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Increase Knowledge and Competency of Point of Care Ultrasound (POCUS) among Emergency Nurse Practitioner Students Incorporating Web-Based Videos and Clinical Benchmarks.
No full textBackground: Point of care ultrasound (POCUS) is a critical skill in Emergency Medicine (EM), and Emergency Nurse Practitioner (ENP) students are increasingly expected to demonstrate proficiency. ENP students often face limited opportunities for hands-on practice compared to EM residents. Research suggests that the didactic component of POCUS training delivered through e-learning is as effective as in-person instruction. The American College of Emergency Physicians (ACEP) supports the flipped classroom model, which maximizes simulation time and focuses on psychomotor skills and clinical application, allowing didactic portions to be delivered online. Additionally, ACEP recommends a benchmark of at least 25 POCUS examinations to achieve clinical competency in each application.
Purpose: This evidence based practice quality improvement project aims to integrate e-learning modules into the existing POCUS curriculum for ENP students, along with establishing a benchmark of completing a minimum of 25 Extended Focused Assessment with Sonography for Trauma (eFAST) exams.
Methods: Participants included both current ENP students and recent graduates. A Likert survey was administered to graduates to assess their confidence in various POCUS applications. Current students were provided access to ACEP-endorsed POCUS modules during the summer of 2024, alongside in-person skills training and ENP courses. They were also required to complete 25 eFAST exams as a clinical benchmark. Confidence levels in performing POCUS applications were assessed using a Likert scale to evaluate the effectiveness of the online modules, while competency was assessed by the POCUS instructor.
Evaluation of Outcomes/Results: Students reported increased confidence in performing eFAST, ocular, and focused echo applications. However, the impact on other POCUS applications remains uncertain. The online didactic resources likely enhanced confidence by providing foundational knowledge, which in turn led to more efficient use of simulation time and allowed for increased hands-on training.
Conclusion: The incorporation of online e-learning modules and the establishment of a benchmark for eFAST exams represent a novel, cost-effective approach to enhancing POCUS training within the ENP curriculum. This approach leads to improved confidence and proficiency in POCUS among ENP students. Future efforts should focus on using online didactic POCUS training to develop a longitudinal sonography curriculum, exploring how increased confidence and skill translate to higher utilization of POCUS in clinical practice.
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Keywords: POCUS, online training, curriculum, emergency, ultrasoun
Burning Questions: A Response to Fishkin, Long, Lu, Mack, and Vallier
Full text linkI’m indebted to Larry Alexander and Steve Smith for organizing this conference, and to Joseph Fishkin, Roderick Long, Rachel Lu, Eric Mack, and Kevin Vallier for their thoughtful responses to my book, Burning Down the House: How Libertarian Philosophy Was Corrupted by Delusion and Greed. When San Diego organized this conference, I gave them the names of the people whom I was most eager to engage with, scholars I admire despite some deep disagreements. They have forced me to sharpen my own views. I am very lucky
Virtual Reality and Nursing Education: A Randomized Control Trial of the Effectiveness of Virtual Reality as a Simulation Modality
Full text linkVirtual Reality (VR) is an emerging technology being utilized in educational and professional training in fields such as engineering, heavy industry, and the military. VR also has the potential to be utilized in pre-licensing nursing education; however, nursing programs have been slow to adopt VR as a simulation modality to train pre-licensed nurses in clinical skills. As such, there is a lack of research on the effectiveness of VR training in critical skills that nurses will utilize in clinical settings. This research is vital because utilizing VR as a training tool can reduce the time and cost of preparing nurses to enter clinical settings. This study examines the extent to which VR is effective in training nursing students in clinical skills via a randomized control design (post-test only). Data was collected from two cohorts of first-year nursing students who were randomly assigned to a VR intervention group (n = 41) or to a control group that did not have access to the VR platform (n = 42). Students in the intervention group accessed VR training for 20-minute sessions (over 1 week), at the end of which both the intervention and control group engaged in a live 30-minute simulation, assessed by the course instructor. The primary outcome is clinical skills, operationalized as performance on a live simulation (scored on a 36-point scale). Additionally, qualitative data were collected from the intervention group on how students felt about VR as an overall enhancement to their learning. Differences in performance scores were compared between the control and intervention groups as well as for subgroups by gender, race, and age. Additional analysis was conducted to examine the relationship between the intensity of VR use and performance outcomes. Findings suggest statistically significant differences by gender in the intervention group and a statistically significant relationship between intensity of VR use and performance outcomes, but not in the anticipated direction. Data from course evaluations indicated that students viewed VR as an enhancement to their learning, although in running a t-test, I found that the results were not statistically significant. Findings of the study provide insights into ways VR can be used within nursing education
Peacebuilding at the San Diego-Tijuana Border: A Ground Level View
Full text linkThis brief complements the work of researchers like Kleinfeld and Blattman by seeking to understand in a more inductive way the work of peacebuilders on the ground in Tijuana, a city experiencing systemic, chronic violence. Based on survey research and interviews conducted with those peacebuilders, the brief identifies insights that can help inform a peacebuilding field that includes and integrates work in conflict zones and non-conflict zones experiencing widespread violence. Developing this more integrated approach is particularly important at the moment as we move into President Trump’s second term and begin to see the impacts of his administration in the San Diego-Tijuana region.https://digital.sandiego.edu/ipj-research/1108/thumbnail.jp
Engaging the Educators: Enhancing Faculty Support in Online Graduate Programs
Full text linkIn this action research study, I explored how the University of San Diego’s Division of Professional and Continuing Education can better support faculty in increasing their presence in online graduate programs. Drawing from the literature on faculty engagement and student satisfaction in online education, I investigated two guiding questions: How do online graduate students perceive faculty engagement, and what support do faculty need to sustain high levels of engagement? Guided by Kemmis and McTaggart’s (2000) action research spiral, the four-phase study began with an analysis of student evaluations (n = 592), derived from 58 course sections, followed by a student survey (n = 94), faculty focus groups (n = 9), and a leadership discussion (n = 5). Thematic analysis showed students value feedback, support, availability, communication, and instructor expertise. Faculty highlighted the need for clearer expectations, targeted development, and community-building. Structural challenges included inconsistent evaluations and unclear definitions of engagement, with leadership noting tensions between autonomy and consistency across programs. Ultimately, my research offers data-informed recommendations to strengthen faculty development, enhance online instruction, and foster more equitable, student-centered virtual learning. As institutions continue to invest in online education, they must also invest in the people who make that learning meaningful
Enhancing Peer Coach Learning Outcomes: Integrating Alumni Insights for Future Development
Full text linkMy research aimed to enhance learning outcomes for the coaches participating in a peer coaching internship program. The research question was: how can I work and engage peer coach alumni to better support the professional development of future peer coaches? I incorporated the perspectives of alumni coaches to identify key areas for improvement to support the professional development of future peer coaches. I conducted three cycles: alumni reflections, workshops, and a roundtable resume discussion. A theme that emerged from alumni peer coach reflections were to provide opportunities to engage with more psychology professionals and integrate career readiness into the internship program. The recommendations for enhancing professional development for peer coaches included incorporating workshops targeted at exploring career readiness and exploration including panel discussions, resume and interview preparation, and ongoing check-ins and assessment of active peer coaches’ learning interests and needs
Belonging Is Resistance: Illuminating the Power of Women of Color Mid-Level Administrators in Higher Education
Full text linkResistance has long been a mechanism through which the dominant norms of society are challenged in the name of social justice. White supremacy, heteropatriarchy, and neoliberalism make it difficult for institutions of higher education to increase diversity, advance equity, and prioritize inclusion. Although these systems of domination adversely impact the belonging of all campus stakeholders, the experiences of mid-level administrators are relatively overlooked, and feeling undervalued and underappreciated is a top reason for many, especially women and people of color, who leave the profession altogether. This qualitative study utilized narrative inquiry to understand how dominant societal norms adversely impact the belonging of women of color mid-level administrators in higher education, how they use their power to cultivate belonging in resistance against these norms, and how these belonging efforts impact the organizational culture. The study has three key findings: (a) women of color mid-level administrators are adversely impacted by the prioritization of growth and prestige as well as a sense of stratified value based on role and identities; (b) they practice coalition building through genuine relationships, exercise care and compassion within their locus of control, and maintain a commitment to authenticity as their approaches for cultivating belonging; and (c) these efforts bring about a visible impact of new programs and initiatives as well as a felt impact of shifting mindsets and behaviors that are more aligned with the institution’s social justice values. These findings were derived from the narratives of 13 women of color mid-level administrators recruited from two large, public, 4-year universities in Southern California with a minority-serving designation. The use of kuwentuhan, or Filipino talk story, to inform the semi-structured interviews elicited rich personal accounts that described their highly-nuanced experiences with navigating the organizational culture and cultivating belonging for themselves and those they work with. This research contributes to the understanding of resistance leadership broadly and in higher education, how organizational culture can be shaped and transformed, and the utility of kuwentuhan as a method of critical storytelling