Objective To establish an evaluation framework for clinical practice teaching quality in Master of Nursing Science (MNS) programs, providing an assessment tool for cultivating high-level nursing professionals.
Methods Through literature review, semi-structured interviews, and two rounds of expert consultation, the ordinal ranking method was employed to calculate indicator weights.
Results A final framework comprising 4 primary indicators, 13 secondary indicators, and 42 tertiary indicators was established, covering practice base structure and resources, teaching process and management, teaching effectiveness and evaluation, and feedback and improvement. Expert scoring indicated mean indicator importance > 4.0, coefficient of variation < 0.25, expert authority coefficient of 0.84, and statistically significant increases in Kendall's W value across rounds (p <.05), demonstrating the system's scientific rigor and stability.
Conclusions This evaluation system is comprehensive in content and well-structured. It provides a quantitative basis for assessing the quality of clinical practice teaching, facilitating instructional improvements, and fostering competency development among MNS graduate students. It also serves as a reference for reforming domestic nursing graduate education and cultivating high-level talent.
Passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN) represents a pivotal milestone for nursing graduates, yet a substantial number do not succeed on their first attempt. While existing literature primarily focuses on predicting at-risk students prior to graduation, less is known about the lived experiences of graduates who fail the exam and later pass. This phenomenological study explored the perspectives of nine BSN graduates who were unsuccessful on their first NCLEX-RN attempt but ultimately achieved licensure. Semi-structured interviews were conducted, transcribed, and analyzed using thematic analysis. Six themes emerged: (1) Key Changes in Preparation, (2) Emotional Impact, (3) Consequences of Not Passing, (4) Test-Day Stressors, (5) Mindset and Confidence-Building, and (6) Support Systems. All participants reported substantial adjustments in study strategies, including structured schedules, increased practice question volume, and targeted content review, which they perceived as the primary contributors to later success. Emotional responses to failure were profound, marked by embarrassment, self-doubt, and social withdrawal. More than half experienced tangible consequences such as delayed employment and financial strain, which often served as motivators for reattempting the exam. Test-day factors, including anxiety related to test-site procedures, weather, and fatigue, also influenced performance. Some participants emphasized the value of mindset shifts, positive self-talk, and anxiety-management techniques, while a smaller subset highlighted the importance of family, peer, or employer support. Findings suggest that NCLEX-RN remediation should extend beyond content review to include structured study planning, emotional support, and preparation for the testing environment. Nursing programs may enhance graduate success by providing early outreach, individualized study plans, and psychosocial support for those who do not pass on their first attempt.
Background and objective With the implementation of the NexGen question approach for NCLEX, nursing educators have utilized simulation, case studies, and reflection to assist students in learning to apply clinical judgment to various clinical situations. Very little has been done at a community level. This case report demonstrates how using a community-based service-learning project can help senior nursing students in their community health rotation apply the Clinical Judgment Measurement Model (CJMM) approach in a real-world situation. The objective of this case report was to demonstrate community-based service-learning projects can increase students’ application of clinical judgment in real-world settings using the CJMM as a guide.
Methods Students were assigned a zip code to assess through observing resources, needs, and people, speaking with formal and informal key informants, and government web sourced demographic, biostatistical, and epidemiological data, identify areas of need, prioritize an area to address based on personnel, time, and financial resources, develop and implement an intervention, and evaluate the effectiveness of the intervention.
Results Students successfully demonstrated application of the CJMM to a community-based service-learning project. Students reported an increased confidence in using the CJMM in future clinical situations.
Conclusions A community-based service-learning project can be used to teach students how to apply clinical judgment using the CJMM as a guide.
Background and objectives Technology literacy is emerging as a competence to support clinical decision-making, documentation, and communication. However, while curricula for nursing students emphasize technological competencies, clinical education fails to support nursing students' understanding of technology in clinical practice. To address this gap, we developed a workshop for nursing students in clinical placement. The objective of this study was to evaluate of a workshop-based educational intervention designed to strengthen nursing students’ technology literacy and clinical decision-making.
Methods Design A single group, post-intervention, descriptive design was applied to evaluate nursing students' learning outcomes. The workshop was structured in two parts. Part one focused on everyday technologies in nursing care guided by the TEKU model. Part two focused on future technologies such as AI and remote monitoring, using cases supported by The Pedagogical Reflection model or “The House” in clinical decision-making. To evaluate learning outcomes, a post-workshop questionnaire was completed.
Results Of 112 respondents, 77% (n = 86) had previously attended teaching in technology literacy during their studies, 20% (n = 22) had not, and 4% (n = 4) were unsure. As for self-reported technology literacy post-workshop (n = 82), 62% (n = 51) reported a high or very high understanding, 37% (n = 30) reported moderate, and 1% (n = 1) reported low understanding. Furthermore, 89% (n = 97) reported improved clinical decision-making when encountering new technologies to a moderate 54% (n = 59), high 29% (n = 32), or a very high degree of 6% (n = 6), and 11% reported low (n = 10) or very low (n = 2). Open-ended responses highlighted that reflection and case-based group work were valuable in supporting critical thinking in assessing technology.
Discussion and conclusions The results indicate that authentic and case-based learning activities are effective to support nursing students’ technology literacy and critical thinking and may address the gap between curricular requirements and clinical practice. However, a single group design might limit generalizability. A practice-oriented workshop approach is effective to strengthen nursing students’ technology literacy and support clinical decisions.
Background/Objective Simulation is utilized in nursing programs to develop critical thinking skills during a high-risk scenario in a low-risk environment. Limited research exists regarding interprofessional simulation involving graduate and undergraduate nursing students. This project aimed to explore the impact of interprofessional simulation on graduate and undergraduate nursing students, focusing on realism, role identification, collaboration, communication, delegation, teamwork, and confidence.
Methods The sample population included 35 Student Registered Nurse Anesthetists (SRNAs) and 148 Bachelor of Science in Nursing Students (BSNs). Students participated in an Obstetric Emergency and Neonatal Emergency Simulation. Upon completion of the simulations, a survey was administered consisting of 17 questions, using a 5-point Likert scale.
Results Survey results revealed that students strongly agreed that working in an interprofessional format enabled them to identify roles and responsibilities. Statistically significant differences were found (p <.05) between the BSN and SRNA students in the following areas: motivated learning, realism, identifying roles, promoting teamwork, and effective communication. A statistically significant difference was found between the students' pre-test and post-test scores, indicating that students were more confident to participate in the interprofessional simulation.
Conclusions The results of this project support the implementation of interprofessional simulation in curriculum development to promote communication, teamwork, role identification, and confidence. Interprofessional simulations provide a safe space for students to explore delegation and role development without time constraints that could result in patient injury.
Background A structural gap persists between foundational nursing education and the rapidly evolving technological landscape of clinical incontinence care in Japan. Increasing product differentiation requires healthcare professionals to exercise situational product selection, while undergraduate curricula often lag behind technological innovation. In addition, the diversification of the healthcare workforce introduces further complexity in interpreting locally optimized product logic. This report describes the development and evaluation of an academia-industry collaborative recurrent education program designed to address these structural challenges.
Methods The program was co-developed by university faculty and an industry product development team. Theoretical sessions addressed skin pH dynamics, barrier protection mechanisms, and cleansing principles relevant to incontinence-associated dermatitis. Practical sessions incorporated visualization-based comparative demonstrations, in which simulated stool and urine were simultaneously applied to different absorbent products to externalize structural differences in absorption patterns and surface moisture conditions. The program was delivered in two separate in-person sessions at different venues in Niigata, Japan, in March 2025, with a total of 34 nursing and caregiving professionals participating across both sites, including one foreign care worker.
Results Among respondents (n = 25), 88% reported acquisition of new knowledge and 92% recognized practical applicability. Qualitative feedback emphasized the value of hands-on visualization and expressed intentions to disseminate updated knowledge within clinical workplaces.
Conclusions Academia-industry collaborative recurrent education may function as an adaptive interface between foundational curricula and accelerating clinical innovation. Beyond individual skill acquisition, such programs have the potential to support shared clinical reasoning across diverse professionals and contribute to regional healthcare quality assurance in technologically advancing care systems.
Background Tiered grading practices that use letter, percentage, and numerical systems to express learner achievement of course outcomes are entrenched in nursing education programs. Despite their prevalence, these approaches present notable issues, including limited actionable feedback, challenges in fostering transferable practice competencies, and inconsistencies among evaluators. These concerns highlight the need for alternative assessment practices by educators that better support student learning and achievement of course outcomes.
Methods A fourth-year online nursing course was redesigned by the course instructor to employ specifications grading, an objective-driven, mastery-based assessment model. The implementation strategies and subsequent course revisions are documented and investigated following the highlights from the design.
Discussion The main challenges encountered by the instructor during the implementation phase included adapting new course structures to the existing ones, clarifying learner expectations, and supporting learners in transitioning to a new assessment framework. Revision opportunities helped improve transparency, alignment with learning outcomes, and learner engagement.
Conclusions Specifications grading demonstrates potential as a viable alternative assessment to traditional systems. Considering the novelty of this approach, recommendations and lessons learned are provided to guide educators considering similar approaches.