Clinical Simulation in Nursing最新文献

Introduction

In recent years, the use of simulation has become integral to midwifery education. This study systematically examined the effectiveness of high- and medium-reality simulators in the management of normal labor, focusing on their impact on normal delivery skills, student satisfaction, and self-confidence in learning. The evaluation encompassed both laboratory and hospital settings, providing a comprehensive assessment of the simulators' efficacy in enhancing key aspects of midwifery education.

Material and method

In this experimental randomized controlled study, the sample group comprised 102 students enrolled in the midwifery department of a university in Türkiye. These students were randomly assigned to three groups utilizing Research Randomizer (https://www.randomizer.org). The students consisted of a control group (d1 = slide and video presentation, 30 people) and two experimental groups (d2 = medium-reality simulator, 32 people; d3 = high-reality simulator, 33 people). Data were collected by a single observer using various tools, including the Introductory Information Form, the Student Satisfaction and Self-Confidence in Learning Scale, and the Normal Birth Evaluation Form. Pre- and post-test applications were conducted in both laboratory and hospital settings. This study is registered on ClinicalTrials.org with the registration number NCT05999409.

Findings

Simulation-based learning did not lead to a significant difference between the groups in terms of students' satisfaction and self-confidence in learning (p > .05). However, it was observed that the utilization of both medium- and high-reality simulations significantly impacted students' normal delivery skills, leading to a statistically significant difference between the groups (p < .05).

Conclusion

Medium- and high-reality simulation training proved effective in enhancing the normal delivery skills of midwifery students, with a notable positive impact. However, this training did not have a significant influence on student satisfaction and confidence. The findings suggest that incorporating medium- and high-reality simulation training is crucial for midwifery students to be able to improve their skills in hospital practice.

Background

Practical education is required to address the inexperience of nursing students in operating medical devices and improve their clinical practice competencies. This study confirms the effectiveness and participant experience of extended reality training for nursing students regarding intravenous therapy using an infusion pump.

Methods

This study used a concurrent mixed methods design. Forty-six nursing students, who were initially trained virtually using a head-mounted device participated in the study, followed by practice using an actual infusion pump and arm model. Motivation to transfer learning, learning self-efficacy, and performance confidence were measured using self-report scales; competency was evaluated using an observational checklist by the co-researcher, and the data were analyzed.

Results

Motivation to transfer learning, learning self-efficacy, and performance confidence improved significantly after extended reality training, and enhanced competency was observed. Furthermore, the participants experienced design elements for effective learning, satisfaction with the learning environment, and convenience and efficiency of learning, thus realizing their needs.

Conclusion

In the future, extended reality training programs should be implemented and tested using other medical devices in nursing education.

Background

Given the projected rise in the older population and associated health challenges, there is growing interest in innovative interventions, such as virtual reality, to enhance physical and mental well-being. This systematic review examined the effectiveness of immersive virtual reality simulation programs with head-mounted displays to promote physical activity among older adults.

Methods

Studies were identified by querying PubMed, CINAHL, and Web of Science. A total of 2,365 articles were retrieved, and nine randomized controlled trials published between 2013 and 2023 were included.

Results

The studies indicated significant improvements in physical outcomes such as balance and gait, as well as psychological benefits including reduced anxiety, depression, and stress. Cognitive enhancements and improved quality of life were also noted. Despite concerns about usability and side effects, older adults found the simulation programs engaging and manageable, with minimal adverse effects reported.

Conclusion

This review highlights the promise of virtual reality with head-mounted displays for older adults, emphasizing the need for further research to optimize device design and usability and to explore long-term benefits and broader applicability.

Background

A key challenge to simulation educators is to find the most effective instructional design that would enhance participant learning.

Aim and Methods

An integrative review was undertaken to explore the effects on healthcare practitioners of team-based simulation, underpinned by the deliberate practice framework. This combines well-defined team learning objectives, set at an appropriate level, with opportunities for repetitive team practice under the expert supervision of a coach.

Results

Eight articles were identified with six emerging themes: Instructional design features, participants' performance, knowledge, confidence [self-efficacy], and rating/satisfaction.

Conclusions

The wide variation in the instructional designs, with no standardisation, made comparisons difficult. Nevertheless, studies reported positive benefits in using repeated/repetitive simulation, regardless of the design.

Background

Video technology extends the apprenticeship model, particularly through first-person perspective videos using smart glasses, to support learners’ practices. This study explored how learning and reflection are affected by first-person perspective video debriefing using smart glasses during a nursing simulation.

Methods

Inductive qualitative content analysis was conducted. A hypoglycemic case in a nursing simulation was the focus, with a 1:1 debriefing supported by a first-person perspective video using smart glasses. Sixteen South Korean nursing students enrolled in a baccalaureate program were selected using purposive sampling. Data was collected in December 2023.

Results

Students’ perceptions of the impact of smart glasses on learning and reflection in nursing simulation education were organized into four categories: “evaluation of the simulation design,” “benefits of debriefing using smart glasses,” “empowering learners,” and “challenges of debriefing using smart glasses.”

Conclusion

First-person perspective video debriefing using smart glasses can improve learners’ competency through reflection. However, it needs improvements related to the awkwardness and inconvenience of wearing smart glasses, the limited field of view, and the time required for familiarization with its operation.

Background

The COVID-19 pandemic disrupted nursing students' clinical training, resulting in under preparedness of novice nurses in acute care hospitals due to gaps in knowledge and skills. Portable simulation-based education programs could be used to meet nurses’ learning needs.

Methods

The Mobile Skills and Simulation Cart (MSSC) program was developed based on needs assessment, followed by implementation and a mixed methods program evaluation.

Results

A total of 688 session evaluations were completed by nurses who participated in the MSSC program indicating they were extremely satisfied with the program and reported increased knowledge. It improved nurses’ confidence and skills. Additionally, during the program evaluation phase, 32 nurses who participated in MSSC sessions, along with sixteen clinical leaders, reported integration of learning into clinical practice. Patient safety incident reports showed fewer chest tube issues, and increased safety surrounding heparin infusion practices. Overall, nursing turnover remained stable with early signs of potential improvement and increased morale.

Conclusion

The MSSC has proven effective in enhancing nurses’ knowledge, confidence, and comfort with skills. Simulation may positively impact patient care and safety, with early indications of potential benefits on nursing turnover.

Advanced Practice Providers (APPs) are widely regarded as key members of the interprofessional healthcare team. To build collaborative practice behaviors (CPB), APPs must receive simulation-enhanced interprofessional education (Sim-IPE); however, the integration of APPs in Sim-IPE is inconsistent. Expanding inclusion of APPs in Sim-IPE can include the integration of remote modalities, virtual reality, and high-fidelity simulation. Complexities in providing APPs with Sim-IPE include the availability of resources and competing clinical availability with other healthcare team members. Optimizing interprofessional education for APPs must be a priority, as APPs are prominent members of the healthcare team and Sim-IPE can improve collaborative practice behaviors.

Background

There is a need to understand the clinical decision-making and work practices within ostomy nursing care to support expanding nursing training.

Objective

To develop and evaluate a new metric-based simulation for assessing ostomy nursing care using a human factors approach.

Sample

This pilot study involved eleven stakeholders in the needs assessment, six nurse participants performing simulated ostomy care, and three independent observers assessing procedure reliability.

Method

We conducted a needs assessment of ostomy nursing care and training, developed an enhanced metric-based simulation for ostomy appliance change procedures, and statistically evaluated its reliability for measuring the simulated tasks.

Results

The enhanced metric-based simulation captured different tasks within four task categories: product selection; stoma and peristomal skin care; baseplate sizing and adhesion; and infection control strategies. The video review procedure was reliable for assessing continuous (average ICC≥0.96) and categorical (average κ>0.96) variables.

Conclusion

The new metric-based simulation was suitable for characterizing a broad range of clinical decision-making and work practices in ostomy nursing care.

Background

Safe medication administration remains a crucial element of nursing practice. Immersive virtual reality simulation is one modality to train on safe medication behaviors.

Methods

Three patient care scenarios focused on human and system factors contributing to mediation administration errors were developed for use in the immersive, virtual environment. Face and content validity was conducted to explore usability.

Results

Registered nurses from academia and practice provided feedback on usability and in portraying core competencies of medication administration.

Conclusions

Findings support the need to test this platform in diverse settings with novice and expert nurses.

Objectives

To develop and validate a simulation scenario focusing on the nursing process applied to children with respiratory diseases and their families, and to implement the simulation scenario with nursing students.

Method

Methodological study carried out in two phases: (a) Construction of the simulation scenario with a recurrent case in pediatrics and validation by experts; (b) Testing and implementation of the simulation scenario.

Results

The scenario was validated on all items (CVI >90%) by 11 experts and the suggested adjustments were incorporated into the final version. The implementation was carried out with 26 students, who obtained good knowledge scores with use of the nursing process, satisfaction, and self-confidence from the simulation and achieved satisfactory quality nursing care plans. Most of the outcomes showed excellent reliability (>0.90) and positive correlations were identified between debriefing and self-confidence (p < .05), knowledge and the quality of the nursing process record (p < .01), and self-confidence and the formulation of nursing diagnoses (p < .05).

Conclusion

The simulation scenario can contribute to teaching the nursing process applied to child health, promoting innovations in teaching-learning strategies at the undergraduate or continuing education teaching levels in pediatrics.