Katie A. Haerling’s research while affiliated with University of Washington Tacoma and other places

Background Simulation activities are used increasingly in nursing education to augment or replace traditional clinical experiences. Educators and regulators are called on to make evidence-based decisions about the use of limited clinical and simulation resources. Method This cost-utility analysis addresses the final aim of a study comparing cognitive learning, patient care performance, and self-perceptions of how well learning needs were met among students who were exposed to 4 hours of traditional clinical experience, 2 hours of manikin-based simulation, or 2 hours of screen-based virtual simulation. The costs of each activity were calculated and divided by a composite measure of the utility of each activity. Results The cost-utilities for 4 hours of traditional clinical experience, 2 hours of manikin-based simulation, and 2 hours of screen-based virtual simulation were 0.15, 0.62, and $0.38, respectively, in U.S. dollars per unit of utility. Conclusion The data provide evidence for educators and administrators to make effective and efficient use of limited resources to prepare nurses for practice. [ J Nurs Educ . 2024;63(2):79–85.]

Simulation has been used in nursing education and training since Florence Nightingale's era. Over the past 20 years, simulation learning experiences (SLEs) have been used with increasing frequently to educate healthcare professionals, develop and increase the expertise of practicing professionals, and gain competency in key interprofessional skills. This chapter provides a brief overview of simulation evaluation history, beginning in the late 1990s, and the initial focus on learner self-report data. Using Kirkpatrick's Levels of Evaluation as an organizing model, four types of SLE evaluation are reviewed as well as suggestions for future research.

Simple linear regression is a statistical technique that allows us to predict the relationship between two variables: the predictor variable (x) and the response or results variable (y).

Background: Incivility has been identified as a common occurrence in health care settings. While anecdotal evidence exists that these behaviors negatively impact patient care, more robust evidence is lacking. Purpose: This randomized controlled trial investigated the effects of exposure to incivility on clinical performance, teamwork, and emotions. Methods: Teams of nurses were randomly assigned to a control or experimental group. The experimental group was exposed to incivility. Both groups were then prompted to perform basic life support on a high-fidelity manikin. Teams were scored on cardiopulmonary resuscitation (CPR) performance and teamwork. Individuals completed measures of affect and a cognitive test. Results: There were no differences in CPR, cognitive or teamwork scores, or emotional state. However, 66% of the experimental group had a major error in their CPR performance. None of the control groups made the same error. Conclusions: These findings support anecdotal evidence that exposure to incivility may contribute to errors in clinical performance.

Background: Sound nursing clinical judgment is at the core of competent and safe client care. New graduate nurses face increasing challenges that underscore the importance of investigating how nurse educators teach and measure nursing students' abilities to make clinical judgments. This article presents the National Council of State Boards of Nursing-Clinical Judgment Model (NCSBN-CJM) and discusses the use of the model. Method: A multidisciplinary team conducted a qualitative comparative analysis of the relationships between the NCSBN-CJM and the three leading frameworks for providing clinical judgment education to entry-level nurses. Results: The NCSBN-CJM aligns with the Information-Processing Model and the Intuitive-Humanistic Model. The NCSBN-CJM also can be used to assess the Dual Process Reasoning Theory. Conclusion: The NCSBN-CJM can assist nurse educators in designing effective tools for assessing clinical judgment by helping them target specific cognitive operations. This flexible model expresses the complexities associated with decision making in a simplified manner to enable better measurement of clinical judgment. [J Nurs Educ. 2019;58(2):72-78.].

Background The Team Behavior Assessment Tool for Entry Level Nurses (TBAT-ELN) was developed to assess essential individual teamwork skills in an entry-level nurse. The newly created tool required investigation to determine reliability and validity. Method Scripted simulation videos portraying three levels of student performance were developed. Nurse educators assessed the student's performance in each video using the TBAT-ELN with both a frequency scale and a quality scale. Results Intraclass correlation coefficient of the TBAT-ELN reflected very good interrater reliability. Validity of the data produced by the tool was also supported based on relationships to other variables. Conclusion The TBAT-ELN, with either a frequency scale or quality scale, is a meaningful way to evaluate the individual teamwork skills of nursing students and new graduate nurses.

Introduction: The purposes of this study were to (1) compare learning outcomes between students who participated in mannequin-based simulation activities and students who participated in virtual simulation activities and (2) describe a cost-utility analysis comparing the two types of simulation activities in terms of costs and multiple measures of effectiveness. Methods: Nursing student participants were randomly assigned to one of two experimental groups to complete either a mannequin-based or virtual simulation activity. The simulation scenario was the same for both groups and involved the care of a hospitalized patient experiencing a chronic obstructive pulmonary disease exacerbation. Participants completed presimulation and postsimulation assessments reflecting qualitative and quantitative measures of learning. A random sample of participants from each group completed a postsimulation performance assessment during which they interacted one on one with a standardized patient. Results: Eighty-four nursing students were enrolled in the study and completed the simulation activities. There were no significant differences in quantitative measures of learning or performance between participants in the mannequin-based and virtual simulation groups. Participants' qualitative responses to postintervention written reflections and questions yielded additional data for describing learning from the two interventions. In the cost-utility analysis, the virtual simulation activity had a more favorable cost-utility ratio of US $1.08 versus the mannequin-based simulation activity's US$3.62. Conclusions: Healthcare educators striving to make evidence-based decisions about how to best employ simulation pedagogy may consider these findings about the cost utility of various simulation modalities. However, additional research is needed.