NERI Award Recipients
The Nursing Education Research Initiative (NERI) award was given to 2 group recipients for the 2023 award year. This research initiative focuses on supporting faculty of the College of Nursing and Health Innovation (CONHI) in research endeavors focused on rural health nursing education.
RESEARCH PROJECT #1
Title: “Understanding the Outcomes and Experiences of Rural Nursing Students”
Researchers: Cynthia Koomey, PhD, MSN, RN, CNE
Meagan Rogers, PhD, RN, MSN, NPD-BC
Description of Project:
As the nursing profession recovers from the effects of a raging pandemic, there is a renewed emphasis on meeting our growing workforce demands by increasing the number of applicants accepted into nursing programs. The availability of highly-educated practitioners continues to be a major barrier to improving healthcare outcomes in rural communities. In recent years, CONHI has made a major strategic investment in the Texas rural workforce by increasing admissions and fostering strong partnerships in rural areas. However, little is known about the educational outcomes and post-graduation employment plans of these students completing clinical experiences in rural areas. Understanding the unique needs of rural nursing students is a key component to strengthening the workforce pipeline.
First-time licensure pass rates are the primary quality indicator for nursing programs, with funding and accreditation implications for schools of nursing with pass rates below 80%. Nursing programs have adopted stringent admission and progression criteria based on known predictors of licensure success. However, there is a gap in the current body of evidence associated with predictors of NCLEX failure and the unique needs of rural nursing students. The purpose of this research study is to develop a logistic regression model that predicts NCLEX failure to guide nursing program policy and intervention for at-risk nursing students, with specific variables and outcomes measures related to rural nursing students.
Project’s Importance:
Understanding NCLEX failure and the unique experiences of nursing students in rural areas is a critical first step to ensuring nursing programs can supply a robust pipeline of nurses into the profession. However, there is a gap in the current literature related to the experiences of rural nursing students and predictors of NCLEX failure since nationwide failures rates are only 15% and most schools don’t have a sample size large enough to study this phenomenon. Continuing to increase admissions in rural areas without the resources to ensure these students can be successful is counter-productive. This project addresses barriers to meeting workforce demands with a specific emphasis on graduate nurses in rural areas.
Findings of project:
Data collection process began in July 2023 and data analysis was conducted in August 2023. Overall, the project went well. Our only barrier was the sharp decline in the number of rural students admitted in Spring 2023 that is ongoing. We are continuing our work with program administrators and Academic Partnership on creative strategies to develop workforce pipelines in rural communities so we can continue to admit and retain students from rural areas. We are fortunate to have Rachael Fontenot to assist with the data collection process. We are grateful for the funding and look forward to ongoing partnership opportunities to improve the educational attainment of rural nursing students.
Presentations:
CRHN 2nd Annual Rural Health Conference, October 2023, Poster Presentation
Publications:
Nursing Education Perspectives, “Understanding the Outcomes and Experiences of Rural Nursing Students”, March 2025
RESEARCH PROJECT #2
Title: “Modified Medication Administration Safety Assessment Tool (Modified MASAT) – an updated tool to reflect evidence-based safety practices when validating student nurse competency in simulated medication administration.”
Researchers: Katherine A. Kreis, MSN, RN, CHSE; Michael Holmes, MSN, RN; Paula Wyman, MSN, RN, CNL, CMSRN
Description of Project:
An estimated 7,000 and 9,000 deaths related to medication errors (ME) occur each year in the United States (Tariq et al., 2022). Additionally, the economic impact is estimated at $42 billion USD annually (Donaldson et al., 2017). Imparting consistent safety processes for medication administration to student nurses, and evaluating their performance with a standardized measure, is an integral part of nursing education (Sears et al., 2010). In a review by Sulosaari et al. (2012), the authors described the significant difficulty that nursing students and initial licensure nurses have with the complex processes of med admin and presumed a connection to this leading to higher incidence of ME in hospitalized patients. To standardize a measure for med admin performance, Goodstone and Goodstone (2013) developed a set of metrics to use in simulation-based experience (SBE) known as the Medication Administration Safety Assessment Tool (MASAT). The prevalence of ME and resultant deaths make it vital to evaluate learners on the specific tasks of med admin. Research has shown that up to 80% of senior nursing students were unable to successfully perform med admin without error (Schneidereith, 2021).
Project’s Importance: A modification of the MASAT to include these safety steps is necessary for current nursing educational practice and research in both the urban and rural settings where nursing education is provided.
Findings of project:
The initial update (now referred to as Phase 1) recruited expert nursing faculty (n = 3) for collaboration in the research required for instrument development and validation. In Phase 1, the faculty were tasked with developing items to address each complex step of the medication administration task. The revised item list gives a stepwise process for learners to follow and utilizes objective performance measures (OPM) to improve medication safety and establish a safety protocol in the process. The Modified MASAT was adapted to a 20-item binary scoring instrument, see Appendix D, which was then evaluated by faculty participants (n = 28). Each item was rated on a Likert style scale of 1 to 5 (with 5 being the highest) for relevance to medication administration safety processes. The benchmark of 4.0 was established as the 80% indicator. The Phase 1 results indicated that 19 of 20 components averaged a rating of 4.50+, with only one component rated at 4.44. All 20 items were retained in the instrument.
Phase 2 of Modified MASAT development asked faculty participants (n = 28) to use the instrument to score four simulation scenarios, each recorded by 3 different simulated students, for a total of 12 videos scored by each faculty participant. The Phase 2 results indicate that the instrument demonstrates strong validity in both scenarios 2 and 3, alpha of .80 (W = .486, p < .001) and 0.81 (W = .481, p < .001) respectively, and moderate reliability in scenario 1 with an alpha of .72 (W = .406, p < .001). The high level of variability in scenario 4 (α = .783, W = .221, p < .001) is likely attributed to several factors largely attributed to the use of video recording and easily mitigated in future in-person evaluations.
The instrument is being presented to the Testing Committee in the CONHI Department of Undergraduate Nursing in February 2025. The next step is IRB submission for Phase 3, which will begin in April 2025 and direct use with students is planned for Summer 2025. This round of research will engage students in a live face-to-face scenario with a human in the role of the simulated patient (SP). These simulation-based experiences will be evaluated by faculty using the Modified MASAT as the rubric for both formative and then summative evaluations.
A second site will also test the instrument with students at a private university in Arizona, to consider the usefulness of the tool within a different demographic population of students.
Project Presentations:
Kreis, K. A., Wyman, P., & Holmes, M. (2025, January 10). Modified Medication Administration Safety Assessment Tool (Modified MASAT) – Phase 2 & 3. [Poster] International Meeting for Simulation in Healthcare (IMSH 25). Orlando, Florida, USA https://katkreis-lab.uta.edu/modified-masat-project/
Kreis, K. A., Wyman, P., & Holmes, M. (2024, Dec 5). Modified Medication Administration Safety Assessment Tool (Modified MASAT) – Phase 2. [Poster session] American Academy of Colleges of Nursing, Transform 2024, New Orleans, LA, USA
Kreis, K. A., Wyman, P., & Holmes, M. (2024, June 14). Modified Medication Administration Safety Assessment Tool (Modified MASAT) – Phase 1 [Poster] Council for the Advancement of Nursing Science (CANS), 2024 State of the Science Conference, Washington, D.C., USA
Kreis, K.A., Wyman, P., & Holmes, M. (2024, January 19) Modified Medication Administration Safety Assessment Tool (Modified MASAT), an update to reflect evidence-based safety practices and validate student nurse competency in simulated medication administration during summative skills evaluation. [Poster] Delta Theta Symposium, Innovation through Education, Research, and Evidence-Based Practice, Arlington Texas, USA
Kreis, K.A., Wyman, P., & Holmes, M. (2023, Oct 5) Modified Medication Administration Safety Assessment Tool (Modified MASAT), an update to reflect evidence-based safety practices and validate student nurse competency in simulated medication administration during summative skills evaluation. [Poster] University of Texas at Arlington, Center for Rural Health Nursing 2nd Annual Rural Health Conference, Arlington Texas, USA https://ruralhealthcenter.uta.edu/conference/
Abstract/Poster Submissions:
- Sigma Region 6 Conference, April 4, 2025 – submitted and selected for oral presentation
- National League for Nursing, September 2025 – submitted and selected for poster presentation
Grant Submissions:
- Maverick Advantage Faculty Engagement ‘23–’24 – grant received for $5000
- Sigma Research Endowment 2024 – grant received for $2000
- NLN Nursing Education Scholarship 2024 – received $8000
- Society for Simulation in Healthcare, Early Career Research Grant – submitted, not selected
- THECB limited submission grant competition – submitted, not selected.
- NLN Research Grant – application pending