Ms Danielle Noble

Aim: To explore nursing students' views on being prepared for using electronic medical records during clinical placement. Background: The need for an undergraduate nursing curriculum to include electronic medical record training has been internationally recognised, however successful implementation has been inconsistent worldwide and limited in Australia. Many nursing students are unprepared to effectively provide care during clinical placement using electronic medical records and are therefore not work-ready as registered nurses. Design: Online survey. Methods: Third-year nursing students from two multi-campus universities were invited to complete the survey. Results: Most students believed that learning electronic medical records during simulations would be extremely or very useful. Student confidence levels correlate with the amount and type of exposure to electronic medical records prior to clinical placement. Four themes emerged from qualitative analysis: Don't throw out the baby with the bathwater; Prepare us for practice; Mistakes ¿ hardly any; and Universities need to catch up and put out. Conclusion: Students receiving hospital-based education on eMR and eObs can improve student confidence in preparation for clinical practice. First-year optional eMR university education had a limited impact on students' perception of preparedness for clinical practice. Shared responsibility between both the universities and health services on eMR education would provide improved student confidence and preparedness for clinical practice. This study supports the international research that eMR education needs to be scaffolded over the three years of study with increasing complexity of real-life scenarios.

Background: An Australian academic electronic medical records (AAeMR) program was tested amongst third-year undergraduate nursing students at one large regional university. Methods: An inductive qualitative thematic analysis of focus group data was applied. Results: Four themes emerged 1) Being prepared for an e-change; 2) Is e-learning better or just different? 3) Learning to be safe using workstations on wheels in a safe environment and 4) Caring for patients when connecting with technology. Conclusion: Students identified the AAeMR software promotes the delivery of patient centred care and enhances their preparedness to use electronic records in clinical practice.

Objective: To evaluate the impact of using an academic electronic medical record program on first-year nursing students' confidence and skill in E-documentation after their hospital clinical placement. Background: Registered nurses are the largest user group of health information technology systems such as patient electronic medical records (eMR). As such, nurse undergraduate programs need to reflect contemporary practices and respond to emerging trends including digital technology, however integration of eMR learning has not occurred in many countries. To address this gap, a fit-for-purpose academic eMR simulation program was developed by nursing academics and a university Learning Design Department member. Study Design and Methods: A quasi-experimental study design, with self-administered pre-test, post-test surveys, was used with a convenience sample of all first-year nursing students at one regional university in NSW Australia in 2019 and 2021. Results: A total of 105 students completed the surveys (9.7% pre, and 7.4% post-test survey). Only 23% of respondents received training during hospital clinical placement on eMR and electronic observation charts. There was a significant increase in participant confidence and knowledge in documenting in electronic adult observational charts and notes after using the academic eMR program and attending clinical placement. Three themes emerged from the qualitative data: preparation for practice; more exposure increases confidence; and we can't forget the patient. Conclusion: Students acknowledged the need for repeated practice using an academic eMR program in university learning environments to ensure they would be work-ready. The identified challenge was the communication barrier (computer on wheels) and the potential negative impact on person-centred care and therapeutic communication. Implications for research, policy and practice: Further research is required to determine whether repeated practice with electronic documentation is best placed within a curriculum to increase learner confidence. Simulations that incorporate workstations on wheels should be tested to determine best practice for therapeutic communication. What is already known about this topic? ¿ Registered nurses are the largest user group of health information technology systems. ¿ Nursing undergraduate program needs to reflect contemporary practices including digital technologies. ¿ Integration of eMR education in undergraduate nursing programs has not occurred in many countries. What this paper adds: ¿ Evaluation of a fit-for-purpose academic electronic medical record program integrated into an undergraduate nursing student's curriculum. ¿ There was a significant increase in participant confidence and knowledge in documenting in electronic adult observational charts and notes after using the academic eMR program. ¿ Digital technology education tailored for students of different age groups may be required.

Background: Empathy is integral to therapeutic relationships and person-centered care. Interventions specifically targeting empathy toward people who have a disability may be of benefit to nursing education. Method: In this article, we describe a novel point-of-view simulation designed to enhance empathy toward people who have a disability as a result of acquired brain injury. Nursing students' perspectives of the simulation were examined using a concurrent nested mixed methods design and using the Satisfaction with Disability Simulation Experience Scale, which includes 18 closed and one open-ended question. Results: A total of 384 second-year nursing students from a population of 488 participated, giving a response rate of 79%. The overall mean satisfaction score was 4.49/5.0 (standard deviation = 0.55), indicating a high level of agreement with each of the survey items. Thirty-five participants responded to the open-ended question, and analysis of their comments revealed three themes: A valuable experience, new insights, and standing in someone else's shoes. Conclusion: Given that there is compelling research about the benefits of empathic engagement with patients, the results from this study support continuing investment in point-of-view simulation experiences.

Background Although empathy is an integral component of professional practice and person-centred care, a body of research has identified that vulnerable patients groups frequently experience healthcare that is less than optimal and often lacking in empathy. Aim The aim of this study was to examine the impact of an immersive point-of-view simulation on nursing students' empathy towards people with an Acquired Brain Injury. Setting and Participants A convenience sample of 390 nursing students from a cohort of 488 participated in the study, giving a response rate of 80%. Students undertook the simulation in pairs and were randomly allocated to the role of either a person with Acquired Brain Injury or a rehabilitation nurse. The simulated 'patients' wore a hemiparesis suit that replicated the experience of dysphasia, hemianopia and hemiparesis. Design Characteristics of the sample were summarised using descriptive statistics. A two-group pre-test post-test design was used to investigate the impact of the simulation using the Comprehensive State Empathy Scale. t-Tests were performed to analyse changes in empathy pre post and between simulated 'patients' and 'rehabilitation nurses'. Results On average, participants reported significantly higher mean empathy scores post simulation (3.75, SD = 0.66) compared to pre simulation (3.38 SD = 0.61); t (398) = 10.33, p < 0.001. However, this increase was higher for participants who assumed the role of a 'rehabilitation nurse' (mean = 3.86, SD = 0.62) than for those who took on the 'patient' role (mean = 3.64, SD = 0.68), p < 0.001. Conclusion The results from this study attest to the potential of point-of-view simulations to positively impact nursing students' empathy towards people with a disability. Research with other vulnerable patient groups, student cohorts and in other contexts would be beneficial in taking this work forward.