Simulation as a Strategy to Teach Clinical Pediatrics Within a Nursing Curriculum

A medical play experience: Preparing undergraduate nursing students for clinical practice

BACKGROUND

Undergraduate nursing programs are required to prepare nursing students to care for people across the lifespan, however due to limited paediatric nursing content in undergraduate nursing curricula and limited paediatric clinical placements, nursing graduates may lack competence and experience in caring for children.

OBJECTIVES

The aim of this study was to enhance undergraduate nursing students' work readiness and confidence to care for children by immersing them in a mock paediatric ward experience where students could practice using medical play to communicate and engage with children.

PARTICIPANTS

Participants (n = 22) were undergraduate nursing students recruited across all years from a Bachelor of Nursing program.

DESIGN

Participants were involved in a mock paediatric hospital experience providing them the opportunity to engage with children from 2 to 8 years.

METHODS

A mixed methods approach was used. Participants completed a confidence scale questionnaire pre and post the mock paediatric ward experience and a satisfaction scale post the experience. Inductive thematic analysis was used to analyse qualitative data. Quantitative data was analysed using the Wilcoxon Signed-Ranked Test.

RESULTS

Findings indicated a marked improvement in paediatric nursing skills and work readiness among the student nurses post intervention. Participants developed confidence in the use of medical play in the mock paediatric nursing setting. Improvements in paediatric nursing skills in relation to clinical learning, clinical reasoning and clinical confidence were reported.

CONCLUSIONS

The mock children's ward provided a real time paediatric experience for undergraduate nursing students to practice using medical play to communicate and engage with children. Nursing students had the opportunity to experience children's play, practice age related communication and provide explanations to children about hospital related procedures that children may encounter. With the lack of paediatric placements, it is necessary that nursing curricula examine strategies to enhance the learning for undergraduate students about paediatrics.

Supporting food literacy among children and adolescents: Undergraduate students apply public health nursing principles in clinical practice

Effective public health nurses excel in partnership building and program planning to address priority health concerns, such as childhood obesity and disordered eating. Worldwide, children are at risk for low food and nutrition literacy with associated patterns of low fruit and vegetable consumption. This report focuses on the application of public health nursing principles by undergraduate nursing student teams in the design and delivery of food literacy interventions among a population of children and adolescents. Over a four-year time period, the cumulative intervention reach was 640 children/adolescents. Over 75 nursing students implemented the public health nursing process in support of food literacy, gaining skills across multiple practice domains. Lessons learned from academic-community partnerships to promote food literacy among children and adolescents have direct implications for undergraduate nursing education. Chief among these implications include the growing significance of integrating nutrition in the nursing curriculum and the need for scaffolding to support clinical application of interventions beyond health teaching to address broad determinants of health.

Interactive Clinical Avatar Use in Pharmacist Preregistration Training: Design and Review

BACKGROUND

Virtual patients are interactive computer-based simulations that are being increasingly used in modern health care education. They have been identified as tools that can provide experiential learning and assessment in a standardized and safe environment. However, the study of high-fidelity virtual patients such as interactive clinical avatars within pharmacy is limited.

OBJECTIVE

The aim of this paper is to describe the design and review of three interactive clinical avatar simulations as part of pharmacist preregistration training.

METHODS

A multistep design approach was taken to create interactive clinical avatar simulations on the topics of emergency hormonal contraception (EHC), calculation of renal function, and childhood illnesses. All case studies were reviewed by registered pharmacists to establish content and face validity. The EHC case study and data collection questionnaire were also reviewed by a purposive sample of preregistration trainees and newly qualified pharmacists. The questionnaire used Likert ranking statements and open-ended questions to obtain users' feedback on the design, usability, and usefulness of the interactive clinical avatars as learning tools. Descriptive statistics and content analysis were undertaken on the data.

RESULTS

Ten preregistration trainees and newly qualified pharmacists reviewed the EHC interactive clinical avatars and data collection questionnaire. The data collection questionnaire was associated with a Cronbach alpha=.95, demonstrating good reliability. All three interactive clinical avatar simulations were reported as usable and appropriately designed for preregistration training. Users perceived they were developing skills and knowledge from the simulations. The high-fidelity nature of the avatars and relevance of the simulations to real-life practice were reported as aspects that encouraged the application of theory to practice. Improvements were suggested to ensure the simulations were more user-friendly.

CONCLUSIONS

The design and creation of the interactive clinical avatar simulations was successful. The multistep review process ensured validity and reliability of the simulations and data collection questionnaire. The in-depth explanation of the design process and provision of a questionnaire may help widen the use and evaluation of interactive clinical avatars or other simulation tools in pharmacy education. The interactive clinical avatars were reported as novel learning tools that promoted experiential learning and allowed users to feel like they were engaging in real-life scenarios, thus developing transferable knowledge and skills. This may be potentially beneficial for many health care training courses as a way to provide standardized experiences promoting active learning and reflection.

Using Standardized Actors to Promote Family-centered Care

PURPOSE

The purpose of this study was to examine nursing students' performance in providing family-centered care and empathic communication in a pediatric simulation. This study was considered an innovative approach within our undergraduate program because the use of standardized actors (SAs) was new to the program and had only previously been used in our graduate program.

METHOD

This study used a mixed method design of descriptive comparative data and content analysis to examine nursing students' performance in providing family-centered care and empathic communication in a pediatric simulation.

RESULTS

There were 146 students who participated in this study. Thematic analysis indicated that empathy needs to extend beyond the patient to the family. A comparison of the standardize actors' and peer assessment of student empathy was significant.

CONCLUSIONS

Nurse educators can use standardized actors as caregivers in simulation as an effective teaching strategy to connect theory and the philosophy of family-centered care to its application in pediatric nursing practice.

PRACTICE IMPLICATIONS

Family-centered care is a key philosophy in pediatric nursing. Students report that there is a significant gap between family-centered care theory and its application to practice. Few baccalaureate nursing students receive experience in family interactions during their clinical time. Therefore, this research supports the need for incorporating family-centered care simulation practices in nursing education to increase student nurses' readiness to practice in specialty settings such as pediatrics.

Experiential Learning With Children: An Essential Component of Professional Physical Therapy Education

PURPOSE

The Section on Pediatrics of the American Physical Therapy Association has developed a number of resources to support and improve the consistency of professional pediatric physical therapy education, including a set of core competencies that all graduates must attain. The purpose of this article is to advocate for the inclusion of experiential learning activities with children, including children with participation restrictions, as a necessary component to achieve the core competencies.

KEY POINTS

Experiential learning is a form of practice-based education that provides exposures and opportunities for students to explore the work, roles, and identities they will encounter as future professionals. Experiential learning is learning by doing, and occurs within a relevant setting. Six representative curricular exemplars are presented to provide readers with a variety of suggestions for development and integration of experiential learning.

SUMMARY

Recommendations for future research are provided and 4 key recommendations are provided.

Using integrated simulation in a nursing program to improve medication administration skills in the pediatric population

AIM

The purpose of this evaluative study was to determine the overall influence of a mixed educational approach on student knowledge and self-confidence with pediatric intravenous medication administration.

BACKGROUND

There are diminishing opportunities for students to practice IV medication administration in pediatric patients. Nurse educators must find ways to effectively train students that ready them for the real world of patient care while reducing risk.

METHOD

After lecture and pretesting, junior-level students spent approximately 50 hours in a pediatric unit and 40 hours in a high-fidelity pediatric simulation completing scenarios with medical prescribing and system-based pharmaceutical error, unpredictable medication administration dilemmas, and acute drug reactions.After the clinical rotation, students completed a posttest and self-confidence survey.

RESULTS

. Results revealed a rise in knowledge and student self-reporting of confidence of essential medication administration skills for the pediatric population.

CONCLUSIONS

A clinical rotation enhanced with simulation provides a rich learning environment without endangering patients. It allows students to experience risk-free problem-solving while giving faculty a more predictable process to assess acquisition of skills.

The Use of High-Fidelity Simulation to Teach Home Care Nursing

The use of high-fidelity human patient simulation (HPS) is increasing in nursing education, yet little is known about its use in community health. This study examined an HPS home care experience to determine effects on three outcomes (student satisfaction, self-confidence, and learning). In addition, design characteristics of the simulation and demographic characteristics of students were examined for correlation with these outcomes. Senior baccalaureate students took part in the experience. Results indicated that students were very satisfied with the experience and felt it increased their confidence in providing care in the home, although learning outcomes were not high. Although no demographic characteristics were found to be correlated with outcomes, five design characteristics of a simulation were moderately correlated with the outcomes of satisfaction and self-confidence, especially support. It is recommended that nurse educators design HPS home care simulation experiences that provide student support prior to their first home care visit.

Simulation-enhanced pediatric clinical orientation

Nursing actively engages various technologies to enhance education and training with increased learner confidence and patient safety. Simulation is a key technology to address the strain on the current nursing education system. The purpose of this study was to determine the effect of simulation-enhanced orientation on pediatric acute care examination scores and pediatric clinical course grades among junior-level baccalaureate nursing students. No significant difference between groups (p < 0.05) was detected for the students' examination scores. Clinical grades of the intervention group (mean = 3.7) were significantly higher (t[75.3] = 5.2, p < 0.001) than those of the control group (mean = 3.4). These results support the expansion of simulation in the curriculum and prompt the proposal of simulation as an appropriate substitution for portions of pediatric clinical experience. Given the strain on the current nursing education system, simulation will be a critical component of nursing education in the future.