Browsing by Author "Friesth, Barbara Manz"
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Item A Simulation Pre-Brief Scaffold to Support Clinical Judgment and Independence in Clinical Judgment Decision Making(2024-01) McIntire, Emily S.; Friesth, Barbara Manz; Hendricks, Susan; Reising, Deanna; Danish, JoshuaIt is essential that nurses independently assume patient care, yet new nurses lack necessary clinical judgment skills. The purpose of this study was to examine a simulation pre-brief scaffold to support nursing students’ clinical judgment development and clinical judgment independence. The pre-brief experiential learning scaffold for clinical judgment independence (PELS-CJI) framework informed simulation pre-brief in this experimental study. A convenience sample included traditional and accelerated Bachelor of Science in nursing students in their senior year. Participants were randomly assigned to complete a simulation pre-brief with or without the Interactive-Video Recorded Simulation (I-VRS). Nursing student’s total clinical judgment and individual components of clinical judgment (noticing, interpreting, and responding) in simulation were measured by a single evaluator blinded to condition using the Lasater clinical judgment rubric (LCJR) (Cronbach’s alpha .932). To measure clinical judgment independence, the number of unintended conceptual cues during simulation were counted. Participants in the intervention group had higher clinical judgment scores during simulation (n = 31, M = 28.45, SD = 5.163) as compared to the control group (n = 36, M = 25.06, SD = 5.275), t(65) = -2.653, p < .01. A significant relationship for the noticing and responding subscales of clinical judgment was observed between groups, but not for the interpreting subscale. No significant difference in the number of unintended cues was found between groups. Results support that using an I-VRS in simulation pre-brief enhanced clinical judgment in simulation. The use of the I-VRS adds to the existing limited evidence related to simulation pre-brief to support clinical judgment development among undergraduate nursing students. Future research using an I-VRS during pre-brief is necessary to determine if improvement in clinical judgment is retained and transferrable to the clinical setting. Additional testing of the PELS-CJI to guide simulation pre-brief is encouraged.Item Cancer Treatment-Related Fatigue: Psychometric Testing of the Cancer Treatment-Related Fatigue Representation Scale (CTRFRep) in Patients Undergoing Radiation Treatment for Cancer(2010-02-02T21:24:42Z) Reuille, Kristina M.; Welch, Janet L.; Keck, Juanita F.; Fulton, Janet S.; Friesth, Barbara ManzCancer treatment-related fatigue (CTRF) is recognized as a prevalent and bothersome symptom for patients with cancer. In a model of the CTRF experience, CTRF representation, or the beliefs, thoughts and emotions surrounding the experience of CTRF, is believed to mediate the relationship between CTRF intensity and CTRF distress. To date, there is no reported measure of CTRF representation. The purpose of this descriptive, cross-sectional study guided by Leventhal’s Common Sense Model of Self-Regulation was to evaluate an instrument designed to measure CTRF representation, the CTRF Representation scale (CTRFRep), based on an existing measure, the Illness Perception Questionnaire (IPQ-R). The study included 47 patients (mean age=57.7 years) receiving radiation therapy for cancer interviewed one month post-treatment. 77% of patients had fatigue during treatment. Three content experts and one theory expert assessed content validity of the CTRFRep. The content experts included three behavioral oncology nurse researchers whose focus is on symptom management and/or fatigue. The theory expert was a nurse researcher who is an expert in the area of self-regulation theory. As tested, the CTRFRep consisted of 105 items in 10 subscales addressing beliefs about the Identity, Timeline (Acute vs. Chronic/Cyclical), Consequences (positive/negative), Cause, Control (Treatment/Personal), Symptom Coherence, and Emotional Representation of CTRF. When evaluating psychometrics, the Identity and Cause subscales are analyzed independent of the other subscales. For the Identity subscale, symptoms most reported as related to CTRF were lack of energy, loss of strength, and feeling blue. For the Cause subscale, the most common beliefs regarding causes of CTRF were cancer treatment(s), having cancer, and stress or worry. Results indicate adequate reliability in six of eight remaining subscales (α>=0.70); the item N in those subscales was reduced from 56 to 34. To address construct validity, logistic regression assessed whether CTRFRep mediated the relationship between CTRF intensity and CTRF distress. After controlling for negative affect, the Identity and Consequences subscales were significant mediators – the Acute vs. Chronic Timeline and Emotional Representation scales were partial mediators – of the relationship between CTRF intensity on CTRF distress. These findings indicate fatigue is a problem for people undergoing treatment for cancer, and the CTRFRep may be a reliable and valid measure of CTRF representation for patients undergoing radiation treatment for cancer. Small sample size prevented successful factor analysis of the CTRFRep. Further research of the CTRFRep is warranted.Item Conceptualization of factors that have meaning for newly licensed registered nurses completing nurse residency programs in acute care settings(2016-07-20) Rowland, Beverly Dianne; Reising, Deanna L.; Feather, Rebecca; Friesth, Barbara Manz; Halstead, Judith A.Nurse residency programs (NRPs) have been identified as a means to promote transitioning of new nurses into the professional nursing role. Questions have arisen related to which elements within those programs are most meaningful to the development of new nurses. As the nursing shortage drives the need for quick transition and development of nurses to meet workforce needs, nursing must identify what is meaningful to nurses in their transition to practice. The purpose of this multi-site study was to explicate meaning from the experiences of newly licensed registered nurses (NLRNs) who have just completed NRPs. The research question was “What factors have meaning for NLRNs who have experienced transition to practice in nurse residency programs in acute care settings?” Semi-structured interviews were used to collect data from six NLRNs from three different NRPs after completion of their programs. Using interpretative phenomenological analysis, themes and variations within those themes were derived from the descriptive narratives provided from participant interviews. Overarching themes identified were Relationships, Reflection, Active Learning, Resources and Organizational Systems. Findings have implications for practice and education as the nursing profession strives to find ways to transform nurses in an effective and efficient manner.Item Exploring faculty preparation for and use of debriefing with the debriefing for meaningful learning inventory(2016-07-19) Bradley, Cynthia Diane; Dreifuerst, Kristina Thomas; Ironside, Pamela M.; Wonder, Amy Hagedorn; Friesth, Barbara Manz; Jeffries, Pamela R.Debriefing is the most significant component of simulation, yet the impact of debriefer training for this critical time of learning has not been reported. Although training of debriefers in the use of a structured debriefing method has been recommended by nursing organizations and regulating bodies, a description of the impact of training on the understanding and application of debriefing within nursing programs is largely unknown. Debriefing for Meaningful Learning© (DML) is a structured, evidencebased debriefing method that promotes the development of clinical reasoning among prelicensure nursing students. DML has been adopted for use across the curriculum throughout nursing education. However, little is known regarding how debriefers are trained in this method and how that training impacts their understanding and application of the method. The DML Inventory (DMLI), was developed and tested for this research study, and used to assess and document 234 debriefers’ understanding of the central concepts of DML and subsequent application of DML behaviors during simulation debriefing with prelicensure baccalaureate nursing students. Statistically significant differences were found between those debriefers who had and had not been trained in DML. Statistically significant differences were also found in the understanding of the DML central concepts, and in the application of DML based on the types of training the debriefers received. viii The data indicate that DML trained debriefers consistently apply more DML behaviors than those who had not received training, and that multiple sources of training resulted in a more consistent application of DML debriefing behaviors. Furthermore, understanding the central concepts of DML resulted in debriefers consistently applying more debriefing behaviors consistent with the DML design. This study contributes to the growing body of knowledge of debriefing in nursing education and training in evidence-based debriefing methods, by providing a tested instrument that can be used to assess debriefers using DML. The findings also demonstrate the impact of the type of training on how structured debriefing methods are then implemented in teaching-learning environments, which can be used to improve future training.Item Grit and deomgraphic characteristics associated with nursing student course engagement(2015-03-03) Robinson, Wanda Lynn; Bakas, Tamilyn; McNelis, Angela; Friesth, Barbara Manz; Horton-Deutsch, SaraEducating a sufficient nursing workforce to provide high quality, compassionate, and ethical care to an increasingly diverse population is an ongoing challenge and opportunity for nurse educators. Current literature highlights the importance of engaging students in learning to strengthen student achievements. Fostering student engagement within nursing courses is particularly important. Grit (consistency of interest and perseverance of effort) is a factor that may be associated with student course engagement. Demographic characteristics of age, gender, race/ethnicity, prior education, degree program, and self-reported grade point average (GPA) also may be factors associated with student course engagement. Guided by a conceptual model derived from the literature, the purpose of this study was to determine whether grit and demographic characteristics were associated with student course engagement (skills, emotion, participation/interaction, and performance) within a nursing course. Using an exploratory, descriptive, cross-sectional design, a convenience sample of 97 nursing students in a didactic health assessment course was administered the Student Course Engagement Questionnaire (SCEQ), visual analog scales for student engagement, Grit-S Scale, and a Student Demographic Characteristics form. Using multiple regression, 22% of the variance (21% Adjusted) of total student engagement (SCEQ) was explained by total grit scores (Grit-S) F(1,95) = 26.54, p<.001. Further analyses of student engagement were conducted using the SCEQ subscales and visual analog scales with similar results. Findings provided support for the conceptual model used to guide the study, although replication of the study was recommended across varied learning environments. Findings warrant further study regarding grit as a potential area for the future development of strategies to foster engagement of nursing students in the classroom.Item Master's degree and post-master's certificate preparation for the academic nurse educator role : the use of the National League for Nursing Core Competencies of nurse educators as a curriculum guide(2016-11-08) Fitzgerald, Ann; Billings, Diane M.; Rawl, Susan M.; McNelis, Angela M.; Friesth, Barbara Manz; Morrone, AnastasiaThis study described the education courses in Master of Science in Nursing Education (MSN Ed) degree and post-master’s certificate (PMC) in nursing education programs and determined which of the eight NLN Core Competencies, used to certify nurse educators, were represented. Data regarding the required credit hours, practicum hours, distance accessibility, and preparation for the Certified Nurse EducatorCM (CNE) Examination also were collected. The study used a descriptive design using a web scraping technique. Program information was obtained from the accrediting bodies for graduate nursing programs in 2015. Course description data were obtained from web pages via curriculum plans, course catalogs, graduate handbooks, or other institutional web pages. Data were collected from each program website, collated, uploaded, and analyzed. In both types of programs, evidence was found for the NLN Core Competencies: Facilitate Learning (97%), Participate in Curriculum Design and Evaluation of Program Outcomes (97%), Use Assessment and Evaluation Strategies (95%), Pursue Continuous Quality Improvement in the Nurse Educator Role (88%), Engage in Scholarship (45%), Function as a Change Agent and Leader (30%), Facilitate Learner Development and Socialization (28%), and Function within the Educational Environment (12%). Only 36% and 40% of MSN Ed and PMC in nursing education programs, respectively, were completely distance accessible. Required credit hours varied from 28 to 65 for the entire MSN Ed and from 6 to 47 for the nursing education courses. PMC credit hours varied from 3 to 45. Practicum clock hours, for both programs, ranged from 60–500 while practicum credit hours ranged from 1–18. Revision of MSN Ed and PMC curricula is indicated to improve inclusion of content in all competency areas. Moreover, increasing the number of distance accessible programs may encourage more nurses to consider a master’s degree or post-master’s certificate in nursing education.Item Observational experiential learning facilitated by debriefing for meaningful learning : exploring student roles in simulation(2018-07-25) Johnson, Brandon Kyle; Reising, Deanna L.; Wonder, Amy Hagedorn; Friesth, Barbara Manz; Byrne, Bobbi J.Simulation is an educational strategy used in prelicensure nursing education that has been demonstrated to effectively replace selected clinical experiences. Simulation experiences may include the use of differing roles including the active participant, who makes decisions during the simulation and the passive observer, who watches the simulation unfold. There is a lack of rigorous research testing whether students in the passive observer role during simulations demonstrate and retain knowledge similarly to those in active participant roles. In addition, differences in knowledge applied to a contextually similar case between those who actively participate and passively observe have not been studied. The purpose of this study was to explore the relationship between nursing student’s roles in simulation and cognitive knowledge demonstration, retention, and application about two contextually similar cases of respiratory distress. An experimental, pretest-multiple posttest, repeated measures study was conducted with a convenience sample of 119 baccalaureate prelicensure nursing students from a large multi-campus Southwestern university. Two knowledge instruments were administered throughout different stages of the simulation and four weeks later. Associations between role in simulation and scores on the knowledge instruments were examined using t-tests and mixed repeated measures-analysis of variance. Of the 59 active participants and 60 observers, there were no significant differences in knowledge demonstrated or retained after simulation, after debriefing, or four weeks later. Additionally, there were no significant differences in knowledge demonstrated when applied to a contextually similar case after debriefing or four weeks later between active participant and observer. Future research is needed to examine these relationships in larger and more diverse samples and different contextual clinical situations in simulation. These results will contribute to the further testing and implementation of using observation as a strategy for teaching and learning with simulation for nursing and health professions education.