Effects of high-fidelity simulation teaching on nursing students' knowledge, professional skills and clinical ability: A meta-analysis and systematic review

Simulated practice in the development of clinical reasoning in nursing students: A systematic review protocol

Simulated clinical practice is a pedagogical technique that replicates real-world scenarios in a controlled environment, enabling nursing students to engage in the teaching-learning process actively. While simulated practice is a growing pedagogical strategy, several studies have examined its strengths and limitations. However, evidence of its effectiveness in developing clinical reasoning skills among nursing students still needs to be improved. This systematic review aims to assess the benefits of simulated practice in enhancing the clinical reasoning skills of undergraduate nursing students. Methods: A systematic review will be conducted using three databases: CINAHL, MEDLINE, and PubMed. The search strategy will include MeSH terms "simulation," "nursing students," "nursing education," and "clinical reasoning." Inclusion criteria: Studies published within the last five years (2017-2022) involving undergraduate nursing students and using simulated practice as an intervention. Two independent reviewers will conduct Data extraction and synthesis, with disagreements resolved by a third reviewer, as follows:•Identify the benefits of simulated practice in clinical reasoning among nursing students.•Analyze studies that utilize simulated practice as an intervention.•Evaluate the effectiveness of simulated practice in developing clinical reasoning skills.

Construction and implementation of a comprehensive midwifery skills practice course based on scenario simulation teaching: An action research

BACKGROUND

Midwives play a crucial role in maternal and newborn health, highlighting the need for quality education. Guided by the International Confederation of Midwives' core competencies, the Comprehensive Midwifery Skills Practice (CMSP) course integrates simulation-based learning (SBL) to bridge theory and practice, enhancing students' midwifery competence.

AIM

To construct and implement the CMSP course using SBL, and to investigate its effectiveness on the level of core competence among undergraduate midwifery students.

DESIGN AND METHODS

An action research design was employed. Teachers constructed and optimized the CMSP course by formulating two cycles of "plan-action-observation-reflection" among midwifery students from the 2020 and 2021 classes. Competency was evaluated before and after the course, impressions were gathered through simulated teaching evaluations, and different kinds of qualitative data were collected.

RESULTS

The CMSP course included 12 lessons, 37 teaching cases, 128 midwifery activity scenes, and a resource library. It won the provincial Teaching Innovation Competition and was recognized as a first-class undergraduate course. Midwifery competency evaluation showed significant improvements in professional skills (P = 0.039, Cohen's d = 0.554) and behavior (P = 0.024, Cohen's d = 0.457) for the 2020 cohort, and in total score, knowledge, skills, and behavior for the 2021 cohort (all P < 0.05, Cohen's d > 0.5). Simulated teaching evaluations improved across all dimensions, with notable enhancements in Learning Methods and Expectations (2020) and in Active Learning, Cooperation, Learning Methods, and Simulation (2021) (all P < 0.05). Overall, the students' rich experiences translated to gaining professional growth while experiencing learning difficulties.

CONCLUSION

The constructed and refined CMSP course is both feasible and effective in enhancing midwifery students' core competencies, promoting systematic clinical and research thinking, strengthening teamwork skills, improving adaptability, and fostering professional confidence and growth. Additionally, given the reported learning dilemmas, it is recommended that teachers actively guide and encourage flexible, independent learning while continuously enriching and optimizing the course resource library.

Comparison of standardized patient and medium-fidelity simulation practices on nursing students' knowledge, staging, and satisfaction regarding pressure injuries: A randomized controlled trial

OBJECTIVES

This study aimed to compare the effects of education using standardized patients (SP) and medium-fidelity simulation (MFS) on nursing students' knowledge, staging, and satisfaction related to pressure injuries (PI).

DESIGN

A pre- and post-test, double-blind, randomized controlled trial.

METHODS

The study included nursing students (n = 79) from a nursing faculty in western Turkey between April and July. Data were collected using the Student Characteristics Form, the Pressure Ulcer Knowledge Assessment Tool 2.0 (PUKAT 2.0-T), the Pressure Injury Staging Form, and the Student Satisfaction and Confidence in Learning Scale.

RESULTS

The SP (n = 40) and MFS (n = 39) groups did not demonstrate any significant differences in staging levels (SP: 9.42 ± 3.24, MFS: 10.41 ± 2.96) or PI knowledge (SP: 11.73 ± 3.39, MFS: 12.00 ± 4.52) following the simulation experience. Both groups showed a statistically significant increase in PI knowledge and staging levels after the interventions compared to before (p < .05). The learning satisfaction level of the SP group (23.03 ± 2.37) was significantly higher than that of the MFS group (21.51 ± 4.03) (p < .05). No significant differences were found between the groups regarding self-confidence levels (p > .05).

CONCLUSION

Both simulation methods improved students' PI knowledge and staging levels; however, the satisfaction level of students in the SP group was found to be higher. Therefore, it is recommended to enhance the realism of PI education using SPs and to expand the use of simulation practices.

REGISTRATION

The study has been registered with the National Library of Medicine Clinical Trials: NCT05946291.

Mapping the Landscape of Scenario-Based Simulation Teaching in Nursing: Insights From a Visual Bibliometric Analysis

OBJECTIVE

As scenario-based simulation teaching gains traction in nursing education, a thorough bibliometric analysis is essential to uncover the breadth and depth of existing research, highlight key trends, and address gaps in multicenter studies.

METHODS

This study systematically reviewed articles on scenario-based simulation teaching in nursing published from January 2010 to January 2024, sourced from the Web of Science core collection and Scopus databases. Employing CiteSpace and R language, we analyzed publication patterns, journal distributions, and keyword frequencies to map the field's evolution and collaborative networks.

RESULTS

Our findings reveal a steady increase in publications over the study period, with significant growth noted between 2015 and 2019. Higher education institutions, predominantly from the United States, China, the United Kingdom, and Germany, are at the forefront of research in this area. These nations also exhibit robust international collaborations. Key research hotspots include advancements in medical education methodologies and the integration of modern technologies.

CONCLUSION

This bibliometric analysis provides a comprehensive overview of nursing education's scenario-based simulation teaching landscape. It identifies enduring trends and emerging hotspots, offering a valuable foundation for future research and the development of innovative educational practices.

Clinical simulation for nurses' knowledge on postpartum hemorrhage: a randomized clinical trial

OBJECTIVES

to evaluate the effectiveness of a clinical simulation scenario in enhancing nurses' knowledge of postpartum hemorrhage management.

METHODS

a randomized clinical trial was conducted in the obstetric center of a tertiary-level maternity hospital. Nurses involved in maternal care were divided into two groups. The control group received a didactic lecture (standard institutional training), while the intervention group, in addition to attending the lecture, participated in a clinical simulation for postpartum hemorrhage management. Data were analyzed using R software, version 4.2.0.

RESULTS

the sample consisted of 37 nurses, most of whom were female, with an average age of 40 years. The average pre-test score was 65%. After the clinical simulation-based intervention, the average post-test score increased to 90%.

CONCLUSIONS

clinical simulation was effective in enhancing nurses' knowledge of postpartum hemorrhage management.

Relationship of high-fidelity simulation experience, clinical reasoning, and clinical competence of new nurses: A cross-sectional study

AIM

This study aimed to determine which high-fidelity simulation (HFS) experiences were associated with clinical reasoning and clinical competence among new nurses.

BACKGROUND

HFS has been actively used in nursing education. It is necessary to verify the effects of HFS transfer to the clinical environment.

DESIGN

A cross-sectional study reported following STROBE criteria.

METHODS

Data were collected on new nurses (n = 224) who experienced HFS in their fourth-year undergraduate courses. The number of HFSs, the inclusion of simulation elements, the importance of elements to learning, clinical reasoning, and clinical competence were measured. Hierarchical regression models examined factors associated with clinical reasoning and clinical competence.

RESULTS

Feedback was the most sufficiently included element of the HFS learning, and participants perceived it as the most important. A significant factor associated with clinical competence was clinical reasoning, and HFS design indirectly affected clinical competence through clinical reasoning.

CONCLUSIONS

HFS learning is one of the best ways to improve clinical reasoning. Improving students' clinical reasoning should be an important goal of HFS learning in undergraduate courses to prepare students to be clinically competent nurses.

IMPLICATIONS FOR NURSING

The ultimate goal of nursing education is to prepare nursing students to be competent nurses. Validating the outcomes of nursing education in the clinical environment setting is an essential task to improve clinical practice.

IMPLICATIONS FOR NURSING POLICY

Nurse educators and leaders can increase nurses' clinical competence by emphasizing education to foster nurses' clinical reasoning in nursing education policies.

Pedagogical approaches to foster caring behaviors among nursing students: A scoping review

BACKGROUND

Developing caring behaviors in nursing students is crucial for improving patient care quality. Despite the variety of pedagogical approaches employed to cultivate these behaviors, their comparative effectiveness remains underexplored.

AIM

This review systematically examined various pedagogical approaches used to foster caring behaviors among nursing students and evaluated their outcomes.

DESIGN

This study employed a scoping review design.

METHODS

A comprehensive search across five databases-PubMed, CINAHL, Scopus, Web of Science, and ERIC-was conducted for studies published from January 2000 to the present. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines were followed in reporting the findings.

RESULTS

A total of 22 studies were included in the review. The review identified four primary pedagogical approaches: (1) simulated interactive learning, (2) caring-centered educational programs/courses, and (3) immersion/service learning. All approaches demonstrated positive outcomes in enhancing students' caring behaviors.

CONCLUSION

Employing a diverse range of pedagogical approaches, aligned with experiential, cognitive, and behavioral learning theories, significantly enhances the development of caring behaviors in nursing students. However, the review highlighted the need for more rigorous study designs to further validate these findings.

IMPLICATIONS FOR NURSE EDUCATION

Nurse faculty should incorporate a variety of pedagogical approaches into nursing education to address different learning needs and enhance the development of caring behaviors. Future research should focus on evaluating the effectiveness of these approaches and their long-term impact on nursing practice.

Efficacy of high fidelity pediatric simulation on nursing students' self-awareness and empathy in a Middle Eastern County

Background

The importance of nurses' self-awareness and empathy and the effect of high-fidelity simulation in cultivating self-awareness and empathy among students is yet to be explored.

Methods

This study determined the efficacy of high-fidelity simulation on self-awareness and empathy among undergraduate nursing students. A quasi-experimental approach with a one-group pre-posttest design was employed. Self-awareness was assessed using Self-Consciousness Revised Scale (22 items), while empathy was measured with the Kiersmae Chen Empathy Scale (15 items).

Results

Data from 67 participants were analyzed. Analysis revealed no significant difference in students' self-awareness (t = -0.01, p > 0.05) or empathy (t = -1.92, p > 0.05) pre- and post-high-fidelity simulation. However, there was a notable improvement in cognitive empathy scores. To compare High-fidelity simulation and self-awareness, a one-way ANCOVA was conducted, controlling for gender, GPA, and previous exposure to simulation. The results indicated a non-significant relationship (F (1) = 3.59, p > 0.05). Likewise, High-fidelity simulation and empathy was compared using one-way ANCOVA while controlling for gender, GPA, and previous simulation exposure. The results revealed a non-significant relationship (F(1) = 1.64, p > 0.05).

Conclusion

Though the study findings did not demonstrate significant effects, the observed enhancement in cognitive empathy post-simulation suggests a potential benefit. It is plausible that the intervention dosage was insufficient to induce substantial changes in these skills. Therefore, it is recommended to replicate the study with a larger sample and multiple simulation sessions.

The Effect of "Online-Simulation-Bedside" Three-Step Teaching Method in Team Cardiopulmonary Resuscitation Skills Training of Emergency Department and Critical Care Nursing Interns-An Analysis Based on Kirkpatrick Model

Aim: This study designed a three-step teaching method of "online-simulation-bedside," which was applied to the teaching of cardiopulmonary resuscitation skills in the team of emergency and critical care nursing interns, and the effectiveness of this teaching method was evaluated using the Kirkpatrick model. Background: Mastering knowledge of cardiopulmonary resuscitation and emergency techniques is necessary for nursing interns to fulfill their roles. At present, the first aid awareness and rescue skills of nursing interns are not optimistic. Training programs can improve the cardiopulmonary resuscitation ability of nursing students, but most of them only evaluate the changes in cardiopulmonary resuscitation ability before and after training and rarely use educational evaluation theories and models to evaluate the effectiveness of cardiopulmonary resuscitation training research. Methods: This is a quasi-experimental research design: pretest and posttest design. Our research focuses on nursing interns who interned in the emergency and critical care departments of a hospital from September 2023 to January 2024. Adopting the three-step teaching method of "online-simulation-bedside", provide team cardiopulmonary resuscitation skills training for emergency and critical care nursing interns. The four levels of Kirkpatrick's model, that is, reaction, learning, behavior, and result, were applied for the evaluation together with questionnaires. Conduct a baseline survey before online learning. Evaluate team working ability, clinical thinking ability, confidence in skills, and active participation on the first day after simulated training and the 30th day of clinical practice. On the 30th day of clinical practice, satisfaction and skill level assessments will also be conducted. Results: At the reaction level, the satisfaction rate of nursing interns is 98.80%. At the learning level, there was a statistically significant difference (p < 0.001) in the team work ability and clinical thinking ability of nursing interns before training, on the first day after training, and on the 30th day of clinical practice. At the behavioral level, there was a statistically significant difference (p < 0.001) in the skill confidence and participation initiative of nursing interns before training, on the first day after training, and on the 30th day of clinical practice. At the result level, on the 30th day of clinical practice, the nursing intern team's cardiopulmonary resuscitation skills assessment scores were all good or above, with an average score of 90.09 ± 1.58. Conclusion: The Kirkpatrick model can be used to evaluate the effectiveness of cardiopulmonary resuscitation skills training for nursing intern teams. Nursing interns are highly satisfied with the "online-simulation-bedside" three-step teaching method, which can improve their teamwork ability, clinical thinking ability, active participation, and skill confidence. In addition, through training, students can effectively apply the learned content to clinical practice and possess a good level of skills. Implications for Nursing Management: Managers can develop a distinctive team cardiopulmonary resuscitation training model based on this, improve the team cardiopulmonary resuscitation skills of nursing interns, and cultivate more nursing talents with high-level emergency capabilities for hospitals.

Identifying Research Priorities in Digital Education for Health Care: Umbrella Review and Modified Delphi Method Study

BACKGROUND

In recent years, the use of digital technology in the education of health care professionals has surged, partly driven by the COVID-19 pandemic. However, there is still a need for focused research to establish evidence of its effectiveness.

OBJECTIVE

This study aimed to define the gaps in the evidence for the efficacy of digital education and to identify priority areas where future research has the potential to contribute to our understanding and use of digital education.

METHODS

We used a 2-stage approach to identify research priorities. First, an umbrella review of the recent literature (published between 2020 and 2023) was performed to identify and build on existing work. Second, expert consensus on the priority research questions was obtained using a modified Delphi method.

RESULTS

A total of 8857 potentially relevant papers were identified. Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology, we included 217 papers for full review. All papers were either systematic reviews or meta-analyses. A total of 151 research recommendations were extracted from the 217 papers. These were analyzed, recategorized, and consolidated to create a final list of 63 questions. From these, a modified Delphi process with 42 experts was used to produce the top-five rated research priorities: (1) How do we measure the learning transfer from digital education into the clinical setting? (2) How can we optimize the use of artificial intelligence, machine learning, and deep learning to facilitate education and training? (3) What are the methodological requirements for high-quality rigorous studies assessing the outcomes of digital health education? (4) How does the design of digital education interventions (eg, format and modality) in health professionals' education and training curriculum affect learning outcomes? and (5) How should learning outcomes in the field of health professions' digital education be defined and standardized?

CONCLUSIONS

This review provides a prioritized list of research gaps in digital education in health care, which will be of use to researchers, educators, education providers, and funding agencies. Additional proposals are discussed regarding the next steps needed to advance this agenda, aiming to promote meaningful and practical research on the use of digital technologies and drive excellence in health care education.

Effects of cooperative learning and situational simulation on nursing competence in clinical practice among nursing students: A quasi-experimental study

BACKGROUND

Appropriate cooperative learning and situational simulation designs can enhance mental health and nursing competence in clinical practice. This approach is crucial for cultivating the clinical nursing competence of nursing students.

AIM

To determine the effect of combining cooperative learning and situational simulation on nursing competence in clinical practice.

DESIGN

A quasi-experimental study.

SETTING AND PARTICIPANTS

This study was conducted with 142 second-year students in the nursing department of a university in Taiwan.

METHODS

The experimental group received cooperative learning combined with situational simulation methods, while the control group used only cooperative learning methods. Data were collected using the Clinical Practice Stress Scale and the Fundamental Nursing Competence Scale. Percentiles and frequency distributions were used to analyze the data, and independent t-tests were conducted to compare differences between the groups.

RESULTS

There were no significant differences in descriptive characteristics between the groups (p > .05). Post-test measurements of nursing technical performance, total score on the fundamental nursing competence scale and six sub-dimensional scores of the students in the experimental group were significantly improved compared to the control group (p < .001). However, there were no significant differences in total clinical practice stress scale scores between the groups (p > .05). Interestingly, the knowledge score of the control group was significantly higher than that of the experimental group (p < .05).

CONCLUSION

The combined methods of cooperative learning and situational simulation have been shown to positively impact students' academic and nursing technical performance. The results indicate improvements in nursing competence in clinical practice, with signs of a reduction in clinical practice-related stress. Nurse educators can apply these strategies in clinical nursing education to achieve better outcomes.

Effectiveness of high versus mixed-level fidelity simulation on undergraduate nursing students: A randomised controlled trial

AIM

This study evaluates the impact of high-fidelity simulation on the acquisition and retention of competencies in nursing students.

BACKGROUND

High-fidelity simulation provides a realistic and risk-free environment allowing students to practice, which potentially enhances the acquisition and retention of required competencies.

DESIGN

A blinded, randomised clinical trial with three arms was conducted with a pretest and a follow-up at 6 months (post-test 1) and 12 months (post-test 2).

METHOD

This study was conducted with 105 s-year nursing students, divided into three groups: control (6 low-fidelity simulations), intervention 1 (3 high-fidelity and 3 low-fidelity) and intervention 2 (6 high-fidelity simulations). Competencies were assessed using the Objective Structured Clinical Examination at baseline, 6 and 12 months. Student satisfaction was measured with the Simulated Clinical Experiences Scale.

RESULTS

Initial competency scores were similar across groups. At 6 months, both intervention groups showed significant improvements in critical thinking (6.2 and 6.0, p < 0.05), clinical skills (6.8 and 6.6, p < 0.05), communication (8.0 and 8.3, p < 0.05) and ethics (7.6 and 7.5, p < 0.05) compared with the control group. Intervention group 1 demonstrated better competency retention at 12 months. Overall satisfaction with highfidelity simulation was high (9.13/10), with particular praise for the practical dimension (8.95/10), realism (8.02/10) and the cognitive dimension (9.43/10).

CONCLUSIONS

High-fidelity simulation has the potential to enhance nursing competencies effectively. This approach supports long-term skill retention, highlighting the importance of a well-structured curriculum that integrates different simulation levels for optimal student preparation for clinical practice.

Impact of different teaching modes on medical students' performance under the scoring criteria for multiple-choice questions: A meta-analysis

BACKGROUND

Comparing the impact of different educational modes on medical students' performance under the scoring criteria for multiple-choice questions, would provide a basis for selecting more appropriate and effective teaching modes for talent development.

METHODS

We searched databases such as CNKI, Wanfang, PubMed, and Web of Science to collect publications on the comparison of medical students' performance under the scoring criteria for multiple-choice questions and different teaching modes, with a focus on studies conducted between 2015 and 2024. Chinese search terms included multiple-choice questions, multiple-choice exam, medical students, flipped classroom, simulation teaching, team-based learning, and blended teaching. Equivalent English search terms were "multiple-choice questions," "multiple-choice exam," "medical student," "flipped classroom," "simulation teaching," "team-based learning," and "blended teaching." Two researchers independently conducted publications screening, data extraction, and quality assessment, and performed meta-analysis using R 4.3.0 software.

RESULTS

This study included a total of 24 publications, among them 6 on flipped classroom teaching, 13 on simulation teaching, 2 on team-based learning, and 3 on blended teaching, covering 13 countries and involving 2086 participants in the experimental group and 2113 participants in the control group. Using scores from multiple-choice questions as the criterion, flipped classroom teaching and simulation teaching demonstrated significantly higher scores compared to traditional teaching, with standard mean differences (MDs) of 0.39 (95% CI: 0.14-0.65) and 0.33 (95% CI: 0.18-0.48), respectively. However, team-based learning and blended teaching showed no significant differences in scores compared to traditional teaching, with standard MDs of 0.48 (95% CI: -0.36 to 1.31) and -0.63 (95% CI: -1.85 to 0.59), respectively.

CONCLUSION

Compared to traditional teaching, flipped classroom teaching and simulation teaching were more beneficial for students' performance. It is recommended to continue implementing high-quality flipped classroom teaching and simulation teaching to address the challenges in medical education reform.

Partnering With School Nurses for Continuing Education in Inflammatory Bowel Disease

BACKGROUND

With the rising incidence of inflammatory bowel disease (IBD) in pediatric populations, school nurses are increasingly called on to care for and support these students.

METHOD

The research team surveyed Connecticut school nurses about their experiences, knowledge, and confidence in addressing IBD in the school setting. The team also developed and implemented an online education intervention to improve knowledge and confidence gaps during the 2022-2023 academic year.

RESULTS

Most participants have cared for one to two (46%, n = 66) or several (30%, n = 44) students with IBD. However, 24% (n = 35) have not cared for any students with IBD. School nurses shared their perspectives with three themes identified from the qualitative feedback: (a) limited knowledge and experience with IBD, (b) importance of support at school, and (c) need for interprofessional collaborative practice.

CONCLUSION

The online education significantly improved school nurses' knowledge (p < .001) and confidence scores (p < .001). Participants found this intervention beneficial to their work. [J Contin Educ Nurs. 2024;55(12):589-595.].

The effect of simulation-based training on problem-solving skills, critical thinking skills, and self-efficacy among nursing students in Vietnam: a before-and-after study

PURPOSE

This study investigated the effect of simulation-based training on nursing students’ problem-solving skills, critical thinking skills, and self-efficacy.

METHODS

A single-group pretest and posttest study was conducted among 173 second-year nursing students at a public university in Vietnam from May 2021 to July 2022. Each student participated in the adult nursing preclinical practice course, which utilized a moderate-fidelity simulation teaching approach. Instruments including the Personal Problem-Solving Inventory Scale, Critical Thinking Skills Questionnaire, and General Self-Efficacy Questionnaire were employed to measure participants’ problem-solving skills, critical thinking skills, and self-efficacy. Data were analyzed using descriptive statistics and the paired-sample t-test with the significance level set at P<0.05.

RESULTS

The mean score of the Personal Problem-Solving Inventory posttest (127.24±12.11) was lower than the pretest score (131.42±16.95), suggesting an improvement in the problem-solving skills of the participants (t172 =2.55, P=0.011). There was no statistically significant difference in critical thinking skills between the pretest and posttest (P=0.854). Self-efficacy among nursing students showed a substantial increase from the pretest (27.91±5.26) to the posttest (28.71±3.81), with t172 =-2.26 and P=0.025.

CONCLUSION

The results suggest that simulation-based training can improve problem-solving skills and increase self-efficacy among nursing students. Therefore, the integration of simulation-based training in nursing education is recommended.

Exploring the link of personality traits and tutors' instruction on critical thinking disposition: a cross-sectional study among Chinese medical graduate students

OBJECTIVES

This study aimed to investigate the associations between critical thinking (CT) disposition and personal characteristics and tutors' guidance among medical graduate students, which may provide a theoretical basis for cultivating CT.

DESIGN

A cross-sectional study was conducted.

SETTING

This study was conducted in Sichuan and Chongqing from November to December 2021.

PARTICIPANTS

A total of 1488 graduate students from clinical medical schools were included in this study.

DATA ANALYSIS

The distribution of the study participants' underlying characteristics and CT was described and tested. The Spearman rank correlation coefficient was used to evaluate the correlation between each factor and the CT score. The independent risk factors for CT were assessed using a logistic regression model.

RESULTS

The average total CT score was 81.79±11.42 points, and the proportion of CT (score ≥72 points) was 78.9% (1174/1488). Female sex (OR 1.405, 95% CI 1.042 to 1.895), curiosity (OR 1.847, 95% CI 1.459 to 2.338), completion of scientific research design with reference (OR 1.779, 95% CI 1.460 to 2.167), asking 'why' (OR 1.942, 95% CI 1.508 to 2.501) and team members' logical thinking ability (OR 1.373, 95% CI 1.122 to 1.681) were positively associated with CT while exhaustion and burn-out (OR 0.721, 95% CI 0.526 to 0.989), inattention (OR 0.572, 95% CI 0.431 to 0.759), Following others' opinions in decision-making (OR 0.425, 95% CI 0.337 to 0.534) and no allow of doubt to tutors (OR 0.674, 95% CI 0.561 to 0.809) had negative associations with the formation of CT disposition in the fully adjusted model.

CONCLUSIONS

Factors associated with motivation and internal drive are more important in the educational practice of cultivating CT. Educators should change the reward mechanism from result-oriented to motivation-maintaining to cultivate students' CT awareness.

The efficacy of high-fidelity simulation on knowledge and performance in undergraduate nursing students: An umbrella review of systematic reviews and meta-analysis

OBJECTIVES

This umbrella review aimed to consolidate the evidence base on the impact of high-fidelity simulation on knowledge and performance among undergraduate nursing students.

DESIGN

Umbrella review with meta-analyses of pooled effect sizes, followed by an additional meta-analysis of primary studies from the included systematic reviews, excluding overlapping results.

DATA SOURCES

Systematic searches were performed up to August 2023 in PubMed, Embase, and Cochrane Library. We included reviews that compared high-fidelity simulation against other learning strategies.

REVIEW METHODS

The risk of bias was assessed for each included systematic review (ROBIS tool) and primary study (RoB 2 or ROBINS-I as appropriate). Random-effect meta-analyses of meta-analyses were performed to estimate the pooled effects of high-fidelity simulation on knowledge and performance. Further random-effect meta-analyses of primary studies were conducted, with overlapping studies excluded (12 %). Subgroup analyses were performed to provide a more comprehensive analysis of the findings. Trim-and-fill analyses were conducted to adjust for potential publication bias.

RESULTS

Six systematic reviews were included and encompassed 133 primary studies (2767 and 3231 participants concerning performance and knowledge, respectively). The adjusted pooled effects for knowledge (SMD = 0.877, 95 % CI: 0.182 to 1.572) and performance (SMD = 0.738, 95 % CI: 0.466 to 1.010) closely aligned with those obtained from meta-analyzing the primary studies for knowledge (SMD = 0.980) and performance (SMD = 0.540), both showing high statistical heterogeneity. Traditional lectures represented the more common comparison. The subgroup analysis revealed significant differences in effect sizes across geographic locations, topics, types of control, and how interventions were reported.

CONCLUSIONS

The results provide robust evidence supporting the integration of high-fidelity simulation into undergraduate nursing programs to enhance students' knowledge and performance. The high reported heterogeneity may be attributed to variations in study contexts or methodologies. Future research should explore the optimal use of high-fidelity simulation in different educational and cultural contexts.

The effects of simulation-based education on undergraduate nursing students' competences: a multicenter randomized controlled trial

BACKGROUND

Education in nursing has noticed a positive effect of simulation-based education. There are many studies available on the effects of simulation-based education, but most of those involve a single institution, nonrandomized controlled trials, small sample sizes and subjective evaluations of the effects. The purpose of this multicenter randomized controlled trial was to evaluate the effects of high-fidelity simulation, computer-based simulation, high-fidelity simulation combined with computer-based simulation, and case study on undergraduate nursing students.

METHODS

A total of 270 nursing students were recruited from five universities in China. Participants were randomly divided into four groups at each institution: the high-fidelity simulation group, the computer-based simulation group, the high-fidelity simulation combined with computer-based simulation group, and the case study group. Finally, 239 participants completed the intervention and evaluation, with 58, 67, 57, and 57 participants in each group. The data were collected at three stages: before the intervention, immediately after the intervention, and three months after the intervention.

RESULTS

The demographic data and baseline evaluation indices did not significantly differ among the four groups. A statistically significant difference was not observed between the four methods for improving knowledge, interprofessional collaboration, critical thinking, caring, or interest in learning. While skill improvement differed significantly among the different groups after the intervention (p = 0.020), after three months, no difference was observed (p = 0.139). The improvement in skill in the computer-based simulation group was significantly lower at the end of the intervention than that in the high-fidelity simulation group (p = 0.048) or the high-fidelity simulation combined with computer-based simulation group (p = 0.020).

CONCLUSIONS

Nursing students benefit equally from four methods in cultivating their knowledge, interprofessional collaboration, critical thinking, caring, and interest in learning both immediately and over time. High-fidelity simulation and high-fidelity simulation combined with computer-based simulation improve skill more effectively than computer-based simulation in the short term. Nursing educators can select the most suitable teaching method to achieve the intended learning outcomes depending on the specific circumstances.

TRIAL REGISTRATION

This clinical trial was registered at the Chinese Clinical Trial Registry (clinical trial number: ChiCTR2400084880, date of the registration: 27/05/2024).

Simulation-Based Teaching and Learning in Respiratory Care Education: A Narrative Review

Simulation-based pedagogy has become an essential aspect of healthcare education. However, there is a significant gap in the literature regarding the application of simulation-based modalities in respiratory care education. This review aims to address this gap by providing insight into the theory and current uses of simulation, its effectiveness in respiratory care education, and strategies to enhance faculty development. The study utilizes a narrative synthesis approach to review relevant literature and provide a comprehensive understanding of the topic. The research involved comprehensive searches of electronic databases, including PubMed and Google Scholar, to identify relevant literature, encompassing original articles, reviews, and other pertinent content, focusing on simulation-based teaching and learning in respiratory care education published between 1990 and 2022. Findings suggest that simulation-based education is an effective tool for improving respiratory care education and can enhance the clinical skills of learners. The study concludes by discussing the future of simulation in respiratory care education and the potential benefits it may offer.

Impact of Bedside Laparotomy Simulation and Microlearning on Trauma Nurse Role Clarity, Knowledge, and Confidence

BACKGROUND

The care of patients undergoing low-volume, high-risk emergency procedures such as bedside laparotomy (BSL) remains a challenge for surgical trauma critical care nurses.

OBJECTIVES

This study evaluates simulation and microlearning on trauma nurse role ambiguity, knowledge, and confidence in caring for patients during emergency BSL.

METHODS

The study is a single-center, prospective pretest-posttest design conducted from September to November 2022 at a Level I trauma center in the Mid-Atlantic United States using simulation and microlearning to evaluate role clarity, knowledge, and confidence among surgical trauma intensive care unit (STICU) nurses. Participants, nurses from a voluntary convenience sample within a STICU, attended a simulation and received three weekly microlearning modules. Instruments measuring role ambiguity, knowledge, and confidence were administered before the simulation, after, and again at 30 days.

RESULTS

From the pretest to the initial posttest, the median (interquartile range [IQR]) Role Ambiguity scores increased by 1.0 (1.13) (p < .001), and at the 30-day posttest, improved by 1.33 (1.5) (p < .001). The median (IQR) knowledge scores at initial posttest improved by 4.0 (2.0) (p < .001) and at the 30-day posttest improved by 3.0 (1.75) (p< .001). The median (IQR) confidence scores at initial posttest increased by 0.08 (0.33) (p = .009) and at the 30-day posttest improved by 0.33 (0.54) (p = .01).

CONCLUSIONS

We found that simulation and microlearning improved trauma nurse role clarity, knowledge, and confidence in caring for patients undergoing emergency BSL.

Teaching nursing students: As an umbrella review of the effectiveness of using high-fidelity simulation

AIM

To conduct an umbrella review of the effectiveness of using high-fidelity simulation in nursing student teaching, thereby supporting continuous improvement in teaching practitioners' implementation of high-fidelity simulation intervention strategies.

BACKGROUND

Several systematic reviews have investigated the effectiveness of high-fidelity simulation in nursing student teaching in recent years. However, conclusions vary and a systematic assessment is lacking.

DESIGN

This review encompasses an umbrella review.

METHODS

A search of PubMed, Embase, Cochrane Library, Web of Science and OVID databases was conducted to retrieve data on an umbrella review of high-fidelity simulation effectiveness in nursing student teaching from database inception to November 2023. The quality of the included systematic reviews was independently assessed by two reviewers using the AMSTAR 2 and PRISMA scales. Outcome indicators from the included systematic reviews were graded using the GRADE system.

RESULTS

Twelve systematic reviews focusing on high-fidelity simulation effectiveness in nursing student teaching were included. Notably, all 12 systematic reviews exhibited very-low methodological quality, with 9 exhibiting some degree of reporting deficiencies, 2 exhibiting severe information deficiencies and 1 reporting relatively complete information. A total of 22 outcome indicators and 53 pieces of evidence were included. The results revealed 15 pieces of low-quality evidence and 38 pieces of very-low-quality evidence. Mounting evidence suggests that high-fidelity simulation teaching effectively enhances nursing students' theoretical performance, practical skills and various clinical comprehensive abilities, highlighting a positive teaching effect. However, further validation through high-quality, large-sample studies is warranted.

CONCLUSION

The overall evidence quality of the current systematic reviews evaluating high-fidelity simulation effectiveness in nursing student teaching is low. Additionally, the methodological quality and the degree of reporting standardization require further improvement. Therefore, high-quality, large-sample randomized controlled trials are essential for further substantiating high-fidelity simulation effectiveness in nursing student teaching.

Analysis of cybersickness in virtual nursing simulation: a German longitudinal study

BACKGROUND

Innovative educational approaches such as simulation-based nursing education using virtual reality (VR) technologies provide new opportunities for nursing education. However, there is a lack of information on side effects, especially health-related side effects, of head-mounted displays (HMDs) on the human body when using VR devices for nursing simulation. This study aims to validate the German version of the Virtual Reality Sickness Questionnaire (VRSQ) and to evaluate its associations with sex and age, as reflected in the VRSQG scores (total score, oculomotor, and disorientation) over time.

METHODS

A longitudinal-sectional study was conducted. In addition to the VRSQG (pre-, post-, and 20 min post-intervention), participants (all nursing students) completed data on personal characteristics. Participants completed a VR simulation of a blood draw. Confirmatory factor analysis (CFA) was used to evaluate whether the measured construct was consistent with the original. In addition to the validity, internal consistency was analyzed and generalized linear models (GLMs) were used for data analysis.

RESULTS

A total of 38 nursing students (mean age 26.8 years; SD = 7.1, 79.0% female) participated. The mean time spent in the VR simulation was 21 min. All participants completed the entire simulation. The CFA indicates (CFI = 0.981, SRMR = 0.040) VRSQG structure is given. Internal consistency showed low values for the subdomain Oculomotor (Cronbach alpha 0.670). For Disorientation and the Total score values showed a sufficient internal consistency. GLMs showed significant between subject associations with age over time with VRSQG total score, oculomotor, and disorientation. Older nursing students start with higher VRSQG-Scores. Over time, an approximation occurs, so that all participants reach a similar level by the final measurement point. No associations were found between sex (male/female) and VRSQG scores.

CONCLUSIONS

The VRSQG is a reliable and valid self-assessment for measuring cybersickness in VR based nursing simulations, with cybersickness symptoms positively associated with age. However, in depth-evaluation regarding age-associations with cybersickness should be done. As well as studies to explore additional associations and emphasizes the importance of establishing cut-off values to assess the clinical relevance of the scores.

Vaccine Hesitancy: Developing Competency in Nursing Students Through Simulation

BACKGROUND

Many Americans are undecided about or have barriers to receiving vaccines. Complacency, confidence, convenience, misinformation, and disinformation impact vaccine hesitancy (VH).

PROBLEM

During the COVID-19 pandemic, rates for flu and routine childhood vaccinations declined globally. As vaccination rates decline, the risk of disease outbreaks increases. Nursing students need to be prepared to address VH in the clinical setting.

APPROACH

Four simulation experiences were developed to build confidence and competency in the provision of vaccinations and addressing VH. Nursing students practiced communication skills critical to motivational interviewing, health education, health promotion, and goal setting.

OUTCOME

There were statistically significant increases in student confidence and perceived competence in vaccine administration and addressing VH through motivational interviewing.

CONCLUSIONS

High-fidelity simulation combined with a virtual simulation was effective in developing confidence among nursing students. Students demonstrated skill in addressing VH and motivational interviewing.

In situ simulation training strengthened bachelor of nursing students' experienced learning and development process- a qualitative study

BACKGROUND

In advanced clinical learning labs on campus, high-fidelity simulation has become an essential educational approach in the Bachelor of Nursing Education programme. However, simulation while in clinical placement, in situ, is rarely used in Bachelor of Nursing Education. The aim of the present study was to explore how in situ simulation training at a surgical hospital ward, according to Bachelor of Nursing students, influenced their learning and development process.

METHODS

A qualitative descriptive study was conducted. Data were collected through individual interviews with a sample of 21 s-year Bachelor of Nursing students who completed 40 in situ simulations during their eight-week clinical placement at a Norwegian University Hospital. Data were analysed using inductive content analysis.

RESULTS

The data analysis generated six subcategories constituting two descriptive categories: building professional confidence and internalising nursing knowledge. Although the students found in situ simulation stressful and uncomfortable for being assessed by student peers, the teacher and preceptor, the process of managing clinical situations in simulation helped build professional confidence. What the students had learned in the simulation was directly transferable to real clinical situations because they were in the hospital setting. The simulation sessions enabled them to connect theoretical knowledge and clinical skills. They could test their skills in a safe environment, performing procedures that made them aware of how their knowledge could be used in real life.

CONCLUSION

According to the Bachelor of Nursing students' own experiences, in situ simulation supported the students' learning process, connected theory and practice and contributed to developing confidence in the performance of clinical skills. Including simulation in clinical practice could prove to be an effective way of teaching and learning clinical skills in nursing regarding resources and learning outcomes.

Effects of simulation-based education module on delirium care in undergraduate nursing students: A quasi-experimental study

AIM

To examine the effects of a delirium education module on undergraduate nursing students' knowledge of and perceived confidence and competence in delirium care.

BACKGROUND

Delirium is common in intensive care units (ICUs) and leads to poor clinical outcomes. The under recognition of delirium is a major problem in ICU medicine. Nurses, as first-line health care providers, can address this by recognizing patients who are experiencing delirium. Since undergraduate nursing students will be the future ICU nurses, it is important to deliver the knowledge regarding delirium care. However, education about assessing delirium in ICUs among undergraduate nursing students is lacking.

DESIGN

Quasi-experimental study.

METHODS

A total of 74 undergraduate students were divided into an intervention group (n=34) and a comparison group (n=40). A 2-hour simulation-based delirium education module integrated into a critical care curriculum was delivered to the intervention group only. The classroom-based intervention was administered at a medical university in northern Taiwan. Study outcomes were measured using a structured survey including (1) a 16-item delirium care knowledge quiz, (2) confidence in delirium care scale and (3) competence in delirium care scale. The survey was distributed to students before and after the module in December 2020. The Mann-Whitney U test, chi-square test and Fisher's exact test were adopted to test the differences of all variables between groups. A generalized estimating equation model was used to investigate the adjusted treatment effects.

RESULTS

The participants had a median age of 22 years and 81% were female. The delirium education module yielded greater knowledge (B = 3.04, 95% confidence interval = 2.20-3.88), confidence (B = 4.20, 95% confidence interval = 2.67-5.73) and competence (B = 4.82, 95% confidence interval = 3.33-6.30) in delirium care when the treatment and control groups were compared.

CONCLUSIONS

For undergraduate nursing students, simulation-based education module is effective in improving the knowledge of and confidence and competence in delirium care. It is recommended that this be included in critical care nursing curricula.

Using palliative and end-of-life simulation to enhance pre-licensure nursing students' emotional intelligence, palliative care knowledge and reflective abilities: A single group, pretest-posttest study

BACKGROUND

Nursing students have reported that they lack skills and knowledge in palliative and end-of-life care, and as a result, they faced numerous challenges caring for patients and families receiving palliative and end-of-life care during clinical attachments.

OBJECTIVES

To develop a palliative and end-of-life care simulation program and evaluate its effects on nursing students' emotional intelligence, palliative care knowledge and reflective abilities.

DESIGN

A single group, pretest-posttest quasi-experimental study.

SETTINGS

A simulation center in a Singapore university.

PARTICIPANTS

A convenience sample of 135 third-year undergraduate nursing students.

METHODS

Students attended a two-day simulation program consisting of four scenarios in total. Outcomes were measured before and after the study. Palliative care knowledge was measured using the Palliative Care Knowledge Test, emotional intelligence using the Trait Meta-Mood Scale-24, and reflective abilities using the Groningen Reflective Ability Scale. Outcome and demographic data were analyzed using descriptive and inferential statistics.

RESULTS

Total Palliative Care Knowledge Test scores (p = 0.003) and total Trait Meta-Mood Scale-24 scores (p < 0.001) improved significantly, but there was no significant change in Groningen Reflective Ability Scale scores (p = 0.650). Demographic characteristics did not significantly influence most outcome variables. Students' highest education level and experience with caring for a person receiving palliative or end-of-life care significantly affected the posttest scores of the Palliative Care Knowledge Test. Students with prior experience in caring for a person receiving palliative or end-of-life care scored significantly better in the Palliative Care Knowledge Test post-simulation compared to those who did not (p = 0.011).

CONCLUSIONS

The palliative and end-of-life simulation program significantly improved nursing students' emotional intelligence and palliative care knowledge. Further research is needed on developing a reliable tool to measure nursing students' palliative care knowledge. Future simulations should include structured and deliberate reflection features aside from debriefings to enhance reflective abilities, which is an important nursing competency. More research is needed on the effect of palliative and end-of-life care simulations on emotional intelligence and reflective abilities, and the influence of demographic variables on nursing students' outcomes.

The influence of heart failure high-fidelity simulation education based on NLN Jeffries simulation framework in the prelicensure nursing program: A quasi-experimental study

Objectives

To examine the influence of heart failure high-fidelity simulation education based on the National League for Nursing (NLN) Jeffries Simulation Framework in prelicensure nursing education.

Methods

A heart failure high-fidelity simulation (HFHFS) education pilot project was carried out at Carrington College Sacramento. Twenty-three students participated in the study. This study used a quasi-experimental design. Students' Self-Efficacy, Satisfaction, and Knowledge in Heart Failure Clinical Knowledge were measured pre- and post-HFHFS education.

Results

The results of the high-fidelity simulation education for heart failure showed that students achieved a mean score of 45.39 (SD = 7.88) in self-efficacy, 18.70 (SD = 3.38) in satisfaction, and 64.09 (SD = 10.86) in knowledge after the intervention. The paired-sample t-test significantly improved between the pre- and post-intervention scores (P < 0.001). The students highly rated self-efficacy, student satisfaction, and knowledge because of the positive impact on the teaching effectiveness of simulation design (i.e., objectives, problem-solving, student support, fidelity, debriefing) activity that included the application of quality safety education for nurses (QSEN) three competencies safety, patient-centered care, and teamwork and collaboration during nursing care for patients with acute heart failure. The teaching effectiveness of the heart failure high-fidelity simulation education is closely correlated with student satisfaction, self-efficacy, and improvement of participant knowledge in clinical nursing skills performance and critical thinking.

Conclusion

A heart failure high-fidelity simulation education established upon the National League for Nursing (NLN) Jeffries framework enhanced student knowledge, satisfaction, self-efficacy, application of safety, patient-centered care, and teamwork and collaboration. Nurse educators should consider simulation planning to include the five simulation design characteristics, i.e., objectives, problem-solving, student support, fidelity, and debriefing, while integrating safety, patient-centered care, and teamwork and collaboration to bring about education effectiveness.

Effect of rapid cycle deliberate practice in peripheral intravenous catheters insertion training: A simulation experimental study

AIM

to compare the effect of rapid cycle deliberate practice simulation training with skill-training simulation on peripheral intravenous catheter insertion for Licensed Practical Nurses.

BACKGROUND

The use of peripheral intravenous catheters is associated with high rates of complications, although it is widely used in clinical practice. Training strategies to ensure good performance can minimize the risks inherent to this procedure.

DESIGN

A randomized simulation experimental pre-post interventional study.

METHODS

Sixty participants were allocated to intervention (n = 30) or control (n = 30) groups. Participants allocated to the intervention group were trained through the Rapid cycle deliberate practice simulation strategy, while participants in the control group were trained through the skill-training simulation strategy. A pre-test was applied before any intervention and a post-test after intervention. The primary outcome was the performance in the peripheral intravenous catheter insertion skill. The comparison of correct performance in the tests was analyzed intergroup and intragroup. The effect size of the interventions was also analyzed. The t-Student and Mann-Whitney tests compared the difference between the groups. The training effect was calculated by Cohen's dm and Glass's Δ measures.

RESULTS

Performance between the pre-post-test increased from 59.4% to 96% (p < 0.001) in the intervention group and from 57.8% to 93.5% in the control group (p < 0001). There was no statistical difference between the groups after intervention (p = 0225). Cohen's dm measurement was 2.95 and 3.59 in the control and intervention groups, respectively.

CONCLUSIONS

The rapid cycle deliberate practice simulation strategy resulted in Licensed Practical Nurses' performance improvements in peripheral intravenous catheter insertion, evidenced by the increase of correct performance actions in the post-test compared to the pre-test. However, with no statistical difference compared to the skill-training simulation strategy.

Is Virtual Patient Simulation Superior to Human Patient Simulation: A Randomized Controlled Study

Virtual and human patient simulation methods offer an effective way to increase patient safety, reduce the incidence of errors, and improve clinical decision-making skills. The study was conducted to compare the effects of virtual and human patient simulation methods on performance, simulation-based learning, anxiety, and self-confidence with clinical decision-making scores of nursing students. A quasi-experimental, stratified, randomized controlled study was conducted with third-year nursing students. The students (n = 166) were divided into experimental and control groups. The difference between the pretest-posttest scores of intragroup nursing anxiety and self-confidence with clinical decision-making and total and sub-scale scores of in-group simulation-based learning were statistically significant ( P < .05). Performance scores were found to be statistically significantly high in the virtual patient simulation group ( P < .001). It was determined that virtual patient simulation was superior to other methods in terms of nursing anxiety and self-confidence with clinical decision-making, simulation-based learning, and performance scores.

Training nursing students in motivational interviewing for alcohol misuse: A mixed method study

BACKGROUND

Motivational interviewing led by nurses has been demonstrated to be effective in reducing alcohol consumption among university students. However, most of these professionals feel that they lack the competence necessary for motivational interviewing due to a lack of formal training in the nursing curriculum.

OBJECTIVES

To design, implement and evaluate a motivational interviewing training course for alcohol misuse in an undergraduate nursing curriculum and to explore students' experiences with this course.

DESIGN

A mixed-methods study involving a descriptive comparative quantitative design and qualitative focus group interviews with nursing students.

SETTINGS

An elective nursing course in a Spanish university.

PARTICIPANTS

A total of 21 fourth-year nursing students.

METHODS

The course was developed as a twelve-week, two-hour course. It comprised three modules covering the concepts, tools and skills associated with motivational interviewing for alcohol misuse. Quantitative and qualitative data were collected after the completion of the course to evaluate the training received by students; these data were categorized using Kirkpatrick's model. The quantitative results included students' satisfaction, knowledge, skills and attitudes, which were measured using an ad hoc questionnaire, a multiple-choice exam, and two rater-based assessments (the Peer Proficiency Assessment instrument and an evidence-based checklist). Qualitative focus groups were used to explore students' experiences of the entire programme.

RESULTS

Students' satisfaction with the course was rated 9 out of 10, highlighting the usefulness and adequacy of the course content. The quantitative and qualitative results both indicated that all students acquired the knowledge necessary to perform motivational interviewing and significantly improved their motivational interviewing microskills. Only half of the students reached the level of proficiency in two of the three ratios calculated. The three main themes identified pertained to the learning atmosphere, module methodologies, and students' self-perceptions of competence. Finally, the students reported having transferred their learning to clinical practice.

CONCLUSION

A course on motivational interviewing for alcohol misuse positively influences nursing students both personally and in terms of their future professional work by improving their knowledge, skills, attitudes and self-perceived competence.

Next Generation NCLEX: Why Simulation Matters

BACKGROUND

The Next Generation NCLEX (NGN) is designed to specifically measure nursing clinical judgment. Schools of nursing are looking for ways to better integrate nursing clinical judgment into their curriculum. One effective strategy to promote nursing clinical judgment is simulation.

METHOD

This article explains how to conduct simulations that follow the National Council of State Boards of Nursing Clinical Judgment Measurement Model (NCJMM). Focusing on layer three of the NCJMM, specific examples are provided that link each step of layer three to nursing clinical judgment using simulation.

RESULTS

Beginning with Recognizing Cues, the simulation focuses on each step of layer three ending with Evaluating Outcomes. The simulation concludes with a debriefing session to solidify relationships between the variables.

CONCLUSION

Simulation has the potential to improve nursing clinical judgment as well as pass rate on the NGN. [J Nurs Educ. 2023;62(5):285-289.].

Simulation-based training program on patient safety management: A quasi-experimental study among new intensive care unit nurses

BACKGROUND

Patient safety is an essential responsibility of nurses. However, newly graduated nurses experience patient safety incidents due to a lack of patient safety competency. In particular, intensive care unit nurses provide care to critical patients, making it difficult for new nurses to maintain patient safety. Therefore, it is necessary to improve the patient safety competency of newly graduated nurses working in the intensive care unit.

OBJECTIVES

To analyze the effects of a simulation-based training program on patient safety management on the patient safety competency, patient safety management activity, communication self-efficacy, and teamwork of newly graduated nurses working in an intensive care unit.

DESIGN

A quasi-experimental study.

SETTINGS

The study was conducted at a university in Korea.

PARTICIPANTS

A total of 44 newly graduated nurses working in the intensive care unit of a university hospital.

METHODS

A simulation-based training program on patient safety management was applied to the experimental group (n = 22), while only the usual hospital training program was used for the control group (n = 22). A structured questionnaire survey comprising Patient Safety Competency Self-Evaluation, Patient Safety Management Activities, the Korean version of the self-efficacy questionnaire, and K-self assessment of teamwork was conducted at baseline test (T1), post test (T2), and follow-up test (T3). Data were analyzed using a repeated measures ANOVA.

RESULTS

The experimental group showed significantly higher patient safety competency, patient safety knowledge, and patient safety skills, along with higher communication self-efficacy scores than the control group (p < .05) after the intervention and at four weeks after the intervention.

CONCLUSIONS

The simulation-based training program on patient safety management effectively improved the patient safety competency, patient safety knowledge, and patient safety skills as well as communication self-efficacy of newly graduated nurses working in an intensive care unit.

Analysis of hot spots and frontiers of nursing scenario simulation teaching research at home and abroad

OBJECTIVE

To analyze the research hotspots and trends of nursing scenario simulation teaching at home and abroad, and to provide reference for future nursing talent education.

METHODS

CNKI and Web of Science databases were searched. From the establishment of the database to April 2022, relevant literature on nursing scenario simulation teaching research at home and abroad was retrieved, and Cite Space software was used for visual analysis.

RESULTS

The research focus on China was the application and application effect of nursing scenario simulation teaching. The research hotspots abroad are the quality evaluation, reliability and influence of nursing scenario simulation teaching.

CONCLUSION

The research and development of nursing scenario simulation teaching gradually tend to be systematic.

Second-year undergraduate nursing students' experiences with clinical simulation training in mental health clinical practice: A focus group study

AIM

The aim of this focus group study was to investigate second-year undergraduate nursing students' experiences with clinical simulation training as part of their clinical practice in acute mental health care.

BACKGROUND

The quality of bachelor programmes in nursing has been criticised for lacking theoretical and experiential learning in the mental health modules. Novice nurses feel unprepared to care for patients with mental health challenges and graduate nurses are reported to lack the necessary knowledge and skills to manage patients with mental health issues confidently and competently. Clinical simulation training can facilitate the teaching of clinical and non-clinical skills simultaneously and is a highly suitable method within mental health care for addressing gaps in knowledge and skills in communicating with patients. Clinical simulation training may enhance nursing students' competence and thereby reduce the risk of adverse events and increase safety. However, we know little about undergraduate nursing students' experiences with clinical simulation training as an integrated part of nursing students' clinical practice in acute mental health wards.

DESIGN

Explorative qualitative focus group study.

METHOD

Three focus group interviews were conducted using a semi-structured interview guide with second-year undergraduate nursing students from a university in Norway during spring 2020. In total, 14 students who had experienced clinical simulation training as part of their mental health clinical practice participated in the study. The collected data were analysed using systematic text condensation.

RESULTS

Clinical simulation training as part of the clinical practice increased the students' preparedness, coping and self-awareness. Most of the participants had positive perceptions of the use of high-fidelity simulation-based learning. Furthermore, they highlighted three elements that increased the value of the training. First, the simulation felt authentic and increased their professional skills. Second, the standardised patient had clinical qualifications, which made the simulation feel authentic and close to realistic situations. Third, not having a former relationship with the person acting as the standardised patient enhanced authenticity.

CONCLUSION

Clinical simulation training as part of clinical practice contributed to increasing the students' self-awareness and in-depth reflection and to broadening their nursing competence. The present study lays the groundwork for future studies on clinical simulation training in mental health clinical practice for nursing students.

The effect of two simulations on students' knowledge and skills regarding physical health problems of psychiatric patients: A mixed-method study

BACKGROUND

Simulation-based training can help nursing students improve their mental and physical healthcare knowledge and skills.

OBJECTIVES

This study focused on two different simulation modalities and investigated whether they helped nursing students acquire knowledge and develop skills necessary to address the physical health problems of people with mental disorders.

DESIGN

This is a mixed-method study.

SETTINGS

This study was conducted in Turkey.

PARTICIPANTS

The sample consisted of 61 students divided into two experimental groups and one control group.

METHODS

One experimental group participated in a clinical simulation scenario involving a standardized patient modality, while the other participated in a hybrid simulation modality (standardized patient and high-fidelity model simulator). The control group participated in conventional training. The researchers evaluate the effect of the modalities and conventional training on clinical practice one month after the interventions. Focus group interviews were conducted with all participants one month after the evaluation. Knowledge test was administered to all participants before the intervention, after the intervention, at the third and sixth months after the intervention.

RESULTS AND CONCLUSION

The clinical simulation was statistically effective for students' skill development about physical health problems of psychiatric patients. Also, in the qualitative findings, the clinical simulation increased the knowledge level of the students and improved their physical health assessment skills. Standardized patient simulation and hybrid simulation modalities should be used to help nursing students develop their assessment skills regarding the physical health problems of psychiatric patients.

Efficacy and influencing factors of the four-step approach combining the situational simulation teaching method in the clinical practice of standardized training for residents

Background and Aims

Clinical skills practice is an essential component in standardized residency training. However, traditionally skill training methods are dogmatic and not all residents are exposed to such prescribed situations during their residency. The aims of this study were to evaluate the effectiveness and influence factors of a four-step approach combining situational simulation teaching methods in clinical practice for residents.

Methods

Enrolled all second-year residents from the internal medicine base between May 2017 and May 2018 (n = 94), randomly divided into two groups. Forty-eight residents were selected as experimental group, while the others 46 as the control group. Adopted traditional clinical practice method in the teaching and assessment of the control group, while used four-step approach combining situational simulation teaching method in experimental group. We compared the theoretical and skill assessment scores in preclass and postclass. Conducted a satisfaction survey after class and analyzed the influencing factors of the teaching effect evaluation.

Results

There were no significant differences in the theoretical and skill assessment scores between experimental group and control group at the beginning. After the class, both the average skill assessment and Direct Observation of Procedural Skills scores of the experimental group were higher than those of the control. Satisfaction survey findings identified that the experimental group expressed higher satisfaction. Logistic regression showed that educational background, "situational simulation mode helps to improve clinical skills training," "helps to maintain attention during learning," and "helps improve the ability to exercise analysis and solve problems" were the influencing factors of learners' satisfaction.

Conclusion

The application of four-step approach combining situational simulation teaching methods in the clinical practice of residents can significantly improve skills, thinking ability, decision-making ability, and teaching satisfaction. Therefore, four-step approach combining situational simulation teaching methods is worth promoting in teaching clinical skills for internal medicine residency training.

Evaluation of a Nursing-Focused Training and Education Strategy for a Facility Transitioning to a Level I Pediatric Trauma Center

Background Increasing numbers of facilities are pursuing verification as pediatric trauma centers. Nurses need effective training to provide optimal care for pediatric trauma patients. This study evaluated the implementation of a nursing-focused education strategy that accompanied the process of opening a pediatric trauma center. Method Training comprised a lecture series, skills stations, and simulation. Participation was recorded. Pre- and post-training surveys were used to evaluate effectiveness. Results Participation in training was high (lectures, n = 185; skills stations, n = 151; simulation, n = 301). Survey responses indicated an increased confidence to treat pediatric trauma patients (2 out of 5 vs. 3 out of 5; p < .001). Nearly half (49.1%) of the nurses found simulations to be the most effective element of training on the post-training survey. Conclusion High participation and improved confidence indicate a feasible and effective training curriculum. Simulation was perceived as the most effective training modality. [J Contin Educ Nurs. 2022;53(9):405-410.].