Examining the effect of simulation-based learning on intravenous therapy administration' knowledge, performance, and clinical assessment skills of first-year nursing students

Assessment of undergraduate nursing students' medication administration competency: A systematic review

BACKGROUND

Nursing students must be well-prepared and competent in medication administration (MA) and be able to apply pharmacology knowledge as registered nurses. MA is integral to ensuring patient safety, but nursing students find it challenging to acquire competency in MA. Little is known about assessing medication administration competency in various clinical practice settings.

AIM

To conduct a systematic review of how undergraduate nursing students' medication administration competency is assessed in clinical practice settings.

METHOD

Original research studies were identified using PubMed, Web of Science, CINAHL, PsycINFO, Scopus, ScienceDirect, and ERIC. This systematic literature review included primary research studies using objective competency measures of MA assessment of undergraduate nursing students in a clinical practice setting, published in English between 1990 and 2023. Data was extracted and synthesised using the Preferred Reporting Items for Systematic Reviews.

RESULTS

32 original research papers were included in the review. Studies came from 12 countries. A quasi-experimental design was used by 75 % of studies to examine MA competency assessment. Medication assessments were conducted primarily in simulation labs. Simulation was found to have positive outcomes on MA competency on clinical placement. Studies were grouped into three categories: 'Using technology', 'Educational Strategies', and 'Focus on Safety skills'. Studies reported error rates associated with patient identification and hand hygiene, including those of senior nursing students. Quality appraisal was conducted using the Medical Education Research Study Quality Instrument (MERSQI). The MERSQI Mean score was 12.92/18. Several studies failed to report the sample size calculation and the validity of instruments.

CONCLUSION

A whole-curriculum approach with MA content and skills mapped and scaffolded across the undergraduate nursing program is required to enable students to achieve MA competency. Attention to the design of studies is required to ensure the reliability of results. Further research is required to understand the cognitive and affective behaviours contributing to the ongoing errors, focusing on assessing competency in clinical placement.

Effect of theme game-based learning on psychiatric violence risk assessment and response knowledge, skills, and self-confidence of nursing students: A randomized controlled trial

BACKGROUND

Theme game-based learning has the potential to enrich student learning experiences, leading to improved learning outcomes. Yet, there remains a research gap regarding its application in addressing psychiatric violence, leaving uncertainties about the comparative advantages of theme game-based learning over situational simulation learning strategies.

OBJECTIVES

The goal was to measure the effect of integrating theme game-based learning into psychiatric violence risk assessment and response training on nursing student psychiatric violence-related knowledge, skills, and self-confidence.

DESIGN

This study was a randomized controlled, pre-test, and post-test trial.

SETTING

The study was conducted at a medical university in Guangzhou, Guangdong, China.

PARTICIPANTS

There were 103 third-year nursing undergraduates (intervention group = 51, control group = 52) in the study.

METHODS

An Objective Structured Clinical Exam and the Workplace Violence Management Ability Assessment Questionnaire for Intern Nursing Students were used to assess student skills. The knowledge test and the Confidence in Coping with Patient Aggression Instrument were used to measure student knowledge and self-confidence level before and after intervention.

RESULTS

Nursing students in the theme game-based group demonstrated significantly superior skills and confidence in violence risk assessment and response compared with students in the situational simulation group (p < 0.001, p = 0.039, p = 0.006, respectively). However, there was no significant difference in knowledge of violence risk assessment and response between the two groups (p = 0.510).

CONCLUSION

Theme game-based learning in psychiatric violence risk assessment and response training appeared effective in enhancing the violence management abilities of nursing students.

Examining the effect of training with a teaching for understanding framework on intravenous therapy administration's knowledge, performance, and satisfaction of nursing students: a non-randomized controlled study

BACKGROUND

Nursing students require improvement in their intravenous infusion therapy management skills, yet traditional training models possess deficiencies. The Teaching for Understanding (TfU) Framework can enhance the teaching-learning process and support quality education. Therefore, utilizing TfU framework for training may promote the performance of nurses.

METHODS

Utilizing a non-synchronized design, 102 nurses were recruited using a convenience sampling method. Fifty-one student nurses from August 2019 to January 2021 were designated as the control group, and 51 student nurses from February 2021 to July 2022 were included as the intervention group. The control group received traditional teaching methods, while the intervention group was trained based on TfU framework. The impact was gauged through medical education environment perception, theory and practice assessments, and learning satisfaction surveys.

RESULTS

After the training, there was no significant difference between the control group and the intervention group in the theory assessment. However, the practice assessment scores of the intervention group were significantly higher than those of the control group. Compared with the control group, the learning satisfaction scores of the trained nurses in the intervention group were significantly higher, exhibiting significant differences, particularly in communication ability, teamwork cooperation, summing up capability, and interest in learning improvement. Furthermore, the scores of the learning perceptions, atmosphere, social self-perceptions, and total scores of the intervention group were significantly higher.

CONCLUSION

Training using TfU framework can heighten students' understanding and command over knowledge and skills, fuel their learning fervor, and enhance their communication and collaboration abilities. TfU framework should be disseminated in medical education to improve the quality of education.

The impact of moulage on learners' experience in simulation-based education and training: systematic review

BACKGROUND

Moulage is a technique used to simulate injury, disease, aging and other physical characteristics specific to a scenario, often used in health and emergency worker training, predominantly for simulation-based learning activities. Its use in allied health fields is unclear. Previous work has explored moulage as an adjunct for authentic simulations, however there is opportunity for broadening its scope.

AIM

To explore the effects of moulage interventions in simulation-based education and training, for learner experience. A secondary aim was to understand which pedagogical frameworks were embedded in moulage interventions.

METHOD

Four electronic databases (PubMed, CINAHL, EmBase, Proquest Central) were systematically searched to December 2022 for studies utilising moulage in simulation-based education experiences. Outcomes were focused on learner satisfaction, confidence, immersion, engagement, performance, or knowledge. Study quality was assessed using the Mixed Methods Appraisal Tool.

RESULTS

Twenty studies (n = 11,470) were included. Studies were primarily conducted in medicine (n = 9 studies) and nursing (n = 5 studies) and less frequently across other health disciplines. The findings demonstrated greater learner satisfaction, confidence, and immersion when moulage was used against a comparator group. Minimal improvements in knowledge and performance were identified. One study underpinned the intervention with a pedagogical theory.

CONCLUSION

Moulage improves learner experience in simulation-based education or training, but not knowledge or clinical performance. Further research utilising moulage across a broader range of professions is needed. Interventions using moulage should be underpinned by pedagogical theories.

Developing student nurses' evaluative judgement in clinical practice tertiary education: A systematic scoping review of teaching and assessment methods

OBJECTIVES

This review aimed to systematically scope undergraduate or postgraduate tertiary higher education nursing students' clinical practice teaching and assessment methods to identify features that align with promoting students' evaluative judgement.

INTRODUCTION

Evaluative judgement is a new concept to nursing tertiary education. Currently, there are no published reviews of evaluative judgement in nursing clinical practice education. This review aims to assist nursing educators to operationalise the concept of evaluative judgement in clinical practice education. As such the starting point was to determine features of evaluative judgement in current clinical teaching and assessment designs.

INCLUSION CRITERIA

Peer reviewed qualitative or quantitative studies that have evaluated teaching and/or assessment of tertiary (university/higher education) pre-registration (undergraduate) or post-registration (postgraduate) nursing students' clinical practice.

METHODS

The systematic scoping review was prospectively registered systematic review (OSF DOI 10.17605/OSF.IO/PYWZ6) reported using PRISMA guidelines. A systematic search of five databases (Medline, Scopus, Web of Science, ProQuest, CINAHL) was conducted, limited from 1989 onwards and in English. Two reviewers independently screened titles and abstracts, then full text, with disagreements resolved with a third independent author. Data were extracted, including the frequency and methods of developing students' evaluative judgement across the categories of discerning quality, judgement process, calibration and feedback. A narrative synthesis was performed.

RESULTS

Seventy-one studies were included (n=53 teaching, n=18 assessment). Most of the included studies, included some, but not all, of the features to develop nursing students' evaluative judgment. For teaching methods, the most identified evaluative judgement features in the included studies were discerning quality (n=47), feedback (n=41) and judgement process (n=21). Only three studies included a method of calibration. For the assessment methods, feedback (n=16), discerning quality (n=15), judgement process (n=9) and calibration (n=4) were included. Many clinical practice teaching and assessment methods in nursing included features that develop students' evaluative judgement, with methods relating to discerning quality and feedback well embedded. Further adjustments are required to include methods to assist students to judge and calibrate their own performance.

CONCLUSION

This systematic scoping review identified that evaluative judgement in current nursing clinical teaching and assessment is not an overt aim. With minor adjustment to teaching and assessment design, nursing students could be better supported to develop their ability to judge the value of their own work.