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BACKGROUND: Virtual simulation is an interactive teaching and learning strategy used in undergraduate nursing student education, especially since the onset of the COVID-19 pandemic. Few published studies have reviewed the impact of virtual simulation as a strategy for teaching nursing students the elements of evidence-based practice. AIM: To describe types of virtual simulation that are relevant to nursing student education and examine how these modalities are applied to teach elements of evidence-based practice. METHODS: A rapid review of literature was conducted to discern the use and impact of virtual simulation. Thirty-seven studies published between 2017 and May 2021 that addressed nursing students' educational outcomes were reviewed and summarized as a narrative analysis. RESULTS: Virtual simulation and virtual reality simulation engage learners in role-plays via a computer screen or hand-held phone. Various levels of realism and immersion were apparent across different modalities and with the utilization of educational games. Most studies related to the teaching of best practice evidence-based clinical nursing topics. Twenty primary studies reported objective measures of students' improvement such as knowledge, performance, better documentation, or communication accuracy. Sixteen studies that measured knowledge identified significant knowledge gains. All studies endorsed virtual simulation as a teaching method. LINKING EVIDENCE TO ACTION: Virtual simulation approaches offer an innovative and feasible option for teaching nursing students. Such approaches should be included in undergraduate nursing curricula. While it is apparent that evidence-based practice guidelines inform the design of the virtual simulation scenarios, the effectiveness of the modality for teaching specific elements of evidence-based practice to nursing students is not yet confirmed. Nursing curricula need to include ways of teaching nursing students to search for and critically appraise tr

A scoping review aims to systematically explore and map the research available from a wide range of sources. The objective of this study was to produce a scoping review checklist to guide future scoping studies to enable rigorous review and critique of phenomena of interest. The methods used included a review of literature, expert consensus group meetings, a modified Delphi survey and, finally, verification against recent scoping study examples. Results showed that the checklist was able to identify key elements of scoping reviews. The 22-item Scoping Review Checklist (SRC), which includes two optional stakeholder consultation items, has been developed using rigorous recommended approaches. The checklist can be used to guide the conduct and critique of scoping studies.

Introduction: Clinical placements are a mandatory component of nursing students' education internationally. Despite clinical education being a key to nursing students' achievement of nursing competencies, few studies have reviewed students' narratives to describe their experiences of learning during clinical placement. Such studies may be important in offering a deeper insight into clinical learning experiences than quantitative surveys. Methods: A systematic thematic synthesis of qualitative studies between 2010 and June 2020 was conducted. English language studies that offered a thematic analysis of undergraduate nursing students' experiences of learning during placement were sought. A search was made of five databases PubMed, Ovid Medline, CinahlPlus, SCOPUS, and Google Scholar. The study was guided by the ENTREQ statement for enhancing transparency in reporting the synthesis of qualitative research. Results: Twenty-seven qualitative studies were included in the review. A thematic synthesis showed over 100 themes and subthemes across the studies. A cluster analysis revealed positive elements and others that were seen in the studies as a barrier (hindrance) to clinical learning. Positive elements included supportive instructors, close supervision, and belonging (in the team). Unsupportive instructors, a lack of supervision and not being included were seen as a hindrance. Three key overarching themes that could describe a successful placement were revealed as "Preparation," "Welcomed and wanted" and "Supervision experiences". A conceptual model of clinical placement elements conducive to nursing students' learning was developed to enhance understanding of the complexities associated with supervision. The findings and model are presented and discussed. Conclusion: The conceptual model presents positive elements that influence students' clinical placement experiences of learning. This model may provide a framework to guide professional development programs and strate

Background Anxiety and depression affects many pregnant women. Massage may be beneficial for supporting mental wellbeing during this time. The aim of this study was to assess the feasibility and acceptability of a partner-delivered relaxation massage program for pregnant women, and its impact on symptoms of antenatal anxiety, stress and depression. Methods A feasibility randomised controlled trial was conducted to compare partner-delivered relaxation massage (intervention) with self-directed stress management (control). Women attended an initial workshop at 28–32 weeks gestation followed by completion of a self-directed massage or stress management program. Qualitative data about the feasibility and acceptability (primary outcomes) were collected via online participant diaries and post-birth interviews. Anxiety, depression and stress symptoms (secondary outcomes) were assessed using the Depression and Anxiety Stress Scale (DASS-21). Birth outcomes were collected at the post- birth interview. Results A total of 14 women/partner dyads in the massage group and 13 women in the self-directed stress management group, attended the initial workshops. When interviewed, participants from both groups reported that the programs were feasible and acceptable. Women’s mean scores on all subscales of the DASS-21significantly decreased over time in both the intervention and the control group. Conclusion Pregnant women found the partner-delivered massage program to be feasible and acceptable. Both programs decreased women’s symptoms of anxiety, depression and stress with no significant differences identified between the two groups. An adequately powered experimental study with a large representative sample is needed to determine whether partner-delivered relaxation massage reduces pregnant women’s symptoms of anxiety, depression and stress.

This paper aims to explore and classify studies of the impact and effectiveness of continuing professional education for registered nurses, using existing reviews of literature. Four healthcare databases were searched for publications from 2010 to July 2019 and electronic keywords searches were conducted. Umbrella review methodology was applied and Kirkpatrick's Four-Level Model of training evaluation was used to synthesise results and explicate the levels of educational impact. Of 16 included reviews, 13 were of simulation-based education activities. Three reviews of experimental studies demonstrated strong positive evidence of education impact on nurses' learning. Objective evidence of transfer of knowledge and skills into practice included improved interprofessional team performance and less time taken to complete clinical tasks. Reports of practice improvements and intention to change practice provided further evidence of impact. A small number of individual studies measured impact on service delivery, reporting positive and neutral results. We conclude that nurses learn and newly acquired knowledge and skills are often transferred into practice. Collection of robust evaluative data after completion of education is limited by practical considerations such as access to learners, resources and time constraints. Further studies of translational impact are needed, specifically, of the impact on patient care.

Objective: To measure empathy within the therapeutic relationship between fourth year Traditional Chinese Medicine (TCM) intern practitioners and their patients, who are first-year students within the same program. Methods: An observational design was used to examine the interns’ empathic communication, evaluated by first year students ‘mystery shoppers’ using the Consultation and Relational Empathy Measure (CARE). First year TCM students went undercover to experience a clinical treatment (acupuncture) by a fourth-year intern in a public Chinese Medicine clinic attached to a metropolitan university in Sydney, Australia. Results: Thirty-nine consultations were assessed by 39 undercover shopper students. The Intern practitioners’ consultation and relational empathy was rated as a mean 76.4% (38.2 points of a possible 50 (median 78%; 39); range 24–50. Significant response differences were found between female and male interns with males rated higher. The underlying elements are presented and discussed. Conclusion: The intern practitioners’ level of empathy averaged 76.4% which is consistent with empathy ratings for international studies of healthcare students. Results showed that males were rated higher for empathy than females, indicating further studies examining the specific behaviours that characterise empathy of different genders would be a useful addition to knowledge and assist teaching.

A scoping review aims to systematically explore and map the research available from a wide range of sources. The objective of this study was to produce a scoping review checklist to guide future scoping studies to enable rigorous review and critique of phenomena of interest. The methods used included a review of literature, expert consensus group meetings, a modified Delphi survey and, finally, verification against recent scoping study examples. Results showed that the checklist was able to identify key elements of scoping reviews. The 22-item Scoping Review Checklist (SRC), which includes two optional stakeholder consultation items, has been developed using rigorous recommended approaches. The checklist can be used to guide the conduct and critique of scoping studies.

INTRODUCTION: Emergency nurses are at risk of compassion fatigue. Compassion fatigue caused by exposure to suffering may compromise the individual's personal wellbeing and reduce work efficiency. METHOD(S): A quantitative cross-sectional survey with open responses was conducted using the Professional Quality of Life: Compassion Satisfaction and Compassion Fatigue (ProQOL) scale and open-ended questions. Responses from a convenience sample of 86 nurses from two hospital emergency departments in Victoria, Australia, were analysed. RESULT(S): The median score for Compassion Satisfaction was 78% with all nurses reporting average to high scores. Most had average levels of Compassion Fatigue: Burnout median score was 53% and Secondary Traumatic Stress median score 49%. No statistically significant correlation was found between scales nor with influencing demographic characteristics. A qualification in emergency nursing was predictive of Compassion Satisfaction. Six descriptive job-associated factors contributed to nurses' stress: human resources, the organisation, job-specific components, patient mix and professional and personal components. CONCLUSION/S: Average to high levels of Compassion Satisfaction and low to average levels of Compassion Fatigue were found in emergency nurses. Issues contributing to stress were work and role related. An understanding of these stressors may help nurses and nurse managers to ameliorate emergency nurses' levels of stress and help limit staff burnout.Copyright © 2019 Elsevier Ltd. All rights reserved.

© 2020 Elsevier Ltd Objective: To critically appraise and synthesize the best available evidence on the effectiveness of massage to reduce antenatal women's anxiety and/ or depression. Design: Systematic review with meta-analysis Participants, interventions: Pregnant women over the age of 18 years who receive massage interventions. Measurements and findings: Eight studies were included in the review; seven were randomized controlled trials. Data were collected via pregnant women's self-reported ratings of anxiety or depression using validated tools. Meta-analysis of four studies revealed a moderate effect of massage therapy on women's depressive symptoms as measured by the Center for Epidemiologic Studies Depression Scale (CES-D) (MD = -5.95, 95%CI = -8.11 to -3.80, I2 = 0%) compared with usual care. A moderate effect of massage interventions on women's anxiety were also found based on five studies using various measures (SMD = -0.59, 95%CI = -1.06 to -0.12, I2 = 75%) when compared with usual care. However, none of the trials had a low risk of bias. Key conclusions: Non-pharmacologic treatments for mental health symptoms are an important option for women to use during pregnancy. As shown in meta-analysed data, massage therapy might be more effective in reducing pregnant women's anxiety and depression than usual care, although the current results may be prone to bias. Further high-quality research is required to fully evaluate the impact of massage therapy on pregnant women's mental health symptoms in the immediate and also longer term. Implications for practice: Massage therapy may be an acceptable and feasible approach for pregnant women to employ to reduce their anxiety and depressive symptoms. More research evidence examining the safety and effectiveness of massage is required before practice recommendations can be made.

AIMS AND OBJECTIVES:This paper has two objectives: first, to explain the concept of empathy derived from an integrative review of contemporary nursing literature; and second, to profile a new conceptual model of empathy that can be used to inform the teaching of empathy. BACKGROUND:Empathy is fundamental to therapeutic communication and integral to quality patient care. However, the lack of agreement on the definition or conceptualisation of empathy in the nursing literature can make teaching and evaluating this skill challenging and inconsistent. DESIGN:Integrative review of literature. DATA SOURCES:Publications from January 2000 to July 2018 in Ovid Medline, Scopus, CINAHLPlus, PsychINFO, and PubMed. REVIEW METHODS:As no integrative review checklists are currently available, a PRISMA checklist was adapted to guide this review. A two-stage approach was used to explore the concept of empathy. Key definitions and attributes of empathy were identified from 11 primary studies and tabulated to allow for display and comparison. Next, the definitions and attributes of empathy drawn from a purposeful sample of 18 nursing education studies were examined, tabulated and summarized. Finally, the two samples were integrated and synthesized to form a cohesive summary, which was then illustrated with teaching and learning exemplars. RESULTS:Despite the lack of consensus on the definitions of empathy evident in the literature, recurring attributes and elements of empathy were evident, leading to the development of a new empathy model. CONCLUSION:Patterns of consistency in the attributes of empathy that emerged from the review provided the basis for a new conceptual model, termed 'The Empathy Continuum'. RELEVANCE TO CLINICAL PRACTICE:Each of the stages in The Empathy Continuum can be used to teach learners the meaning, attributes and application of empathy in practice. The model will be relevant to nurse educators as well as educators from other disciplines. WHAT DOES THIS PAPER C