Clinical judgment, person-centered care and professionalism: A transmodal ordered network analysis of student performance in virtual patient simulations

Abstract

Background

Few studies have connected nursing students’ performance in simulations to clinical competencies exemplified in The Essentials and the NCJMM. This retrospective study examined the effectiveness of screen-based virtual patient simulations (VPS) in facilitating ten undergraduate prelicensure students’ practice of clinical judgment, person-centered care, and professionalism.

Methods

Multimodal transcripts capturing patient interactions, exam actions, and documentation in a gerontology and mental health scenario were analyzed using Transmodal Ordered Network Analysis (T/ONA). We examined the strength and order of connections students made to recognizing cues, analyzing cues, diagnosing and prioritizing hypotheses, generating solutions, evaluating outcomes, subjective assessment, therapeutic communication, and care-management and coordination.

Findings

Both scenarios afforded opportunities for students to gather comprehensive data and make evidence-based and patient-centered care decisions. However, students’ patterns of connection making were significantly different for virtual patients who presented palliative care versus mental health care needs.

Conclusion

The assurance for nursing students’ practice readiness can be realized through careful implementation of diverse assignment types and scenarios in VPS. T/ONA provides a novel and systematic approach for studying student behaviors in simulations.