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Question: Describe about the Support Clinical Skills Acquisition? Answer: Part I Translation of the theory of nursing into practice is a matter of concern for nurses, which needs a conceptual understanding. There has been a change in the professional behavior of the nurses in recent times and innovations have diffused into the profession, which needs the implementation of the theoretical knowledge of the nurses into practice. So the translation of the theory into practice is an essential role of the nurses in various clinical settings on which various researchers have been working. Some of them have been discussed below. According to the work of Svavarsdottir et al. (2015), implementation of the knowledge of family systems nursing at a university of Europe has been conducted. Family Systems Nursing (FSN) deals with the relational practices between the nurses and the families of the patients. Since the family members of the patients in the hospital go through complex situations of health. Proper support from the nurses can give them some comfort and they would not experience the feelings of isolation and get vulnerable. So a group of nurses working in the various divisions of the hospital was employed in the study. The study design was quasi-experimental pre and post. The nurses participated in the education and training intervention (ETI) program in FSN, where the theory was guided to apply practically. Training sessions were conducted with lectures and lab training on FSN and were trained to apply the knowledge on the clinical practices. The nurses who participated in the ETI program were found to s how a positive attitude for the care of the families of the patients. However, there was an issue regarding the application of this system of FSN. Since it was carried out in the settings of an institution, the practical application of the implementation of the FNS was not completely deduced. However, applying this practice at different nursing settings can benefit in providing better care for the families and individuals globally. This training of FSN can also facilitate the integration of the needed and new information required in the clinical practice with the theoretical knowledge gained from the training. Christian (2011) carried out research on the evaluation of the educational programs for nursing of the pediatrics and translating the theoretical outcomes of the research into clinical practice. Educational interventions are critical for the improvement of the nursing practice for the pediatrics. The nurses should be provided with proper educational interventions to implement healthy lifestyle and behaviors for the children. The evaluation of the interventions based on theories will determine the impact of the training program on the predicted outcomes and their applications in the real world settings resulting in new knowledge transfer. The study involved the literature review of few research articles that highlighted the translation of the intervention knowledge into nursing practice. The first case involved the implementation of a simulation-based program of education to teach the pediatric nurses patient resuscitation, which eventually resulted in significant improvements in skil l, knowledge and comfort of the nurses. The second case involved the evaluation of a surveillance program development for pediatric nurses for autism identification in infants, which was successful in the improvement of the identification skills of the nurses for communication behavior and social attention. The issues in these case studies were that these were all carried out under experimental environments. However, the real application of these applications of educational interventions is yet to be understood to know the real outcomes in enhancing the pediatric care among nurses. So further research has to be done to estimate the actual outcomes of these educational interventions. The research work carried out by Chan et al. (2011) demonstrated that transfer of the evidence-based knowledge for oral hygiene among the nurses improved the oral health of the patients in the hospital. Oral hygiene is essential for the maintenance of the well-being and health of the patients in the hospital. However, it has been found that the nurses often lacked the proper knowledge to deliver appropriate oral care. Therefore, the research work was conducted to improve the knowledge of the nurses to provide proper oral care to the hospitalized patients and improve their health. For the study, Iowa model was followed for the evidence-based practice. The model describes the transformation of knowledge and guiding the implementations of the research findings in to the clinical practice. A team of patients and nurses was formed and the pre and post changes to the implementation were measured. The nurses showed remarkable results after the implantation of the knowledge in oral assessmen t and risk profile of the patients. The project, which was evidence, based elevated the awareness of the nurses on oral care and heightened their knowledge. This also led them to evidence-based practice and improved the health of the hospitalized patients. The project faced several issues during the implementation of the knowledge. The first issue was the logistic issue regarding the training of the nurses. The second issue was insufficient duration of observation of the trained nurses. The third issue was that the same patient was not followed up for the entire duration of post training observation as they got discharged from the hospital. Cheng Solomon (2014) demonstrated that Life Course Theory (LCT) explains disease and health issues across populations in a more powerful way to conceptualize the disparities of health for improvements. There is a need to bring about a change in the paradigms and priorities in the delivery system of healthcare. Three areas need the implantation of LCT with relevance to care in the clinical settings. The areas are the recognition of the context and approach, longitudinal approach and need for development and integration. So the research was conducted on the addressing the influences of the society on the clinical practices and health. Facilitators and barriers to implementation were also reviewed. LCT can help in guiding the recent technology and innovations in the nursing clinical practice for the improvement of the life course. LCT training to the nurses can change the priorities and paradigms in the clinical care settings, which helps in reducing the disparities and optimizes the h ealth system. For the elimination of the health disparities, the nurses should focus on the preventive and research-based strategies and perspectives. LCT trained nurses were found to anticipate the early onset of the adult diseases and can delay their onset like for depression, diabetes and cardiovascular diseases. One of the issues in the LCT training impartment is the cultural and structural barrier. The mental health, physical and dental services have to be integrated and transcend the traditional bureaucratic and disciplinary boundaries. The LCT training will also require an approach that is team-based and interdisciplinary. Mellott et al. (2012) came up with the research work on Relationship Based Care (RBC), which involved the care of the hospitalized and elderly patients based on the foundations of better relationships. Better commitment would lead to better relationship between the nurses and the patients. For this, the nurses were trained to provide the patient and his family few commitments. The nurses regarding advocacy of healthcare in case of reproductive care ensured the patients. The patient should be appreciated with his individual needs. Building up better communications with the patients to keep the patient aware of his options. Provide support emotionally to provide the best care and educate them properly while taking decisions. A team was made from different segments of the hospital with the nurses and group activities and classes provided sufficient training. Meetings were conducted at regular intervals to discuss the outcomes of the RBC model and sufficient analysis was done in the area s of lag. The outcome was measured from different phases of the training and in different periods of the post-training sessions. Student nurses were also included among the participants and their observations were shared by the examples of communication with the patients and teamwork instances. RBS was found to have deep impact on the hospitals accountability and commitment to the patients and their families. The patient also felt very happy and satisfied with the implementation of the RBC program. However, the issue that remained is that the study was performed in a single hospital. So the potential negative effects of the program were not properly analyzed and the different perception levels of the nurses were not properly measured with different types of patients. Part II E-learning in nursing engage them by the creating motivation and interest and provide opportunities for protection and participation in the interest of the organization including documented training. Consistent engagement brings success in this process of learning. Lahti, Hatonen Valimaki (2014) carried out a study to review the effect of e-learning on the education of nurses. The application of e-learning in nursing is based on the understanding of the students. E-learning has not been claimed to be superior to conventional learning but has been recognized as an alternative process of learning. Therefore, the scope of the study was to determine the effect of e-learning on the satisfaction, skills and knowledge of the nursing students over the conventional method of learning. Although the study claimed the effectiveness of e-learning over traditional methods, it never went beyond the scope of the study. The outcome of the study suggested that e-learning is not superior to the conventional method of learning. It is just an alternative method of learning and there are no significant differences in the results. However, this study can be effectively used to select the education method of choice. As per the knowledge level and satisfaction of the students and supporting the practice of change, the suitable educational method can be chosen. The theory and the study were linked to the application of meta analysis of RCT (randomized controlled trials) and systematic review. Both these methods were sound enough to link the theory and practice of the study. Various electronic databases were also searched and reviewed like Medline, Cinahl, Psychinfo, etc. which provided ample information regarding the study. Eleven methodical trials were found suitable for the analysis, which included 2491 nursing students and professional nurses. Bloomfield Jones (2013) suggested that e-learning supports the acquisition of clinical skills. The various needs of the nursing students have to be accommodated which can be facilitated by e-learning. The study was carried out to explore the experiences and perceptions of the nursing students in addition to the conventional methods of learning the clinical skills. The study was based on the mixed methods and quantitative and qualitative approaches. This was based on the theory of e-learning and its scope. 83 graduate students participated in the study and they acquired the clinical skills with the help of e-learning. Descriptive statistics were employed for data analysis. The findings of the study suggested that e-learning can go beyond the traditional methods of skill acquisition and also beyond the theoretical claim of this study. The students perceived both the e-learning and traditional teaching methods favorable. They assisted to develop the psychomotor and knowledge techniques required for the clinical skills acquisition. E-learning facilitates the learning process of the clinical skills and maximizes the experience of the students. The reasoning employed in the study was to explore the experiences and perceptions of the graduate nursing students of e-learning was found to be sound. E-learning was used as an addition to the conventional methods for the acquisition of the clinical skills of nursing. It was found from the study outset that the findings would not reveal the actual information about the learning quality from e-learning. It would only provide the information about the perceptions and the utility for the development of the clinical skills. According to Feng et al. (2013), situated e-learning has enhancing effects on the nursing education. Traditional education is getting limited to provide the opportunity for patient-student interaction due to the increased complexity of the healthcare system. So the effectiveness of situated e-learning has been analyzed in the study. For the study, various literature databases were searched and analyzed like Pubmed, Medline, ERIC, etc. for the study. The effectiveness of e-learning was examined on the performance and knowledge outcomes of the nursing students. The calculations of the effect sizes were done with about 95% of the intervals of confidence. From these observations, it can be said that the application was based on the theory of e-learning and its scope in nursing education. Although situated e-learning is efficient method for the improvement of performance of the learner, its effect on the cognitive ability is not profound when compared with the conventional learning proces s. Hence, the application of the study does not go beyond the claim of the theory. It can just be an additional supplement to the conventional learning of nursing but does not seem to go beyond the methods of traditional learning for the practicing nurses. The study was found to be sound when it came to the linking of the application with the theory. The study was performed on 14 articles and meta analysis was performed. The mean effect size was 1.35 for performance and 0.24 for knowledge. It came out be a useful and effective model for teaching the nursing students. Ilott et al. (2014) determined the approach to increase the management of dysphagia by blended e-learning process for the nurses. The study was conducted on a clear understanding of the related theory and its scope. Dysphagia has been recognized as a life-threatening issue and nurses are known to provide crucial support in the management of the disease. Therefore, blended e-learning program training was conducted to improve the patient care for the nurses. The study did not, however, go beyond the claim of the theory. This was because the learning effects were not clear as per the behavioral terms. Also, there was a need for the longitudinal perspective on the knowledge of instrumental use. Future research was also recommended. The reasoning linking the application and the theory was quite sound as the blended e-learning sessions required needs analysis, programs for e-learning, action planning and improvement of practical skills. The participants were healthcare assistants and regis tered nurses. Data analysis was done using non-parametric tests and analysis of the content. According to Keefe Wharrad (2012), e-learning can be employed to increase the education of the nurses regarding pain management. E-learning can be important in the intervention of the management of pain. The application was based on a good understanding of the theory and its scope. Due to the absence of the pain management in the curricula of the nursing students, diversity has been noticed among the students regarding the awareness and understanding of pain. So e-learning has been employed as a resource for pain management. The application goes beyond the theoretical claim and has contributed effectively to pain management. E-learning was found to significantly develop the resources of pain education. E-learning has also been found to be beneficial for research studies in future. The reasoning, which is linking the theory and the application, has been found to be sound enough as two variants have been developed for resources on e-learning. Nursing students were employed for the stu dy and the results were obtained by comparing the scores between two groups of variants. References Bloomfield, J. G., Jones, A. (2013). Using e-learning to support clinical skills acquisition: Exploring the experiences and perceptions of graduate first-year pre-registration nursing studentsA mixed method study.Nurse education today,33(12), 1605-1611. Chan, E. Y., Lee, Y. K., Poh, T. H., Ng, I. H. L., Prabhakaran, L. (2011). Translating evidence into nursing practice: Oral hygiene for care dependent adults. International Journal of Evidence Based Healthcare,9(2), 172-183. doi:10.1111/j.1744-1609.2011.00214.x Cheng, T. L., Solomon, B. S. (2014). Translating life course theory to clinical practice to address health disparities.Maternal and Child Health Journal,18(2), 389-395. doi:10.1007/s10995-013-1279-9 Christian, B. J. (2011). Research CommentaryEvaluating educational programs in pediatric nursing: Translating research outcomes to improve practice.Journal of Pediatric Nursing,26(4), 383-384. doi:10.1016/j.pedn.2011.05.003 Feng, J. Y., Chang, Y. T., Chang, H. Y., Erdley, W. S., Lin, C. H., Chang, Y. J. (2013). Systematic Review of Effectiveness of Situated E Learning on Medical and Nursing Education.Worldviews on Evidence Based Nursing,10(3), 174-183. Ilott, I., Bennett, B., Gerrish, K., Pownall, S., Jones, A., Garth, A. (2014). Evaluating a novel approach to enhancing dysphagia management: workplace based, blended e learning.Journal of clinical nursing,23(9-10), 1354-1364. Keefe, G., Wharrad, H. J. (2012). Using e-learning to enhance nursing students' pain management education.Nurse education today,32(8), e66-e72. Lahti, M., Htnen, H., Vlimki, M. (2014). Impact of e-learning on nurses' and student nurses knowledge, skills, and satisfaction: A systematic review and meta-analysis. International Journal of Nursing Studies,51(1), 136-149. doi:10.1016/j.ijnurstu.2012.12.017 Mellott, J., Richards, K., Tonry, L., Bularzik, A. M. H., Palmer, M. (2012). Translating caring theory into practice: A relationship-based care experience.Nurse Leader,10(5), 44-49. doi:10.1016/j.mnl.2012.02.006 Svavarsdottir, E. K., Sigurdardottir, A. O., Konradsdottir, E., Stefansdottir, A., Sveinbjarnardottir, E. K., Ketilsdottir, A.. . Gumundsdottir, H. (2015). The process of translating family nursing knowledge into clinical practice.Journal of Nursing Scholarship,47(1), 5-15. doi:10.1111/jnu.12108