Clinical reasoning is a vital competence for nursing students, as it is required for solving problems arising in complex clinical situations. Identifying the factors that influence nursing students’ clinical reasoning competence in the social context can help their implicit educational needs. Therefore, this study aimed to determine the factors associated with developing clinical reasoning competency among undergraduate nursing students. In total, 206 senior nursing students were included in this study. Self-reported measures were used to obtain data on participants’ clinical reasoning competence, problem-solving abilities, academic self-efficacy, and level of clinical practicum stress. Relationships among continuous variables were analyzed using Pearson’s correlation coefficients. A multiple linear regression analysis was conducted to identify factors related to clinical reasoning competence. Our findings show that participants with better problem-solving abilities and academic self-efficacy perceived themselves as having higher levels of clinical reasoning competence. Nursing students with lower clinical practicum stress reported higher clinical reasoning competence. Significant factors identified were younger age and subcategories of problem-solving ability such as problem clarification, alternative solution development, planning/implementation, and self-regulated efficacy. Our findings highlight essential factors necessary for developing a nursing curriculum that contributes to professional nurses’ clinical reasoning competence.

Background: Depression is a severe psychological concern that negatively affects health in older adults. Serious games applied in various fields are considered appropriate interventions, especially in mental health care. However, there is a lack of evidence regarding the effects of serious games on depression in older adults. Objective: This study aimed to investigate the characteristics and effectiveness of serious games for depression in older adults. Methods: A systematic review and meta-analysis of randomized controlled trials were conducted. In total, 5 electronic databases (PubMed, CINAHL, Embase, PsycINFO, and Cochrane Library) were searched to identify relevant studies published until July 6, 2021. A total of 2 reviewers independently conducted study selection, data extraction, and quality appraisals. The risk of bias in the included studies was assessed using the JBI Critical Appraisal Checklist. For the meta-analysis, the effect size was calculated as the standardized mean difference (SMD) by using a random effects model. Results: A total of 17 studies with 1280 older adults were included in the systematic review, and 15 studies were included in the meta-analysis. Serious game interventions were classified into 3 types: physical activity (PA), cognitive function, and both PA and cognitive function. The meta-analysis demonstrated that serious games reduced depression in older adults (SMD −0.54, 95% CI −0.79 to −0.29; P<.001). Serious games had a more significant effect size in community or home settings (SMD −0.61, 95% CI −0.95 to −0.26; P<.001) than in hospital settings (SMD −0.46, 95% CI −0.85 to −0.08; P=.02); however, the difference between groups was not significant. Among the types of games, games for PA (SMD −0.60, 95% CI −0.95 to −0.25; P<.001) and games for both (SMD −0.73, 95% CI −1.29 to −0.17; P=.01) had a significant effect on reducing depression in older adults. However, no significant correlations were observed between the duration or number of serious games and depression. Conclusions: Serious games were beneficial in reducing depression in older adults. Regardless of the study setting, serious games appeared to reduce depression. Particularly, serious games including PA had a significant impact on reducing depression. Furthermore, high-quality randomized controlled trials are needed to establish substantial evidence for the effectiveness of serious games on depression in older adults. Trial Registration: PROSPERO CRD42021242573; https://tinyurl.com/26xf7ym5

Objectives: Academic electronic medical records (AEMRs) can be utilized for a variety of educational programs that can enhance nursing students’ nursing informatics and clinical reasoning competencies. This study aimed to identify the applicability and effectiveness of simulation education incorporating AEMRs.Methods: We developed simulation education scenarios incorporating AEMRs and evaluated them with 76 third- and fourth-year nursing students from five nursing schools using a mixed-methods design. We incorporated three simulation case scenarios involving preeclampsia, diabetes mellitus, and myocardial infarction into the AEMRs. After the simulation education, participants’ feedback on the usability of the AEMR system and their self-efficacy for AEMR utilization were collected via self-reported surveys. Subsequently, the simulation education incorporating AEMRs was evaluated through a focus group interview. The survey data were examined using descriptive statistics, and thematic analysis was done for the focus group interview data.Results: The average mean scores for the AEMR system’s usability and participants’ self-efficacy for AEMR utilization were 5.36 of 7 and 3.96 of 5, respectively. According to the focus group interviews, the participants were satisfied with the simulation education incorporating AEMRs and recognized their confidence in AEMR utilization. In addition, participants addressed challenges to simulation education incorporating AEMRs, including the need for pre-education and AEMR utilization difficulties.Conclusions: Nursing students weresatisfied with and recognized the value of simulation education incorporating AEMRs. Although the actual application ofsimulation education incorporating AEMRs remains challenging, further research can help develop and implement this approachfor nursing students.

A cancer diagnosis often triggers significant emotional and psychological challenges, underscoring the importance of addressing psychological distress. While psychological distress in patients with gastrointestinal (GI) cancer has been widely studied, less attention has been focused on those who are newly diagnosed. This scoping review aims to map the existing literature on psychological distress in newly diagnosed patients with GI cancer. A scoping review was conducted following the framework outlined by Arksey and O'Malley. The last search was carried out on September 23, 2024, across PubMed, CINAHL, EMBASE, Scopus, and PsychINFO for literature published between January 2013 and September 2024. The search terms included "newly diagnosed," "distress," "patients," and "gastrointestinal cancer." A meta-analysis was conducted using the R package to synthesize the prevalence of psychological distress across studies, with a random-effects model applied to account for heterogeneity. Fifteen studies were included in the analysis, revealing an average prevalence of psychological distress of 28.1% (99% CI: 181.84, 433.39). Psychological distress was most prevalent during the diagnostic phase and gradually decreased over time. Factors such as older age, advanced cancer stage, poor performance status, and a lack of social support contributed to increased psychological distress. Additionally, only 20% of the studies were intervention-based. Approximately one-third of newly diagnosed patients with GI cancer may experience psychological distress. Early identification and intervention to address this distress before treatment initiation are crucial for improving patient outcomes. osf.io/n2796.