Jessica Doolen

Parental disconnect between perceived and actual weight status of children: a metasynthesis of the current research.

Purpose: Obesity is one of the most common chronic diseases in childhood. Many studies offer a variety of explanations for the alarming increase in childhood obesity; however, none discuss why an apparent disconnect exists in parental perceptions of their childs weight status. The purpose of this article was to review the current research literature on parental perceptions about their childrens weight. Data source: The articles included in this review were retrieved through a literature search using PubMed. Key words used to obtain relevant articles include childhood obesity, childhood overweight, and parental perception. Conclusions: Several studies looked at parental perceptions of childhood obesity generated from the United Kingdom, Australia, Italy, and the United States. Universally, parents were more likely to misperceive their childs weight. This was especially true for parents who were themselves overweight. Implications for practice: If parents do not recognize their child as at risk for overweight or overweight, they cannot intervene to diminish the risk factors for pediatric obesity and its related complications. More research is needed to identify why this phenomenon occurs. Only then can effective interventions be initiated.

An evaluation of mental health simulation with standardized patients.

Abstract Interviewing standardized patients (SPs) trained to model psychiatric disorders can promote student nurses’ interview skills and therapeutic communication, while at the same time increasing their confidence and decreasing anxiety. From a constructivist view of education and Kolb’s (1984; Experiential learning: Experience as the source of learning and development. Edgewood Cliffs, NJ: Prentice-Hall) theory of experiential learning, this article describes the development and use of SPs as a learning strategy. The use of SPs helps faculty in overcoming some of the challenges of competing for clinical sites and meeting objectives in limited clinical time. In this simulation, baccalaureate nursing students had the opportunity to interact with SPs, who had been trained to demonstrate symptoms of bipolar disorder, anxiety, and schizophrenia. During debriefing, students critiqued their performances, identifying strengths and weaknesses. The advantage to nursing students was the ability to improve their interviewing skills in a safe educational environment before encountering these patients in a clinical experience. Both faculty and student evaluations of this experience support its integration into psychiatric undergraduate courses.

Effectiveness of a poverty simulation in Second Life®: changing nursing student attitudes toward poor people.

Abstract Social justice is a fundamental value of the nursing profession, challenging educators to instill this professional value when caring for the poor. This randomized controlled trial examined whether an interactive virtual poverty simulation created in Second Life® would improve nursing students’ empathy with and attributions for people living in poverty, compared to a self-study module. We created a multi-user virtual environment populated with families and individual avatars that represented the demographics contributing to poverty and vulnerability. Participants (N = 51 baccalaureate nursing students) were randomly assigned to either Intervention or Control groups and completed the modified Attitudes toward Poverty Scale pre- and post-intervention. The 2.5-hour simulation was delivered three times over a 1-year period to students in successive community health nursing classes. The investigators conducted post-simulation debriefings following a script. While participants in the virtual poverty simulation developed significantly more favorable attitudes on five questions than the Control group, the total scores did not differ significantly. Whereas students readily learned how to navigate inside Second Life®, faculty facilitators required periodic coaching and guidance to be competent. While poverty simulations, whether virtual or face-to-face, have some ability to transform nursing student attitudes, faculty must incorporate social justice concepts throughout the curriculum to produce lasting change.

Primary Care Management of Patients Following Bariatric Surgery

Purpose To evaluate the nutritional, psychosocial, and other primary care issues faced by nurse practitioners (NPs) and their patients in the long‐term management of the increasing population of patients who have had bariatric surgery. Data sources An extensive review of the literature provides the foundation for development of assessment and management strategies highlighted in a case study. Conclusions Management of the patient after bariatric surgery does not end with successful surgical healing. Numerous long‐term implications, including significant psychosocial and nutritional issues, require the informed attention of the primary care provider for the rest of the life span. Implications for practice Each year an increasing number of obese patients pursue a surgical solution to obesity, up to an estimated 100,000 in 2004. Numerous long‐term health implications are specific to this population. NPs can improve the quality of primary care to these patients by being informed regarding the different procedures and their impact on physiologic phenomena, and the psychosocial issues inherent to extreme weight loss.

Low Back Pain in Student Nurses: Literature Review and Prospective Cohort Study.

Abstract There is consensus that registered nurses worldwide have a high prevalence of work-related musculoskeletal disorders, particularly of the back. Patient handling activities such as lifting present the highest risk of injury, activities that begin in nursing school. A literature review identified 21 studies of back pain in nursing students, indicating a wide range of prevalence rates. A prospective cohort study of nursing students in a United States baccalaureate program followed 119 students who completed the Nordic Musculoskeletal Questionnaire upon beginning the 16 month upper division major and then a year later. There was no statistically significant change in low back pain prevalence over time. While nursing students have intermittent and brief exposure to patient handling activities, nursing schools must nevertheless protect them before they enter the high risk profession of nursing by teaching evidence-based safe patient handling techniques, empowering students to refuse unsafe manual lifts, and ensuring that the clinical settings with which they affiliate have adequate mechanical equipment available.

Simulation gone wild: SIM OUT.

What happens when you throw out the simulation rules, add competition and a little chaos, and make it a game? You get nursing students who are actively engaged and excited about nursing. Educational games promote learning and enhance collaboration among students. They keep learning active and student centered in a nonthreatening environment. As nursing care becomes more complex, the intensity of nursing education also increases. Applying critical-thinking skills, using theoretical foundations, and learning complex psychomotor skills are challenging and often stressful for nursing students. In addition, the intensity of nursing programs can invoke performance anxiety in nursing students. When the teaching/learning process is perceived as fun, students’ stress and anxiety may be reduced. Furthermore, games have the potential to stimulate interest in learning. In an effort to decrease stress that nursing students often experience and provide some fun during learning, the concept of SIM OUT was created.

Board 147 - Program Innovations Abstract Simulation Using Standardized Patients as a Learning Strategy for Psychiatric Nursing Students (Submission #1016)

Introduction/Background The challenges facing healthcare educators in modern educational and healthcare environments are well known. Educators are being called upon to graduate greater numbers of graduates into an increasingly complex healthcare environment. An innovative learning strategy that healthcare programs can use to prepare students for professional practice is standardized patient (SP) encounters. This abstract describes how one school of nursing incorporated simulation into a mental health course with SPs as mental health patients. Methods Three simulation case studies were developed, including bipolar, schizophrenia and anxiety disorders. The learning objectives were developed and based on the mental health course outcomes.. With curriculum needs met, nursing faculty met with the SP Coordinator (SPC), SP Training Assistant (SPTA) and Simulation Technician. Standardized patient training consisted of two, four hour group rehearsals. Training topics included the project overview, introduction to the simulation rooms and debrief area, costumes/attire, emesis odor, verbal feedback, stimulated recall, read through and clarification of the scenarios, role playing, review and discussion of an example video, training in verbal feedback techniques and SP errors and how to avoid them.1 The second training session included a dress and technical rehearsal. Mental health faculty members observed the case scenarios to help ensure the SPs were accurately portraying the psychiatric patients in the case studies. During implementation, the interaction phase of each SP simulation entailed two learners pairing up to interview the patient. The interaction phase was limited to 20 minutes and most learners finished the interview before reaching the time limit. After the SP simulation the learners, mental health faculty and SP debriefed for 20 minutes. Including the SP in the debrief process allowed students to hear the perceptions and feelings of their patient. Lastly, the students and SPs provided written feedback of the simulations. At the days end, the entire team debriefed and reviewed the learners and SPs feedback. This allowed every team member to share their experiences and perceptions and make suggestions for future simulations. Results: Conclusion Kirkpatrick and Kirkpatrick’s Model of Training Evaluation2 (KPE) was selected to guide program evaluation of the new SP simulation program. Level one of the KPE model evaluates student’s reaction to the new SP simulations. Thirty seven mental health nursing students (100%) completed a feedback survey of the SP experience. Students (100%) felt they could: 1) recognize and assess signs and symptoms of anxiety, bipolar disease and schizophrenia, 2) develop interview and therapeutic communication skills and 3) promote patient safety. In addition, 37 (100%) students reported the SP simulation decreased their fear of interviewing live patients and was effective in preparing them for their mental health clinical rotation. Also, all 37 (100%) students stated the SP simulation provided them with an overview of their own competency and performance when conducting an interview with a mental health patient. The student’s reactions to the SP simulations were overwhelmingly positive, providing support for the continuation of the SP experiences for mental health nursing students. Consequently, in the fall of 2013, faculty will develop performance measures based on level two of KPE - an evaluation of s changes in students1 ‘knowledge, skills and attitudes.’ Our School of Medicine has also concluded that the anxiety case is a worthy simulation experience for their 3rd year students, since this presentation is rarely seen on clerkships anymore. References 1. Bloom, B.S.: The thought process of students in discussion. Accent on teaching: Experiments in general education 1953; pp 23-46. 2. Kirkpatrick, D. Kirkpatrick J. Implementing the four levels: A practical guide for effective evaluation of training programs. San Francisco: Berrett-Kobiler Publishers Inc; 2007; pp 47-79. Disclosures None.