Effectiveness of neonatal emergency nursing education through simulation training: Flipped learning based on Tanner's Clinical Judgement Model

Effectiveness of simulation-based interprofessional education on teamwork and communication skills in neonatal resuscitation

BACKGROUND

The role of effective interprofessional teamwork is especially vital in the Neonatal Intensive Care Unit (NICU) where infants facing emergency situations are admitted. Proper neonatal resuscitation, facilitated by comprehensive resuscitation training, can significantly decrease the mortality rates associated with neonatal asphyxia and respiratory failure. This study aimed to develop a simulation-based interprofessional education (IPE) programme for medical staff working in a nursery and NICU and to assess its effectiveness on teamwork, communication skills, clinical performance, clinical judgement, interprofessional attitudes, and education satisfaction.

METHODS

Through a demand survey, neonatal resuscitation was selected as the theme, and an IPE team comprised of one doctor and two nurses was formed. The education programme consisted of three sessions lasting a total of 140 min: two simulation exercises and one theoretical education session. Data were collected from 18 nurses working in the nursery and NICU and 9 doctors working in the paediatrics department.

RESULTS

A comparison of the metrics before and after applying simulation-based IPE programmes revealed teamwork (Z=-2.67, p = .008), communication skills (Z=-2.68, p = .007), clinical performance (Z=-2.52, p = .012), clinical judgement (Z=-4.52, p < .001), and interprofessional attitude (Z=-3.64, p < .001) to have significantly improved. Education satisfaction scores were 4.73 points on average out of a maximum of 5. The simulation-based IPE programme was effective in improving the teamwork, communication, and clinical performance of resuscitation teams, individual clinical judgement, and interprofessional attitude.

CONCLUSIONS

Simulation-based IPE is effective for enhancing teamwork, team communication, clinical judgement skills, and clinical performance in neonatal resuscitation. This programme has the potential to contribute to the improvement of patient safety and the quality of neonatal care. Additional studies are needed to longitudinally examine the effects of the programme on patient safety and quality of neonatal care.

Effect of Unfolding Case-Based Learning on Clinical Judgment Among Undergraduate Nursing Students

BACKGROUND

To prepare students for Next Generation National Council Licensure Examination-Registered Nurse (NCLEX-RN), nurse educators need to develop teaching strategies to foster students' clinical judgment.

PURPOSE

This study examined the effects of unfolding case-based learning (CBL) on baccalaureate nursing students' clinical judgment upon graduation.

METHODS

A prospective cohort design was adopted. Students' self-reported responses to the Lasater Clinical Judgment Rubric were compared between the unfolding CBL (n = 140) and non-CBL (n = 126) cohorts at a school of nursing in the United States.

RESULTS

While students' responses were similar between the study cohorts, a trend was noted for improved clinical judgment among students in the unfolding CBL cohort. Furthermore, unfolding CBL significantly enhanced students' perceived proficiency in conducting focused observation.

CONCLUSIONS

The findings support early introduction and consistent use of the unfolding CBL throughout the undergraduate nursing program so that students have ample opportunities and contexts to cultivate clinical judgment skills in the classroom.

Development of clinical decision-making among undergraduate nursing students: the effect of unfolding case-based learning

OBJECTIVES

This prospective cohort study evaluated the effect of unfolding case-based learning on undergraduate nursing students' self-perceived clinical decision-making ability.

METHODS

Students' self-reported responses to Jenkins's Clinical Decision Making in Nursing Scale were compared between the unfolding case-based learning cohort (n=140) and the comparison cohort (n=126) at a school of nursing in the United States.

RESULTS

The results revealed similar students' responses between the two study cohorts. However, unfolding case-based learning significantly increased students' perceived proficiency in "search for information and unbiased assimilation of new information".

CONCLUSIONS

Findings from the present study highlight possibilities presented by unfolding case-based learning in undergraduate nursing education. The study supports that unfolding case studies can be introduced early on, and then nurtured throughout the undergraduate program to influence the development of nursing students' clinical decision-making skills.

Effects of simulation with problem-based learning (S-PBL) on nursing students' clinical reasoning ability: based on Tanner's clinical judgment model

BACKGROUND

Clinical reasoning ability, a complex cognitive and metacognitive process, is a crucial core competency required in nursing practice. Therefore, undergraduate nursing students should be provided with nursing education to strengthen their clinical reasoning ability based on real-life nursing scenarios.

METHODS

This study was conducted using a quasi-experimental single-group pretest-posttest design. Three sessions (lasting three hours each) of Simulation with Problem-Based Learning (S-PBL) using high-risk obstetrics-gynecology scenarios were provided to 71 third-year nursing students of a university. The sessions were conducted from September to December 2022, and they aimed to strengthen their clinical reasoning ability. For data collection, an online survey was conducted using Rubric for Clinical Reasoning and learning satisfaction evaluation tool. Data were analyzed using descriptive statistics and repeated measures analysis of variance in SPSS.

RESULTS

The mean score of clinical reasoning ability significantly increased from 29.42 (standard deviation: 4.62) out of 40 points in the pre-test to 32.28 (4.36), 33.44 (5.35), and 33.80 (5.91) after the first, second, and third S-PBL sessions, respectively (F = 61.668, p < .001). The learning satisfaction score was as high as 107.04 (12.66) out of 120 points.

CONCLUSION

This S-PBL program is an effective nursing education strategy to strengthen nursing students' clinical reasoning ability. Future studies must examine learner variables and standardize the S-PBL design and operation process by comparison to a traditional teaching approach and a higher range of clincal reasoning ability.

Assessment of Clinical Reasoning While Attending Critical Care Postsimulation Reflective Learning Conversation: A Scoping Review

BACKGROUND

The critical care environment is characterized with a high level of workload, complexity, and risk of committing practice mistakes. To avoid clinical errors, health care professionals should be competent with effective clinical reasoning skills. To develop effective clinical reasoning skills, health care professionals should get the chance to practice and be exposed to different patient experiences. To minimize safety risks to patients and health care professionals, clinical reasoning with a focus on reflective learning conversation opportunities can be practiced in simulated settings.

OBJECTIVES

To explore the most valid and reliable tools to assess clinical reasoning while attending adult critical care-related simulation-based courses in which reflective learning conversations are used.

METHODS

A scoping review was conducted following Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews Extension for Scoping Reviews. Eight electronic databases were searched, and full-text review was completed for 26 articles.

RESULTS

The search resulted in no studies conducted to measure clinical reasoning while attending adult critical care-related, simulation-based courses in which the reflective learning conversation method was embedded.

DISCUSSION

This highlights the need to evaluate current available clinical reasoning tools or develop new tools within the context of adult critical care simulation where reflective learning forms a key part of the simulation procedures.

The effects of neonatal resuscitation gamification program using immersive virtual reality: A quasi-experimental study

BACKGROUND

Clinical practice in neonatal intensive care units for nursing college students has been restricted due to the COVID-19 pandemic outbreak; thus, the gamification program has emerged as an alternative learning method. Consequently, there is a need to examine the effectiveness of such alternative learning methods to enhance the response to high-risk newborn emergencies.

OBJECTIVES

To examine the effects (neonatal resuscitation nursing knowledge, problem-solving and clinical reasoning ability, self-confidence in practical performance, degree of anxiety, and learning motivation) of a neonatal resuscitation gamification program using immersive virtual reality based on Keller's ARCS model.

DESIGN

A non-randomized controlled simulation study with a pretest-posttest design.

SETTING

Lab and lecture rooms of two universities in South Korea, from June to November 2021.

PARTICIPANTS

Prelicensure nursing students.

METHODS

The virtual reality group (n = 29) underwent a neonatal resuscitation gamification program using virtual reality based on Keller's ARCS model. The simulation group (n = 28) received high-fidelity neonatal resuscitation simulations and online neonatal resuscitation program lectures. The control group (n = 26) only received online neonatal resuscitation program lectures. Changes in scores among these groups were compared using analysis of variance and analysis of covariance with SPSS for Windows version 27.0.

RESULTS

Post intervention, neonatal resuscitation knowledge [F(2) = 3.83, p = .004] and learning motivation [F(2) = 1.79, p = .025] were significantly higher in the virtual reality and simulation groups than in the control group, whereas problem-solving ability [F(2) = 2.07, p = .038] and self-confidence [F(2) = 6.53, p < .001] were significantly higher in the virtual reality group than in the simulation and control groups. Anxiety [F(2) = 16.14, p < .001] was significantly lower in the simulation group than in the virtual reality and control groups.

CONCLUSIONS

The neonatal resuscitation gamification program using immersive virtual reality was found to be effective in increasing neonatal resuscitation knowledge, problem-solving ability, self-confidence, and learning motivation of the nursing students who participated in the trial application process.

Prebriefing in clinical simulation in nursing: scoping review

ABSTRACT Objective To map the concept and structural elements of the prebriefing phase in clinical simulations in nursing. Method Scoping review with searches between May and June 2021 in the databases PubMed, Virtual Health Library, EMBASE, CINAHL, SCOPUS, Web of Science, CAPES Catalog of Theses and Dissertations, Brazilian Digital Library of Theses and Dissertations and Google Scholar, in portuguese, spanish and english, without time limit. Results 24 studies were selected. In 17 articles (70.8%) the authors used the spelling prebriefing (in italics and amended), to refer to the stage that precedes the simulation, including preparatory activities and guidance. Alternative methods for prebriefing were described (reflective practices, laboratories, games and videos). Conclusion There is no consensus regarding the concept and elements that constitute the prebriefing. This simulation stage contributes to participant satisfaction, participation and psychological safety, with better learning outcomes.

The effectiveness of the virtual patient-based social learning approach in undergraduate nursing education: A quasi-experimental study

BACKGROUND

In nursing education, knowledge and competence in conducting physical assessments are crucial. Therefore, physical assessment knowledge has become a fundamental and essential education program for nursing students. However, most of the current nursing courses are taught via a didactic teaching approach, making it difficult for students to think deeply about relevant issues due to the lack of interaction and context. This may, in turn, have an impact on learning effectiveness and clinical judgment.

OBJECTIVE

A virtual patient (VP)-based social learning approach is proposed to enhance nursing students' performance and clinical judgment in education programs.

DESIGN

A quasi-experiment method was adopted to evaluate the effectiveness of the proposed approach.

PARTICIPANTS

A total of 40 senior nursing students participated in the study (VP-based social learning approach group = 20, control group = 20).

METHODS

The study involved a pre- and post-test to examine students' learning achievements, self-efficacy, and communication skills. The experimental group adopted the VP-based learning approach, while the control group adopted the conventional didactic learning approach. ANCOVA was employed to compare the performances of the two groups.

RESULTS

The experimental results indicate that using a VP for learning can enhance students' learning achievements, self-efficacy, and communication skills. In addition, based on the analysis of the results, students generally believed that learning with a VP makes learning more enjoyable.

CONCLUSION

The VP-based social learning approach would be an effective strategy to train nursing students who have limited opportunities to experience real clinical situations, in particular during the COVID-19 pandemic.

O prebriefing na simulação clínica em enfermagem: revisão de escopo

RESUMO Objetivo Mapear o conceito e elementos estruturais da fase de prebriefing nas simulações clínicas em enfermagem. Método Scoping review com buscas, entre maio e junho de 2021, nas bases de dados Pub Med, Biblioteca Virtual em Saúde, EMBASE, CINAHL, SCOPUS e Web of Science, Catálogo de Teses & Dissertações da CAPES, Biblioteca Digital Brasileira de Teses e Dissertações e Google Scholar, nos idiomas português, espanhol e inglês, sem limite de tempo. Resultados Foram selecionados 24 estudos. Em 17 artigos (70,8%), os autores utilizaram a grafia prebriefing (em itálico e emendado), para se referir a etapa que antecede a simulação, incluindo atividades preparatórias e orientações. Foram descritos métodos alternativos para o prebriefing (práticas reflexivas, laboratórios, jogos e vídeos). Conclusão Não há consenso a respeito do conceito e dos elementos que compõem o prebriefing. Essa etapa da simulação contribui na satisfação, participação e segurança psicológica do participante, com melhores resultados de aprendizagem.