Background: The conventional written tests and professional assessment have limitation in fair judgement of clinical competence. Because the examiners may not have total objectivity and may lack standardization throughout the assessment process. We sought to design a valid method of competence assessment in medical and nursing specialties. This work was aimed to develop an Objective Structured Clinical Exam (OSCE) to evaluate novice nursing practitioners’ clinical competency, work stress, professional confidence, and career satisfaction. Methods: A Quasi-experimental study (pre-post). Fifty-five novice nursing practitioners received the OSCE three-months following their graduation, which consisted of four stations: history taking, physical examination, problem-directed management, interpersonal communication, and the required techniques of related procedures. The examiners had to complete an assessment checklist, and the participants had to complete a pre-post questionnaire (modified from a Nursing Competency Questionnaire, a Stress scale, and Satisfaction with Learning scale). Results: Among the novice nursing practitioners, 41 of them (74.5 %) passed the exam with a mean score of 61.38 ± 8.34. There was a significantly higher passing rate among nurses who were working in medical-surgical wards (85.7 %) and the intensive care unit-emergency department (77.8 %) compared to novice nursing practitioners working in other units. All the novice nursing practitioners at Station A had poor performance in assessing patients with a fever. OSCE performance was more associated with educational attainment and work unit, rather than the gender. Finally, the participants showed statistically significant increases in their clinical competency, confidence in their professional competence, satisfaction with the clinical practice, and decreased work stress after the OSCE. Conclusions: We found that the OSCE process had a positive educational effect, in providing a meaningful and accurate assessment of the competence of novice nursing practitioners. An appropriate OSCE program is vital for novice nursing practitioners, educators, and administrators. The effective application of OSCEs can help novice nursing practitioners gain confidence in their clinical skills.

The evidence-based practice (EBP) approach to high-quality care is designed to improve patient outcomes. However, little research has been conducted to determine how EBP is adopted and implemented among school nurses in Taiwan. This study evaluated an EBP training program implemented among school nurses in Taiwan to determine whether and how effectively it improved their knowledge levels, attitudes, skills, and self-efficacy. A pretest-posttest research design was employed. Participants were recruited via convenience sampling from among 193 primary schools throughout Tao-Yuan and New Taipei City in Taiwan. The EBP program implemented both mobile learning technology and the flipped classroom format. The learning outcomes were evaluated before, immediately after, and at a 3-month follow-up. In this regard, the data were collected using the School Nurse Evidence-Based Practice Questionnaire. The results showed that the participant scores for the items of knowledge and self-efficacy significantly increased over the study period. Somewhat differently, scores for the skill items significantly increased from the pre-test to the immediate post-test, but significantly decreased from the immediate post-test to the final follow-up. Overall, however, the EBP program led to marked improvements in knowledge, skills, and self-efficacy. These findings can help guide the development of a creative evidence-based school nursing curriculum.

Objective: Metabolic syndrome (MetS) gains more attention due to high prevalence of obesity, diabetes and hypertension among adults. Although obesity, diabetes and hypertension can certainly compromise health-related quality of life (HRQoL), the correlations of sociodemographic factors, quality of life and MetS remains unclear. This study aims to investigate the association between HRQoL and MetS in an Asian community of the sociodemographic characteristics. Research design and methods: We performed a cross-sectional study by recruiting 2588 Taiwanese patients aged ≥30 years between August 2015 and August 2017. Sociodemographic data and anthropometric variables were obtained from medical records and physical examination. Meanwhile, HRQoL was assessed by 36-Item Short-Form Health Survey questionnaires. Results: The overall prevalence of MetS was 32.8%. Multivariate analysis revealed that age ≥65 years (OR=1.987, p<0.001), body mass index (BMI) ≥24 kg/m² (OR=7.958, p<0.001), low educational level (OR=1.429, p=0.014), bad self-perceived health status (OR=1.315, p=0.01), and betel nut usage (OR=1.457, p=0.048) were associated with the development of MetS. For patients with MetS, the physical and mental health domains of HRQoL are negatively correlated with abdominal obesity and hypertension, respectively. Conclusions: Adult MetS in Taiwan was associated with certain sociodemographic factors including older age, high BMI, low educational level, bad self-perceived health status, and betel nut use. Abdominal obesity and hypertension was correlated with HRQoL in patients with MetS.

Interprofessional collaborative practice is a core competency and is the key to strengthening health practice systems in order to deliver safe and high-quality nursing practice. However, there is no Interprofessional Collaboration Practice Competency Scale (IPCPCS) for clinical nurses in Taiwan. Therefore, the purposes of this study were to develop an IPCPCS and to verify its reliability and validity. This was a psychometric study with a cross-sectional survey using convenience sampling to recruit nurses from the seven hospitals of a medical foundation. A self-designed structured IPCPCS was rolled out via a Google survey. The data were analyzed using descriptive statistics, principal-axis factoring (PAF) with Promax rotation, Pearson correlation, reliability analysis, and one-way ANOVA. PAF analysis found that three factors could explain 77.76% of cumulative variance. These were collaborative leadership and interprofessional conflict resolution, interprofessional communication and team functioning, and role clarification and client-centered care. The internal consistency of the three factors (Cronbach’s α) was between 0.970 to 0.978, and the Pearson correlation coefficients were between 0.814 to 0.883. Significant differences were presented in the IPCPCS score by age, education level, total years of work experience, position on the nursing clinical ladder, and participation in interprofessional education. In conclusion, the three factors used in the IPCPCS have good reliability and construct validity. This scale can be used as an evaluation tool of in-service interprofessional education courses for clinical nurses.

Background: Pain remains a critical issue among hospitalized children and may negatively affect postoperative recovery. In addition to pharmacological pain management, nonpharmacological approaches have been used to support pediatric care. Among these emerging approaches, socially assistive robots (SARs) may offer an opportunity to support children during hospitalization. However, limited evidence exists regarding the use of SARs in pediatric postoperative recovery and their influence on children’s emotional responses during child-robot interaction (CRI). Objective: This study aimed to examine changes in postoperative pain levels following a SAR intervention among hospitalized children. In addition, it aimed to explore emotional responses during CRI using automated facial expression analysis. Methods: A single-arm pre-post study was conducted in a pediatric surgical ward. Children recovering from surgery participated in a structured SAR intervention consisting of 3 phases: warm-up, educational video, and interactive engagement. Pain outcomes were assessed using the self-reported Wong-Baker FACES pain rating scale and the observer-rated FLACC (face, legs, activity, cry, and consolability) scale. Emotional responses were evaluated using automated facial expression analysis, which generated continuous emotional valence scores ranging from −1 (negative) to +1 (positive). Wilcoxon signed-rank tests were used to analyze pain outcomes, and Friedman tests were used to examine differences in emotional valence across intervention phases. Results: A total of 37 children were included in the pain outcome analysis, and 35 (95%) children were included in the emotional valence analysis after excluding participants with insufficient facial expression data. Significant reductions were observed in both self-reported and observed behavioral pain following the intervention. Self-reported pain scores decreased from a median of 6 (IQR 4-6) to 4 (IQR 2-4; P <.001), and FLACC scores decreased from a median of 3 (IQR 2-4) to 1 (IQR 1-2; P <.001). Emotional valence remained negative across all intervention phases. The Friedman test did not reach statistical significance across the 3 phases and showed a small effect size ( P =.05). Conclusions: The SAR interventions may be associated with lower postoperative pain scores among hospitalized children. Although emotional valence did not significantly change during CRI, automated facial expression analysis was implemented and demonstrated the feasibility of continuous affective assessment in a real-world pediatric clinical setting. These findings support the potential use of the SAR interventions as a complementary strategy in pediatric postoperative care and provide preliminary evidence supporting the integration of real-time affective assessment into pediatric health care.