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A gradual replacement of the mercury thermometers with alternative devices is ongoing around the world as effect of the global strategies to reduce mercury pollution. However, to reduce the risks of misdiagnosis, unnecessary treatments, and omission of care in the pediatric population, more evidence on the reliability and validity of alternative thermometers are needed. The aim of this comparative observational study was to detect any differences in temperature measurements between the gold-standard axillary mercury thermometer (AXLMER) and the alternative devices. Temperature values in Celsius (°C) were simultaneously measured in a group of Albanian children aged up to 14 years using both (AXLMER) and digital axillary thermometers (AXLDGT), as well as forehead and tympanic infra-red thermometers. The AXLDGT device, compared with the AXLMER, showed no clinically significant difference in the mean values (-0.04 ± 0.29 °C) and the narrowest 95% Level of Agreement (+0.53 °C to -0.62 °C) in the paired comparisons. For cut-off points of 37.0 °C and 37.5 °C, the AXLDGT showed the highest levels of sensitivity (67.4% and 72.5%) and specificity (95.3% and 99.1%) in detecting fever. This study indicates that the AXLDGT thermometer may prove the better option since it adequately balances accuracy, safety and children’s comfort.

High-Fidelity Simulation (HFS) founded on critical care scenarios requires nursing students to perform clinical interventions to effectively face life-threatening conditions. Since little evidence is available on the effectiveness of HFS on knowledge, self-confidence, self-efficacy, performance, and satisfaction of postgraduate nursing students attending an intensive care course, a before-and-after study was conducted on 28 students to document any change of learning outcomes in a respiratory failure scenario. After the HFS session, a significant improvement for self-confidence was revealed. Beyond the statistical significance, the HFS demonstrated to be a valuable complement to traditional education for many students, determining an improvement of their knowledge and self-efficacy. High level in performance and satisfaction during and after HFS session were also documented, confirming HFS as a valid teaching method in the achievement of learning goals, especially when associated with the traditional work placement models, in nursing students attending a postgraduate academic course on intensive and emergency care.

The study aims were to define the psychometric properties of the Albanian Jefferson Scale of Empathy–Health Professional Students’ version, compare empathy levels among Albanian Health Professional students, and explore any relationship among students’ characteristics and their empathy levels. To achieve these aims, a comparative cross-sectional study was conducted. A preliminary exploratory factor analysis was conducted to determine the factor structure of the scale, while group comparisons of empathy scores were examined using t-test and ANOVA F-test. A total of 1,240 students were enrolled in the study. Psychometric properties of the scale were confirmed. Midwifery, physiotherapy, and female students showed higher levels of empathy than other groups. Similarly, third-year students showed higher empathy than first- and second-year students. Monitoring empathy levels is fundamental to the adoption of useful educational strategies by faculties to improve empathy skills in Health Professional students and guarantee better care of patients, especially those in need of psychological support.

High-Fidelity Patient Simulation (HFPS) allows the nursing students’ immersion in a learning environment marked by complexity, dynamism, reality, and safety, connecting theory to practice. The increased use of the HFPS was also sustained by the beneficial impact that HFPS seems to produce on nursing students’ learning outcomes. However, available research is still conflicting, and several methodological issues do not allow achieving best-quality evidence. To analyse the impact of the HFPS on nursing students’ learning outcomes in critical care area, a methodological overview of the studies included in a systematic review was conducted. Heterogeneity about the geographic area, methods, simulation techniques, and control approaches was pointed out. However, studies based on cardiocirculatory scenarios showed the highest standardization of methods and assessment tools. The development and application of shared guidelines derived from adequately-sampled randomized controlled trials are expected to demonstrate the high-fidelity simulation to be a valuable adjunct to the traditional training program.

ObjectiveThe purpose was to analyse the effectiveness of high-fidelity patient simulation (HFPS) based on life-threatening clinical condition scenarios on undergraduate and postgraduate nursing students’ learning outcomes.DesignA systematic review and meta-analysis were conducted based on the Cochrane Handbook for Systematic Reviews of Interventions and its reporting was checked against the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist.Data sourcesPubMed, Scopus, CINAHL with Full Text, Wiley Online Library and Web of Science were searched until July 2017. Author contact, reference and citation lists were checked to obtain additional references.Study selectionTo be included, available full-texts had to be published in English, French, Spanish or Italian and (a) involved undergraduate or postgraduate nursing students performing HFPS based on life-threatening clinical condition scenarios, (b) contained control groups not tested on the HFPS before the intervention, (c) contained data measuring learning outcomes such as performance, knowledge, self-confidence, self-efficacy or satisfaction measured just after the simulation session and (d) reported data for meta-analytic synthesis.Review methodThree independent raters screened the retrieved studies using a coding protocol to extract data in accordance with inclusion criteria.Synthesis methodFor each study, outcome data were synthesised using meta-analytic procedures based on random-effect model and computing effect sizes by Cohen’s d with a 95% CI.ResultsThirty-three studies were included. HFPS sessions showed significantly larger effects sizes for knowledge (d=0.49, 95% CI [0.17 to 0.81]) and performance (d=0.50, 95% CI [0.19 to 0.81]) when compared with any other teaching method. Significant heterogeneity among studies was detected.ConclusionsCompared with other teaching methods, HFPS revealed higher effects sizes on nursing students’ knowledge and performance. Further studies are required to explore its effectiveness in improving nursing students’ competence and patient outcomes.