The aim of this review is to inform future educational strategies by synthesising research related to blended learning resources using simulation videos to teach clinical skills for health students. An integrative review methodology was used to allow for the combination of diverse research methods to better understand the research topic. This review was guided by the framework described by Whittemore and Knafl (2005), DATA SOURCES: Systematic search of the following databases was conducted in consultation with a librarian using the following databases: SCOPUS, MEDLINE, COCHRANE, PsycINFO databases. Keywords and MeSH terms: clinical skills, nursing, health, student, blended learning, video, simulation and teaching. Data extracted from the studies included author, year, aims, design, sample, skill taught, outcome measures and findings. After screening the articles, extracting project data and completing summary tables, critical appraisal of the projects was completed using the Mixed Methods Appraisal Tool (MMAT). Ten articles met all the inclusion criteria and were included in this review. The MMAT scores varied from 50% to 100%. Thematic analysis was undertaken and we identified the following three themes: linking theory to practice, autonomy of learning and challenges of developing a blended learning model. Blended learning allowed for different student learning styles, repeated viewing, and enabled links between theory and practice. The video presentation needed to be realistic and culturally appropriate and this required both time and resources to create. A blended learning model, which incorporates video-assisted online resources, may be a useful tool to teach clinical skills to students of health including nursing. Blended learning not only increases students' knowledge and skills, but is often preferred by students due to its flexibility.

OBJECTIVE. The aim of this research project was to obtain an understanding of the barriers to and facilitators of providing palliative care in neonatal nursing. This article reports the first phase of this research: to develop and administer an instrument to measure the attitudes of neonatal nurses to palliative care. METHODS. The instrument developed for this research (the Neonatal Palliative Care Attitude Scale) underwent face and content validity testing with an expert panel and was pilot tested to establish temporal stability. It was then administered to a population sample of 1285 neonatal nurses in Australian NICUs, with a response rate of 50% (N = 645). Exploratory factor-analysis techniques were conducted to identify scales and subscales of the instrument. RESULTS. Data-reduction techniques using principal components analysis were used. Using the criteria of eigenvalues being >1, the items in the Neonatal Palliative Care Attitude Scale extracted 6 factors, which accounted for 48.1% of the variance among the items. By further examining the questions within each factor and the Cronbach's α of items loading on each factor, factors were accepted or rejected. This resulted in acceptance of 3 factors indicating the barriers to and facilitators of palliative care practice. The constructs represented by these factors indicated barriers to and facilitators of palliative care practice relating to (1) the organization in which the nurse practices, (2) the available resources to support a palliative model of care, and (3) the technological imperatives and parental demands. CONCLUSIONS. The subscales identified by this analysis identified items that measured both barriers to and facilitators of palliative care practice in neonatal nursing. While establishing preliminary reliability of the instrument by using exploratory factor-analysis techniques, further testing of this instrument with different samples of neonatal nurses is necessary using a confirmatory factor-analysis approach.

The provision of simulation to enhance learning is becoming common practice as clinical placement becomes harder to secure within Bachelor of Nursing programs. The use of simulation videos within a blended learning platform enables students to view best practice and provides relevant links between theory and practice. Four simulation videos depicting family assessment viewed by a cohort of Australian undergraduate nursing students were evaluated. These videos were professionally developed using actors and experienced family nurses. Surveys were used to explore the students' self-assessed knowledge, confidence and learning preferences before and after exposure to blended learning resources. Students' engagement with the simulated videos was captured via the Learning Management System. Time 1 survey was completed by 163 students and Time 2 by 91 students. There was a significant increase in students' perceived knowledge of family theory Item 1 from a mean 4.13 (SD = 1.04) at Time 1 to 4.74 (SD = 0.89) (Z = -4.54 p < 0.001) at Time 2; Item 2- Knowledge of family assessment improved from mean 3.91 (SD = 1.02) at Time 1 to 4.90 (SD = 0.67) (Z = -7.86 p < 0.001) at Time 2. Also a significant increase in their confidence undertaking family assessment Item 5 from a mean 3.55 (SD = 1.14) at Time 1 to 4.44 (SD = 0.85) (Z = -6.12 p < 0.001) at Time 2. The students watched the videos an average of 1.9 times. The simulated videos as a blended learning resource increases the students' understanding of family assessment and is worth incorporating into future development of courses.