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BACKGROUND: In spring 2020, nursing education programs abruptly transitioned the teaching and learning of nursing practice skills to virtual environments as the result of the coronavirus disease 2019 (COVID-19) pandemic. METHOD: This study sought to describe ethnographically how faculty and students formed and integrated clinical judgment and other nursing practice skills within this quickly formed virtual subculture. Thirty-seven associate-degree nursing students participated in small group interviews, and four faculty participated in one-to-one interviews. RESULTS: Two overarching themes were identified: (1) the pervading mood of learning through the pandemic; and (2) the primacy of the nursing traditions of direct care experience. Themes were nested further within the five essentials for human learning: curiosity, authenticity, emotion, sociality, and failure. CONCLUSION: Virtual simulation cases with focused prebriefing and debriefing sessions provided experiences that were targeted, shared, guaranteed, and safe. Adequately supported virtual simulation platforms can enhance the learning of nursing skills. [J Nurs Educ. 2023;62(10):541-547.].

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OBJECTIVES: The aim of this research was to understand obstetric nurses' perceived barriers to immediate skin-to-skin contact (SSC) in the operating room (OR) after cesarean birth. METHODS: Semistructured, open-ended interviews were conducted via videoconferencing. Conventional content analysis methods were used to analyze the data for common themes. Investigation team consensus was reached to validate the analysis findings. RESULTS: Ten nurses who care for women during labor and birth were interviewed. The primary overarching theme was performing safe and effective SSC after cesarean birth. Nurses strongly believe in the benefits of SSC after cesarean and try to implement it as often as possible, but various factors prevented SSC in the OR from occurring on a regular basis. Providing immediate SSC is not considered a priority during the cesarean by all members of the team. All participants reported that there were no formal policies and procedures in their facilities for SSC in the OR. Challenges with safety, nurse staffing, and logistics were described as well as professional barriers, and varying practices between geographical location and facilities. Nurses discussed concepts that were facilitators for changing their current practices to support SSC after cesarean. CLINICAL IMPLICATIONS: Implications: Developing effective policies and procedures that support SSC in the OR after cesarean and changing practice accordingly is recommended. Adequate nurse staffing in the OR is essential.

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Simulated practice of clinical skills has occurred in skills laboratories for generations, and there is strong evidence to support high-fidelity clinical simulation as an effective tool for learning performance-based skills. What are less known are the processes within clinical simulation environments that facilitate the learning of socially bound and integrated components of nursing practice. Our purpose in this study was to ethnographically describe the situated learning within a simulation laboratory for baccalaureate nursing students within the western United States. We gathered and analyzed data from observations of simulation sessions as well as interviews with students and faculty to produce a rich contextualization of the relationships, beliefs, practices, environmental factors, and theoretical underpinnings encoded in cultural norms of the students' situated practice within simulation. Our findings add to the evidence linking learning in simulation to the development of broad practice-based skills and clinical reasoning for undergraduate nursing students.

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BACKGROUND: Major nursing organizations, federal agencies, and researchers are recommending that all nurses be educated to at least the baccalaureate level. METHODS: This article reports the results of a qualitative study of the experiences of students enrolled in a direct associate's degree to baccalaureate degree nursing program. Based on multiple small group interviews conducted during an 18-month period, a multistep interpretive analytic process was used that ultimately described themes within a holistic view of the phenomenon. FINDINGS: The results showed an overarching theme of transformative change over time, centered within the "place" of the university. CONCLUSION: The study suggested that there are differences beyond additional coursework that describe a transformative process in associate's degree to baccalaureate degree education. An atmosphere, or "space created," for reflection on learning is significant to consider in the development of education programs.

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In this article, we present a theory-based application of clinical simulation in psychiatric-mental health nursing education. As described by Benner, Sutphen, Leonard, and Day, a three-pronged apprenticeship that integrates intellectual, practical, and ethical aspects of the professional role is critical in the development of practical reasoning in nursing education and training. Clinical encounters are often fraught with ambiguity and uncertainty. Therefore, educating for a practice discipline requires experiential and situated learning. Using the three-pronged experiential model in simulated psychiatric-mental health nursing practice supports the development of critical nursing skills, ethics, and theoretical concepts. A clinical scenario is presented that demonstrates the application of this model of professional apprenticeship in psychiatric-mental health education. Applications of the concept presented may be used in training nurses new to the practice of psychiatric-mental health nursing.

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The goal of this interpretive research study was to articulate the lived experience of students in an accelerated master's of nursing entry program learning the practice of nursing within a clinical setting. Specific questions included: How did previous life experiences, education, and career choices influence the experience of second-degree students? What were the potential effects on learning of condensing and accelerating the curriculum as is requisite in second-degree programs? Data from small group and individual interviews were collected and analyzed using interpretive phenomenological methods. Akin to the experience of tourists or new immigrants, students were confronted with new physical demands, new equipment, new time patterns, and most importantly, new ways of relating to people, all within a condensed time frame. What stood out most in these students' accounts was the ubiquitous context of inpatient nursing care in which lives were at stake.

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