Khairul Dzakirin Bin Rusli

BACKGROUND Interprofessional communication is needed to enhance the early recognition and management of patients with sepsis. Preparing medical and nursing students using virtual reality simulation has been shown to be an effective learning approach for sepsis team training. However, its scalability is constrained by unequal cohort sizes between medical and nursing students. An artificial intelligence (AI) medical team member can be implemented in a virtual reality simulation to engage nursing students in sepsis team training. OBJECTIVE This study aimed to evaluate the effectiveness of an AI-powered doctor versus a human-controlled doctor in training nursing students for sepsis care and interprofessional communication. METHODS A randomized controlled trial study was conducted with 64 nursing students who were randomly assigned to undertake sepsis team training with an AI-powered doctor (AI-powered group) or with medical students using virtual reality simulation (human-controlled gro...

BACKGROUND The capacity of health care professionals to perform clinical procedures safely and competently is crucial as it will directly impact patients’ outcomes. Given the ability of head-mounted virtual reality to simulate the authentic clinical environment, this platform should be suitable for nurses to refine their clinical skills for knowledge and skills acquisition. However, research on head-mounted virtual reality in learning clinical procedures is limited. OBJECTIVE The objectives of this study were (1) to describe the design of a head-mounted virtual reality system and evaluate it for education on clinical procedures for nursing students and (2) to explore the experience of nursing students using head-mounted virtual reality for learning clinical procedures and the usability of the system. METHODS This usability study used a mixed method approach. The stages included developing 3D models of the necessary instruments and materials used in intravenous therapy and subcutaneo...

AimTo evaluate the effectiveness of an online program on nurse preceptors’ knowledge and self‐efficacy in their roles to support students’ clinical education, and to examine their online experience.BackgroundProfessional development of nurse preceptors is paramount to fostering work readiness of future graduate nurses on entering the workforce. The support from academic institutions in developing preceptors’ roles in clinical teaching and assessment is pivotal.DesignThis study employed a mixed‐methods design.MethodA total of 59 nurse preceptors from six healthcare institutions participated in an online preceptor program by collaborating with academic educators in facilitating student clinical learning and assessment through telesimulation following web‐based instruction. Pre‐test and post‐tests were administered to evaluate the preceptors’ knowledge and self‐efficacy in their roles. Survey questionnaires and focus group discussions were conducted to evaluate their online experience....

Academic‐practice collaborations between academic educators and preceptors are important to ensure the success of clinical education. This study explored the perceptions of academic educators and preceptors on their collaborations in a transition‐to‐practice program for nursing students. A qualitative exploratory study was undertaken with a purposive sample of 12 preceptors and 13 academic educators across three hospitals and one university in Singapore. Individual interviews were conducted. Four main themes emerged from the thematic data analysis: “hierarchical communication” that prevents academic educators and preceptors from communicating directly with each other, “uncertainty about learning objectives” among preceptors, “discrepancies in clinical assessments” due to a lack of support for preceptors in the assessment process, and “not knowing each other's practice,” which could result in theory‐practice gaps. The findings reflect the need to strengthen collaborations between...

BACKGROUND Interprofessional team training is needed to improve nurse-physician communication skills that are lacking in clinical practice. Simulation has been proved to be an effective learning approach for team training. Yet, it has logistical constraints that called for the exploration of virtual environments in delivering team training. OBJECTIVE This study aimed to evaluate a team training programme using virtual reality versus conventional live simulation on medical and nursing students’ communication skills performances and teamwork attitudes. METHODS In June 2018, the authors implemented a nurse-physician communication team training using the communication tools. A randomized controlled trial study was conducted with 120 undergraduate medical and nursing students who were randomly assigned to undertake the team training using virtual reality or live simulation. Participants from both groups were tested on their communication performance through team-based simulation assessme...

AIMS AND OBJECTIVES To identify and consolidate the available evidence about nursing-related competencies for home-based care. BACKGROUND Over recent years, the demand for home-based nursing care has increased because of the need to meet the increasing need for chronic disease care to be delivered in patients' homes. However, knowledge is lacking about the expected competencies for home-based care nurses. DESIGN A scoping review was conducted in accordance with Arksey and O'Malley's six-step scoping review framework and the PRISMA-ScR guidelines. The review identified literature using five electronic databases (CINAHL, PubMed, Embase, Cochrane and Scopus) and a hand search for grey literature in relevant home-based care journals and online searches. Key search terms and inclusion and exclusion criteria were used as strategies to identify relevant articles. RESULTS Sixty-four articles were eligible for inclusion. Mapping and narrative synthesis of 116 elements related to home-based nursing care competencies identified the following 10 competencies: (1) care assessments; (2) performance of nursing procedures; (3) management of health conditions; (4) critical thinking and problem-solving skills; (5) interpersonal relationships and communication; (6) interdisciplinary collaboration; (7) leadership and resource management; (8) professional development; (9) technological literacy; (10) quality and safety. CONCLUSION AND RELEVANCE TO CLINICAL PRACTICE This review provides insight into current knowledge about home-based nursing care competencies. These competencies could be used to evaluate nurses' competence level for home-based care or for development of appropriate professional education. The review also outlines the scope of nursing practice in home-based care, which provides support for some form of standardisation of home-based nursing care expectations across various stakeholders.

Adults ≥65 are more susceptible to influenza infection and its associated complications. This paper critically reviews the literature, identifying the need for and priorities of a public health strategy to improve vaccination awareness and uptake among older adults. Four electronic databases were searched for peer-reviewed articles in English published between 2001 and 2016. Twelve studies were included. Three themes were identified on analysis: impact on healthcare services; barriers and motivators influencing influenza vaccination uptake; and health promotion interventions. Studies suggest vaccination may reduce the health-care costs of influenza-associated infection. Socioeconomic factors, information about vaccination and cultural beliefs may influence an individual's decision. Multicomponent interventions, such as home visits combined with reminders, support increased uptake. Interventions are identified that could be adopted at the community level in Singapore and other countries to improve influenza vaccination uptake among older adults.

Empowerment plays significant roles in the complex management of type 2 diabetes. International guidelines have provided recommendations on management of Muslims who fast during Ramadan. However, there remains a lack of patient-centered epistemic tool to empower healthcare providers and patients in managing diabetes during Ramadan. This study discussed the development and evaluation of such tool. The collaborative algorithm was developed with reference to the nominal group technique by a board-certified clinical pharmacist and discussed with endocrinologists, nurses, and family physicians. The empowerment component of the algorithm was developed based on the Basic Psychological Needs Theory. The algorithm was evaluated through a randomized controlled trial. Glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), and postprandial glucose (PPG) levels and safety profiles in terms of hypoglycemic events were assessed. The collaborative algorithm was developed with four components: screening, education, dose modification by healthcare provider, and dose adjustment by patient. A total of 62 individuals were recruited, with 30 and 32 randomized into the intervention and control groups, respectively. The mean age was 58.4 years, with majority being females (67.7%). There was a reduction in mean HbA1c from 7.9% ± 0.9% to 7.5% ± 0.8% (P < 0.001) in the intervention group, while no significant difference was observed in the control group (P = 0.270). FPG (P < 0.001) and PPG (P = 0.002) also improved significantly in the intervention group. There were no major hypoglycemic events and minor hypoglycemia comparable between both groups (P = 0.465). The collaborative algorithm incorporated empowerment and promoted shared decision-making in diabetes management, hence promoting safe and effective fasting.

Academic-practice collaborations between academic educators and preceptors are important to ensure the success of clinical education. This study explored the perceptions of academic educators and preceptors on their collaborations in a transition-to-practice program for nursing students. A qualitative exploratory study was undertaken with a purposive sample of 12 preceptors and 13 academic educators across three hospitals and one university in Singapore. Individual interviews were conducted. Four main themes emerged from the thematic data analysis: “hierarchical communication” that prevents academic educators and preceptors from communicating directly with each other, “uncertainty about learning objectives” among preceptors, “discrepancies in clinical assessments” due to a lack of support for preceptors in the assessment process, and “not knowing each other's practice,” which could result in theory-practice gaps. The findings reflect the need to strengthen collaborations between academic educators and preceptors through joint teaching and assessments in clinical or simulated settings. This will provide opportunities to learn from each other's practice as well as build rapport, which are critical elements in reducing theory-practice divides and decreasing hierarchical levels between academic educators and preceptors.

Adults ≥65 are more susceptible to influenza infection and its associated complications. This paper critically reviews the literature, identifying the need for and priorities of a public health strategy to improve vaccination awareness and uptake among older adults. Four electronic databases were searched for peer-reviewed articles in English published between 2001 and 2016. Twelve studies were included. Three themes were identified on analysis: impact on healthcare services; barriers and motivators influencing influenza vaccination uptake; and health promotion interventions. Studies suggest vaccination may reduce the health-care costs of influenza-associated infection. Socioeconomic factors, information about vaccination and cultural beliefs may influence an individual's decision. Multicomponent interventions, such as home visits combined with reminders, support increased uptake. Interventions are identified that could be adopted at the community level in Singapore and other countries to improve influenza vaccination uptake among older adults.

Aims and objectives
To identify and consolidate the available evidence about nursing-related competencies for home-based care.

Background
Over recent years, the demand for home-based nursing care has increased because of the need to meet the increasing need for chronic disease care to be delivered in patients' homes. However, knowledge is lacking about the expected competencies for home-based care nurses.

Design
A scoping review was conducted in accordance with Arksey and O'Malley's six-step scoping review framework and the PRISMA-ScR guidelines. The review identified literature using five electronic databases (CINAHL, PubMed, Embase, Cochrane and Scopus) and a hand search for grey literature in relevant home-based care journals and online searches. Key search terms and inclusion and exclusion criteria were used as strategies to identify relevant articles.

Results
Sixty-four articles were eligible for inclusion. Mapping and narrative synthesis of 116 elements related to home-based nursing care competencies identified the following 10 competencies: (1) care assessments; (2) performance of nursing procedures; (3) management of health conditions; (4) critical thinking and problem-solving skills; (5) interpersonal relationships and communication; (6) interdisciplinary collaboration; (7) leadership and resource management; (8) professional development; (9) technological literacy; (10) quality and safety.

Conclusion and relevance to clinical practice
This review provides insight into current knowledge about home-based nursing care competencies. These competencies could be used to evaluate nurses’ competence level for home-based care or for development of appropriate professional education. The review also outlines the scope of nursing practice in home-based care, which provides support for some form of standardisation of home-based nursing care expectations across various stakeholders.