Simulation in Nursing Education Programs: Findings From an International Exploratory Study

Scoping communication training in undergraduate children's nursing programmes: A mixed method study examining delivery methods and content

AIM

The aim of this study was to scope communication curriculum reported as currently being delivered within undergraduate children's nursing programmes across the Republic of Ireland and the United Kingdom.

BACKGROUND

Communication between a children's nurse and a child/young person influences a child/young person's healthcare experience. Despite an identified need for a comprehensive and effective communication curriculum within undergraduate nursing, there is a notable gap of understanding of the delivery and content of communication training within children's nursing curricula.

DESIGN

A mixed method, online anonymous self-report survey design was adopted.

METHODS

Programme Leads of undergraduate children's nursing programmes in the Republic of Ireland and the United Kingdom were asked to report on how communication training is delivered to students on undergraduate children's nursing programmes. The Checklist for Reporting of Survey Studies (CROSS) was used for the reporting of this study.

RESULTS

Thirty-two programme leads completed the survey (51 % response rate). Findings show variability in the delivery and content of communication training across Higher Educational Institutions. Core communication modules featured across all nursing programmes, however, only two programme leads reported delivering standalone child-centred communication modules. Communication training was not always delivered by an educator with professional experience of children and young people in healthcare. Curriculum capacity had an impact on the delivery of communication training, with clinical practice being relied on to supplement child specific communication training. Programme leads highlighted the need for greater inclusion of child voice in shaping and delivering undergraduate children's nurse education.

CONCLUSIONS

This study shows that while communication is covered as a core part of the undergraduate nursing curriculum across the Republic of Ireland and the United Kingdom, it generally lacks a focus on children and young people and is not always supported by educators with professional experience of children and young people in healthcare. More work needs to focus on equipping undergraduate children's nurses with the unique skills needed to communicate effectively with children and young people and incorporate learnings into nursing pedagogy.

Comparing didactic approaches for practical skills learning in Scandinavian nursing simulation centres: A qualitative comparative study

AIM

To explore and compare the didactic approaches to practical skills learning at simulation centres in Scandinavian universities and university colleges.

BACKGROUND

Academic simulation centres are an important arena for learning practical nursing skills which are essential to ensure competent performance regarding patient safety and quality of care. Knowledge of didactic approaches to enhance learning is essential in promoting the provision and retention of students' practical nursing skills. However, research on didactical approaches to practical nursing skills learning is lacking.

DESIGN

A qualitative comparative design was used.

METHODS

During November and December 2019, interviews were conducted with a total of 37 simulation centre directors or assistant directors, each of whom possessed in-depth knowledge of practical skills in teaching and learning. They represented bachelor nursing education in Denmark, Norway and Sweden. A qualitative deductive content analysis was conducted.

RESULTS

The results revealed all five predetermined didactical components derived from the didactical relationship model. Twenty-two corresponding categories that described a variation in didactic approaches to practical skills learning in Scandinavian nursing simulation centres were identified. The didactical components of Learning process revealed mostly similarities, Setting mostly differences and Assessment showed only differences in didactic approaches.

CONCLUSION

Although various didactic approaches were described across the countries, no common approach was found. Nursing educational institutions are encouraged to cooperate in developing a shared understanding of how didactic approaches can enhance practical skills learning.

IMPLICATIONS FOR PROFESSION AND/OR PATIENT CARE

Cross-country comparisons of practical nursing skills learning in Scandinavian countries highlight the importance of educator awareness concerning the impact diverse didactic approaches may have on competent performance in nursing education. Competent performance is pivotal for ensuring patient safety and the provision of high-quality care.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

REPORTING METHOD

This study followed the Consolidated Criteria for Reporting Qualitative Research reporting guidelines.

Simcrafting: A comprehensive framework for scenario development for simulation

Simulation can be an excellent teaching and learning method if the scenarios are created appropriately. It starts with assessing the learner's needs and is followed by laying down objectives embracing the SMART principles. While creating a scenario, it is essential to consider the different aspects of realism, such as physical, contextual and psychological aspects. Using moulages and props helps in creating physical realism. The simulation expert should also be aware of the learner's experience and decide the SimZones for their learners based on their level of clinical expertise. The scenario progression needs to be laid down in stages. The role of the embedded participant needs to be decided a priori, and the embedded participant should be well-versed in their role. Pilot testing is a crucial step in simulation development as it keeps the simulation expert aware of the loopholes in the simulation scenario before running.

Simulation-based education for nurse and midwife advanced practitioner education: a scoping review protocol

OBJECTIVE

The objective of this scoping review is to identify and describe the extent and type of the available evidence on simulation-based education for nurse and midwife advanced practitioner education.

INTRODUCTION

Simulation-based education is widely adopted in undergraduate nurse and midwife education, but the extent of the use, format, and evidence for simulation-based education in nurse and midwife advanced practitioner education is under explored.

INCLUSION CRITERIA

Studies will be included where the population is registered nurses or midwives enrolled in education programs leading to an award of, or eligibility to register as a nurse or midwife advanced practitioner. Participants will have been exposed to simulation-based education as a teaching methodology. Simulation-based education may take place in practice and/or in an academic setting in any geographical location.

METHODS

An initial limited search was conducted in Embase and CINAHL to identify articles relevant to the topic. Text words contained within the titles and abstracts of articles, as well as index terms describing the relevant articles, were used in the development of the full search strategy. The keywords and index terms identified in the Embase search strategy will be adapted across other nursing, midwifery, and educational databases, including MEDLINE, PsycINFO, and ERIC. Studies published in any language, spanning any date range will be included. Records retrieved will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Two reviewers will independently assess the records for inclusion against the defined criteria and extract data using an adapted JBI data extraction form. The data will be charted using narrative summary text, tables, and figures.

Ethical Considerations of Replacing Clinical Hours With Simulation in Undergraduate Nursing Education: Means to an End, or an End in Itself?

In the current health-care environment, undergraduate nursing programs are expected to provide high-quality clinical experiences for students despite increasing difficulty accessing clinical placements. Expectations for newly graduated nurses have increased in the last few years, with an emphasis on "work-ready" graduates. At the same time, the availability of a variety of clinical practicum placements has decreased in some areas, increasing the difficulty of meeting the increasing numbers of nursing students required for future workforce planning, a situation exacerbated by the ongoing COVID-19 global pandemic. Nursing educators are caught between industry requirements for clinically prepared students and the regulatory requirements of their educational institutions. One solution being espoused internationally is substituting simulation for clinical practicum hours. Simulation offers many advantages, especially for patient safety, providing students with opportunities to link theory to practice in a controlled environment. This article discusses the ethical considerations of substituting simulation for clinical hours in undergraduate nursing education. Is this substitution justified as a means to an end or an end in itself?

Cenários simulados em enfermagem: revisão integrativa de literatura

RESUMO Objetivos: identificar na literatura científica quais os cenários clínicos simulados desenvolvidos e validados para o ensino e aprendizagem em enfermagem. Métodos: revisão integrativa, realizada em sete fontes de informação. Utilizaram-se o programa Rayyan para seleção, a análise de conteúdo para exploração dos achados e a ferramenta de avaliação metodológica do percurso de validação, intitulada Avaliação da Qualidade para Estudos de Validade. Resultados: identificaram-se, inicialmente, 1.179 manuscritos e 14 compuseram a amostra. Definiram-se duas categorias: Perfil dos cenários clínicos simulados produzidos em enfermagem; e Habilidades clínicas desenvolvidas e seus mecanismos de avaliação. Considerações Finais: houve preponderância de cenários de alta fidelidade, construídos no Brasil, nos últimos cinco anos, voltados a estudantes de enfermagem sobre as temáticas da urgência e emergência, cuidado materno e estomaterapia, abordando a avaliação das habilidades cognitivas, psicomotoras e afetivas em enfermagem. A maioria dos estudos obteve boa qualidade metodológica em seu processo de validação de conteúdo.

Simulated scenarios in nursing: an integrative literature review

ABSTRACT Objectives: to identify in scientific literature which simulated clinical scenarios were developed and validated for teaching and learning in nursing. Methods: integrative review, carried out in seven sources of information. The Rayyan program was used for selection, content analysis to explore the findings and the methodological assessment tool of the validity process, entitled Quality Appraisal tool for Validity Studies. Results: initially, 1,179 manuscripts were identified and 14 were part of the sample. Two categories were defined: Profile of simulated clinical scenarios produced in nursing; and Clinical skills developed and their assessment mechanisms. Final Considerations: there was a preponderance of high-fidelity scenarios, built in Brazil in the last five years, aimed at nursing students on the themes of emergency, maternal care and stomatherapy, addressing the assessment of cognitive, psychomotor and affective skills in nursing. Most studies obtained good methodological quality in their content validity process.

Vicarious learning and communication self-efficacy: A pediatric end-of-life simulation for pre-licensure nursing students

BACKGROUND

End-of-life clinical experiences, particularly in pediatrics, are quite limited for pre-licensure nursing students. Though effective, end-of-life simulations can be costly, require facilitators trained in palliative and end-of-life care, and are restricted by limited space and time availability. Such barriers prompt the question as to whether there is an effective alternative to simulation by which students can gain improved self-efficacy in therapeutic communication during pediatric end-of-life situations.

PURPOSE

Bandura's Social Cognitive Theory and work exploring self-efficacy posits that vicarious learning provides learners opportunities to gain experience and knowledge through observation of peers in simulated settings. This study evaluated the effectiveness of vicarious versus active learning on pre-licensure nursing students' perceived self-efficacy in providing therapeutic communication during a pediatric end-of-life situation.

METHOD

Data were collected over three time points - pre-simulation, post-simulation, and post-debriefing - using a modified Self-Efficacy in Communication Scale.

RESULTS

Learners in both groups had significant improvement in self-efficacy across all time points. Only two items had significant differences between vicarious and active learner groups, but the effect was minor.

CONCLUSION

Vicarious learning presents as a viable pedagogical approach for providing pre-licensure nursing students important learning opportunities related to pediatric end-of-life simulations during both the scenario and debriefing.

Dose-Response Relationship between High-Fidelity Simulation and Intensive Care Nursing Students' Learning Outcomes: An Italian Multimethod Study

Background: The best application modality of high-fidelity simulation in graduate critical care nursing courses is still rarely investigated in nursing research. This is an important issue since advanced nursing skills are necessary to effectively respond to critically ill patients' care needs. The aim of the study was to examine the influence of a modified teaching model based on multiple exposures to high-fidelity simulations on both the learning outcomes and the perceptions of graduate students enrolled in a critical care nursing course. Methods: A multimethod study involving a sample of graduate critical care nursing students was conducted. A theoretical teaching model focused on multiple exposures to high-fidelity simulations is currently applied as a teaching method in an Italian critical care nursing course. According to the Kirkpatrick model for evaluating training programs, the performance, self-efficacy, and self-confidence in managing critically ill patients were considered learning outcomes, while satisfaction with learning and students' lived experiences during the experimental phases were considered students' perceptions. Results: Multiple exposures to high-fidelity simulations significantly improved performance, self-efficacy, and self-confidence in managing virtual critically ill patients' care needs. The satisfaction level was high, while lived experiences of participants were positive and allowed for better explanation of quantitative results of this study. Conclusions: Multiple exposures to high-fidelity simulations can be considered a valuable teaching method that can improve the learning outcomes of graduate nurses enrolled in an intensive care course.