Clinical Simulation in Nursing最新文献

Background

First responders classically train to manage Mass Casualty Incidents (MCIs) by practicing incident command skills during Field Drills which mimic real-world conditions but are also costly and logistically complex to conduct. We therefore present the Sukkah Drill (named for its similarity to the hut used on the holiday of Sukkot) as an alternative, low-cost and simple innovative teaching method for MCI management. This study compares the Field and Sukkah Drills to better understand the advantages and disadvantages of this new training method.

Methods

We compared the physical design features of the Sukkah and Field Drills qualitatively. A checklist of fourteen procedural actions was used to evaluate incident commanders during six Field Drills and seven Sukkah Drills, and the rates of performance of each action compared quantitively.

Results

Despite differences in design, thirteen of fourteen procedural actions were performed at similar rates across both Sukkah and Field Drills.

Conclusions

The Sukkah Drill provides a comparable simulation experience to the Field Drill. Its simplicity and affordability may make it especially useful for lower-resource organizations.

Introduction

Sepsis is one of the leading causes of death for children. Simulation provides a framework for improvement in teamwork and communication, which are essential skills in conditions such as sepsis, where early recognition is crucial.

The purpose of this mixed methods project was to understand the effects of adding sandbox Electronic Health Record (EHR) on realism and team dynamics. This study was conducted during multidisciplinary (pediatric residents and nurses) in-situ sepsis simulations.

Methods

This study was conducted during multidisciplinary (pediatric residents and nurses) in-situ sepsis simulations.

Groups were randomized to receive EHR or paper. Team clinical times were recorded. After completion, participants completed a survey about attitudes and workload, and some completed qualitative interviews.

Results

Participants in both groups wanted to have EHR in future simulations. Differences in workload and clinical times were not significantly different. Themes that emerged were: EHR improved realism allowing for skills practice but could be a distraction. Key elements for the simulated EHR design were identified and aligned with prior literature.

Conclusions

Acute care simulations that utilized EHR were perceived by learners to improve realism and can allow for skills practice.

Background

Escalating maternal morbidity and mortality rates in the United States demand effective healthcare provider training. This study examined an interprofessional team's communication, clinical judgment, and patient safety using a high-fidelity simulator versus a wearable simulator by a standard patient.

Methods

The study employed a two-group comparative, quasi-experimental design. The intervention group used a wearable simulator, while the control group used a high-fidelity mannequin.

Results

The final sample consisted of 85 individuals (49 intervention, 33 control group). No significant differences in simulation effectiveness were observed between groups.

Conclusion

Equivalent performance outcomes suggest institutions can choose simulation modalities based on cost, availability, and logistical considerations without compromising training quality.

Background

With the wide spectrum of simulation modalities, combining different modalities may support the development of complex clinical skills that can prepare nursing students for making the transition to graduate nurse practice.

Aim

To describe the design and evaluation of a multi-modal simulation to facilitate final-year nursing students’ transition to clinical practice.

Methods

A mixed methods study design was employed to evaluate the multi-modal simulation. Pre and post-tests were conducted to evaluate final-year nursing students’ readiness for clinical practice. Individual interviews were conducted to evaluate long-term impact on clinical practice.

Result

The students reported significant improvement (p < .001) in their readiness for their clinical practice. Three themes emerged for the impact on their clinical practice: self-efficacy in clinical procedures; metacognitive awareness for transfer of learning; and beyond communication to building relationships.

Conclusion

The multi-modal simulation has an immediate effect on improving nursing students’ readiness for clinical practice. It also has a significant clinical impact on enhancing their self-efficacy in performing clinical procedures and metacognitive awareness as they migrate into the real clinical world.

Rural hospitals providing obstetric care are expected to maintain a broad variety of knowledge, skills, and abilities with low volume of occurrences, yet have limited access to continuing education and hands-on experience for high-risk situations. Women and their families experience healthcare disparities for adequate obstetrical care due to maternal deserts. To overcome these disparities, the interdisciplinary Perinatal Simulation Outreach Team (PSOT) has utilized in situ simulation to provide rural hospitals with continuing education opportunities since 2018 to reduce perinatal mortality rates, decrease maternal health disparities, and improve the quality of birth experiences. The criteria of the Healthcare Simulation Standards of Best Practice™ Simulation Design is used as a blueprint for PSOT program development. Program evaluations show in situ is a valuable learning experience that has enhanced teamwork and provided continuing education to make evidence-based practice changes for quality, safe patient care.

Background

Improving self-efficacy for nursing students to manage aggressive behaviours in clients with dementia supports better outcomes for clients. No studies have been conducted on the use of immersive virtual reality as a potential tool.

Method

A mixed-methods, randomized control trial explanatory design compared perceived self-efficacy for practical nursing students who used the CareGiVRTM virtual reality application with those who did not, using the Inventory of Geriatric Nursing Self-Efficacy (IGNSE) along with qualitative focus groups.

Results

Forty-six students (49%) participated in the quantitative component. Fifteen students elected to participate in the follow-up qualitative focus groups. Findings indicate participants who used the CareGiVRTM application reported statistically significant higher levels of perceived self-efficacy post-intervention and when compared with those in the control group following their clinical rotation. Four themes were identified: getting real-world experience, a safe place to practice, meeting the client where they are at, and a tool not a replacement.

Conclusion

Immersive virtual reality can be an effective tool to increase perceived self-efficacy for managing aggressive behaviours in clients with dementia in practical nursing students.

Background

A forensic sexual assault nurse examiner (SANE) provides specialized care for individuals who have experienced sexual assault. Because the training of new SANEs is critical for expanding the workforce, simulation and debriefing are used due to limited clinical learning opportunities with assault survivors. Debriefing following the simulation requires an expert SANE, yet very often these clinicians are new to debriefing; little is known about how expert SANEs learn to debrief.

Method

A 90-minute focus group interview was conducted with three experienced SANEs who had completed a five-video debriefing training and conducted at least two debriefings with novice SANE trainees.

Results

Inductive qualitative content analysis resulted in two primary categories and six sub-categories that described the process of expert SANEs learning to debrief.

Conclusion

Expert SANEs compared learning to debrief to learning a new language. Participants described how reflective debriefing and trauma-informed interviewing both emphasize the importance of creating a safe and supportive environment, fostering open communication, promoting self-awareness and learning, empowering individuals, and adopting a non-judgmental approach.

Healthcare simulation has emerged as an invaluable tool for training healthcare professionals, fostering clinical skills, and enhancing patient safety. In the context of simulation-based education, various debriefing modalities have been employed to maximize learning outcomes. This article examines four debriefing modalities—self-reflection, self-debriefing, facilitated debriefing, and tele-debriefing within the healthcare simulation setting. The article explores the circumstances under which each modality is appropriate, highlights the benefits they offer, and discusses the barriers that may impede their effectiveness. By comparing and contrasting these modalities, educators and practitioners can make informed decisions about the most suitable debriefing approach for their specific simulation scenarios.

Aim/Objective

This study's aim was to examine the use of simulation technologies in the form of standardized patients to enhance gender affirming assessment skills in a sample of undergraduate nursing students.

Background

Lack of provider knowledge regarding gender affirming care impacts health care for individuals who identify as lesbian, gay, bisexual, transgender, queer, and people with other expansive identities (LGBTQ+).

Design

A pre- and post-survey was used to evaluate a LGBTQ+ competency-based simulation scenario using standardized patients.

Methods

The simulation intervention was incorporated into an undergraduate medical surgical-nursing course with 70 students. Prior to taking part in the simulation experience, students completed an educational module in an open-source learning management system. The educational module compiled by the researcher included a glossary of LGBTQIA+ terms, readings, and Sexual Orientation and Gender Identity videos, a PowerPoint and a script for interviewing. On the day of the simulation students took a pre-simulation survey that was number coded in order to provide an anonymous identifier. After participating in the simulation scenario students used the same number, that coded their pre-simulation survey, to code their post-simulation survey.

Results

Wilcoxon-signed ranks test revealed that there were no significant differences between the pre- and postsurvey as a composite. However, one of the individual questions regarding addressing sexual orientation and another question regarding perceived competence in providing care demonstrated significance and trending toward significance. Also, noteworthy, were the positive student responses regarding the simulation experience.

Conclusion

Finding's from the standardized patient simulation has the potential to inform continual education interventions designed to strengthen competency at all levels of nursing practice in the provision of LGBTQ+ competent and affirming care.