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Background: Simulation within nurse education has been widely accepted as an educational approach. However, this is mainly led by the facilitator with the student maintaining a passive role in the learning., Objectives: This paper describes a study that was undertaken to analyse the effectiveness of peer-led simulations in the undergraduate nursing programme., Design: A mixed-method approach was used for this study design., Settings: This study took place in a simulation suite within a university in the Midlands., Participants: Twenty four second-year child branch students were purposively selected to take part., Methods: Students designed and facilitated a simulation based on the care of a critically ill child. Formal assessment of the learning was collected via the use of a structured clinical examination. Students completed an evaluation of their perceived confidence and competence levels., Results: There was 100% pass rate in the assessment of students' clinical competence following the simulation. Thematic analysis of the evaluation highlighted the learning achieved by the students, not only of their clinical skills but also their personal development., Conclusions: The use of peer-led simulation promotes new learning and is a valuable educational approach.

Aim: To examine the efficacy of the early introduction of a medicines management 'objective structured clinical examination' (OSCE) into an undergraduate adult nursing students' programme of education and to determine if the acquisition of applied drug/pharmacology knowledge and drug administration of medicines had improved prior to qualification., Method: A longitudinal comparative design was selected for this study. A convenience random samples method of three cohorts of adult nursing students (N=90) undertaking a pre-registration nursing programme was used to identify participants. Participants were assessed at the following points during their preparatory educational programmes. Cohort one (N=30) had completed 8 months of their programme, cohort two (N=30) had completed 20 months of their programme and cohort three (N=30) had completed 30 months of education. Students were asked to undertake a drug administration simulated activity (DASA) to generate the data for this study and differences between the students' performance was compared against the criteria of the DASA., Results/findings: There were statistical differences observed on almost every criteria of the DASA between the three groups of students. Students who had been previously exposed to medicines management OSCEs as an assessment method demonstrated superior medicines management skills and pharmacology knowledge than the control group (group three)., Conclusion: The authors of this study conclude that early introduction of clinical examinations, namely OSCEs with an integrated approach to pharmacology and medicines management teaching, does facilitate and improve students drug administration and applied pharmacology ability.

A variety of approaches to teaching and learning are required to encompass the complexity of nursing. Simulated practice involves computer-based simulated environments, human patient simulation and role play, enabling multiple learning objectives to be taught in a realistic clinical environment without harming patients. The Nursing and Midwifery Council recognizes the use of simulated practice and has enabled higher education pre-registration nurse programme providers to incorporate a maximum of 300 hours of simulated practice as part of the 2300-hour practice hours component. However, not all students respond positively to simulated activity, which should be used to augment clinical practice and not replace it. It is important to ensure the quality of the simulation enables the educational experience to be positive for students.

Aim: To investigate students' perspectives on their skills acquisition and knowledge during the foundation year of their nursing programme, and whether this improved students' levels of competence and confidence., Method: Two groups of nursing students (n=140) responded to a clinical acquisition skills survey (CASS) to elicit their perceptions of clinical skills acquisition. Additionally, students' competence levels were examined, drawing comparisons with the students' objective, structured clinical examination (OSCE) results., Results/findings: Students identified that the curriculum supported the acquisition of clinical skills, and clinical examination results confirmed that 95% of students were competent to pass their OSCE., Conclusion: Students' responses to items that related to perceived confidence and competence levels were positive. This indicates that the introduction of clinical skills teaching and assessment within a university's simulation suites augmented with structured assessment within the clinical environment improved the acquisition of clinical skills.

There has been increasing pressure to remove medical devices containing mercury from clinical areas, which is leading to the demise of the mercury sphygmomanometer. As a result, automated blood pressure devices have been embraced by clinicians for their convenience and ease of use. However, it is essential that clinicians are aware of their limitations and are able to select the correct sphygmomanometer dependent upon the clinical need. It is a recommendation of the Independent Advisory Group that auscultation, as a method of determining blood pressure, should continue to be taught to healthcare professionals. Nevertheless, the reality is that in most clinical areas the automated sphygmomanometer is readily available and appears to be the device of choice. Therefore, where treatment protocols are based on accurate blood pressure readings, the clinician must ensure that the equipment used is appropriate for that application.

Automated blood pressure devices have been embraced by clinicians for their convenience and ease of use. However, the pressure to remove mercury-containing medical devices is leading to the demise of the mercury sphygmomanometer and the loss of manual blood pressure measurement skills. The article argues that there is still a place for the mercury sphygmomanometer, particularly when a clinical decision is based on the blood pressure readings. It presents a review of the available literature to explain the rationale for the use of manual sphygmomanometry and gives a step-by-step guide to the procedure with current supporting evidence. There is a brief discussion of special considerations when dealing with certain client groups. Normal blood pressure ranges for adults and children have been included along with a definition of hypertension for both groups.