To synthesize existing knowledge on the phenomenon of cybersickness and discomfort associated with the use of HMDs in delivering fully immersive VR experiences within educational contexts. Virtual reality (VR) plays an increasingly important role in education; however, head-mounted displays (HMDs) may trigger cybersickness and discomfort. A systematic review (PROSPERO: CRD42024583656) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, CINAHL, Cochrane Library and Scopus databases were searched to identify primary studies in English or Italian, published from 2013 to 2024. Twenty-five studies were included. Ad hoc questionnaires followed by the Simulator Sickness Questionnaire and the Motion Sickness Assessment Questionnaire were mainly used to detect cybersickness. In 12 studies, inconsistent or very low scores of cybersickness were reported. Oculomotor disturbances were the most frequently documented negative effects, followed by disorientation. Discomfort was assessed in eight studies, mainly with ad hoc questionnaires, with five of them reporting inconsistent or minimal discomfort. Students and professionals should be informed about the possibility of some adverse effects, especially if they undertake daily activities after the educational sessions (e.g. oculomotor issues and driving).

To explore the differences, if any, in the competences perceived by newly graduated nurses who attended their education before and during the COrona VIrus Disease 19 (COVID-19) restrictions. Nursing education has undergone significant changes because of the COVID-19 restrictions. However, to date the perceived competences at the point of graduation have not been investigated over the restrictions years compared with the pre-restrictions era. A repeated cross-sectional study followed by a pseudo-panel analysis. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used. Data on individual, nursing programme and perceived competences with Nurse Competence Scale (NCS) were collected and analysed by also using a pseudo-panel approach. Two universities were involved. Those eligible were nursing students who graduated: (1) in 2020 (=323) as the first post-COVID-19 group, who were studying in the 3rd year at the onset of the restrictions; (2) in 2021 (=250) as the second post-COVID-19 graduated group, who were in the 2nd year at the restrictions onset; and (3) in 2022 (=247) as the third post-COVID-19 group, attending the 1st year of nursing education at the onset of the restrictions. Data were compared with those who graduated in 2019 (=336, pre-COVID-19 group). The overall NCS score was higher in the pre-COVID-19 group (68 out of 100, 95 % Confidence of Interval [IC] 66.4-69.5), lower in the first post-COVID-19 graduates (62.9, 95 % CI 60-65.8), higher in the second (66.6, 95 % CI 63.6-69.4) and lower again in the third post-COVID-19 group (63.8, 95 % CI 60.9-66.5). A sinusoidal pattern also emerged for the frequency of use of the competences from the pre-COVID-19 (2.3 out of 3) and the first group (2.1) and increased between the second and the third group (from 2.1 to 2.3) (p< 0.001). These sinusoidal trends are also evident in the pseudo-panel analysis. A different degree of perceived competences at the point of graduation emerged, with higher competences in the pre-restrictions group, lower in the first post-COVID-19 generation, higher again in the second and third group. However, all scores were over 60 points out of 100, thus indicating sufficient competences. The frequency of use of such competences slightly changed over the years with limited practical relevance. The findings may inform reflections regarding innovations in the clinical placements pathways as well as in the strategies supporting newly graduates nurses in their transition from education to health-care settings.

Orthoplastic surgery, which combines orthopedic and plastic surgery principles, plays a crucial role in the treatment of open fractures of the lower limb. Clinical Practice Guidelines (CPGs) are valuable tools for standardizing and improving patient care. To assess the availability and quality of international CPGs for orthoplastic treatment of open fractures of the lower limb. A secondary objective was to provide a detailed analysis of the specific recommendations by comparing them among different CPGs. A systematic review was conducted in 2023 according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines across major medical databases and gray literature. Inclusion criteria focused on guidelines specific to orthoplastic surgery for lower limb open fractures. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool, a widely accepted instrument for guideline assessment, was utilized to evaluate the methodological rigor and transparency of the selected guidelines. Three orthoplasty CPGs have been identified, 2 of which were judged reliable according to the AGREE II methodology. Orthoplastic recommendations are no more than 7 per CPG. Consistent agreement was observed on the timing of debridement, the importance of early fixation, and definitive coverage. CPGs are critical to set up clinical pathways that are safe and evidence-based. Only 3 international CPGs address orthoplastic treatment of open lower limb fractures, 2 of which are judged reliable according to methodology. Therefore, it becomes essential to develop and disseminate high-quality, evidence-based guidelines, which are critical to improving patient outcomes and standardizing clinical practice worldwide.

Background: The COVID‐19 pandemic led to significant changes in nursing education; however, their impact on competencies and self‐directed learning (SDL) skills achieved at the point of graduation has been limitedly investigated. Aims: To compare the perceived SDL skills and competencies at the time of graduation between pre‐ and postpandemic graduates; and to assess correlations, if any, between the SDL skills and competencies in both groups. Design: A repeated cross‐sectional study design following the Strengthening of the Reporting of Observational Studies in Epidemiology checklist. Methods: All 2019 (prepandemic) and 2023 (postpandemic group) new graduates from two Italian Universities and willing to participate were included. The Self‐Rating Scale of SDL (SRSSDL _ITA ) and the Nurse Competence Scale (NCS) were administered. Descriptive and inferential statistics were used. Results: Postpandemic graduates reported slightly lower SDL scores (pre‐ 4.27 vs. postpandemic 4.18 out of 5, p = 0.030), with significant declines in “Awareness” ( p = 0.005), “Learning Strategies” ( p < 0.001), and “Interpersonal Skills” factors ( p = 0.007). Perceived overall competence as measured with the NCS was higher in the postpandemic group (pre‐ 68.01 out of 100 vs. post‐ 71.08, p = 0.020), with significant gains in “Helping Role” ( p = 0.005), “Teaching‐Coaching” ( p < 0.001), and “Ensuring Quality” dimensions ( p < 0.001). Correlations between SDL skills and competencies perceived were weaker in the postpandemic group. Conclusions: The perceived competencies have improved while the SDL skills slightly declined in the postpandemic group, suggesting new needs of graduates in the transition to their professional role. The weak correlation between SDL skills and competencies in the postpandemic group underlines the importance of clinical experience in promoting self‐direct learning. Implications for Nursing Management: Nurse Managers are required to develop tailored strategies to support the transition process beyond the development of clinical competencies, with greater support for independence in learning—a crucial skill to become resilient and adaptable and to continually face the complexities of modern healthcare.

Background/Objectives: Several Italian regions have started to introduce the Family and Community Nurse model. The aim of this study was to describe the facilitating and hindering factors that have influenced the implementation of the model by analyzing regional policies from the perspective of nurses appointed as Family and Community Nurses. Methods: A qualitative study from 2023 to 2024 following the Standards for Reporting Qualitative Research. Nurses attending a training course were eligible (N = 68) and multi-method data collection was used. Mandatory written project works were requested at the end of the course, and interviews conducted after six months with 14 purposively selected nurses were used. The data were subjected to content analysis. The factors identified were categorized by level (nurse, microsystem, mesosystem, exosystem, and macrosystem) and by the domains of the Consolidated Framework for Implementation Research. Results: A total of 23 facilitating factors and 20 hindering factors were identified across all levels and four domains of the Consolidated Framework for Implementation Research. Implementation required nurses to shift from a task-oriented to a user-oriented approach to care that emphasizes accountability and citizen needs. Facilitating factors were the availability of advanced competencies, digital skills, familiarity with communities, and effective teamwork supported by leaders. Challenges arose from fragmented systems and unmet community expectations. Strengthening cross-sector collaboration, fostering trust, and engaging third sector resources were critical factors hindering holistic, patient-centred care. Conclusions: The Family and Community Nurses model promotes integrated, patient-centred care through proactive approaches that require advanced competence and interprofessional collaboration. Training, leadership support, and the removal of systemic barriers are critical. Future research should focus on integrating the identified factors into strategies to optimize the implementation of the Family and Community Nurses model.

Aims: To understand the role of simulation in ensuring the development of the competencies expected by newly graduated register nurses (NGRNs) from the work initiation up to 5 months of transition.Methods: Mixed‐method study design. A longitudinal phase employing the Nurse Competence Scale (NCS, from 0 to 100, excellent) to assess the perceived competencies among NGRNs (N = 151) at three time points (first day of work up to fifth month); followed by a qualitative phase involving four focus groups of preceptors (N = 16) to explore the potential role of simulation in the NGRNs' working transition. Integration was performed at findings level, using the building procedures and joint displaying the results.Results: During the different time periods, variations emerged in the NCS scores from 64.41 out of 100 in the first day of work to 61.82 after 15 days, reaching 69.25 and 73.21 at 3 and 5 months. Nine potentialities have been identified as having simulation supporting NGRNs during their transition to independent practice. Simulation may contribute to develop competencies in some competence domains (diagnostic function, managing situation, therapeutic intervention, quality assurance and working role) while not in others (helping role and teaching–coaching).Conclusion: Early interventions, through integration of simulation sessions into strategies offered at the unit's level may be useful to ensure an effective working transition.Impact: Problem the study addresses: Challenges in transition from education to working settings are increasing given the difficulties of the units in providing time and support to NGRNs. Main findings: Competencies of NGRNs' are fluctuant in the five first months of work, and sub‐optimal in certain domains. Simulation may support the full development of most competencies. Impact on research: Healthcare organisations can support NGRNs to ensure smoother transitions by integrating simulations in their strategy.Reporting Method: This study was conducted following the Good Reporting of a Mixed‐Methods Study.Patient or Public Contribution: Only healthcare professionals were involved.