The effect of flipped learning on blood pressure knowledge and self-directed learning skills of first-year nursing students: A randomized controlled trial

AimThis study investigated the effect of flipped learning on first-year nursing students’ blood pressure knowledge levels and self-directed learning skills.BackgroundFlipped learning is an innovative approach that helps nursing students learn about blood pressure and how to measure how to measure blood pressure accurately. Flipped learning also promotes active and student-centered learning settings and encourages nursing students to develop self-directed skills.DesignThis study adopted a pretest-posttest open-label randomized controlled trial.MethodThe sample consisted of 94 first-year nursing students randomized into experimental (n = 48) and control groups (n = 46). The experimental group participants were trained using the flipped learning model. Data were collected using a personal information form, the Blood Pressure Knowledge Test (BPKT) and the Self-Directed Learning Skills Scale (SDLSS).ResultsThere was no significant difference in pretest BPKT scores between the experimental and control groups. However, there was a significant difference in posttest BPKT scores between the experimental and control groups (p = 0.011). Moreover, there was a significant difference between the experimental group's mean pretest, posttest and follow-up SDLSS scores (p = 0.009).ConclusionThe experimental group had a significantly higher mean posttest BPKT score than the pretest score. They had significantly higher mean posttest SDLSS total and “self-monitoring,” “motivation,” and “self-confidence” subscale scores than the pretest score.     

Using unfolding case studies to develop critical thinking skills in baccalaureate nursing students: A pilot study

BackgroundResearch has consistently demonstrated that new graduate nurses do not possess sufficient critical thinking skills when they transition to clinical practice. Unfolding case studies encourage students to participate in a number of critical thinking skills including information-seeking, logical reasoning, and analyzing of clinical data.ObjectiveThe aim of this study was to determine how the use of unfolding case studies as a learning modality affected baccalaureate students' critical thinking skills in their Adult Health Theory course. The researcher compared course examination scores earned by nursing students who were taught using traditional case studies to scores obtained by nursing students who completed unfolding case studies.SettingThe pilot study took place at a moderate-sized comprehensive university in Wisconsin.DesignA non-experimental correlational design using course examination scores data was employed to examine how the use of unfolding case studies as a learning modality affected baccalaureate students' critical thinking skills in their Adult Health Theory course.ParticipantsA total of 160 students comprised the intervention group while an additional 142 students represented the control group in the study.MethodsAn independent-samples t-test was performed to explore differences in mean scores between the intervention and control groups.ResultsResults of the t-test indicate that mean examination scores were significantly higher for the intervention group (M = 234.9, SD = 13.1) than for the control group (M = 228.2, SD = 13.3); t(299) =, p < .001.ConclusionsResults of this study suggest that unfolding case studies more effectively develop students' critical thinking skills than do a more traditional, static case study.     

Using branching path simulations in critical thinking of pain management among nursing students: Experimental study

BackgroundNursing education has to promote nursing students' critical thinking skills especially those who are going to work with people with dementia suffering from pain. Therefore, nursing education needs to incorporate new and effective teaching methods in nursing curricula for critical thinking skills promotion. Branching path simulation is an interactive learning tool which helps students; (1) to make decisions about treatment options for patients and get feedback immediately and (2) to demonstrate and promote their critical thinking skills in a safe and supported environment before dealing with complex and real-life case scenarios.ObjectivesThe present study aimed to examine the effectiveness of branching path simulation in promoting the critical thinking skills of undergraduate nursing students.MethodsThis an equivalent control group pretest-posttest experimental study was done in 2019 on 102 undergraduate nursing students who had registered in both practical and theoretical courses of Advanced Adult Health Nursing. A pretest posttest experimental design with concurrent control group and random assignment to the treatment/nontreatment variable was used and a convenience sample of 102 nursing students was recruited in this study. The students were randomly assigned and divided into two equal intervention and control groups and each group attended different training sessions. The control group was trained by traditional lectures while the intervention group was trained by branching path simulation. The researcher used a demographic questionnaire and the Critical Thinking Self-Assessment Scale (CTSAS) for data collection.ResultsAfter the training sessions, the mean scores of the CTSAS and its subscales domain in the intervention group were significantly higher than the control group.ConclusionsBranching path simulation is an effective teaching method to promote students' critical thinking skills. Future studies are recommended to examine the effect of branching path simulation on other nursing students learning outcomes.     

Effects of unfolding case-based learning on academic achievement,critical thinking,and self-confidence in undergraduate nursing students learning health assessment skills

AimTo determine whether using unfolding case-based learning for undergraduate nursing students learning health assessment skills enhanced academic achievement, critical thinking and self-confidence, in comparison to traditional learning methods.BackgroundUnfolding case-based learning is an effective strategy for nursing students to narrow the gap between classroom learning and clinical practice. Little is known about whether unfolding case-based learning can be applied effectively in learning health assessment skills for undergraduate nursing students in China.MethodsA quasi-experimental design was used in this study. One hundred and fifteen undergraduate nursing students were recruited using convenience sampling from a medical university in southern China. They were assigned to an intervention group (n = 54) receiving unfolding case-based learning of health assessment skills, or a control group (n = 61) using traditional learning methods based on students’ choices. Learning outcomes were evaluated by students’ academic achievement, critical thinking and self-confidence. Data for critical thinking and self-confidence were collected before and after using the teaching strategies.ResultsThe academic achievements of undergraduate nursing students in the intervention group were better than those in the control group. The total average scores of critical thinking (272.51 vs. 266.47) and self-confidence (24.92 vs. 21.04) for nursing students in the intervention group were also higher than those in the control group after implementing teaching strategies. There were statistical differences in the theory test (P = 0.041), skill test (P = 0.013), critical thinking (P = 0.008) and self-confidence (P = 0.036) between the two groups. Additionally, the statistical significance of the scores for critical thinking (264.36 vs. 272.51, P < 0.001) and self-confidence (18.76 vs. 24.92, P < 0.001) before and after teaching strategies were also observed among participants in the intervention group, but not in the control group (P = 0.143, P = 0.738).ConclusionsUnfolding case-based learning may be effective and suitable for undergraduate nursing students learning health assessment skills. The findings of this study provide useful information to nursing teachers for the development of unfolding case-based learning when teaching other nursing skills to undergraduate nursing students.     

Mock trials and web-based education using malpractice cases: A randomised controlled trial

BackgroundWeb-based education using malpractice cases is increasingly used as an effective program to improve nurses' patient safety competency, and education on legal obligations is vital for nursing students.AimTo evaluate the effectiveness of web-based education using mock trials of medical malpractice cases in improving nursing students' legal obligations, patient safety competency, and critical thinking.MethodsForty-three senior nursing students were randomly assigned to be exposed to blended learning of mock trials (4 weeks) and web-based education (4 weeks) in experimental group (n = 23), and web-based education (4 weeks) alone in control group (n = 20). Pre-test (before randomisation) and post-test (after intervention) data were collected at a university in Korea between October and December 2019.ResultsThere were statistically significant differences in patient safety competencies (t = 3.59, P = 0.001), including skills (t = 2.89, P = 0.006) and knowledge (t = 2.60, P = 0.013), as well as a significant difference in critical thinking disposition (t = 3.09, P = 0.004) between the two groups in the pre−post changes. The two groups had no difference in knowledge and cognition of legal obligation.ConclusionBlended learning of mock trials and web-based education can enhance nursing students' patient safety competency. In particular, mock trials are an active participatory learning method that helps nursing students develop critical thinking skills to ensure patient safety competency compared to web-based education alone. Incorporating mock trial education using medical malpractice cases into the curriculum could enhance nursing students' patient safety competency and critical thinking disposition.     

Development and Evaluation of a Home-visit Simulation Scenario for Elderly People with Diabetes Mellitus Who Live Alone

ABSTRACT

Purpose: Developing and evaluating a simulation scenario for community nursing practicum students.

Design: One group, pretest posttest design with 87 nursing students.

Methods: Data were collected through questionnaires. The simulation was based on Jeffries’ simulation model and used a standardized patient.

Findings: Self-efficacy and critical thinking increased with the developed simulation. Positive correlations were identified among critical thinking, learning effectiveness, and self-efficacy.

Conclusions: The home-visit simulation scenario was effective in providing students with a problem-solving experience in conditions similar to reality.

Clinical Evidence: Further research is needed to develop various types of community simulation scenarios to enhance competency for community health practice.     

Effect of multi-disciplinary teaching on learning satisfaction,self-confidence level and learning performance in the nursing students

AimThe aim of this study was to design a multidisciplinary teaching method that combines game-based learning with a clinical situation–based teaching program and to test learning motivation, learning satisfaction and self-confidence.BackgroundResearch has suggested that game-based learning and clinical situation-based teaching can effectively capture student attention and stimulate student learning motivation as well as increase learning satisfaction and self-confidence.DesignThe randomized and experimental design used in this study was a pretest–posttest control group design.MethodsThis study recruited participants from a technical college in the north of Taiwan. The experimental group (receiving multidisciplinary teaching) comprised 48 participants and the control group (receiving traditional teaching) comprised 50 participants. Participants took a pretest before the multidisciplinary teaching intervention, received a total of 12 weeks of intervention and then took a posttest within 1 week of the end of the course. These participants completed a questionnaire regarding learning satisfaction, confidence and learning performance.ResultsThe multidisciplinary teaching intervention improved learning satisfaction (t = 7.36, p < 0.001), self-confidence (t = 7.34, p < 0.001) and learning performance (t = 6.66, p < 0.001). Multidisciplinary teaching interventions can improve learning satisfaction, self-confidence and learning performance among nursing students.ConclusionsMultidisciplinary teaching should be promoted in the context of nursing teaching and students have the multidisciplinary learning.     

Comparison of the effects of simulation training and problem-based scenarios on the improvement of graduating nursing students to speak up about medication errors: A quasi-experimental study

BackgroundMedication administration errors are common among new nurses. Nursing students might be less willing to speak up about errors because of a lack of knowledge and experience.ObjectivesTo examine the effects of simulation training and problem-based scenarios on speaking up about medication errors among graduating nursing students.DesignProspective, controlled experimental study design.SettingA university four-year nursing program in Taiwan.ParticipantsIn total, 93 graduating nursing students in their last semester were recruited. Sixty-six students who received both a problem-based scenario and medication administration simulation training comprised the experimental group, while 27 students who received problem-based scenarios alone comprised the control group.MethodsExperimental group students underwent 2 h of simulation training. This training class was designed based on Kolb's experiential learning theory for knowledge development and speaking up about errors. Students in both groups administered medications in problem-based scenarios with eight embedded errors. Students' performance in speaking up about medication errors was directly observed and graded using an objective structured checklist. The McNeamer Chi-squared test, paired t-test, Z test, t-test, and Hedges' g effect size were conducted.ResultsThe number of times participants spoke up about medication errors significantly improved in both the experimental group (pre-test: 2.05 ± 1.12 and post-test 6.14 ± 1.25, t = 22.85, p<0.001) and control group (pretest: 2.04 ± 1.16 and post-test: 4.26 ± 1.63, t = 6.33, p<0.001). However, after the intervention, the mean number of times participants spoke up about medication errors in the experimental group was significantly higher than that in the control group (t = 5.99, p<0.001) in the post-test.ConclusionsSimulation training exhibited more-significant improvements than problem-based scenarios. Nursing schools and hospitals should incorporate simulation training or at least problem-based scenarios to improve medication safety.     

Effects of web-based concept mapping education on students' concept mapping and critical thinking skills: A double blind,randomized, controlled study

BackgroundUsing concept maps in nurse education improves students' critical thinking skills. Offering web-based concept mapping education can increase motivation for learning in students actively using the Internet.ObjectivesTo examine the effects of web-based concept mapping education on nursing students' concept mapping and critical thinking skills.DesignThis is a double-blind, randomized, controlled, experimental study.SettingsA nursing faculty at a state university in Turkey.ParticipantsSecond-year nursing students taking the course surgical nursing in the spring term of the academic year of 2018/2019.MethodsThe experimental group (n = 201) was offered web-based concept mapping education before starting practicums. Data were collected using a students' information form, concept map evaluation keys, and the Critical Thinking Motivational Scale at the end of the practicums. A structured questionnaire was used to reveal opinions of the students about concept mapping.ResultsThere was a significant difference in concept mapping scores between the students offered web-based concept mapping education (16.45 ± 10.91) and those not receiving this education (12.70 ± 9.31) (p= .000). Also, there was a significant difference in students' scores for the subscales of Critical Thinking Motivational Scale expectancy, attainment and utility between the groups. The students reported that concept maps facilitated their learning and management of nursing processes but that they occasionally experienced difficulty.ConclusionIt can be concluded that web-based concept mapping education improves concept mapping skills and motivation for critical thinking skills. Web-based education could be utilized as a tool to enhance nursing students' concept mapping and critical thinking skills.     

Is Moulage effective in improving clinical skills of nursing students for the assessment of pressure injury?

BackgroundIn wound care simulations, the practice can be performed on 3D-wounds formed by moulage. Moulage helps the student to perceive the etiology, physiology, and healing processes of the wound, and it can also be used to improve the students' wound assessment skills.ObjectiveThe aim of this study is to investigate the effectiveness of moulage in the improvement of pressure injury assessment skills of nursing students.DesignA quasi-experimental study.SettingsA nursing faculty at a public university.ParticipantsAll fourth-year students (n = 73) who take the simulation elective course were invited to participate.MethodsFall semester students (n = 38) constituted the control group and spring semester students (n = 35) formed the intervention group. The coin-flipping method was used to match the education period and student groups. The intervention group simulation was performed using moulage, and the control group simulation was performed using a pressure ulcer visuals. The same simulation scenarios were used for both groups. The data were collected using the Simulation Design Scale, Student Satisfaction and Self-Confidence Scale, and student identification form, knowledge test, performance checklist and feedback form developed by the researchers.ResultsStudents' knowledge scores for pressure injury assessment have improved significantly in both the intervention group (pre-test:61.71 ± 9.77 and post-test 70.57 ± 12.53, t = −4.27, p < 0.001) and the control group (pre-test: 66.81 ± 13.47 and post-test 73.06 ± 15.50, t = −2.34, p = 0.02). Laboratory and clinical pressure injury assessment skill scores of the intervention group students were significantly higher than the control group. Besides, the correct staging percentages of the intervention group students are higher than the control group students during the clinical practice (χ2 = 5.05, p = 0.02).ConclusionsIt can be concluded that the simulation with moulage was effective in improving the skills of nursing students who received training for pressure injury assessment and in transferring what they learned to the clinical setting.     

Impact of high-fidelity simulation on the development of clinical judgment and motivation among Lebanese nursing students

BackgroundHigh-fidelity simulation (HFS) offers a strategy to facilitate cognitive, affective, and psychomotor outcomes and motivate the new generation of students.ObjectivesThe purpose of this study was to examine the impact of using high-fidelity simulation on the development of clinical judgment and motivation among Lebanese nursing students.DesignA post-test, quasi-experimental design was used.SettingsTwo private universities in Lebanon were targeted to implement the intervention.ParticipantsA convenience sample of 56 nursing students from two private universities in Lebanon were recruited.MethodsData were collected using the Lasater Clinical Judgment Rubric and the Motivated Strategies for Learning questionnaires.ResultsNursing students exhibited significant improvement in clinical judgment and motivation due to exposure to HFS. There was a significant difference post HFS between the intervention group and the control group in clinical judgment intervention (t = 5.23, p < 0.001) and motivation for academic achievement (t = − 6.71, p < 0.001). The intervention group had a higher mean score of clinical judgment (29.5, SD = 5.4) than the control group (22.1, SD = 5.7) and, similarly, students had higher mean scores of motivation (198.6, SD = 10.5) in the intervention group than in the control group (161.6, SD = 20). The analysis related to differences between the intervention and control groups in motivation and clinical judgment; controlling for previous experience in health care services, the analysis showed no significant difference (Wilk's lambda = 0.77, F = 1.09, p = 0.374).ConclusionThere is a need for nursing educators to implement HFS in nursing curricula, where its integration can bridge the gap between theoretical knowledge and nursing practice and enhance critical thinking and motivation among nursing students.     

Human patient simulation versus case study: Which teaching strategy is more effective in teaching nursing care for the hypoglycemic patient?

With the ever-increasing safety concerns presented in a health care setting, it is imperative that nursing students are prepared for the demand of utilizing the skill of critical thinking while providing care to patients experiencing hypoglycemia. Nurse educators strive to implement different teaching strategies to promote critical thinking skills. The purpose of the study was to evaluate the effectiveness of two teaching strategies: human patient simulation (HPS) and a single case study during diabetes education. In addition, the study was used to validate the inclusion of HPS in the authors' nursing program curriculum. A quasi-experimental, two-group pretest and posttest design was utilized to evaluate these teaching strategies. Faculty also completed an objective clinical evaluation, which evaluated students' clinical reasoning, and all students completed a postsurvey evaluating the teaching strategies. Study results indicated the pretest average scores for both groups were identical. The posttest results for the case study group were slightly higher than the simulation group results. On the clinical evaluation tool, the simulation group scored much greater than the case study group. Both results were statistically significant. The postlesson survey results were greater overall for the simulation group on all statements. All students agreed or strongly agreed that simulation was effective. According to the student test results and clinical evaluations, both teaching strategies are beneficial in nursing education; moreover, the student surveys and comments validated the addition of simulation as a valuable teaching strategy. As a result of this research, HPS was formally implemented into the nursing curriculum.     

Comparison of the effectiveness of two styles of case-based learning implemented in lectures for developing nursing students’ critical thinking ability: A randomized controlled trial

PurposeTo explore and compare the effectiveness of two styles of case-based learning methods, unfolding nursing case and usual nursing case, implemented in lectures for developing nursing students’ critical thinking ability.Methods122 undergraduate nursing students in four classes were taught the subject of medical nursing for one year. Two classes were randomly assigned as the experimental group and the other two the control group. The experimental group received the lectures presenting unfolding nursing cases and the control group was taught the usual cases. Nineteen case-based lectures were provided in 8 months in two semesters to each group.ResultsThe two groups started with a similar level of critical thinking ability as tested by the instrument of Critical Thinking Disposition Inventory—Chinese version (CTDI-CV). After receiving 19 case-based learning lectures for 8 months, both groups of students significantly improved their critical thinking ability. The improvement in the experimental group was significantly higher than that in the control group (with the average total score of 303.77 ± 15.24 vs. 288.34 ± 13.94, p < 0.05). The experimental group also had significantly better improvement in six out of seven dimensions whereas the control group showed improvement in only three out of seven dimensions of CTDI-CV.ConclusionsThe study suggests the feasibility of implementing case-based learning in lectures. Unfolding nursing cases appear to be significantly more effective than the usual nursing cases in developing undergraduate nursing students’ critical thinking ability in the subject of medical nursing. Further research can implement the unfolding nursing cases in other nursing subjects.     

Video-based tools to enhance nurses' geriatric knowledge: A development and pilot study

BackgroundThe need for health care professionals with geriatric knowledge is expected to increase due to aging of society. Educational tools that fit the specific learning styles of nurses and nursing students might be useful for this. Serioussoap.nl (available in Dutch and English) is an educational tool that integrates video-based gaming and storytelling, and it might be an effective way to improve the geriatric knowledge of nurses or nursing students.ObjectivesTo investigate the effect of Serioussoap.nl on the geriatric knowledge of nurses and nursing students, and to evaluate its usability.DesignWe conducted a development and an explorative pilot study, using a pretest posttest quantitative design to investigate the effect of Serioussoap.nl on geriatric knowledge. A qualitative approach was used to evaluate its usability.Participants and settingThree vocational nursing schools (n = 119 second/third year students), one baccalaureate nursing university (n = 77 first year vocational nurses) and one home-care organization (n = 44 vocational nurses) in the Netherlands participated in the quantitative study, and 94 vocational students participated in the qualitative study.MethodsWe measured the effect on geriatric knowledge with the Knowledge of Older People Questionnaire (KOP-Q, score 0–30). The qualitative study included observations of 94 participants while they played Serioussoap.nl, four semi-structured focus groups and eleven individual interviews.ResultsThe study demonstrated a significant increase of geriatric knowledge of 7.8% (+2.3 score on the KOP-Q, 95% Confidence Interval (1.4–3.2, p < 0.001). The qualitative data showed that Serioussoap.nl contributed to the reflective learning-style and enhanced meaningful learning.ConclusionSerioussoap.nl increased the students' geriatric knowledge and was perceived as a suitable and effective educational tool for vocational nursing students and nurses.     

A spiritual education course to enhance nursing students’ spiritual competencies

The study aimed to determine the impact of an elective spiritual education course for nursing students on spiritual competencies. A convenience sample of nursing students (N = 92) was recruited from a baccalaureate school of nursing between February and July 2016. The intervention group (n = 45) was comprised of students enrolled in the elective spiritual education course which integrated non-Christian Eastern cultural beliefs; the control group was comprised of students not enrolled in the elective (n = 47). A quasi-experimental design examined pretest, posttest, and follow-up data from students' self-administered questionnaires. The intervention effect of the course was analyzed using generalized estimation equation. The results indicated posttest scores among nursing students in the intervention group were significantly better than the comparison group for spiritual health. Practicum stress and professional commitment were significantly better at follow-up. Spiritual care attitudes, caring behavior, and religious belief were significantly improved from pretest to posttest, and at follow-up for the intervention group compared with the control group. In conclusion, a spiritual education course should be considered as a regular course in the nursing curriculum, which could improve students’ spiritual competencies, individual spiritual growth, and the ability to care for patients.     

Web-based experiential learning strategies to enhance the evidence-based-practice competence of undergraduate nursing students

BackgroundEvidence-based practice (EBP) is considered a key competence for practicing high-quality and safe nursing. However, undergraduate nursing programs continue to provide traditional classroom teaching strategies that have limitations in facilitating the development of critical competences for engaging in EBP in real clinical contexts.Objective and designThe purpose of this study was to develop a web-based experiential learning program aimed at improving the engagement and experience of nursing students in EBP. A quasi-experimental research with non-equivalent control-group with non-synchronized design was used to describe the process of program development and the innovative learning method, and discuss the outcomes of the program.MethodsThe experimental group was exposed to a web-based experiential learning program, while the control group received traditional learning with written material. Self-reported EBP scores (knowledge and skills, attitude, and practice) and clinical-questioning confidence were evaluated to assess the effects of the program.ResultsThe result showed that web-based experiential learning strategies were effective in significantly improving the EBP knowledge and skills score (F = 12.29, p = .001) and the score for confidence in asking clinical questions (F = 12.14, p = .001). The attitudes toward EBP (F = 0.75, p = .389) and practice score (F = 3.22, p = .076) did not show a significant difference between the experimental group and the control group.ConclusionThe web-based experiential learning was found to be an effective method for enhancing the EBP competence of nursing students. Based on the study results, we suggest using web-based experiential learning to supplement the traditional learning method or as the mainstream learning method for nursing students.     

Trajectory of growth in Taiwanese nursing students' professional self-concept over two years and its association with critical thinking and class climate

BackgroundNursing is a practice-oriented profession, and the goal of education is to cultivate confidence and assertiveness for future clinical practice. Nurturing a professional self-concept at school is expecting to help students to approach their success in the nursing profession.PurposeUsing a hierarchical model associated with critical thinking, academic achievement, class climate, and work experience, this longitudinal correlational study explored the growth trajectory of professional self-concept over two years in students attending 2- or 4-year baccalaureate nursing programs.MethodThis was a longitudinal and correlational study with five repeated measurements. Questionnaire data were collected by using the Chinese version of the Nurses Self-Concept Instrument (NSCI-C) and the California Critical Thinking Disposition Inventory (CCTDI).ResultsScores for overall professional self-concept ranged from 84.51 (standard deviation [SD] 12.34) when the students began this study to 89.28 (SD 11.23) at graduation. Hierarchical linear modeling yielded the growth trajectory of professional self-concept was significantly associated with time (β = 0.93, p < .01), CCTIDI (β = 0.13, p < .001), and class climate (β = 5.20, p < .01). An intraclass correlation coefficient was 55.48%.ConclusionThis study confirmed the positive growth trajectory of the professional self-concept in the nursing students' two academic years. The continuous development of the professional self-concept of nursing students is encouraged. Development of critical thinking through their studies, feelings of belonging in their classes, and campus culture all contributed to this trend. To construct a comprehensive hierarchical model, future investigations should use large sample sizes from various classes and conduct multisite evaluations.     

Effects of a tiered competence-based simulation educator development program

AimThis study aimed to develop and identify the effects of a tiered competence-based simulation educator development program on knowledge, competence and attitudes.BackgroundCompetence and educational needs-based training is required to improve nursing simulation educators' learning outcomes.DesignThis study used a one-group pretest–posttest design.MethodsA convenience sample of 65 nursing simulation educators completed a self-administered questionnaire. Three levels of training programs were implemented: basic, intermediate and advanced courses. The pretest–posttest differences in knowledge, competence and attitude scores were analyzed using the paired t-test. The main variable scores for the three programs were compared using one-way ANOVA and the Scheffé post hoc test.ResultsPosttest levels of knowledge, competence and attitudes were higher than the pretest measures. Simulation educators in the basic course reported greater improvements in perceived competence when compared with participants in the intermediate course.ConclusionsThe tiered competence-based simulation educator development program improved nursing simulation educators' knowledge, competence and attitudes across all course levels.     

Development and evaluation of a clinical simulation for new graduate nurses: A multi-site pilot study

BackgroundNew nursing graduates have revealed that they perceive a gap between theory and practice with reference to their education and the real workplace setting. Additionally, many nurses experience a reality shock when they participate in clinical practice.PurposeThe purpose of this study was to develop and test the effects of a scenario-based simulation training program on new graduate nurses' competency, critical thinking dispositions, and interpersonal communication skills.MethodThis pilot multi-site study used a pretest-posttest control group design. It was conducted at four sites of a university-affiliated simulation center in Korea. Participants were recruited utilizing a convenience sample from four tertiary hospitals in Korea. Twenty-four new graduate nurses participated in this study.ResultsAt the three-month follow-up, the levels of communication skills used in practice among the intervention group were statistically significantly higher than those of the control group participants (U = 151.50, p = .005). However, there were no significant differences between the groups in changes in nursing competency (U = 287.50, p = .992) or critical thinking disposition scores (U = 269.50, p = .702). The participants' mean rating scores concerning the objectives, intentions, and recommendations for other nurses were positive and high.ConclusionThe involvement of current practicing of nursing in certain scenarios and the implementation of simulation learning could enhance the readiness of new graduate nurses.