Striving for Higher Levels of Evaluation in Simulation

Kirkpatrick's Evaluation of Simulation and Debriefing in Health Care Education: A Systematic Review

BACKGROUND

Simulation is an integral component of health care education. Research suggests a positive relationship between simulation and learning outcomes. Kirkpatrick's framework is a four-level model based on the premise that learning resulting from training programs can be classified into four levels: reaction, learning, behavior, and results. Evaluation of educational impact provides valuable feedback to educators that may assist with development and improvement of teaching methods.

METHOD

This review is based on the PRISMA guidelines for conducting a systematic review. Inclusion criteria included articles (a) written in the English language, (b) published between 2000 and 2016, (c) describing a debriefing intervention after high-fidelity patient simulation, and (d) based in health care.

RESULTS

Thirteen studies met criteria for inclusion in the review.

CONCLUSION

Results indicated a paucity of studies at the highest levels of evaluation, indicating an area where future research is needed to assist with the development and improvement of simulation education. [J Nurs Educ. 2018;57(7):393-398.].

An Innovative Approach: Using Simulation to Teach Primary Care Gynecologic Procedures

INTRODUCTION

In response to the growing body of evidence that simulation is a satisfactory way to instruct procedural skills, we developed an innovative model to teach common gynecologic procedures such as cervical cancer screening, cervical polyp removal, intrauterine device removal, and endometrial biopsy. The objectives of this study were to describe the construction of the model and to assess participants' satisfaction and confidence in applying the learning objectives to their clinical practice.

METHODS

The researchers created the model with reusable and readily available materials. During a hands-on skills workshop, practicing clinicians performed simulated cervical cancer screening, endocervical polyp removal, intrauterine device removal, and an endometrial biopsy on a low-fidelity gynecologic model. Using convenience sampling, each participant completed a survey designed to measure satisfaction with the workshop and self-confidence in their newly acquired skills.

RESULTS

All (N = 30,100%) of the participants agreed at the "agree" or "strongly agree" level that the gynecologic skills workshop using lecture and a hands-on model was a satisfying and self-confidence-building experience.

CONCLUSIONS

An easily reproducible and reusable gynecologic procedure simulator was highly rated as a means of teaching common primary care gynecologic procedures. The simulated model provided an opportunity for hands-on skills learning for clinicians who wish to expand their gynecologic procedure skill set.

A systematic review of online learning programs for nurse preceptors

BACKGROUND

Nurse preceptors guide students to integrate theory into practice, teach clinical skills, assess clinical competency, and enhance problem solving skills. Managing the dual roles of a registered nurse and preceptor poses tremendous challenges to many preceptors. Online learning is recognized as an effective learning approach for enhancing nursing knowledge and skills.

OBJECTIVE

The systematic review aims to review and synthesise the online learning programs for preceptors.

DESIGN

A systematic review was designed based on the Cochrane Handbook for Systematic Reviews of Programs.

DATA SOURCES

Articles published between January 2000 and June 2016 were sought from six electronic databases: CINAHL, Medline OVID, PubMed, Science Direct, Scopus, and Web of Science.

METHODS

All papers were reviewed and quality assessment was performed. Nine studies were finally selected. Data were extracted, organized and analysed using a narrative synthesis.

RESULTS

The review identified five overarching themes: development of the online learning programs for nurse preceptors, major contents of the programs, uniqueness of each program, modes of delivery, and outcomes of the programs.

CONCLUSION

The systematic review provides insightful information on educational programs for preceptors. At this information age, online learning offers accessibility, convenience, flexibility, which could of great advantage for the working adults. In addition, the online platform provides an alternative for preceptors who face challenges of workload, time, and support system. Therefore, it is paramount that continuing education courses need to be integrated with technology, increase the flexibility and responsiveness of the nursing workforce, and offer alternative means to take up courses.

A systematic review of the effectiveness of simulation-based education on satisfaction and learning outcomes in nurse practitioner programs

BACKGROUND

High-fidelity simulation (HFS) is becoming an integral component in healthcare education programs. There is considerable evidence demonstrating the effectiveness of HFS on satisfaction and learning outcomes within undergraduate nursing programs; however, there are few studies that have investigated its use and effectiveness within nurse practitioner (NP) programs.

OBJECTIVE

To synthesize the best available evidence about the effectiveness of HFS within NP education programs worldwide. The specific review question was: what is the effect of HFS on learner satisfaction, knowledge, attitudes, and skill performance in NP education?

METHODS

Joanna Briggs Institute systematic review methodology was utilized. The following databases were searched: MEDLINE, CINAHL, EMBASE, Epistemonikos, PROSPERO, HealthSTAR, AMED, Cochrane, Global Health and PsycINFO. Studies were included if they were quantitative in nature and reported on any aspect HFS within a NP program.

RESULTS

Ten studies were included in the review. All studies were conducted in the United States and published between 2007 and 2014. Outcomes explored included: knowledge, attitudes, skills and satisfaction. The majority of studies compared HFS to online learning or traditional classroom lecture. Most study scenarios featured high acuity, low frequency events within acute care settings; only two studies utilized scenarios simulated within primary care.

CONCLUSIONS

There is limited evidence supporting the use of HFS within NP programs. In general, HFS increases students' knowledge and confidence, and students are more satisfied with simulation-based teaching in comparison to other methods. Future studies should explore the effectiveness of simulation training within NP programs in reducing the theory to practice gap, and evaluate knowledge retention, transferability to real patient situations, and impact of simulation on patient outcomes.