Clinical Simulation in Nursing最新文献

Background

Providers’ diagnostic skills and reasoning are essential to the health and safety of patients and the healthcare system. Simulation is a promising modality for improving diagnostic reasoning, with the ability to practice, receive feedback, and reflect in a safe learning environment.

Methods

This study used a quasi-experimental, pretest/posttest one group design to investigate the effect of a 5-week intervention screen-based simulation intervention on metacognitive awareness, knowledge, and diagnostic reasoning factors in family nurse practitioner students in their final semester of clinical coursework. Univariate descriptive statistics were used to describe demographic data and study variables. Paired sample t-tests were used to examine differences in the three study variables pre- and postintervention.

Results

In the study sample of 72 students, there were statistically significant increases (p < .001) in knowledge, metacognitive awareness, and diagnostic reasoning scores from pretest to posttest after a screen-based simulation intervention.

Conclusions

Findings of this study suggest that the overall improvement in students’ metacognition and knowledge led to an improvement in diagnostic reasoning, which could lead to accurate diagnosis and prevent errors.

Background

Standardized patient simulations are an effective method for acquiring skills and knowledge. The purpose of this study was to explore nursing students' perceptions of the learning methods used in clinical simulation.

Methods

A cross-sectional study was conducted evaluating two different clinical simulations: 1) basic simulations, where the actor/patient was the teacher, the simulations were performed in pairs, and the rest of the students were present in the same classroom; and 2) simulation-based peer-assisted learning, where the actors/patients were third-year students, the simulations were performed individually, and the rest of the students watched them from another classroom via a video recording system.

Results

In terms of their perceptions, both types of simulation scored 4.4 out of 5 on the Student Perception of Clinical Simulation tool (SD ±0.7 and ±0.8, respectively). In addition, the results of the characteristics of each simulation are presented.

Conclusions

Basic simulations helped students to internalize theoretical knowledge and gain confidence. Peer-assisted learning based on simulations increased their self-confidence and ability to predict clinical changes in patients. As a result, they felt better prepared to care for real patients. The use of both simulation modalities is a flexible method that can be adapted to educational needs.

Simulation-based experiences are increasingly integrated into educational experiences and even replacing clinical practice hours. However, it is important to provide high-quality simulation that will improve practice and, ultimately, patient care. The newly developed INACSL Endorsement program is a way for a simulation program to conduct a self review that demonstrates the application of the Healthcare Simulation Standards of the following Best Practices: Prebriefing, Facilitation, Professional Integrity, and Debriefing to all simulation-based experiences. These four Standards are known as the Cornerstones of Best Practice. Want to find out more about the Endorsement program? This article is for you!

Background

Learner engagement in distance debriefing introduces challenges for educators. The influence of complexity in a simulation scenario on debriefing engagement is unclear. This study aimed to investigate the connection between scenario complexity and educator, social, and cognitive presence during distance debriefing, and the relationships with psychological safety and mental workload.

Methods

We investigated the influence of a more complex versus less complex simulation case on debriefing engagement of healthcare professionals using a latent regression Rasch model.

Results

There was no statistical significance found in debriefing engagement of the 30 participants in the intervention (M = 109.66, SD = 16.17) versus 30 participating in the control (M = 112.42, SD = 15.30). No statistically significant difference between the intervention and control groups in team psychological safety (M = 15.00; SD = 2.07 and M = 14.52 and SD = 1.73) or in mental workload (M = 72.28; SD = 19.52 and M= 73.13; SD = 19).

Conclusions

Our findings indicate that having an experienced and skilled debriefer who can establish high levels of psychological safety can create an engaging debriefing conversation regardless of the simulation.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Background

Presimulation preparation is critical to prepare learners to participate fully in clinical simulations; however, many do not complete assigned presimulation activities.

Research Question

Which presimulation preparation activities will senior nursing students choose and perceive as helpful?

Methods

A quasi-experimental study evaluated senior nursing student (n = 115) pre-simulation preparation preferences. Students had access to eight activities including a case study and a virtual simulation game (VSG). Participants indicated which activities they completed, and rated the case study and VSG in terms of usability, engagement, and impact on learning.

Results

Overall, 57% of participants completed the paper-based case study and 37% played the VSG. Participation in any preparation resulted in significant improvements in competence (t = 2.3; p = .02). Learners rated VSG higher than case study in terms of usability (t = 2.6; p = .01), engagement (t = 2.8; p = .01) and impact on learning (t = 2.4; p = .02).

Conclusion

Results revealed nursing students have different preferences for pre-simulation preparation. Although more students completed the case study than the VSG, those who played the game rated it higher. This supports providing a choice in presimulation preparation activities.

Background

Increasing demand for palliative care necessitates effective training for nursing students in end-of-life (EOL) and advanced care planning (ACP). Conventional teaching methods often fall short.

Methods

A single-arm pre-post design involved 219 nursing students in VR and SP simulations. Quantitative measures and qualitative feedback were obtained.

Results

Statistical analysis revealed significant improvement post-intervention (p < 0.001). Qualitative feedback highlighted realism, interactivity, and skill development. Challenges included emotional intensity and scenario repetition.

Conclusions

Combining virtual reality (VR) and simulated participant (SP) simulation significantly enhances nursing students' confidence and communication for end-of-life (EOL) conversations, offering a realistic educational experience. Further research is recommended in understanding this teaching method.

Background

Developing low-cost simulators is an evolving area within clinical simulation. As such, there is a need for instruments to assess these simulators. The study aimed to develop and evaluate an instrument's face and content validity to assess if an own-made low-cost simulator meets the essential characteristics low-cost simulators should have.

Method

Methodological study in two phases. Phase 1 developed the instrument's items, and phase 2 assessed the content and face validity of the instrument and items developed in the previous phase. Twenty-six experts evaluated the face and content validation of the instrument in terms of its representativeness, relevance, clarity and inter-rate reliability.

Results

Twenty-five items distributed in six factors were proposed to experts. All factors and items showed adequate content validity indexes and inter-rater reliability. Face validity was also endorsed for the instrument to represent the desirable key attributes of low-cost simulators.

Conclusion

This study provides The Low-Cost Simulator Assessment Instrument, available in Spanish and Portuguese. The instrument, composed of twenty-five items distributed in six factors, has shown adequate content and face validity.

Background

This study sought to explore the perceptions of newly graduated nurses (NGNs) regarding the use of immersive virtual reality (IVR) as a tool for skills development in rural clinical settings.

Method

NGNs working in a rural hospital setting, participated in a pre-experimental study. The objective was to explore the acceptability and feasibility of an IVR intervention using quantitative and qualitative data.

Results

The intervention was considered acceptable (Md = 4, IQR [0.5-1]) with little cybersickness (Md = [0-1], IQR [0-1.5]) and feasible according to four identified themes.

Conclusion

IVR could be a useful tool for the development of multiple NGNs skills.

Background

Graduate nurses are unprepared to recognize and respond to patient deterioration. Simulation involving micro-debriefing with feedback and opportunities for repeated performance can improve simulated clinical practice.

Methods

A prospective quasi-experimental design evaluating two simulation approaches (Standard simulation versus Rapid Cycle Intentional Simulation) recruited 138 second year undergraduate nursing students.

Results

During simulations the intervention groups demonstrated behaviors associated with situational awareness, in context of a deteriorating patient. Conversely control groups initiated incorrect clinical actions throughout the scenario, potentially harming the simulated patient.

Conclusions

Simulation that involves interruptions and micro-debriefings has been shown to improve student performance in deteriorating patient simulations.

Background

The occurrence of natural disasters is unpredictable. Nurses need to have the core competency of disaster nursing to effectively respond to natural disasters. This study aimed to develop and evaluate the effectiveness of an immersive cinematic escape room (ICER) instructional approach in disaster preparedness and self-efficacy in nurses.

Method

This quasi-experimental research design used a convenience sample of 115 nurses. The course contents covered establishment of medical stations, incident command system (ICS), personal preparedness and protection in disasters, and mass casualty triage (START). Evaluation of disaster preparedness and self-efficacy occurred before, one week after and four weeks after the course.

Results

The experimental group, lacking prior disaster preparedness education experiences, demonstrated a statistically significant improvement (p < .01) compared to the control group with more such experiences. At week four, both groups showed improvement in the self-efficacy scores, but the improvement did not achieve statistical significance (p > .05).

Conclusion

The ICER approach significantly enhanced nurses’ disaster preparedness and self-efficacy. Educators are encouraged to adopt this approach for comprehensive disaster nursing education.