Development and evaluation of a telehealth-based simulation to improve breastfeeding education and skills among nursing students.

The aim of this study was to evaluate undergraduate nursing students' perceptions of using telehealth-based simulations for practicing their breastfeeding education skills. Telehealth can help bridge the gap between the high need for healthcare services and the limited access to these services, such as breastfeeding mothers in rural settings. However current literature suggests that there is lack of telehealth education among healthcare providers, as well as, a shortage of adequately trained nurses on breastfeeding, making it difficult to provide new mothers with the support they need to successfully breastfeed. Telehealth simulation has shown to be acceptable and helpful in teaching clinical reasoning, increasing exposure to telehealth experiences, and preparing nursing students for real interaction experiences with patients. For this cross-sectional descriptive study, two breastfeeding telehealth simulation scenarios were developed and delivered through Zoom for Bachelor of Science in Nursing students in a high-level institution in Florida. Selected students interacted over Zoom as healthcare providers with a female simulated patient who played as a mother with a breastfeeding concern. Students in their role of healthcare providers assessed the breastfeeding needs of the mother and conducted breastfeeding education as appropriate. After debriefing, students received feedback from faculty and students who observed the simulation and completed an optional evaluation about their telehealth simulated experience. A total of 205 students completed the evaluation. Most students (n = 136, 66.3%) were not familiar with telehealth prior to the simulation. Most students (n = 199, 97.1%) also found the simulation helpful for supporting breastfeeding mothers and wanted more telehealth simulations in the future (n = 162, 79%). Feedback for improving the simulations included: improving the technical setup (n = 17, 8.3%), increasing the time that students interacted with the mother (n = 16, 7.8%), and observing the correct performance of the simulation after debriefing (n = 16, 7.8%). Telehealth simulation is a promising modality for clinical competency assessment, thus it is essential to integrate telehealth education into nursing curriculum. It is evident that telehealth-based breastfeeding simulations can be used to address the exposure/knowledge gap among nursing students who are missing or have limited exposure to breastfeeding content and telehealth use in their nursing curriculum.

Villegas N ，Cianelli R ，Cerisier K ，Fernandez-Pineda M ，Jacobson F ，Lin HH ，Sanchez H ，Davenport E ，Zavislak K ... -  《-》

Student and educator experiences of maternal-child simulation-based learning: a systematic review of qualitative evidence protocol.

MacKinnon K ，Marcellus L ，Rivers J ，Gordon C ，Ryan M ，Butcher D ... -  《-》

Expectations and experiences of nursing students in supporting new mothers to breastfeed: A descriptive qualitative study.

Improving breastfeeding support to mothers has been the focus of several national and international health organisations. There is evidence that theoretical and clinical education improves breastfeeding knowledge and attitudes among nursing and other health professional students prior to clinical placement, to support women who are breastfeeding. To explore the expectations and experiences of Taiwanese nursing students in supporting breastfeeding on clinical placement. To gain additional insight into student experience, we also sought the perspectives of mothers, nursing staff and teachers about the role of nursing students in supporting breastfeeding mothers. A qualitative descriptive approach guided this study. Focus groups and small group interviews were conducted with four participant groups in southern Taiwan. Ethical approval was obtained prior to data collection. The consolidated criteria for reporting qualitative research checklist was used. Three main themes emerged from the data that captured the nursing students' experiences during clinical practice, which were "High expectations"; "The reality is different"; and "Improving confidence in students." The study found that students lacked confidence in supporting breastfeeding in the clinical setting. Students were expected to support women to achieve their breastfeeding goals under the supervision. The students highlighted the importance of establishing trust to effectively support mothers, and for the students to feel confident to provide the breastfeeding information. Despite structured theoretical breastfeeding education prior to clinical placement, students did not feel they were adequately prepared to support women who are breastfeeding during their clinical placement. The findings demonstrated the need for further support in developing effective communication skills and building confidence prior to clinical placement. Enhancing the content of theoretical and simulated breastfeeding education to incorporate women's breastfeeding experience combined with realistic clinical student allocation could serve to improve students' confidence in supporting breastfeeding.

Yang SF ，Burns E ，Salamonson Y ，Schmied V ... -  《-》

The impact of telehealth objective structured clinical evaluations in intraprofessional nursing education: A mixed methods study.

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.

George TP ，Munn AC ，Phillips TA ，Marty Hucks J ... -  《-》

Baccalaureate nursing students' experiences with multi-patient, standardized patient simulations using telehealth to collaborate.

Nurse faculty must utilize teaching strategies that promote student achievement of essential competencies, and simulation can provide experiential learning to help prepare students for professional practice. The purpose of this phenomenological qualitative study was to explore baccalaureate nursing students' experiences with multi-patient, standardized patient simulations that used telehealth to provide opportunities to learn and practice intra- and interprofessional collaboration. Student perceptions of their ability to utilize lessons from the simulations in clinical practice were also examined. Focus group interviews were conducted with 27 final-semester baccalaureate nursing students after they had participated in two telehealth-enhanced simulations. Analysis revealed five themes: Anxiety due to lack of experience, Improved clinical reasoning, Real world practice, How to communicate effectively, and Application to clinical practice. The use of telehealth helped overcome barriers to implementing collaborative simulations and provided students with experiential learning that addressed essential competencies for safe and effective professional nursing practice.

Powers K ，Neustrup W ，Thomas C ，Saine A ，Sossoman LB ，Ferrante-Fusilli FA ，Ross TC ，Clark K ，Dexter A ... -  《-》