The value of simulation-based learning in pre-licensure nurse education: A state-of-the-art review and meta-analysis

Beyond Discussion: Implementing Multimodal Learning in a Nurse Practitioner Program

ABSTRACT

End-of-program feedback from students reflected a decreased level of active engagement and retention in learning at a public university in the upper Midwest of the United States. Results prompted educators to explore integration of multimodal instruction within the postlicensure family nurse practitioner program. A graduate program faculty work group was created to review and revise the curriculum. Through the utilization of national organization standards, implementation of evidence-based best practices, and a shared vision, a small group of nurse faculty was able to complete significant improvement in the graduate curriculum within a single academic year.

Effect of a rapid e-learning module and brief interprofessional simulation event on medical and nursing student collaborative attitudes and behaviors

Objectives Undergraduate nursing and first-year medical students participated in a brief, scenario-based, interprofessional event. The experimental group only was provided an innovative, rapid e-learning instructional module focused on interprofessional roles/responsibilities and communication prior to the event. Methods Pre-post attitudes toward physician-nurse collaboration were surveyed, and collaborative behaviors were observed during the event. Results For the experimental group, a statistically significant (p<0.05) attitude improvement was found between pre-post e-learning module scores as well as pre-e-learning module and post-simulation event scores. For the control group, a statistically significant (p=0.001) attitude improvement was found between pre-post simulation event scores. No statistically significant differences in team collaborative behaviors were observed between experimental and control. Conclusions The combination of module and simulation event was not a more effective option than the event alone. As both interventions present unique challenges in regards to technology and facility requirements, having multiple effective intervention options will be of benefit to educational institutions.

Improving the Use of Simulation in Nursing Education: Protocol for a Realist Review

BACKGROUND

Nursing education has evolved in line with societal needs, and simulation-based learning (SBL) is increasingly being used to bridge the gap between practice and education. Previous literature reviews have demonstrated the effectiveness of using SBL in nursing education. However, there is a need to explore how and why it works to expand the theoretical foundation of SBL. Realist reviews are a theory-based approach to synthesizing existing evidence on how complex programs work in particular contexts or settings.

OBJECTIVE

This review aims to understand how, why, and in what circumstances the use of simulation affects learning as part of the bachelor's program in nursing.

METHODS

A realist review will be conducted in accordance with the realist template for a systematic review. In particular, we will identify and explore the underlying assumption of how SBL is supposed to work, that is, identify and explore program theories of SBL. The review will be carried out as an iterative process of searching, appraising, and synthesizing the evidence to uncover theoretical concepts that explain the causal effects of SBL. In the final section of the review, we will involve stakeholders in the Norwegian community in a web-based Delphi survey to ensure that the emerging theoretical framework derived from the published literature aligns with stakeholders' experience in practice.

RESULTS

The Norwegian Centre for Research Data (project number 60415) has approved the study. We have performed an initial literature search, whereas quality appraisal and data extraction are ongoing processes.

CONCLUSIONS

The final outcome of the review is anticipated to extend the theoretical foundation for using simulation as an integrated component of the bachelor's program in nursing. Furthermore, the findings will be used to produce a briefing document containing guidance for national stakeholders in the community of simulation-based nursing education. Finally, the review findings will be disseminated in a peer-reviewed journal as well as national and international conferences.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/16363.

Increasing competence in wound care: A cross-sectional study to evaluate use of a virtual patient by undergraduate student nurses

Concerns have arisen internationally over the competency of student nurses to perform wound care. A global shortage of nursing faculty and clinical practice opportunities is regarded as a contributing factor. Virtual simulation offers a possible solution. The aim of this study was to describe the development and educational evaluation of a virtual patient to supplement undergraduate learning of wound care. The National League for Nursing Jeffries model informed the design of the media. Evaluation of the virtual patient by penultimate year nursing students (n = 148) was conducted using a survey design. Findings are presented from statistical and directed content analyses. Most students rated the educational value of the virtual patient and its support of learning highly. They reported a perceived increase in confidence and ability to meet wound care competency outcomes. The virtual patient also provided students with opportunities to develop their clinical reasoning skills. This study provides evidence that virtual patient simulation is an effective pedagogy to increase clinical competence in wound care. It allows nursing students the opportunity to practice skills and utilise theory repetitively in a safe environment, unhampered by a lack of resources such as clinical placement availability and a declining faculty.

Stimulating Intrinsic Motivation in Millennial Students: A New Generation, a New Approach

There has been a fundamental change in health care pedagogy to address the demands and challenges posed by the present generation of millennial students. There is also a growing recognition of the role of intrinsic motivation as a catalyst in a positive learning experience. The term intrinsic motivation refers to energizing behavior that comes from within an individual and develops due to an inherent interest in the activity at hand. However, stimulating intrinsic motivation in the present generation of millennial health care students is a daunting task, considering their diverse and disparate nature. In addition, the inherent generational differences between educators and students, and an increasing emphasis on technological tools have resulted in a dichotomy in the educational environment leading to the development of a greater incidence of burnouts among students. Hence, numerous innovative techniques have been introduced in health care education to enhance the levels of intrinsic motivation in these students. Unfortunately, most of these approaches have only been moderately successful due to their limited ability to address the unique educational expectations of millennial students. The cumulative evidence suggests that specific approaches to stimulate intrinsic motivation should aim at nurturing the learning efforts of students, bridging the generational barriers between educators and students, and ameliorating the stress associated with health care education. Hence, the specific aim of this narrative review is to suggest empirically proven curricular strategies and institutional reforms to enhance intrinsic motivation in health care students belonging to the Millennial Generation.

Perceptions about the Self-Learning Methodology in Simulated Environments in Nursing Students: A Mixed Study

The self-learning methodology in simulated environments (MAES©) is an active method of education. The aim of this study was to analyze the perceptions and opinions of undergraduate and graduate nursing students about the self-learning methodology in simulated environments. A mixed, cross-sectional, descriptive study based on a survey tool made ad hoc (quantitative approach) and an open questionnaire (qualitative approach) was carried out. A sample of 149 undergraduate and 25 postgraduate nursing students were tested. The score was high for all the variables of the questionnaire analyzed: for perception of simulation performance, M = 73.5 (SD = 14.5), for motivation, M = 23.9 (SD = 5.9), for the opinion about facilitators, M = 25.9 (SD = 4.5), and for the promotion of team work, M = 16.9 (SD = 3.4). Five dimensions were identified and evaluated in the qualitative research. The students were pleased with MAES© and had a positive perception, since they considered that MAES© increased their learning.

Effects of high-fidelity simulation based on life-threatening clinical condition scenarios on learning outcomes of undergraduate and postgraduate nursing students: a systematic review and meta-analysis

OBJECTIVE

The purpose was to analyse the effectiveness of high-fidelity patient simulation (HFPS) based on life-threatening clinical condition scenarios on undergraduate and postgraduate nursing students' learning outcomes.

DESIGN

A systematic review and meta-analysis were conducted based on the Cochrane Handbook for Systematic Reviews of Interventions and its reporting was checked against the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist.

DATA SOURCES

PubMed, Scopus, CINAHL with Full Text, Wiley Online Library and Web of Science were searched until July 2017. Author contact, reference and citation lists were checked to obtain additional references.

STUDY SELECTION

To be included, available full-texts had to be published in English, French, Spanish or Italian and (a) involved undergraduate or postgraduate nursing students performing HFPS based on life-threatening clinical condition scenarios, (b) contained control groups not tested on the HFPS before the intervention, (c) contained data measuring learning outcomes such as performance, knowledge, self-confidence, self-efficacy or satisfaction measured just after the simulation session and (d) reported data for meta-analytic synthesis.

REVIEW METHOD

Three independent raters screened the retrieved studies using a coding protocol to extract data in accordance with inclusion criteria.

SYNTHESIS METHOD

For each study, outcome data were synthesised using meta-analytic procedures based on random-effect model and computing effect sizes by Cohen's d with a 95% CI.

RESULTS

Thirty-three studies were included. HFPS sessions showed significantly larger effects sizes for knowledge (d=0.49, 95% CI [0.17 to 0.81]) and performance (d=0.50, 95% CI [0.19 to 0.81]) when compared with any other teaching method. Significant heterogeneity among studies was detected.

CONCLUSIONS

Compared with other teaching methods, HFPS revealed higher effects sizes on nursing students' knowledge and performance. Further studies are required to explore its effectiveness in improving nursing students' competence and patient outcomes.

Effectiveness of a learning support program for respiratory physical assessment: A quasi-experimental study

BACKGROUND

Although the need for physical assessment in home nursing care has been shown, little research has examined the development of visiting nurses' physical assessment capabilities.

OBJECTIVES

This study aimed to evaluate the effectiveness of a learning support program to help working visiting nurses utilize their respiratory physical assessment skills.

DESIGN

This study used a quasi-experimental design of two groups with pre-test, post-test measurements of training and follow-up test 8 weeks practice in their work place after the training.

METHODS

57 currently working visiting nurses were assigned to 1 of 2 groups: a control group in which nurses would not receive any special support after respiratory physical assessment training, and an experimental group in which nurses would receive support to utilize the knowledge and skills they had learned during the training.

RESULTS

The average practical examination score was significantly higher after the training. In the experimental group, the average score 8 weeks after training was not significantly higher than that obtained just after training. Further, after 8 weeks, the experimental group's average score was not significantly higher than that of the control group. Practice evaluation scores obtained by an investigation of daily clinical practice were not significantly higher seventh weeks compared to third weeks after training for either the experimental or control groups. Seventh weeks after training, the average practice evaluation score of the experimental group was significantly higher than that of control groups. The mean learning support program satisfaction score was higher among the experimental group than the control group.

CONCLUSIONS

The results suggested that support from others was effective in maintaining motivation for learning and making use in the regular practice of the knowledge and skills acquired in the respiratory physical assessment training.

Discovering mental models and frames in learning of nursing ethics through simulations

The acquisition of ethical competence is necessary in nursing. The aims of the study were to analyse students' perceptions of the process of learning ethics through simulations and to describe the underlying frames that inform the decision making process of nursing students. A qualitative study based on the analysis of simulated experiences and debriefings of six simulated scenarios with ethical content in three different groups of fourth-year nursing students (n = 30), was performed. The simulated situations were designed to contain ethical dilemmas. The students' perspective regarding their learning and acquisition of ethical competence through simulations was positive. A total of 15 mental models were identified that underlie the ethical decision making of the students. The student's opinions reinforce the use of simulations as a tool for learning ethics. Thus, the putting into practice the knowledge regarding the frames that guide ethical actions is a suitable pedagogical strategy.

Design-based research in designing the model for educating simulation facilitators

The purpose of this article is to introduce the concept of design-based research, its appropriateness in creating education-based models, and to describe the process of developing such a model. The model was designed as part of the Nurse Educator Simulation based learning project, funded by the EU's Lifelong Learning program (2013-1-DK1-LEO05-07053). The project partners were VIA University College, Denmark, the University of Huddersfield, UK and Metropolia University of Applied Sciences, Finland. As an outcome of the development process, "the NESTLED model for educating simulation facilitators" (NESTLED model) was generated. This article also illustrates five design principles that could be applied to other pedagogies.