Incorporating peer-to-peer facilitation with a mid-level fidelity student led simulation experience for undergraduate nurses

BackgroundThe aim of this study was to evaluate peer-to-peer facilitated student led mid-level fidelity simulation experiences.MethodsSecond and third year nursing students (N = 637) were invited to complete a 16-item 6-point Likert scale questionnaire after the simulation experience.ResultsStudents reported high self-confidence in their nursing skills (M = 4.14, SD = 0.92) and a high level of satisfaction in the learning they received during the peer-to-peer facilitated student led simulation experience (M = 4.42, SD = 0.93).ConclusionUsing peer-to-peer teaching strategies during student led simulation experience is an effective approach for ensuring active engagement of all learners during midlevel fidelity group-based simulations and has the potential for broad applicability.     

Maximising graduate status in pre-registration nursing programmes: utilising problem based learning

This paper debates the use of problem based learning in accelerated pre-registration nursing programmes that are specifically designed for candidates with ‘graduate status’. We discuss the benefits of using problem based learning (PBL) within a graduate entry nursing (GEN) curriculum and its effectiveness in producing dynamic nurses who are both capable and value-centred practitioners.     

标准化引导性反馈在高仿真模拟教学中的应用

目的在高仿真护理模拟教学中应用标准化引导性反馈,并对应用效果进行评价。方法选择我院2015级54名护理本科生为研究对象,将其分为8个小组,每组学生于2018年3月-2019年1月接受40学时的高仿真护理模拟教学,反馈时采用表达感想-回顾目标-分析行为-总结反思四段式进行引导性反馈。模拟教学结束后采用自制问卷评价标准化引导性反馈的应用效果。结果标准化引导性反馈可使反馈紧紧围绕教学目标进行、避免离题(100%),可促进模拟教学参与者主动反思(100%),使参与者、观察者均能积极参与模拟后讨论(100%),有利于明确模拟过程中病人存在的不足(100%),有利于培养学生的临床推理能力(96.3%),可促使观察者仔细观察病人的表现(96.3%),有利于实现以学生为主体的教育理念(96.3%)。结论标准化引导性反馈可激励学生积极参与引导性反馈,促进学习者主动反思自身的不足,提升了引导性反馈的效果,值得借鉴和推广。     

Measuring third year undergraduate nursing students' reflective thinking skills and critical reflection self-efficacy following high fidelity simulation: A pilot study

Critical reflection underpins critical thinking, a highly desirable generic nursing graduate capability. To improve the likelihood of critical thinking transferring to clinical practice, reflective thinking needs to be measured within the learning space of simulation. This study was divided into two phases to address the reliability and validity measures of previously untested surveys. Phase One data was collected from individuals (n = 6) using a ‘think aloud’ approach and an expert panel to review content validity, and verbatim comment analysis was undertaken. The Reflective Thinking Instrument and Critical Reflection Self-Efficacy Visual Analogue Scale items were contextualised to simulation. The expert review confirmed these instruments exhibited content validity. Phase Two data was collected through an online survey (n = 58). Cronbach's alpha measured internal consistency and was demonstrated by all subscales and the Instrument as a whole (.849). There was a small to medium positive correlation between critical reflection self-efficacy and general self-efficacy (r = .324, n = 56, p = .048). Participant responses were positive regarding the simulation experience. The research findings demonstrated that the Reflective Thinking and Simulation Satisfaction survey is reliable. Further development of this survey to establish validity is recommended to make it viable.     

The influence of an undergraduate problem/context based learning program on evolving professional nursing graduate practice

Graduates' perception of the value of their undergraduate program is a critical component of professional program evaluation and contributes a viewpoint rarely reported in the literature. It has been proposed that Problem Based Learning (PBL) enhances knowledge acquisition, clinical competency and professionalism as a consequence of students assuming the role of registered nurse as they work through real practice situations on a daily basis in the classroom. The purpose of this study was to determine how PBL graduates describe the contribution of the educational experience to their professional practice as nurses. Using focused ethnography, PBL graduates (N=45) participated in the study as individuals or through focus group discussions. Graduates described themselves as: self aware and self directed critical thinkers, patient advocates able to engage in evidence based holistic practice and interdisciplinary team members able to take on leadership roles and handle conflict.     

仿真模拟教学在护生实习前强化训练中的应用

目的 探讨在实习前强化训练中应用仿真模拟教学的意义和可行性.方法 在实习前对400名2011级护理本科生采用仿真模拟强化训练,自行设计问卷调查护生对仿真模拟强化训练的评价及满意度.结果 98.7%护生认为有必要开展强化训练,85.9%的护生认为达到了预期效果,91.4%的护生认为有助于尽快适应临床护理工作,72.3%~91.1%的护生认为有助于提升综合能力,并且满意度较高.结论 仿真模拟可使护生将理论与实践密切联系,有利于护生尽快适应临床护理工作,提升护生的综合能力和教师的教学水平.     

Development of the Simulation-Positive Learning Evaluation (SIM-PLE) rubric for use in medical-surgical nursing high fidelity simulations

Clinical nurse educators in a BSN program developed the SIM-PLE (Simulation-Positive Learning Evaluation) rubric to evaluate student performance in simulation. A pilot study was conducted over two semesters with junior level medical-surgical classes made up of approximately 110–130 students each semester, and the tool was revised and re-evaluated. Inter-rater reliability testing utilized 69 SIM-PLE rubric student evaluations (N = 69). Inter-rater reliability was assessed with comparison of lead faculty with three other instructors utilizing two raters for each simulation experience. The intraclass correlation coefficient (ICC) suggested high inter-rater reliability. The t-test difference was not significant. One-way analysis of variance (ANOVA) showed a significant difference in the Collaboration subcategory score. Univariate ANOVA indicated both raters scored consistently with each other overall and that they both scored JR1 differently than JR2. The pilot study and testing of interrater reliability of the rubric revealed positive findings. The role of the rubric in providing formative feedback during debrief sessions empowered students to analyze their own performance and/or experience to self-correct or improve their future practice based on these experiences.     

小组合作联合情景教学法对提高护生急救能力

目的 探讨小组合作联合情景教学法在提高护生急救能力中的应用效果。方法 将2017年6月至2018年3月160名在重庆医科大学附属第二医院实习的大专和本科护生按进科批次奇偶数分为对照组（奇数）和实验组（偶数）,每组80名。对照组采用传统教学法,实验组采用小组合作联合情景教学法,比较两组护生的教学效果。结果 实验组护生的出科技能操作成绩为（94.68±1.64）分,高于对照组的（90.11±2.03）分（P＜0.001）;实验组护生出科评判性思维量表总分为（307.1±8.2）分,高于对照组的（296.6±9.4）分（P＜0.001）;实验组护生出科自评和教学效果与对照组比较差异有统计学意义（P<0.01）。结论 将小组合作联合情景教学法运用到护生急救能力培训中,有利于提高急救技能和评判性思维能力,培养护生学习的主体意识及合作参与意识,提升团队协作精神。     

对高等学历护生开展循证护理教学的研究

目的对高等学历护生开展循证护理的教学进行探讨。方法对高等学历护生学习现状调查、循证护理相关知识学习和临床循证护理实践指导进行。结果建立了符合国情的临床护理教学模式。结论明确了教学目标,培养了学生循证护理实践的能力。     

The use of simulation as a learning approach to non-technical skills awareness in final year student nurses

Understanding what non-technical skills are and their relevance for healthcare practitioners has become a new area of exploration. Although recent literature has highlighted the necessity of introducing non-technical skills training and assessment within medical education, nursing education has still to fully embrace this skills training. The purpose of this paper is to explore the use of simulated practice as a learning approach to demonstrate and assess non-technical skills for final year nursing students. An established ward simulation exercise was refocused to incorporate opportunities for these nursing students to be assessed on their ability to demonstrate application of non-technical skills. Opinions on whether this was a successful strategy were sought from the students by means of module evaluation questionnaires. Analysis of this data revealed that the majority of the students agreed that it was an effective learning approach, allowing them to demonstrate their non-technical skills, be assessed and subsequently identify further learning needs.     

Examining the impact of high and medium fidelity simulation experiences on nursing students' knowledge acquisition

Aim

This paper describes a study that measured and compared knowledge acquisition in nursing students exposed to medium or high fidelity human patient simulation manikins.

Background

In Australia and internationally the use of simulated learning environments has escalated. Simulation requires a significant investment of time and money and in a period of economic rationalisation this investment must be justified. Assessment of knowledge acquisition with multiple choice questions is the most common approach used to determine the effectiveness of simulation experiences.

Method

This study was conducted in an Australian school of nursing; 84 third year nursing students participated. A quasi-experimental design was used to evaluate the effect of the level of manikin fidelity on knowledge acquisition. Data were collected at three points in time: prior to the simulation, immediately following and two weeks later.

Results

Differences in mean scores between the control (medium fidelity) and experimental (high fidelity) groups for Tests 1, 2 and 3 were calculated using independent t tests and were not statistically significant. Analysis of covariance (ANCOVA) was conducted to determine whether changes in knowledge scores occurred over time and, while an improvement in scores was observed, it was not statistically significant.

Conclusion

The results of this study raise questions about the value of investing in expensive simulation modalities when the increased costs associated with high fidelity manikins may not be justified by a concomitant increase learning outcomes. This study also suggests that multiple choice questions may not be the most appropriate measure of simulation effectiveness.     

Low‐fidelity simulation for patients and caregivers in the use of lubricants in clean intermittent catheterization

Can low‐fidelity simulation improve the knowledge and skills of patients undergoing clean intermittent catheterization (CIC) and their caregivers to prevent complications? Patients undergoing CIC are exposed to risks, such as urethral trauma and urinary tract infections. Objective of this paper was to assess the implications of low‐fidelity simulations for patients and caregivers in the use of clean intermittent catheterization in the event of urethral trauma and for its prevention. A quasi‐experimental study carried out between November 2015 and February 2016 in the rehabilitation centre of a university hospital, with patients undergoing CIC and/or their caregivers. Following the ethical precepts, data collection was performed during nursing consultations by means of interviews, structured observation, and a knowledge test applied before and after the low‐fidelity simulation. Patients undergoing CIC and/or caregivers underwent a low‐fidelity simulation of CIC with urethral trauma and then they were guided by the researchers following the protocol established in the department. They then underwent another simulation with the same characteristics. Fifty‐five patients participated in this study, in which most of them (33 [60·0%]) were men, with an average age of 31·7 years. Bleeding was reported by 19 patients (34·5%), of which 18 were men. The performance of low‐fidelity simulations proved to be effective for patients or caregivers in adverse situations, such as bleeding, resistance to the introduction of the catheter and negative urine drainage. The performance of low‐fidelity simulation is easily accessible and shows efficiency when used in teaching‐learning processes of health education and development of skills and competencies.     

The use of team-based learning in a second year undergraduate pre-registration nursing course on evidence-informed decision making

More engaging teaching and learning strategies are needed to teach research-related courses to pre-registration nursing students. Team-based learning was implemented within a second year pre-registration nursing evidence-informed decision making course. Results from a questionnaire survey indicated that 70% believed team-based learning was appropriate for the course, 60% that it was an effective and motivating learning strategy, and 54% recommended using team-based learning in other courses. The results from ten student interviews illustrated the positive way in which team-based learning was perceived, and how the students thought it contributed to their learning. Test results were improved with an increase in the numbers of students achieving 70% or higher; and higher scores for students in the lowest quartile. Team-based learning was shown to be an effective strategy that preserved the benefits of small group teaching with large student groups.     

A protocol for a scoping review of the use of mental simulation and full-scale simulation in practising healthcare decision-making skills of undergraduate nursing students

AimThis scoping review aims to explore the effect of FSS and mental simulation on the decision-making skills of nursing students.BackgroundFull-scale simulation (FSS) has been the most used simulation modality in nursing education due to its applicability to enhance both technical and non-technical skills. However, FSS can be excessively costly and other factors such as technophobia and lack of trained staff and support make FSS less accessible, especially for nursing education. Therefore, a novel mental simulation that is interactive and supported by visual elements can be a substitute for FSS, at least for some of the skills, such as clinical decision-making. Reviews comparing the effectiveness of FSS and mental simulation on decision-making skills in nursing students are lacking. Further knowledge on the effectiveness of these two modalities on decision-making skills for nursing students is needed to inform the nursing education curriculum and to decide between the two modalities.DesignThis protocol adheres to the guidelines outlined in the PRISMA extension for scoping reviews (PRISMA-scr) checklist.MethodThe methodological framework for scoping reviews will be followed for this scoping review. Scopus, EBSCOhost the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE and for the grey literature ERIC and BASE will be searched for related studies. The search will be limited to January 2008 and April 2023 (up-to-date) and English. A detailed search strategy was developed with an experienced research information manager and this strategy will be adapted to each database. A single screening will be performed by an author who will screen all abstracts and titles and full-text publications. After the study selection step of the framework, the data from the included studies will be charted using a data extraction form. The data will be synthesised by comparing the effect of FSS and mental simulation on decision-making skills.ConclusionA synopsis of the publication on FSS and mental simulation on nurse students’ decision-making skills will be useful for stakeholders when choosing between two modalities to deliver decision-making skills to nursing students and also help to inform the nursing education and simulation practice.Scoping Review RegistrationProtocols.io (doi: 10.17504/protocols.io.e6nvw57y7vmk/v1)     

The contribution of high‐fidelity simulation to nursing students' confidence and competence: a systematic review

YUAN H.B., WILLIAMS B.A. & FANG J.B. (2011) The contribution of high‐fidelity simulation to nursing students' confidence and competence: a systematic review. International Nursing Review 59 , 26–33 Background: High‐fidelity simulation (HFS) has been proposed as a novel, supplemental teaching‐learning strategy to enhance students' confidence and competence in nursing practice. Aim: To describe available evidence about the effects of HFS on students' confidence and competence within nursing educational programmes. Methods: A review of studies published between 2000 and 2011 was undertaken using the following databases: CINAHL, Proquest, MEDLINE, Science Direct, OVID and Chinese Academic Journal. The concepts of confidence and competence as they related to HFS in nursing education were used for screening the literature. Quantitative studies were assessed for methodological quality. Findings: Eighteen English and six Chinese studies addressed confidence and competence as outcomes of simulation and were retrieved in this review. The results of meta‐analysis indicated a mixed contribution of HFS to confidence and competency with a lack of high‐quality random control trials and large sample sizes. Conclusions: Although qualitative studies presented positive results, there was still insufficient evidence for supporting the notion that students' confidence and competency are enhanced through HFS. More quantitative studies are needed to demonstrate effectiveness. There was a deficit of formal measurement tools available to evaluate HFS. Most research pays no attention to validation of measurements. The increased confidence and competence after simulation may not be realized until the student experiences a real situation like the one in the simulation. More research is needed to examine the transferability of the simulation experience into real situations.     

"Coming ready or not" high fidelity human patient simulation in child and adolescent psychiatric nursing education: diffusion of Innovation

This paper is the first to address high fidelity human patient simulation (HFHPS) as a technique to prepare pre-registration nursing students for practice in child and adolescent psychiatric nursing (CAPN). By examining the published literature in a systematic review, no evidence was located that discussed the application of this innovative mannequin-based educational technique for this population. Indeed, mental health nursing preparation generally had minimal literature addressing the adoption of HFHPS.Rogers' (2003) model of the “Diffusion of Innovation” was applied as a lens to explain this observation. His model fitted this observed pattern well and provided a range of explanatory paradigms. It was limited, however, in its predictive ability to suggest when and under what conditions HFHPS might be expected to be adopted by nursing preparation programmes for CAPN.At the conclusion to this examination, the absence of a conversation evident in the mental health or CAPN literature on the preparation of pre-registration nursing students using this educational technique is striking. The potential of this approach to be combined in new ways to better prepare nursing students for the challenges of practice in mental health or CAPN needs extensive examination.     

Evaluating the use of developmental action inquiry in constructing a problem-based learning curriculum for pre-registration nursing education in Hong Kong: a student perspective

BACKGROUND: Developmental action inquiry (DAI) was chosen as the change strategy for introducing problem-based learning (PBL) in a pre-registration nursing programme. The central task was to transform the tutor and student participants to become collaborators in this curriculum reconstruction project. AIM: This paper expounds the way in which the action inquiry was constructed and in light of students' feedback analysis, the way in which PBL has made a difference in student learning was evaluated. DESIGN: Taking into consideration the change context and different group characteristics, the DAI was conducted in terms of two dynamically interlinked circles that formed partnerships between PBL core group members and tutors, and between tutors and students in coconstructing knowledge useful for PBL curriculum development. FINDINGS: The findings of the student evaluation questionnaire reveal that the majority of students felt PBL made a difference to their expectations of self, the student group and the teacher role in creating a facilitative environment to enhance learning. However, there was a significant difference among individual student group responses. The students' positive and negative PBL experience in self-learning, tutor-student interaction, and group-learning were identified as crucial factors contributing to these group variations. CONCLUSION: The evaluation findings show that a paradigm shift from teacher-centred to student-centred learning, from valuing self-learning to co-operative group-learning, and from theory-based to practice-based learning occurred among the students. DAI was found to be an effective change strategy for transforming participants to become collaborators in searching for useful knowledge and coconstructing the PBL learning context.     

Developing a multi-method approach to data collection and analysis for explaining the learning during simulation in undergraduate nurse education

Simulation has become an established feature of undergraduate nurse education and as such requires extensive investigation. Research limited to pre-constructed categories imposed by some questionnaire and interview methods may only provide partial understanding. This is problematic in understanding the mechanisms of learning in simulation-based education as contemporary distributed theories of learning posit that learning can be understood as the interaction of individual identity with context. This paper details a method of data collection and analysis that captures interaction of individuals within the simulation experience which can be analysed through multiple lenses, including context and through the lens of both researcher and learner. The study utilised a grounded theory approach involving 31 under-graduate third year student nurses. Data was collected and analysed through non-participant observation, digital recordings of simulation activity and focus group deconstruction of their recorded simulation by the participants and researcher. Focus group interviews enabled further clarification. The method revealed multiple levels of dynamic data, concluding that in order to better understand how students learn in social and active learning strategies, dynamic data is required enabling researchers and participants to unpack what is happening as it unfolds in action.     

The use of simulation technology in the education of nursing students

This article provides a broad overview of simulation use in nursing education. An example of a simulation experience focusing on the development and debriefing of a medication safety exercise is presented based on a theoretic approach. Questions for future consideration by nursing educators and researchers are also presented with the ultimate goal of producing safer patient care and more deliberate reflecting practitioners.