Effect of simulation modules on Jordanian nursing student knowledge and confidence in performing critical care skills: A randomized controlled trial

Implementation of simulation training in the Intensive Care Units (ICU) during the COVID-19 pandemic: A scoping review

INTRODUCTION

In response to the important influx of critically ill patients as well as resources limitation, simulation would be a tool ensuring the continuum of medical training.

AIM

To assess the impact of simulation training on both education and performance related to protocol development during COVID-19 pandemic, in critical care.

METHODS

This scoping review was written in accordance with the PRISMA Guideline. Data sources and studies were identified by searching "MEDLINE", "Cochrane library" databases and "Clinical trial.gov". Study inclusion adhered to the PICO criteria: Population, Intervention, Comparison, and Outcomes. The Kirkpatrick Model, is a tool for evaluating the level of impact of training results according to four levels Results: The search algorithm yielded sixteen articles of which eight were meeting criteria for inclusion and finally seven were available. The number of participants ranged from 12 to 108 with a median of 61 (IQR: 8-76). The length of intervention ranged from 12 min to three hours with a median of 38 min (IQR: 12-135). Studies reported that incorporating simulation yields a more pronounced impact compared to theoretical and clinical training alone in enhancing knowledge and confidence. Regarding the role of simulation in protocol development, results have shown that in the pre-test, all the participants failed donning and doffing Personal Protective Equipment (PPE), the mean cognitive load was high (7.43±0.9 points) and the performance was low (2.5±0.8) while in the post-test, 100% of participants were successful in donning the PPE, the mean of the cognitive load decreased (4.1±1.4 points), and the performance substantially increased (7.9±1.1). In addition, five studies showed behavioral changes after training and thus the simulation reached Kirkpatrick level three.

CONCLUSION

Results supported the impact of simulation, in critical care, as an effective method to enhance knowledge and confidence, and to improve protocol development during pandemics such as COVID-19.

The efficacy of high-fidelity simulation on knowledge and performance in undergraduate nursing students: An umbrella review of systematic reviews and meta-analysis

OBJECTIVES

This umbrella review aimed to consolidate the evidence base on the impact of high-fidelity simulation on knowledge and performance among undergraduate nursing students.

DESIGN

Umbrella review with meta-analyses of pooled effect sizes, followed by an additional meta-analysis of primary studies from the included systematic reviews, excluding overlapping results.

DATA SOURCES

Systematic searches were performed up to August 2023 in PubMed, Embase, and Cochrane Library. We included reviews that compared high-fidelity simulation against other learning strategies.

REVIEW METHODS

The risk of bias was assessed for each included systematic review (ROBIS tool) and primary study (RoB 2 or ROBINS-I as appropriate). Random-effect meta-analyses of meta-analyses were performed to estimate the pooled effects of high-fidelity simulation on knowledge and performance. Further random-effect meta-analyses of primary studies were conducted, with overlapping studies excluded (12 %). Subgroup analyses were performed to provide a more comprehensive analysis of the findings. Trim-and-fill analyses were conducted to adjust for potential publication bias.

RESULTS

Six systematic reviews were included and encompassed 133 primary studies (2767 and 3231 participants concerning performance and knowledge, respectively). The adjusted pooled effects for knowledge (SMD = 0.877, 95 % CI: 0.182 to 1.572) and performance (SMD = 0.738, 95 % CI: 0.466 to 1.010) closely aligned with those obtained from meta-analyzing the primary studies for knowledge (SMD = 0.980) and performance (SMD = 0.540), both showing high statistical heterogeneity. Traditional lectures represented the more common comparison. The subgroup analysis revealed significant differences in effect sizes across geographic locations, topics, types of control, and how interventions were reported.

CONCLUSIONS

The results provide robust evidence supporting the integration of high-fidelity simulation into undergraduate nursing programs to enhance students' knowledge and performance. The high reported heterogeneity may be attributed to variations in study contexts or methodologies. Future research should explore the optimal use of high-fidelity simulation in different educational and cultural contexts.

Evaluating Clinical Skill Competence and Professional Behaviors in Nursing Students Following Simulation Training at the University of Tabuk

Introduction

Simulation training has become an integral component of nursing education, offering students opportunities to develop and refine their clinical skills in a controlled and safe environment.

Objective

This study aimed to evaluate the clinical skill competence and professional behaviors of undergraduate nursing students following simulation training.

Design

A descriptive cross-sectional design was employed for this study.

Setting

The study was conducted in the simulation center at the University of Tabuk using the Clinical Competency Questionnaire (CCQ), with data collected between January 1, 2023 and February 28, 2023. Participants were enrolled using a convenience sampling method, including nursing students in the 3rd and 4th years who trained in the simulation center and agreed to participate.

Results

The study results indicate that a majority of students demonstrated strong theoretical knowledge and practical competence in performing sterile techniques and administering oral medications with minimal or no supervision, with percentages of 74.7% and 73.3%, respectively. A significant proportion of students reported uncertainty or lack of skill in performing shift reports using SBAR (38.4%) and assessing gastrostomy tube placement (32.9%). Students exhibited satisfactory knowledge and competence in maintaining appropriate appearance, attire, and conduct (71.2%), understanding, and supporting group goals (71.2%), and comprehending patients' rights (69.9%).

Conclusion

The findings suggest that nursing students attain a relatively high level of clinical competence and self-confidence after simulation training. This study recommends incorporating simulation training in nursing education, which enhances professional behaviors like appearance, group goals, and patient rights, but requires improvement in constructive criticism, problem prevention, and cultural competence.

Healthcare professionals' knowledge and attitudes towards surgical site infection and surveillance: A quasi-experimental study

AIM

SSI is one of the most prevalent healthcare-associated infections and is associated with extended hospital stays, increased need for reoperation and higher hospital readmission rates. Implementing systematic SSI surveillance can reduce these adverse outcomes. Implementing a surveillance system into a hospital is a complex intervention requiring that staff involved in a patient's perioperative journey have the knowledge of SSI prevention, the data required for surveillance, an understanding of how data informs quality improvement initiatives and their role in surveillance. The aim of this study was to evaluate the impact of a complex intervention on the knowledge and attitudes of healthcare professionals towards surgical site infection (SSI), SSI prevention and surveillance in a university hospital setting.

DESIGN

The study used a quasi-experimental pre-test-post-test design.

METHOD

The impact of a complex intervention was evaluated by measuring healthcare professionals' (n = 74) knowledge of and attitudes towards SSI and surveillance. Normalisation process theory (NPT) guided the study and the development of the intervention.

RESULTS

There was a statistically significant increase in scores on the knowledge of SSI and prevention from pre-intervention to post-test. The knowledge of risk factors scores at post-test was significantly higher than that at pre-intervention. Overall attitudes to SSI prevention and surveillance were good both pre-intervention and post-test but there was a significant change in the attitude of participants. The findings reveal an overall positive impact of the complex intervention on the knowledge and attitude of healthcare professionals relating to SSI, SSI prevention and surveillance; however, the extent of the change varied across items measured.

Influence of simulation design on stress, anxiety and self-confidence of nursing students: Systematic review with meta-analysis

AIM

To evaluate the simulation design characteristics that may influence the stress, anxiety and self-confidence of undergraduate nursing students during learning.

DESIGN

Systematic review with meta-analysis.

DATA SOURCES

Searchers were conducted in October 2020 and updated in August 2022 in the databases CENTRAL, CINAHL, Embase®, ERIC, LILACS, MEDLINE, PsycINFO®, Scopus and Web of Science, PQDT Open (ProQuest), BDTD, Google Scholar and specific journals on simulation.

REVIEW METHODS

This review was conducted according to the recommendations of Cochrane Handbook for Systematic Reviews and reported according to the PRISMA Statement. Experimental and quasi-experimental studies that compared the effect of simulation on stress, anxiety and self-confidence of nursing students were included. The selection of studies and data extraction was performed independently by two reviewers. Simulation information was collected as prebriefing, scenario, debriefing, duration, modality, fidelity and simulator. Data summarization was performed by qualitative synthesis and meta-analytical methods.

RESULTS

Eighty studies were included in the review, and most reported in detail the structure of the simulation, contemplating prebriefing, scenario, debriefing and the duration of each step. In subgroup meta-analysis, the presence of prebriefing, duration of more than 60 min and high-fidelity simulations helped reduce anxiety, while the presence of prebriefing and debriefing, duration, immersive clinical simulation modalities and procedure simulation, high-fidelity simulations and use of mannequins, standardised patients and virtual simulators, contributed to greater students' self-confidence.

CONCLUSIONS

Different modulations of simulation design components imply reduction of anxiety and increased self-confidence in nursing students, especially highlighting the quality of the methodological report of simulation interventions.

RELEVANCE TO CLINICAL PRACTICE

These findings help to support the need of more rigorous methodology in simulation designs and research methods. Consequently, impact on the education of qualified professionals prepared to work in clinical practice. No Patient or Public Contribution.

The Effect of Simulation on Newly Licensed Nurses' Confidence in Initiating Cardiopulmonary Resuscitation: A Narrative Review

Hospitalized patients experiencing cardiac arrest are more likely to receive resuscitative interventions such as cardiopulmonary resuscitation (CPR), advanced cardiac life support, and defibrillation, than patients who experience a cardiac arrest outside the hospital setting. Annually, there are nearly 290,000 inpatient cardiac arrests each year in the United States. These cardiac arrests are associated with a mean survival rate of only 25%. Increasing nurses' feelings of confidence in initiating CPR may lead to faster reaction times, shorter hospital stays, and improved patient outcomes. A narrative review of literature about the effectiveness of simulations on newly licensed nurses' perceived confidence in initiating CPR confidence levels yielded 16 articles.

Concepts and issues related to adolescent health in nursing education

OBJECTIVE

analyze the structure of teaching programs and contents of the adolescent health and its development in nursing education.

METHOD

descriptive observational study conducted in Colombia, Ecuador and Peru. Data was collected by the Instrument for (self-)evaluation of the adolescent health and development component in undergraduate nursing programs, and investigated using descriptive statistics.

RESULTS

A total of 95 nursing schools participated in the study (84.1% of the total). Of the faculty responsible for teaching contents relating to adolescent health, 31.6% had no specific training on the topic and 18.9% had no educational/pedagogical training. Behavior, gender identity and sexual orientation, bullying and cyberbullying, use of digital technologies, partner violence, parenting, and pubertal delay were the main topics which could be incorporated into nursing education.

CONCLUSION

the faculty of the schools analyzed have limited education in pedagogical/educational topics and specific adolescent health issues. Curricula should be updated, including knowledge of laws and policies, thus expanding nurses' ability to generate, analyze and use data for decision making.

(1) 31.6% of faculty have no specific education in adolescent health. (2) 18.9% of faculty have no educational/pedagogical training. (3) Progress is needed in the use of active methodologies and interactive multimedia. (4) Knowledge of laws and policies for the adolescent population must be expanded. (5) Current and relevant adolescent health issues need to be addressed in nursing education.

Nursing Students’ Satisfaction and Self-Confidence Levels After Their Simulation Experience

Background

Nursing students should be well prepared before going to clinical setting as they provide direct care to patient. Simulation gives the learners the opportunity to be active learners who practice, train, and give a reflection on a specific experience.

Objective

To obtain an understanding of the human patient simulation experience and nursing students’ perceptions of satisfaction and self-confidence.

Method

Cross-sectional, descriptive design was undertaken. Using purposive sampling, 273 nursing students were enrolled in basic adult nursing courses at levels four and five at female nursing college at King Saud University, Riyadh, Saudi Arabia. A questionnaire was used to measure the demographic characteristics, simulation design characteristics, and simulation educational practice context. Student Satisfaction and Self-confidence in Learning Scale was used to measure students’ satisfaction and self-confidence. Bivariate analyses were utilized where needed and multiple linear regression analysis was performed to find the relationship between variables.

Results

The current study revealed overall, nursing students were satisfied and self-confident after their human patient simulation experience. A relationship was observed between demographic characteristics, simulation design characteristics, and simulation educational practice context with students’ satisfaction and self-confidence.

Conclusion

Simulation is an effective teaching strategy that prepares nursing students for real clinical practice. Findings provided policymakers with information on nursing students’ current levels of satisfaction and self-confidence that can lead to developing future policies.