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The Effects of Simulation-Based Training, Underwent Before or After the Clinical Practice for the Nursing Students
Abstract
Purpose: This study was conducted to compare the effects of simulation-based training on knowledge, self-efficacy and clinical performance, underwent before or after the clinical practice for the nursing students. Method: A comparison group design was established with pre-clinical practice group (n
... 자의 사생활 보호라는 측면에서 관찰의 기회가 매우 제한적이 어서 [3,4] [2,[10][11][12], 자신감이나 자기효능감 증진 [3,4,10,13,14] 및 임상수행능력 향상 [2,3,7,11,12,[14][15][16][17]]은 물론 비판적 사고 또는 문제해결능력이나 임상판단력 향상 [7,13,14,18,19] ...
... 자의 사생활 보호라는 측면에서 관찰의 기회가 매우 제한적이 어서 [3,4] [2,[10][11][12], 자신감이나 자기효능감 증진 [3,4,10,13,14] 및 임상수행능력 향상 [2,3,7,11,12,[14][15][16][17]]은 물론 비판적 사고 또는 문제해결능력이나 임상판단력 향상 [7,13,14,18,19] ...
PURPOSE: To identify the effects of delivery-nursing simulation education using team-based learning on the delivery nursing knowledge, self-efficacy, and clinical competence of nursing students.
METHODS: The study used a nonequivalent, control group, quasi-experimental design. The team-based learning was applied to the experimental group, while the individual learning was applied to the control group. Data were collected from October 12 to December 7, 2016, and analyzed using the SPSS/WIN 22.0 program.
RESULTS: Comparison between the experimental and control group showed no significant difference in delivery-nursing knowledge (t=−0.33, p=.741) or self-efficacy (t=−0.65, p=.515). However, a significant difference (t=−2.09, p=.048) in the nursing-skills aspect of clinical competence was found between the experimental and control groups after the practical simulation education.
CONCLUSION: Delivery-nursing simulation education using team-based learning was more effective in improving the nursing-skills aspect of nursing competence than was delivery-nursing simulation education based on individual learning.
Purpose:
The purpose of this study was to develop a maternal nursing competency reinforcement program for nursing students and assess the program's effectiveness in Korea.
Methods:
The maternal nursing competency reinforcement program was developed following the ADDIE model. This study employed an explanatory sequential mixed methods design that applied a non-blinded, randomized controlled trial with nursing students (28 experimental, 33 control) followed by open-ended interviews with a subset (n=7). Data were analyzed by both qualitative and quantitative analysis methods.
Results:
Repeated measures analysis of variance showed that significant differences according to group and time in maternal nursing performance; assessment of and intervention in postpartum uterine involution and vaginal discharge (F=24.04, p<.001), assessment of and intervention in amniotic membrane rupture (F=36.39, p<.001), assessment of and intervention in delivery process through vaginal examination (F=32.42, p<.001), and nursing care of patients undergoing induced labor (F=48.03, p<.001). Group and time improvements were also noted for problem-solving ability (F=9.73, p<.001) and emotional intelligence (F=4.32, p=.016). There were significant differences between groups in self-directed learning ability (F=13.09 p=.001), but not over time. The three themes derived from content analysis include "learning with a colleague by simulation promotes self-reflection and learning," "improvement in maternal nursing knowledge and performance by learning various countermeasures," and "learning of emotionally supportive care, but being insufficient."
Conclusion:
The maternal nursing competency reinforcement program can be effectively utilized to improve maternal nursing performance, problem-solving ability, and emotional intelligence for nursing students.
Background
Simulation-based experiences (SBEs) are accepted as an effective strategy for learning about patient safety in operating rooms, which are known as high-risk working environments. In implementing SBEs, there is a need to investigate when students prefer simulation and when it is effective for students' success.
Methods
A total of 56 students were included in the study, which was designed as a quasiexperimental study. The data were collected through the Theoretical Knowledge Test, Skills Assessment Form, Student Satisfaction and Self-Confidence in Learning Scale, Simulation Design Scale, and Educational Applications Questionnaire forms.
Results
Although there were no differences found between students' satisfaction, self-confidence, and education practices, there was a remarkable decrease in the Simulation Design Scale responses of the students in the group who applied the SBE after clinical practice compared with those of the group who applied the SBE before clinical practice, and there was a statistically significant difference in the support subdimension.
Conclusion
The results of this study show that scenario implementation during education about patient safety in the operating room is more effective if performed before clinical application.
Background
Scheduling simulation experiences for labor and delivery to promote optimal learning outcomes has not been fully investigated.
Methods
This study compared self-efficacy, clinical-experience stress, and clinical-practice satisfaction between two groups of third-year nursing undergraduate students who experienced a different timing of simulations in an obstetrical rotation. One group of nursing students performed simulations before clinical practice (n = 42); a second group performed simulations after clinical practice (n = 38).
Results
No significant differences emerged in scores of self-efficacy, clinical-experience stress, and clinical-practice satisfaction between the two groups. Survey questions on simulation timing demonstrated that 55 (69%) students preferred simulation practice at the end of obstetrics clinical rotations.
Conclusions
Students reported individual preferences for various reasons. Nurse educators should consider students' viewpoints regarding the timing of labor and delivery simulations to provide optimal outcomes.
The purpose of this study was to identify the effects of simulation-based education regarding care in a cardio-pulmonary emergency care as related to knowledge, critical thinking, and problem solving ability in nursing students. The study was conducted with a nonequivalent control group pre-posttest design. Seventy four participants were assigned to either the experimental group(34) or control group(40). The simulation-based cardio-pulmonary emergency care education included lecture, team-based practice, and debriefing, and it was implemented with the experimental group for a week from September 1 to December 11, 2015. Data were analyzed using chi-square, t-test and ANCOVA by using SPSS 21.0 program. The experimental group who had the simulation-based education showed significantly higher knowledge(F
This research was conducted for the purpose of developing a high-fidelity simulation education program, applying it to clinical field and analyzing this program's effect on nursing college students in order to solve problems being caused from the gap between the adult nursing theoretical class and practical education. As the analysis method, this study developed a scenario including an algorithm for caring hyperkalemia patients, the evaluation check list, and debriefing according to the adult nursing theoretical class's learning goal and measured the high-fidelity simulation program's effect in using the non-equivalent control group pre-test and post-test design. As the results from the analysis, there secured the simulation education program's general properties and dependent variable's homogeneity in the experimental group and the control group. The nursing simulation practice program for hyperkalemia patients showed slight effect on the experimental group compared to the control group in fields such as nursing practice ability, problem solving ability, critical thinking skills, self-confidence of nursing, and knowledge. (t=-83.313, p
PURPOSE: The purpose of this study was to analyze the effectiveness of simulation-based maternity nursing practice by applying problem based learning (PBL) on the problem solving process, self-confidence in clinical performance and nursing competence of nursing students.
METHODS: This study was one group pre-posttest design, with 123 third year nursing students. Data were collected from March 19 to May 29, 2013 as the students completed their simulation practice class. Students completed a survey about their problem solving process, self-confidence, and nursing competence at the beginning and the end of the class.
RESULTS: Students' problem solving process, self-confidence, and nursing competence showed significant improvements after the simulation-based maternity nursing practice.
CONCLUSION: Therefore, it is recommended that current maternity nursing curriculum should be reviewed and improved, and the students should be provided variety of simulation-based education and maternity nursing skills.
Purpose:
The purpose of this study was to evaluate the effects of clinical practice and simulation-based practice for obstetrical nursing in terms of self-efficacy, practice satisfaction, and practice stress.
Methods:
A non-equivalent control group post test design was used. The participants were 171 junior nursing students, 103 in the experimental group, and 68 in the control group. Simulation-based practice consisted of nursing assessment during labor, nursing assessment and intervention for normal and high risk mother, nursing education for mother and family during labor, and open lab. The experimental group participated in simulation-based practice for two days and the control group participated in clinical practice at delivery room for two weeks.
Results:
The experimental group showed higher level of self-efficacy (p=.043), practice satisfaction (p<.001) and practice stress (p=.003) compared to the control group.
Conclusion:
Simulation-based practice is an effective learning method for obstetrical nursing and can be used as the alternative for clinical practice. However, stress management strategies are needed for simulation-based practice.
Purpose: The purpose of this study was to review nursing studies with regard to simulation- based learning in Korea. Methods: This systematic review examines the literature on simulation in nursing education from 2003 to 2012. The electronic databases reviewed included: RISS, the National Assembly Library, the National Library of Korea, and major nursing journal databases in Korea. The MeSH search terms included nursing, simulation, simulator, and standardized patient. Results: In total, 52 studies were included in the literature review. We included 21 quasi-experimental studies and 25 studies using high-fidelity simulation. They included knowledge and problem-solving ability in the cognitive domain; self efficacy, learning satisfaction, interpersonal relationships and communication, and confidence in the affective domain; and clinical performance ability and learning performance evaluation in the psychomotor domain. This systematic literature review revealed that simulation is useful in nursing education but uncovered a gap in the literature pertaining to the transfer of knowledge to performance and how to learn from cognitive reflection. Conclusions: This result suggests that it is necessary to conduct additional research on the cognitive learning process and transition to performance.
Clinical training for nursing students is limited to rudimentary skills to avoid potential risks. Simulation-Based Training (SBT) can overcome the shortcomings of clinical training. We evaluated the educational effect of SBT for obstetrical nursing students using high-fidelity simulation courses.
We developed a simulation program for obstetrical nursing students to practice nursing skills that are necessary to provide quality care. The program consisted of four sessions. 1st: An orientation and a preliminary test. 2nd: Learning core skills required in obstetrical nursing. 3rd: Testing each student with scenario. 4th: Providing a debriefing session. At the beginning of the program, students were surveyed about their self-confidence in obstetrical nursing care, and at the end of the program, they were surveyed about the adequacy of SBT as well as self-confidence.
Students' self-confidence showed a significant difference before and after simulation. Mean adequacy of SBT was 7.15±1.35 (out of 10). Most students became more interested in Women's Health Nursing after SBT.
The results from evaluating the effects of simulation-based obstetrical nursing training show that SBT provides invaluable clinical experience for obstetrical nursing students by overcoming the lack of actual clinical involvement in clinical training programs.
It is important to demonstrate learning outcomes of simulation in technology based practices, such as in advanced health care. Although many studies show skills improvement and self-reported change to practice, there are few studies demonstrating patient outcome and societal efficiency. The objective of the study is to investigate if and why simulation can be effective and efficient in a hi-tech health care setting. This is important in order to decide whether and how to design simulation scenarios and outcome studies.
Core theoretical insights in Science and Technology Studies (STS) are applied to analyze the field of simulation in hi-tech health care education. In particular, a process-oriented framework where technology is characterized by its devices, methods and its organizational setting is applied.
The analysis shows how advanced simulation can address core characteristics of technology beyond the knowledge of technology's functions. Simulation's ability to address skilful device handling as well as purposive aspects of technology provides a potential for effective and efficient learning. However, as technology is also constituted by organizational aspects, such as technology status, disease status, and resource constraints, the success of simulation depends on whether these aspects can be integrated in the simulation setting as well. This represents a challenge for future development of simulation and for demonstrating its effectiveness and efficiency.
Assessing the outcome of simulation in education in hi-tech health care settings is worthwhile if core characteristics of medical technology are addressed. This challenges the traditional technical versus non-technical divide in simulation, as organizational aspects appear to be part of technology's core characteristics.
Simulation-based learning is an emerging learning modality with promising potential for certified nurse-midwife (CNM) and certified midwife (CM) education. Unlike standard didactic methods, simulation-based learning affords opportunities to address multiple domains of learning and performance. Unlike standard clinical education, simulation-based learning provides learners exposure to events that are rare in the clinical setting, and allows learners to assume leadership roles in emergencies. Simulation-based learning is consistent with constructivist learning principles, which promote retention, understanding, and active use of skills. A simulation-based shoulder dystocia learning module was implemented on a pilot basis in a class of four student nurse-midwives. Student nurse-midwives self-assessed their preparedness to manage a shoulder dystocia in the cognitive, psychomotor, and affective domains before and after the simulation-based learning exercise. Feedback from student evaluations was promising. Although the small sample precluded statistical analysis, student self-assessment scores appeared to be higher after the simulation-based learning exercise. Open-ended student feedback was unanimous that simulation-based learning should be incorporated into the curriculum. Further implementation and evaluation of simulation-based learning in CNM and CM education is warranted.
The purpose of this study was to test the validity of a modified clinical performance examination (CPX) for preclinical students in nursing.
70 nursing students in their second semester of the junior year at C University participated in CPX. Scenarios and checklists were developed by our research team from September to October 2005. Six stations were organized. Evaluation included physical examination of a patient with lung cancer, education on usage of a metered dosage inhaler, and lobectomy postoperative care. Students were randomly assigned to a station.
There was a difference in the CPX scores according to stations. The agreement of scoring between trained faculty members and SPs was more than moderate (r=.647). The correlation between the CPX score and the average grade in the previous semester and between the CPX score and the average grade of a paper and pen test of the pulmonary system of adults was low (r=.276; r=.048).
Traditional CPX is generally recommended, however, modified CPX is appropriate for preclinical students in the current Korean Nursing school setting if there are additional scoring systems to balance the testing level at each station.
Purpose: The purpose of this study was to identify the clinical practice experiences of nursing students who completed the courses of nursing curricula in college. Method: The data was collected using a questionnaire with 191 task elements in 8 nursing standards specified by the Korean Nurses Association(2003), from December 2004 to January 2005. Three hundred thirty-three nursing students from five three-year and five four-year colleges of nursing were selected for respondents. Result: The nursing activities which over 70% of the students had performance experiences with were 23 items(12.04%) practiced frequently in clinical settings, simple, low in malpractice risk and noninvasive in characteristic. In addition, the nursing activities which under 30% of students had performance experiences with were 87 items(45.55%). The nursing activities which over 70% of students had only observation experiences with were 20 items(10.47%). Also, the nursing activities that over 30% of students didn't have any experiences with were 19 items(9.95%) not frequently seen in the clinical setting. Conclusion: It is concluded that the students are not fully qualified as the new nurses of the future. Therefore, every effort to develop a more effective clinical nursing education in school, clinical settings and in students themselves is needed.
Purpose: The purpose of this study was to analyze how a nursing student recognizes PBL with simulation education and its relationship to academic achievement. Methods: The study objects were the students in C college who learn through PBL using simulator for 15 weeks(September 2007 to December 2007). Learning element recognition was developed by Cho(2002) and three key evaluations(performance, self-evaluation, and colleague evaluation) were designed by professors. Results: Learning element recognition ranged from 2.37 to 4.83 with the average at 3.94. For Learning element recognition, students who preferred discussion score 4.15. This was statistically more significant than those who do not. Students who preferred presentations show significantly higher score in colleague evaluation. For Learning element recognition and academic achievement, self-evaluation and colleague evaluation showed relationship to PBL learning element. Conclusion: There was definitely a relationship with PBL learning element and academic achievement after learning the PBL with simulation education.
Purpose: With the decrease in available clinical sites, a decrease in adequately prepared clinical faculty, and demand to prepare health care students to begin work, we need alternative methods to teach clinical skills for health care professionals. The use of simulation as an educational process that can replicate clinical practices is becoming popular in nursing. Therefore, this study was conducted to review directions of simulation-based learning in nursing education. Methods: A systematic review of quantitative studies was undertaken using Medline, KERIS, and KISS. The primary search terms were simulation and nursing. Reference lists from relevant papers and the websites of relevant nursing organizations were also searched. Nine studies met inclusion criteria and were analyzed in detail. Results: All studies reported simulation as a valid teaching/learning strategy. Six of the studies (66.7%) showed that simulation technology was a practical and successful model to use in teaching a variety of clinical skills for nursing students and nurses. Conclusion: Simulation may have some advantages over other teaching methods, depending on the scenario, context, topic, and method. Further study is needed to determine the effect of team size on learning and to develop a universal method of outcome measurement.
Purpose: The purpose of this study was to explore experiences among undergraduate nursing students in a high-fidelity simulation education course for a semester. Method: The participants in this study were 10 nursing students in the senior classes and volunteers. Data collection was conducted using a focus group interview for 100 minutes, which was recorded on video tape. Transcribed data was analyzed through qualitative content analysis. Result: The results of this study were deduced as 4 codes and 22 themes. Study participants reported experiences due to the simulation method itself, interaction among peer group and personal experiences during high-fidelity simulation education. Additionally, experiences related to clinical application were examined. The participants indicated positive outcomes such as developing clinical judgment skills and confidence. Conclusion: Overall, the results of this study supported the usability and effectiveness of a high-fidelity simulation education method in undergraduate nursing curriculum. Further studies are needed to provide more reliable and valid educational information.
Purpose: The purpose of this study was to ascertain the current state of clinical nursing education at hospitals. Methods: Questionnaires were sent out to 236 hospitals which have over 300 beds. Out of these, 116 hospitals responded, and the collected data was analyzed by mean, frequency, t-test, and ANOVA test. Results: These hospitals have teaching agreements with 4.2 nursing colleges and clinical education lasts 8 months. Clinical education status regarding hospital characteristics, between a university hospital, non-university hospitals, among advanced general hospitals, general hospitals, and special hospitals showed statistical differences in colleges per hospital and nurses' degree. 37.9% of cases have no internal regulation for nursing education, and in 68.1% of cases, students' practice was limited to simple nursing care. The current primary guide for student's practice was head nurse (61.25%), and the course professor took charge of mainly the conference. The difficulties as an educational hospital are increases in work load, difficulties in teaching, excessive number of students, simultaneous practical training, complaints from patients, lack in training manpower, and stress. Conclusion: This study determined that the big hospitals are heavily burdened by nursing education and that it will be necessary to establish standards for educational hospitals to ensure higher quality education.
Purpose: The objective of this study was to identify the effects of problem based learning (PBL) combined with simulation on the basic nursing competency of nursing students. Method: A pretest-posttest design with a nonequivalent control group was used to examine the effects of problem based learning combined with simulation for 9 weeks in a group of 283 nursing students. The PBL group of 141 students participated in PBL classes with simulation, 4 hours a week for 9 weeks compared to control group of 142 students who received the usual fundamental nursing class. Results: The group that had PBL with simulation showed significant increases in problem solving and self-directed learning competency, although there were no significant changes in communication competency as compared to the control group. Conclusion: The findings of this study demonstrate that PBL with simulation for nursing students may increase problem solving and self-directed learning competency and suggest that utilizing this teaching-learning method may be beneficial as an effective nursing education strategy.
Purpose: The purpose of this study was to compare the effects of nursing simulations between multi-mode simulation and simulation on nursing students' nursing competency, satisfaction, and simulation participation experience in nursing care for patients with dyspnea. Method: Subjects were 107 junior nursing students in R College of Nursing in Seoul from June to November in 2009. Students were allocated to either a Multi-mode simulation group or a simulation group. The multi-mode simulation consisted of standardized patients combined with Vital Sim, comparing the group. Result: The Multi-mode simulation group reported higher levels of nursing competency (p=.017) but lower communication skills (p
Purpose: This research was done to identify how PBL education using a simulator affects nursing students' critical thinking, self-efficacy, and meta-cognition by applying and developing a PBL module using the Simman simulator. Method: With a one group pre-post test design, the research was conducted with a convenience sampling on 66 students in C College on Jeju Island for 8 weeks from August to October, 2005. The collected data on critical thinking, self-efficacy, and meta-cognition were analyzed using T-test. SPSS 10.0 was used to assist analysis. For study-related variables, means and standard deviations were used. Results: The finding of the research showed that most of the students were in favor of use of PBL-in the curriculum with more than 50% of the scores indicating satisfaction with content of the teaching, the teaching method, and self-confidence in nursing. The results also showed that there was an increase in interest among the students regarding campus practical education. Conclusion: As the application of the PBL module using the Simman simulator elicited more interest and satisfaction from the students, it is worth using this simulator as a the teaching method to improve the practical education in nursing.
The purpose of this study was to establish basic materials for providing a learning type specific simulation education through identifying the differences in self-efficacy, problem solving ability and clinical competence before and after a learning type specific simulation education, with 145 3rd-year nursing students at a university as the study subjects. This study is a single-group, before-and-after designed experiment for verifying the learning type specific effects after simulation education. As a result of the experiment on the learning types of nursing students, the adaptors were seen to be the most, and the after-simulation education problem solving ability (F=5.015, p = 0.02) and the after-education clinical competence (F=3.288, p = 0.02) showed statistically significant differences. From which, based on the fact that the convergers were seen to be significantly higher than the adaptors and the divergers were higher than the adaptors in regard to problem solving ability, and the fact that the convergers were seen to be significantly higher than the adaptors in regard to clinical competence, it was possible to ascertain that there are differences in the effects of learning type specific simulation education. However, self-efficacy did not show any statistically significant differences. Based on these results, it can be expected that a simulation education by learning types can be provided.
The aim of this study was to provide information on what the student nurses found facilitating and obstructing for their learning during clinical practice.
Earlier studies of experiences of learning in clinical practice have shown that factors as the possibilities of variations of experiences, the culture of the workplace, and communication between the educational institution and health care facilities are of importance. Less is known about the opportunities which students are given in order to practise the skills that they will be expected to perform as new graduate nurses.
The experiences of 47 degree student nurses from two colleges in Sweden were gathered in weekly diaries during their final period of clinical practice. A content analysis technique was used to analyse their diaries.
The students emphasized responsibility and independence, opportunities to practise different tasks, and receiving feedback as facilitating factors. Other perceived promoting factors included perceptions of control of the situation and understanding of the 'total picture'. Examples of obstructing factors were the nurses as supervisors not relying on the students, supervision that lacked continuity and lack of opportunities to practise. Perception of their own insufficiency and low self-reliance were drawbacks for some students.
Recommended proposals are presented to lecturers and supervising staff concerning organizational and educational changes, and changes of attitudes for elucidating the students' experiences of different facilitating and obstructing factors. Changes may contribute to making easier the students' transition into the nursing profession.
Full-body patient simulators have been used for a number of years to educate nurse anesthetists and anesthesiologists. These lifelike mannequins operate from a sophisticated computerized system with the ability to generate multiple physiologic events and respond to numerous pharmacologic stimuli. The authors recently integrated the use of the patient simulator into the curriculum to educate their acute care nurse practitioner students. The learning process was divided into three steps: the presimulation experience, the simulation experience, and the postsimulation experience. These steps are described as well as important principles that need to be integrated into each phase of the process. A case scenario on respiratory failure provides an example of the simulation experience. In addition, the advantages and disadvantages of this teaching method, as identified by faculty and students, are discussed.
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