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Background: International organizations recognize the importance of evidence-based practice (EBP) for nurses. The objective of teaching EBP in the Nursing degree is to train future nurses on this subject. Different teaching models exist for this, from less active traditional models to more active ones such as the flipped classroom., Objective: To compare the degree of EBP competence of undergraduate nursing students after an EBP course, through the application of a traditional methodology versus a flipped classroom methodology., Design: Quasi-experimental study of non-equivalent groups., Setting: The study was composed by a group of students who received training on EBP with the traditional model (face-to-face), and another intervention group with whom the flipped classroom model was utilized, using the online teaching platform EBP-eToolkit., Participants: The study was conducted with 4th-year Nursing degree students enrolled in the course evidence-based practice, in academic years 2019/20 and 2021/2022., Methods: Before and after the course, the students completed a questionnaire about EBP competence (EBP-COQ), and an objective test was given at the end of the year., Results: A sample of 152 students in the face-to-face group (control), and 143 students in the flipped classroom group (intervention) participated. The intervention group significantly improved its competence on attitude (p = 0.01, η 2  = 0.022), skills (p = 0.019, η 2  = 0.018), and global competence in EBP (p = 0.003, η 2  = 0.030), with respect to those who were taught using the traditional method. However, there were no significant differences in the impact on knowledge, neither through the self-report dimension of the EBP-COQ (p = 0.188) nor the final test score, control group 6.89 (SD: 1.35) and flipped classroom group 7.12 (SD: 1.53) (p = 0.206)., Conclusions: The flipped classroom model is adequate for the teaching of EBP to undergraduate nursing students. It produced a slight increase in attitude, as well as in skills and global competence in EBP. Nevertheless, this increase was not significantly different from face-to-face learning in terms of impact on EBP knowledge., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Introduction: Applause is a common behavior during simulation case learning sessions. Some simulation facilitators believe that this should not be allowed, arguing that it can mislead students when they make mistakes during simulation. This study was conducted to explore the opinions of students about spontaneous applause (initiated by the participants), as a habitual behavior in the simulation sessions, in the undergraduate and postgraduate nursing degrees., Methods: A qualitative research study was conducted based on the content analysis of 7 focus groups composed of simulation students (N = 101, both undergraduate and graduate students). The participants were asked to conduct a debate about the following question: What is your opinion about the spontaneous applause given to participants by their peers at the completion of the scenario as they go to the debriefing, and why? An inductive method of content analysis was used to interpret the data., Results: The majority considered applause as a sign of support; one student disapproved of the practice. For most participants, receiving spontaneous applause from their peers after finishing the simulation represented a spontaneous example of moral support that reduced the participants' stress., Conclusions: Applause within the context of clinical simulation is a motivational act, which should not be repressed by the facilitator, as long as it is a spontaneous and genuine act by the participants once the simulation experience ends., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 Society for Simulation in Healthcare.)

Objective: To develop and validate a tool to assess the non-technical skills of medical and surgical hospital units undergraduate nursing students., Background: In the area of healthcare, non-technical skills complement technical ones, and contribute to patient safety. High-fidelity simulation is an ideal resource for working on these skills. Thus, evaluation instruments are needed to understand the efficiency of this methodology. Although many evaluation instruments already exist, none measure non-technical skills of undergraduate nursing students in medical and surgical hospital units., Design: An instrumental study design was employed., Methods: Two-phases were used to develop and validate the scale: 1) Scale development. A group of experts defined the dimensions and components. Afterwards, the content was validated by experts, and a pilot study was conducted with undergraduate Nursing students. 2) Analysis of the psychometric properties of the scale. A total of 393 students were evaluated in high-fidelity simulation scenarios by three evaluators, through the use of the Non-Technical Skills in Medical and Surgical Hospital Units (NTS-Nursing) Scale., Results: The content validity indexes were adequate for the total of the items and the total of the scale. The statistical descriptors of the items, the internal structure, and the reliability (internal consistency and inter-evaluator reliability) were analyzed, as well as the external evidence of validity, with adequate values obtained., Conclusion: The NTS-Nursing scale is a valid and reliable instrument. Its structure of 10 items makes its use fast and easy., Competing Interests: Conflict of interest None., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Aim/objective: The aim of this study was to identify the main patterns of errors that 4th year nursing students made in simulated clinical practice with scenarios of care for people with Autism Spectrum Disorder (ASD)., Background: Clinical simulation currently plays a major role in the training of nursing students and provides the participants with the opportunity to practice and develop their clinical sills with a pediatric patient diagnosed with ASD., Design: A retrospective longitudinal qualitative study was performed., Methods: Content analysis of the existing debriefing records from a period of 7 academic years (2016-2022) was carried out. The scenario was simulated by a standardized patient diagnosed with ASD, with 23 groups of nursing students., Results: The results showed different patterns of errors. These patterns were grouped into 1 main category (weaknesses) and 5 major subcategories: clinical, communication, knowledge about ASD, emotions, and behavior towards parents. The most repeated errors were excessive use of verbal communication, abundant stimuli, low demand for information from primary caregivers, low demand for information about the child's emotions and interests, and a lack of knowledge of the profile of the child with ASD., Conclusion: From the findings of this study, we can highlight the lack of training that students received on the practical approach for providing care to these individuals. It has also been inferred in this study that clinical simulation is a tool that favors reflection and experiential learning for students when they are faced with caring for people with ASD., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Clinical simulation learning includes a debriefing after the simulated experience. Debriefing consists of several stages. In this work we focus on the last stage (summary or transfer phase), in which the participants present the most relevant of what they learned during the session., Objectives: To analyze the perception of 4th year Nursing Degree students on the most significant aspects they learned during the simulation sessions., Method: A qualitative, cross-sectional and descriptive study was conducted, with students in their last year of the Nursing Degree at the Catholic University of Murcia. The opinions of 67 students from 5 groups, on the debriefing phase, were analyzed, by comparing them with the objectives that were initially proposed during the design of the scenarios used in the simulations., Results: A total of 78 clinical scenarios were analyzed, with 292 pre-established learning objectives, on a total sample of 67 students. The participants provided a total of 464 learning outcomes that were significant for them, of which 101 coincided with those that were initially planned (21.8%), while the rest, 363 (78.2%), were considered emergent (not planned a priori). For the most part, the learning outcomes described by the students were technical knowledge and/or skills (70.5%), as compared to non-technical knowledge and/or skills (29.5%)., Conclusion: For the most part, the learning outcomes considered by the students to be significant did not correspond with the objectives set a priori in the design of the scenarios. Most were emergent elements, especially those that referred to the technical knowledge and skills. The emergent knowledge must be considered crucial by the educators for the teaching and training of students., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Self-reported scales and objective measurement tools are used to assess Evidence-based Practice (EBP) learning. An agreement between these measures has not been widely investigated among nursing students., Objective: The aim of the present study was to examine the relationship between EBP competency in undergraduate nursing students, defined as the capability to choose and use an integrated combination of EBP knowledge, skills and attitudes, evaluated with the self-reported EBP-COQ questionnaire and the final test score of an EBP course included in a Nursing Degree Program., Design: A cross-sectional study was carried out., Settings: University of Murcia (Spain), Nursing Degree, academic year 2019/2020., Participants: The study population was comprised by 210 4th-year undergraduate nursing students enrolled in the Clinical Practice and Evidence-based Nursing course. All the students were invited to participate., Methods: A validated EBP-COQ questionnaire (1 "lowest score" to 5 "highest score") and an objective test (score from 0 to 10) were used to assess EBP competency. The SPSS 26.0 program was used to perform descriptive, bivariate and multivariate analyses., Results: 152 students participated (response rate 72.4%), the sample was 81.4% female, and the median age was 20 years old; 76.3% attended more than 75% of the class hours. After the EBP course, the students obtained a high overall EBP competency score (mean = 4.21; SD = 0.26). The mean score on the objective test was 6.86 (SD = 1.36). A moderate positive correlation was found between the subjective and objective EBP competency measurements (Pearson's correlation coefficient 0.5; p < 0.0001)., Conclusions: Our findings contribute with new and significant evidence of the convergent validity of the EBP-COQ questionnaire, which increases the value of this instrument for evaluating the EBP competency of Nursing Degree students., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: The self-learning Methodology in Simulated Environments (Spanish acronym: MAES©, (Murcia, Spain) is a type of self-directed and collaborative training in health sciences. The objective of the present study was to compare the level of competence of postgraduate surgical nursing students in the clinical safety of surgical patients, after training with the MAES© methodology versus traditional theoretical-practical workshops, at different points in time (post-intervention, after three months, six months post-intervention, and at the end of the clinical training period, specifically nine months post-intervention)., Methods: We conducted a prospective study with an experimental group of surgical nursing postgraduate students who participated in MAES© high-fidelity simulation sessions, and a control group of postgraduate nursing students who attended traditional theoretical-practical sessions at two universities in Catalonia (Spain). The levels of competence were compared between the two groups and at different time points of the study., Results: The score was higher and statistically significantly different in the experimental group for all the competencies, with a large effect size at every measurement point previously mentioned., Conclusions: The postgraduate nurses were the most competent in the clinical safety of surgical patients when they trained with the MAES© methodology than when they learned through traditional theoretical-practical workshops. The learning of surgical safety competencies was more stable and superior in the experimental group who trained with MAES©, as compared to the control group.