Using High-Fidelity Simulation to Introduce Communication Skills about End-of-Life to Novice Nursing Students

Designing, implementing and testing an intervention of affective intelligent agents in nursing virtual reality teaching simulations-a qualitative study

Emotions play an important role in human-computer interaction, but there is limited research on affective and emotional virtual agent design in the area of teaching simulations for healthcare provision. The purpose of this work is twofold: firstly, to describe the process for designing affective intelligent agents that are engaged in automated communications such as person to computer conversations, and secondly to test a bespoke prototype digital intervention which implements such agents. The presented study tests two distinct virtual learning environments, one of which was enhanced with affective virtual patients, with nine 3rd year nursing students specialising in mental health, during their professional practice stage. All (100%) of the participants reported that, when using the enhanced scenario, they experienced a more realistic representation of carer/patient interaction; better recognition of the patients' feelings; recognition and assessment of emotions; a better realisation of how feelings can affect patients' emotional state and how they could better empathise with the patients.

Vaccination Training for Pharmacy Undergraduates as a Compulsory Part of the Curriculum?-A Multicentric Observation

In order to increase vaccination rates, the Government of Germany introduced vaccination against influenza and COVID-19 into the regular care administered by pharmacists. However, vaccination training is yet not integrated into the German pharmacy curriculum. Therefore, the Institute for Clinical Pharmacy and Pharmacotherapy in Duesseldorf had developed an innovative vaccination course using high-fidelity simulation for students. To investigate the acceptance further, the course was carried out at three different German universities (Bonn, Duesseldorf, Greifswald). Students were asked to give their self-assessment before and after and satisfaction only after the training course. Responses from 33 participants from the University of Bonn, 42 from the University of Duesseldorf and 49 from the University of Greifswald were analyzed. Every participant at the respective universities showed a significant increase in their self-assessment and indicated a high level of satisfaction with the course. The results also did not differ significantly between the respective universities. Consequently, the results lead to the hypothesis that the satisfaction of pharmacy students with this kind of training using high-fidelity simulation is very high and attractive, and can be recommended for other German universities. The integration of such vaccination training into the German pharmacy curriculum might be a future step.

End-of-Life Communication Skills Training for Undergraduate Nursing Students to Address Cultural Obstacles in China

Nurses face many difficulties and challenges related to how patients and their families deal with communication about end-of-life (EOL) care in China because of the strong influence of traditional Chinese culture. Moreover, education and training opportunities in EOL communication skills for nursing students are rare in mainland China. This study designed a progressive case involving a common EOL communication dilemma related to traditional Chinese culture and trained 50 undergraduate nursing students in EOL communication skills. A quasi-experimental design was used to compare the training outcomes of nursing students who were divided into a standardized patient simulation group and a role-playing group. The role-playing group (23 participants) was trained via group case discussion and role-playing among classmates, while the standardized patient simulation group (27 participants) completed EOL communication training by interacting with standardized patients and their families in a high-fidelity simulation. Attitudes toward death, self-confidence in EOL communication, and communication learning were evaluated in both groups during preintervention and postintervention. The results showed that all 3 variables improved after the intervention. This study shows that EOL communication skills training has a positive effect on nursing students to a certain extent.

Development and Assessment of Innovative High-Fidelity Simulation Vaccination Course Integrating Emergency Cases for Pharmacy Undergraduates-A Randomized Controlled Study

Recently, pharmacists in Germany were allowed to administer influenza and COVID-19 vaccines for people aged 12 years and older in order to increase vaccination coverage rates. In order to adapt the pharmacy curriculum for clinical practice, an innovative, vaccination training course using a high-fidelity simulator (HFS) was developed, implementing clinical scenarios to manage adverse events. In a randomized controlled trial using a pre and post design with pharmacy undergraduates, the intervention group interacted with an HFS, while the control group was trained with low-fidelity injection pads. Before and after the respective training, each participant went through an objective structured clinical examination (OSCE) and completed a self-assessment questionnaire and knowledge quiz. Both training methods showed a significant increase in skills, but there was also a significant greater increase in the intervention group when compared to the control group, particularly with respect to the vaccination process. Furthermore, every individual in the intervention group improved from the pre- to post-training OSCEs. Therefore, HFS has been proven to be an appropriate tool to train pharmacy students for the purposes of vaccine administration and to prepare for future challenges. Particularly, recognizing and managing adverse reactions can be addressed in a very effective way.

Vicarious learning and communication self-efficacy: A pediatric end-of-life simulation for pre-licensure nursing students

BACKGROUND

End-of-life clinical experiences, particularly in pediatrics, are quite limited for pre-licensure nursing students. Though effective, end-of-life simulations can be costly, require facilitators trained in palliative and end-of-life care, and are restricted by limited space and time availability. Such barriers prompt the question as to whether there is an effective alternative to simulation by which students can gain improved self-efficacy in therapeutic communication during pediatric end-of-life situations.

PURPOSE

Bandura's Social Cognitive Theory and work exploring self-efficacy posits that vicarious learning provides learners opportunities to gain experience and knowledge through observation of peers in simulated settings. This study evaluated the effectiveness of vicarious versus active learning on pre-licensure nursing students' perceived self-efficacy in providing therapeutic communication during a pediatric end-of-life situation.

METHOD

Data were collected over three time points - pre-simulation, post-simulation, and post-debriefing - using a modified Self-Efficacy in Communication Scale.

RESULTS

Learners in both groups had significant improvement in self-efficacy across all time points. Only two items had significant differences between vicarious and active learner groups, but the effect was minor.

CONCLUSION

Vicarious learning presents as a viable pedagogical approach for providing pre-licensure nursing students important learning opportunities related to pediatric end-of-life simulations during both the scenario and debriefing.

Creation and validation of a high-fidelity simulation scenario for suicide postvention

OBJECTIVE

to create and validate a high-fidelity simulation scenario about the initial support to suicide bereaved people.

METHOD

a methodological research study to create and validate a simulation scenario about postvention. Its creation was based on scientific recommendations, the validation process was carried out by experts, based on an instrument developed by the authors; the data were statistically analyzed using the Content Validity Index and Gwet concordance coefficient.

RESULTS

the scenario was created to provide initial support to suicide bereaved people in the Primary Health Care context. As learning objectives, welcoming, health care and organization monitoring were proposed according to technical-scientific recommendations. The scenario was validated by 10 specialists in the themes of postvention (5 judges) and high-fidelity simulation (5 judges). The scenario items met the acceptance and reliability criteria (Content Validity Index = 0.80) and satisfactory concordance (Gwet coefficient = 0.640).

CONCLUSION

the study presented in full a scenario on postvention with innovative potential that can be used free of charge in clinical simulation development during training of different categories of health professionals, to act in support of suicide bereaved people.

Efficacy of a Standardised Patient Simulation Programme for Chronicity and End-of-Life Care Training in Undergraduate Nursing Students

BACKGROUND

Standardised patient simulations seem to be useful for improving the communication skills of health sciences students. However, it is important to define the effectiveness of these types of interventions in complex scenarios linked to disease chronicity and end-of-life contexts.

METHODS

A quasi-experimental study with pre- and post-intervention measures was carried out in a single group. A total of 161 nursing students completed different assessment instruments to measure their attitudes towards communication (Attitude Toward Communication Scale), self-efficacy (Self-Efficacy of Communication Skills, SE-12), and communication skills (Health Professionals Communication Skills Scale, EHC-PS) before and after simulation training with standardised patients. The objective of the program was to train students in non-technical skills for complex situations involving chronicity and end-of-life care. It comprised eight sessions lasting 2.5 h each.

RESULTS

The results showed notable baseline gender differences in attitudes towards communication and in the informative communication dimension, with women obtaining higher scores. The participants' self-efficacy and communication skills significantly improved after completing the intervention, with no significant differences being found for the attitudes towards communication variable.

CONCLUSION

The standardised patient simulation programme for complex scenarios related to chronicity and end-of-life contexts improved communication self-efficacy and communication skills in these nursing students. In future work it will be important to analyse the influence of gender and attitudes towards communication as variables in the learning of communication skills in nursing students.