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Introduction: Clinical services require feasible assessments of parent-infant interaction in order to identify dyads requiring parenting intervention. We assessed the reliability and predictive validity of two observational tools and tested whether briefer forms could be identified which retain acceptable psychometric properties over short observation periods. Methods: A stratified high-risk community sample of 250 mother-infant dyads from The Wirral Child Health and Development Study completed 7-min play-based interaction at 6-8 months. Film-footage was independently coded by two trained raters using PIIOS and NICHD-SECCYD systems. Incremental predictive validity was assessed from 3, 5 and 7 min observation to attachment outcomes (Strange Situation; 14 months) and infant mental health (BITSEA; 14 and 30 months). Results: Excellent inter-rater reliability was evident at code and subscale level for each tool and observation period. Stability of within-rater agreement was optimal after 5 min observation. ROC analysis confirmed predictive (discriminant) validity (AUCs >0.70) to top decile age 2 mental health outcomes for PIIOS total score and a brief 3-item composite from NICHD-SECCYD (sensitivity, intrusiveness, positive regard; NICHD-3), but not to attachment outcomes. Logistic regression showed dyads rated at-risk for externalizing problems using NICHD-3 were also at significantly higher risk for insecurity at 14 months (OR = 2.7, p = 0.004). Conclusion: PIIOS total and NICHD-3 ratings from 5 min observation are both reliable and valid tools for use in clinical practice. Findings suggest NICHD-3 may have greater utility due to its comparative brevity to train and code, with suitability for use over a broader developmental time frame (3-24 months).

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BACKGROUND: Metacognition can assist students in improving poor examination (exam) performance. An exam wrapper is a metacognitive tool used to assess a student's thought processes and behavioral patterns during test-taking. PURPOSE: The purpose of this study was to determine the effect of an exam wrapper tool used during one-to-one exam review sessions with faculty on prelicensure nursing students' subsequent exam performance. METHODS: Paired t-tests and repeated measures ANOVA were used to compare undergraduate students' (n = 91) exam scores before and after an exam review session with faculty in which the exam wrapper tool was used. RESULTS: Students who completed a one-to-one exam review session with faculty using the exam wrapper showed significant improvement in subsequent exam scores. CONCLUSIONS: Use of an exam wrapper tool as part of a one-to-one exam review session with faculty is a viable way to leverage metacognition to improve student exam performance.

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ABSTRACT: Concept-based curricula have been widely implemented to combat content oversaturation in undergraduate nursing education. While nursing programs have focused on changing the classroom environment, only a few have integrated conceptual learning into clinical education. This qualitative descriptive study measured student perceptions of the effectiveness of concept cards, a concept-based clinical learning activity, in maternity and medical-surgical clinical sites. Two phases of the study indicated that the use of concept cards in clinical practicum deepened and reinforced understanding of concepts and enhanced student learning in the clinical setting.

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BACKGROUND: Concept-based curricula, coupled with conceptual approach to teaching, fosters conceptual learning. There is a need for clarity in the definition of conceptual learning. METHOD: Walker and Avant's method of concept analysis was used. RESULTS: Conceptual learning is a process in which learners organize concept-relevant knowledge, skills, and attitudes to form logical cognitive connections resulting in assimilation, storage, retrieval, and transfer of concepts to applicable situations, familiar and unfamiliar. Attributes identified were (a) recognizing patterns in information, (b) forming linkages with concepts, (c) acquiring deeper understanding of concepts, (d) developing personal relevance, and (e) applying concepts to other situations. Antecedents were (a) learner cognitive potential, (b) organized conceptual framework, and (c) conceptual approach to teaching. Consequences were (a) enhanced synthesis and analysis, (b) improved problem solving, (c) ability to translate theory to practice, (d) appreciation of linear/nonlinear ways of thinking, and (e) enhanced concept construction. CONCLUSION: This analysis provides a referent for recognizing the occurrence of conceptual learning and developing instruments to measure its outcomes. [J Nurs Educ. 2019;58(1):7-15.].

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