Clinical Simulation in Nursing最新文献_第3页

Use of the Anesthetists’ Non-technical Skills (ANTS) Framework with screen-based simulation for nurse anesthetists 将麻醉师非技术技能（ANTS）框架与基于屏幕的麻醉师护士模拟训练相结合

IF 3.4 3区医学 Q1 NURSING

Clinical Simulation in Nursing

Pub Date : 2024-11-02 DOI: 10.1016/j.ecns.2024.101641

Winifred Hwang DNP, CRNA, Staff CRNA , Jeffrey A. Groom PhD., CRNA, FSSH , Suzan Kardong-Edgren PhD, RN, ANEF, CHSE, FSSH, FAAN , Virginia C. Simmons DNP, CRNA, CHSE-A, FAANA, FAAN

Background

Non-technical skills (NTS) include situational awareness, teamwork, decision making, and leadership. Intraoperative errors and adverse patient outcomes are associated with providers lacking NTS. Screen-based simulation (SBS) can be used to teach NTS.

Methods

Using Kane's validity framework, the validity of a multiplayer SBS versus manikin-based simulation (MBS) as a platform for NTS education and assessment of Certified Registered Nurse Anesthetists (CRNA) using the Anesthetist's NTS (ANTS) Framework was examined. Scripted scenarios were recorded in a commercial platform for SBS and mirrored in a MBS. Expert panelists completed the SBS scenario, and rated performances, SBS fidelity, and platform utility.

Results

Expert panelists agreed the scenario was relevant to CRNA practice, ANTS was an appropriate assessment tool with SBS, and the SBS platform was appropriate for CE activities yet inappropriate for high-stakes assessments. Kane's extrapolation inference was supported, while scoring, generalization, and implication inferences require further investigation.

Conclusions

The evaluated SBS platform and scenario could be used to teach CRNAs NTS, yet the use of SBS for high-stakes assessments requires further validation.

背景非技术技能（NTS）包括态势感知、团队合作、决策和领导力。术中失误和不良的患者预后与缺乏 NTS 的医疗人员有关。方法采用 Kane 的有效性框架，使用麻醉师非技术技能（NTS）框架，研究多人 SBS 与基于人体模型的模拟（MBS）作为注册麻醉师（CRNA）NTS 教育和评估平台的有效性。在 SBS 商业平台上录制了脚本情景，并在 MBS 中进行了镜像。专家组成员完成了 SBS 情景，并对表演、SBS 真实度和平台实用性进行了评分。结果专家组成员一致认为，该情景与急诊麻醉师的实践相关，ANTS 是与 SBS 相匹配的评估工具，SBS 平台适合 CE 活动，但不适合高风险评估。凯恩的外推法推论得到了支持，而评分、概括和暗示推论则需要进一步研究。结论经评估的 SBS 平台和情景可用于向注册急诊护士教授 NTS，但将 SBS 用于高风险评估需要进一步验证。

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引用次数: 0

Clinical judgment, person-centered care and professionalism: A transmodal ordered network analysis of student performance in virtual patient simulations 临床判断、以人为本的护理和专业精神：对虚拟病人模拟中学生表现的跨模式有序网络分析

IF 3.4 3区医学 Q1 NURSING

Clinical Simulation in Nursing

Pub Date : 2024-11-02 DOI: 10.1016/j.ecns.2024.101622

Mamta Shah PhD , Amanda Davis PhD , Muhammad H. Ashiq , Yeyu Wang MS , Brendan Eagan PhD , Francisco Jimenez PhD , Cheryl L. Wilson DNP , David Williamson Shaffer PhD

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.

背景很少有研究将护生在模拟中的表现与《要点》和 NCJMM 中规定的临床能力联系起来。这项回顾性研究考察了基于屏幕的虚拟病人模拟（VPS）在促进 10 名本科执照前学生实践临床判断、以人为本的护理和专业精神方面的有效性。方法使用跨模态有序网络分析（T/ONA）分析了老年学和心理健康情景中病人互动、检查操作和记录的多模态记录。我们考察了学生在识别线索、分析线索、诊断和确定假设的优先次序、产生解决方案、评估结果、主观评估、治疗沟通以及护理管理和协调等方面建立联系的强度和顺序。然而，对于提出姑息治疗需求的虚拟病人和提出精神健康护理需求的虚拟病人，学生的联系模式有明显不同。T/ONA为研究学生在模拟中的行为提供了一种新颖而系统的方法。

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引用次数: 0

2024 to 2027 Research Priorities continue to mirror INACSL's core values 2024 年至 2027 年的研究重点继续体现国际南极科学院的核心价值

IF 3.4 3区医学 Q1 NURSING

Clinical Simulation in Nursing

Pub Date : 2024-11-01 DOI: 10.1016/j.ecns.2024.101650

Kelly L. Rossler PhD, RN, CHSE, CNE, Denise Campbell DNP, APRN, ACNS-BC-CEN, CHSE-A

引用次数: 0

Prebriefing in simulation from the nursing student perspective: A qualitative descriptive study 从护理专业学生的角度看模拟教学中的前期简报：定性描述研究

IF 3.4 3区医学 Q1 NURSING

Clinical Simulation in Nursing

Pub Date : 2024-10-31 DOI: 10.1016/j.ecns.2024.101634

Brittany A. Brennan PhD, RN, CHSE, CNE, Wayne Hintz MSN, RN, Renee’ Zacher MSN, RN

Background

Prebriefing is the phase of simulation before the scenario to assist learners to meet learning objectives. The purpose of this study is to explore nursing students’ experiences with prebriefing and their descriptions of factors in prebriefing they feel facilitate or hinder learning.

Methods

A qualitative descriptive study design using focus groups was guided by Experiential Learning Theory. Participants were purposively sampled from a Midwestern university in the US. Content analysis was used to analyze data.

Results

Twenty-five participants across three focus groups identified four main categories: preparation should give a clear picture of the simulation, get in the right mindset in briefing, there's a disconnect between preparation and briefing, and outcomes of prebriefing. Subcategories further delineated these findings.

Conclusions

Findings underscore the necessity for integrated preparation and briefing phases in prebriefing, emphasizing clarity, relevance, and timing of information delivery. These insights inform the development of tailored prebriefing strategies to enhance educational outcomes in healthcare simulations.

背景预习是模拟情景前的一个阶段，目的是帮助学习者达到学习目标。本研究的目的是探讨护理专业学生对预汇报的体验，以及他们对预汇报中促进或阻碍学习的因素的描述。方法以体验式学习理论为指导，采用焦点小组的定性描述研究设计。参与者从美国中西部一所大学有目的地抽取。结果三个焦点小组的 25 名参与者确定了四个主要类别：准备工作应清楚地说明模拟情况、在简报中保持正确的心态、准备工作和简报之间存在脱节以及简报前的结果。结论研究结果表明，有必要在简报前综合准备和简报阶段，强调信息传递的清晰度、相关性和时间安排。这些见解为制定量身定制的简报前策略提供了参考，以提高医疗模拟的教育效果。

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引用次数: 0

Rapid cycle deliberate practice for an ECMO emergency simulation training for nurses: A quasi-experimental study 护士 ECMO 急救模拟培训的快速循环刻意练习：准实验研究

IF 3.4 3区医学 Q1 NURSING

Clinical Simulation in Nursing

Pub Date : 2024-10-30 DOI: 10.1016/j.ecns.2024.101630

Bakker Gabriela Barcellos MSc, RN , Campos Juliana Faria PhD, RN , Oliveira Hudson Carmo PhD, RN , Busquet Ferreira Luciana Lopes MSc,RN , Reis Luciana MSc, RN , Santos Pires Paula Rodrigues MSc, RN

Background

The air entering the ECMO circuit is considered a mechanical emergency with a high mortality rate. Team training for nurses is necessary to handle these emergencies.

Method

Quasi-experimental pre- and post-intervention study. Data were collected from October 2021 to February 2022 at a hospital in Rio de Janeiro, Brazil. The intervention was the Rapid Cycle Deliberate Practice simulation training. The analysis included comparing performance between pre and post-test, time to action, and satisfaction and self-confidence. Inferential statistics and intervention effect size were calculated.

Results

28 nurses participated in the research. Performance scores increased by 44.1% in the post-test, with an average reduction of 3.54 minutes in time spent on actions (p < .0001). The effect size of the intervention was high, and participants were satisfied and self-confident.

Conclusion

RCDP can be applied as a simulation strategy for training in the management of an arterial air ECMO emergency, with improved participant performance.

背景进入 ECMO 循环的空气被认为是一种机械性紧急情况，死亡率很高。有必要对护士进行团队培训，以处理这些紧急情况。数据收集时间为 2021 年 10 月至 2022 年 2 月，地点在巴西里约热内卢的一家医院。干预措施为快速循环慎重实践模拟训练。分析包括比较测试前后的表现、行动时间、满意度和自信心。结果28名护士参与了研究。测试后的成绩提高了 44.1%，行动时间平均减少了 3.54 分钟（p < .0001）。结论 RCDP 可作为动脉空气 ECMO 紧急情况处理培训的模拟策略，并能提高参与者的表现。

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引用次数: 0

Comparing two online learning activities addressing interprofessional approach on health science students’ attitudes towards teamwork 比较两种针对跨专业方法的在线学习活动对健康科学专业学生团队合作态度的影响

IF 3.4 3区医学 Q1 NURSING

Clinical Simulation in Nursing

Pub Date : 2024-10-30 DOI: 10.1016/j.ecns.2024.101638

Derya Uzelli RN, PhD , Esra Akın RN, PhD , Derya Özer Kaya PT, PhD , Gülşah Kaner Tohtak ND, PhD , Bumin Nuri Dündar MD , Duygu Yıldırım RN, PhD , Gamze Çalık ND, MSc , Merve Keskin PT, MSc

Background

Physical distancing restrictions during the COVID-19 pandemic led to the transition from in-person to online learning for many health sciences educators. This study was conducted to compare the effects of two online learning activities addressing interprofessional teamwork on health science students’ attitudes towards teamwork.

Methods

This study was designed as a randomized quasi-experimental study. The nursing (n = 30), physiotherapy and rehabilitation (n = 30), and nutrition-dietetics (n = 30) students were assigned to either online standardized patient simulation (n = 45) or online case analysis (n = 45) groups. Students’ attitudes towards interprofessional teamwork were collected pre- and post-test evaluation using the TeamSTEPPS Teamwork Attitudes Questionnaire (T-TAQ).

Results

No significant differences were found between T-TAQ mean scores prior the intervention (p > .05). However, following the intervention, whilst the T-TAQ mean scores were not found to be statistically significant between the two groups (p > .05), the students’ pretest and posttest T-TAQ mean scores did show a statistically significant difference (p < .05).

Conclusion

We found online learning activities to be a successful alternative to physical interprofesional education activities and a worthwhile opportunity to develop health science students to interprofesional teamwork.

背景COVID-19大流行期间的物理距离限制导致许多健康科学教育工作者从面对面学习过渡到在线学习。本研究旨在比较两种针对跨专业团队合作的在线学习活动对健康科学专业学生团队合作态度的影响。护理学（n = 30）、物理治疗和康复（n = 30）以及营养饮食学（n = 30）的学生被分配到在线标准化病人模拟（n = 45）或在线案例分析（n = 45）组。使用TeamSTEPPS团队合作态度问卷（T-TAQ）收集学生在测试前后对跨专业团队合作的态度。结果在干预前，T-TAQ平均分之间没有发现显著差异（p > .05）。然而，在干预之后，虽然发现两组之间的 T-TAQ 平均分没有统计学意义（p >.05），但学生在测试前和测试后的 T-TAQ 平均分确实显示出统计学意义上的显著差异（p <.05）。

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引用次数: 0

Effects of immersive virtual reality simulation–based maternity nursing education: A randomized controlled trial 沉浸式虚拟现实模拟产科护理教育的效果：随机对照试验

IF 3.4 3区医学 Q1 NURSING

Clinical Simulation in Nursing

Pub Date : 2024-10-30 DOI: 10.1016/j.ecns.2024.101631

Sookyung Jeong PhD , Chiyoung Cha PhD

Background

We investigated the impact of an immersive virtual reality (IVR)-based scenario simulation education program as an alternative to traditional maternity nursing practicums.

Method

A simulation maternity nursing class at Wonkwang University in South Korea was conducted with 59 junior nursing students (experimental group = 30, control group = 29). This randomized controlled trial evaluated the effects of the IVR simulation on students’ knowledge, satisfaction, self-efficacy, and confidence in delivering nursing care. We conducted data collection from September 2021 to February 2022. SPSS version 25.0 was used for data analysis.

Results

Both groups’ most common previous-semester grade was B, followed by A and C. In the experimental group, 17 participants reported high or very high satisfaction, and 12 in the control group reported high satisfaction. The groups showed significant differences in knowledge (p = .024), satisfaction (p < .001), self-efficacy (p = .018), and confidence (p < .001) in normal vaginal delivery nursing care.

Conclusions

Compared to traditional simulation, IVR simulation can enhance maternity nursing students’ knowledge, satisfaction, self-efficacy, and confidence.

背景我们研究了基于沉浸式虚拟现实（IVR）的情景模拟教育项目作为传统产科护理实习替代方案的影响。方法在韩国圆光大学为 59 名大三护理专业学生开设了模拟产科护理课程（实验组=30 人，对照组=29 人）。这项随机对照试验评估了 IVR 模拟对学生提供护理服务的知识、满意度、自我效能和信心的影响。我们从 2021 年 9 月至 2022 年 2 月进行了数据收集。结果两组学生最常见的上学期成绩都是 B，其次是 A 和 C。在实验组中，有 17 名学生表示很满意或非常满意，对照组中有 12 名学生表示很满意。两组在正常阴道分娩护理知识（p = .024）、满意度（p <.001）、自我效能感（p = .018）和信心（p <.001）方面均有显著差异。

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引用次数: 0

Scenario-based simulation training, occupational burnout and psychological capital in hospital-based nursing instructors: A cross-sectional study 医院护理讲师的情景模拟训练、职业倦怠和心理资本：横断面研究

IF 3.4 3区医学 Q1 NURSING

Clinical Simulation in Nursing

Pub Date : 2024-10-30 DOI: 10.1016/j.ecns.2024.101615

Bingbing Li , Jiabao Ju , Xiaohong Sun , Jinyu Guo , Chao Gao , Sanli Jin , Yan Zhang

Aim

This study aimed to scrutinize the extent of engagement in the implementation of scenario-based simulation training within hospital settings and the status of occupational burnout and psychological capital among nursing instructors.

Methods

This research spanned from August 2022 to June 2023. A total of 172 nursing instructors from 67 hospitals participated in an electronic survey, which included knowledge, attitudes, and practices questionnaires related to scenario-based simulation training, the Maslach burnout inventory-general survey for assessing occupational burnout, and the 24-item Psychological Capital Questionnaire.

Results

The findings revealed that the average scores for knowledge and attitude in scenario-based simulation training among the 172 nursing instructors were (54.85 ± 13.26) and (76.55 ± 28.82), respectively. Out of these, 105 instructors (61.0%) have engaged in scenario-based simulation training, with an average practice score of (64.0 ± 25.4). Psychological capital emerged as a significant influencing factor on the attitudes and practices of nursing instructors in scenario-based simulation training (p = .046, p = .004, respectively). Positive correlations were observed between knowledge, attitude, and practice, while a positive association was noted between occupational burnout and psychological capital.

Conclusion

Nursing instructors exhibited a relatively low proficiency in knowledge acquisition, positive attitudinal disposition, and inadequacy in engagement concerning scenario-based simulation training. The study advocated for the augmentation of standardized training programs tailored specifically for nursing instructors in scenario-based simulation training. Additionally, the study underscored the importance of prioritizing interventions that could enhance the psychological capital of nursing instructors as a pivotal strategy to ameliorate the overall quality of simulation training.

研究目的：本研究旨在探讨护理带教人员在医院环境中参与实施情景模拟培训的程度以及职业倦怠和心理资本的状况。研究方法：本研究的时间跨度为 2022 年 8 月至 2023 年 6 月。共有来自 67 家医院的 172 名护理带教人员参与了电子调查，调查内容包括与情景模拟培训相关的知识、态度和实践问卷，用于评估职业倦怠的马斯拉赫倦怠清单--一般调查，以及 24 项心理资本问卷。其中，105 名带教老师（61.0%）参与过情景模拟培训，平均实践分数为（64.0±25.4）分。心理资本是影响护理带教人员情景模拟培训态度和实践的重要因素（分别为 p = .046 和 p = .004）。知识、态度和实践之间呈正相关，而职业倦怠与心理资本之间呈正相关。该研究提倡在情景模拟培训中加强专门为护理指导员定制的标准化培训计划。此外，该研究还强调了优先采取干预措施的重要性，这些措施可提高护理指导者的心理资本，是改善模拟培训整体质量的关键策略。

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引用次数: 0

Efficacy of simulation over live clinical rotations in nurse practitioner prenatal education: A retrospective cohort study 在执业护士产前教育中，模拟临床轮转比现场临床轮转更有效：回顾性队列研究

IF 3.4 3区医学 Q1 NURSING

Clinical Simulation in Nursing

Pub Date : 2024-10-29 DOI: 10.1016/j.ecns.2024.101640

Diana I.G. Lithgow PhD, DNP, RN, FNP-BC, FAANP , Georgia Mueller Luckey PhD, MS , Khoa Dang DNP, APRN-CNP, FNP-C

Background

Clinical simulations are often perceived by faculty as a substitute in the absence of live rotations in healthcare training, rather than the primary medium. This study aimed to evaluate efficacy of prenatal simulations by comparing prenatal exam outcomes when students experienced live prenatal clinicals to competency exam outcomes when students experienced simulation prenatal clinical only.

Method

A retrospective cohort study was used to examine data collected before and after simulation-based training that substituted for live clinical training with Family Nurse Practitioner (FNP) students. Data was collected from FNP nursing student scores on a predictor national certification exam in the prenatal category between 2015 and 2022 (4 years prior to and 4 years during simulation clinicals).

Results

During live clinical rotations, the average Prenatal Score was 66.4, and during simulation clinicals, the average Prenatal Score increased to 78.2. There was a significant difference in the average Prenatal Scores (p < .0001).

Conclusions

Case-based simulation experiences in prenatal clinical training improved student scores in the prenatal category within the predictor national certification exam taken by FNP students.

背景在医疗保健培训中，临床模拟通常被教师视为缺乏现场轮转时的替代品，而非主要媒介。本研究旨在通过比较学生经历现场产前临床和仅经历模拟产前临床时的产前检查结果，评估产前模拟的功效。方法采用回顾性队列研究，检查家庭护士（FNP）学生在模拟培训替代现场临床培训前后收集的数据。数据收集自 FNP 护理学生在 2015 年至 2022 年（模拟临床前 4 年和模拟临床期间 4 年）产前类别预测性国家认证考试中的分数。结果在现场临床轮转期间，平均产前分数为 66.4，而在模拟临床期间，平均产前分数增至 78.2。结论在产前临床培训中基于案例的模拟经验提高了全科医生学生在预测性国家认证考试中产前类别的分数。

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引用次数: 0

Operationalizing the Healthcare Simulation Standards of Best Practice (HSSOBPTM) to avoid training scars: An interprofessional exemplar 实施医疗保健模拟最佳实践标准 (HSSOBPTM)，避免培训留下疤痕：跨专业范例

IF 3.4 3区医学 Q1 NURSING

Clinical Simulation in Nursing

Pub Date : 2024-10-28 DOI: 10.1016/j.ecns.2024.101628

Loretta Aller PhD, RN, CHSE , Ashley E. Franklin PhD, RN, CNE, CHSE-A , Cynthia E. Johnson PhD, RN, CHSE , Paulo Gonzalez MA, EMT-B , Gina Nix LP

Training scars represent residual performance habits and psychological damage when facilitators or peers fail to help learners improve during training. Originally recognized by emergency response professionals, training scars negatively influence providers’ mental health, workforce attrition, patient safety, and the future of our professions. Simulation facilitators need to be mindful that learners experience training scars, particularly when patient safety events occur in simulation without enough debriefing or expert facilitation to unpack associated emotions. The purpose of this conceptual paper is to raise awareness of training scars across disciplines and to tell the story of how expert facilitation can prevent training scars after patient safety events. An interprofessional exemplar is presented with recommendations for operationalizing the Healthcare Simulation Standards of Best Practice^TM (HSSOBP^TM) to avoid simulation training scars.

培训疤痕是指在培训过程中，培训师或同行未能帮助学员改进表现时留下的习惯和心理伤害。培训疤痕最初是由应急响应专业人员认识到的，它对医疗服务提供者的心理健康、劳动力流失、患者安全和我们职业的未来都有负面影响。模拟培训师需要注意学员会留下培训疤痕，尤其是当模拟培训中发生患者安全事件而没有足够的汇报或专家协助来疏导相关情绪时。这篇概念性论文的目的是提高各学科对培训伤疤的认识，并讲述专家指导如何在患者安全事件发生后防止培训伤疤。本文介绍了一个跨专业的范例，并提出了实施《医疗保健模拟最佳实践标准》（HSSOBPTM）以避免模拟培训疤痕的建议。

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引用次数: 0