simulation-based interventions effectively enhance nursing students’ cultural awareness and SDOH knowledge. Using standardized patients may be particularly effective for improving SDOH knowledge. These findings emphasize the importance of incorporating diverse patient scenarios and SDOH considerations in nursing education to promote patient-centered care and student competence.

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Mary Anne Rizzolo Simulation Doctoral Research Award

Abstract:  Background and Aim: Collaboration and decision-making among students are essential competencies in nursing education. However, how students collaborate and make decisions in simulation is a complex phenomenon and not well understood. This study aimed to develop a framework that describes peer collaborative clinical decision-making (PCCDM) among nursing students in simulation. Methodology: Charmaz’s constructivist grounded theory method was used to develop the PCCDM framework, including multi-stage coding using constant comparison analysis. Participant interviews and recorded simulations were collected and analyzed. Virtual reality simulation with five medical-surgical nursing case studies appropriate for the participant’s knowledge and skills were used. Participants and Setting: Thirty-two nursing students (16 dyads) from two associate degree nursing programs in a western state in the United States were recruited using convenience, purposive, and theoretical sampling. Results: The PCCDM framework described three functional domains: cognition, behavior, and emotion. These domains are interrelated and experienced through three processes: awareness, communication, and regulation. The domains and processes alternate between individual and collaborative spaces and change across the simulation’s acuity and stakes. The framework provided nuances of how collaboration unfolds among peers participating in simulations. Implications: The framework can be applied in facilitating and designing nursing simulations to promote PCCDM. Nurse educators can also apply this framework in classroom and clinical settings that require students to make collaborative decisions. The framework will hopefully contribute to the science of nursing education, aligns with National League for Nursing’s research priorities, and provide a pathway for developing an instrument to measure PCCDM in simulation.

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Co-sponsored Grants

NLN/Sigma Foundation for Nursing Diane Billings Research Award

Abstract:  People with disabilities (PWD) experience health disparities in accessing healthcare and receiving culturally congruent nursing care. Despite recommendations to include disability content in nursing education, nursing students have limited exposure to disability education via experiential learning, which would help to develop necessary knowledge, skills, and attitudes in learning to care for PWD. This study aims to evaluate the effect of the health assessment and promotion simulation with disability content on nursing students’ knowledge, skills, and attitudes towards PWD. The National League for Nursing (NLN) Jeffries Simulation Theory (JST) (2022), World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) (WHO, 2002), Core Competencies on Disability for Health Care Education (Alliance for Disability in Health Care Education (ADHCE), 2019), and international simulation guidelines (the International Nursing Association for Clinical Simulation and Learning (INACLS), 2021; Lewis et al., 2017) guided the development of simulation scenario design, evaluation, implementation, and standardized patient training processes. The research design is a longitudinal, pre and posttest, educational intervention study. Prelicensure degree nursing students who are enrolled in a first sequence 4-credit health assessment and promotion (HAP) course will attend simulation sessions with disability content as a required part of their coursework during the Fall 2023 semester. The outcomes of the simulation learning sessions will be evaluated via the 41-item knowledge, skills, and attitudes survey toward PWD, demographic survey, and a 5-item researcher developed Simulation Participation Survey.

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NLN/Eastern Nursing Research Society Doctoral Research Award

Abstract: Nurse educators have been charged with preparing a future nursing workforce that provides empathetic, person-centered care, that is free from bias. Age bias has been associated with poorer physical and cognitive health, and an overall decrease in quality of life; furthermore, age bias has been identified as a significant barrier to achieving health equity in an increasingly aging population. Educational interventions that improve empathy are one way to address bias. This presents an opportunity for nurse educators to develop and examine innovative educational strategies with methodologically sound research. Guided by Davis’s theory of empathy and Alligood and May’s Nursing Theory of Interpersonal Empathy, this study, aligning with the NLN research priority I, seeks to evaluate an innovative teaching strategy to help build the science of nursing education. A quasi-experimental control group design using a sample of second degree, accelerated nursing students will examine the effect of a virtual reality (VR) experience on self-perceived empathy and ageist attitudes in student nurses, as compared to a traditional case study activity. In addition, the study will investigate the relationship between students’ self-perceived empathy and their demonstrated empathic behaviors, as measured by a Standardized Patient. It will provide a foundation for future research on the use of VR to increase empathy in an effort to improve nursing students’ preconceived attitudes and biases towards older adults. 

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NLN/Southern Nursing Research Society Doctoral Research Award

Project Title: Using Simulation to Evaluate the Association Between Clinical Judgment and Emotional Intelligence in Undergraduate Nursing Students

Abstract: Background: Clinical judgment (CJ) has recently become a priority in nursing education due to its potential to rapidly improve the efficiency and quality of patient care while reducing nursing burnout. CJ is a decision-making process in nursing that can be difficult to evaluate. Another thought process, emotional intelligence (EI), is easily measured and shares similar characteristics with CJ. However, the relationship between CJ and EI is poorly understood and lacks empirical testing. Method: This correlational, quantitative, cross-sectional, descriptive study empirically evaluated the relationship between EI, as measured by the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) and CJ, as evaluated within a simulation-based experience with the Lasater Clinical Judgment Rubric (LCJR) in 46 pre-licensure undergraduate nursing students. Results: No significant correlations were identified between total MSCEIT and LCJR scores (r = 0.076, p = 0.616). However, small to near-medium correlational strengths between LCJR and EI branch scores were noted. Conclusion: Results suggest that the LCJR and MSCEIT do not measure decision-making processes similarly in undergraduate nursing students. However, a comparison of branch scores indicates that core components found within CJ may be intermingled within EI. These findings suggest a need for further investigation to better understand EI and CJ, how they might be improved, and how the measures impact the profession of nursing. This study relates to National League for Nursing’s Research Priority to build the science of nursing education. It provides evidence-based research with direct implications for nursing simulation education on CJ.

NLN/Western Institute of Nursing Research Award

Abstract: Purpose: This study seeks to gain an understanding of professional identity formation from the perspective of nursing students in diverse countries as a foundation for curriculum that supports nursing professional identity from a global perspective. Using the insights of students from varying settings allows educators to identify those concepts and experiences that are universal and those that are geographically dependent. Significance: This study and the resulting collaborations have the potential to globalize nursing professional identity research and curriculum. There is insufficient research on global similarities and variations in professional identity formation. Gaining a better understanding of these universal elements will guide the work of educators and researchers around the globe to develop educational environments and experiences that support nursing professional identity development. Research Design: This research takes a descriptive phenomenological approach to understand the lived experience of professional identity development from the perspective of soon-to-graduate nursing students. Each participant is interviewed using a universal, previously tested interview guide that includes questions about the meaning of nursing professional identity and the experiences and environments that contribute to its development. Responses will then be analyzed for concurrence and divergence between sites, forming a basis for a global understanding of nursing professional identity development. NLN Research Priority: This research aligns with the NLN nursing education research priority number one. It helps to develop innovative teaching and learning strategies, specifically through the creation of a robust multi-site research design and by building capacity in global nursing education.