The use of simulation to address the acute care skills deficit in pre-registration nursing students: a clinical skill perspective

Comparing formative and summative simulation-based assessment in undergraduate nursing students: nursing competency acquisition and clinical simulation satisfaction

BACKGROUND

Formative and summative evaluation are widely employed in simulated-based assessment. The aims of our study were to evaluate the acquisition of nursing competencies through clinical simulation in undergraduate nursing students and to compare their satisfaction with this methodology using these two evaluation strategies.

METHODS

Two hundred eighteen undergraduate nursing students participated in a cross-sectional study, using a mixed-method. MAES© (self-learning methodology in simulated environments) sessions were developed to assess students by formative evaluation. Objective Structured Clinical Examination sessions were conducted to assess students by summative evaluation. Simulated scenarios recreated clinical cases of critical patients. Students´ performance in all simulated scenarios were assessed using checklists. A validated questionnaire was used to evaluate satisfaction with clinical simulation. Quantitative data were analysed using the IBM SPSS Statistics version 24.0 software, whereas qualitative data were analysed using the ATLAS-ti version 8.0 software.

RESULTS

Most nursing students showed adequate clinical competence. Satisfaction with clinical simulation was higher when students were assessed using formative evaluation. The main students' complaints with summative evaluation were related to reduced time for performing simulated scenarios and increased anxiety during their clinical performance.

CONCLUSION

The best solution to reduce students' complaints with summative evaluation is to orient them to the simulated environment. It should be recommended to combine both evaluation strategies in simulated-based assessment, providing students feedback in summative evaluation, as well as evaluating their achievement of learning outcomes in formative evaluation.

High-Fidelity Virtual Objective Structured Clinical Examinations with Standardized Patients in Nursing Students: An Innovative Proposal during the COVID-19 Pandemic

In response to the cancellation of in-person objective structured clinical examinations (OSCEs) prompted by confinement due to the COVID-19 pandemic, we designed a solution to adapt our traditional OSCEs to this new reality in nursing education. We implemented an innovative teaching proposal based on high-fidelity virtual OSCEs with standardized patients. The purposes of our study were to describe this innovative teaching proposal and compare nursing competence acquisition in final year nursing students through virtual and in-person OSCE modalities. The study included 234 undergraduate students: 123 students were assessed through high-fidelity virtual OSCEs during May 2020, whereas 111 students were assessed through in-person OSCEs during May 2019. The structure of OSCEs, including its stations, clinical simulated scenarios, and checklists, was the same in both OSCE modalities. The effect size of the differences among the competence categories of checklists, including their total scores, was small. Regarding our virtual OSCEs was similarly successful to in-person OSCEs, this online format was found to be useful, feasible, and cost-saving when in-person OSCE was not possible. Therefore, high-fidelity virtual OSCEs with standardized patients could be considered as another choice of OSCE not only in the current COVID-19 pandemic but could also be extended to normal situations, even post-pandemic.

Reversible causes of cardiac arrest: Nursing competency acquisition and clinical simulation satisfaction in undergraduate nursing students

BACKGROUND

It is essential to determine and treat the reversible causes of cardiac arrest, so emergency nurses must acquire the competencies needed for its adequate management.

METHOD

106 undergraduate nursing students participated in a cross-sectional study, using a mixed-method. Simulated scenarios recreated critically ill patients with diagnoses of potentially reversible causes of cardiac arrest in an emergency room. An internally validated questionnaire was used to analyse students' satisfaction and perceptions about clinical simulation sessions. Nursing competencies were assessed using a verification list. Data were analysed using the IBM SPSS Statistics version 24.0 (quantitative data) and ATLAS-ti version 8.0 (qualitative data) software.

RESULTS

Nursing students expressed a high level of satisfaction (most of the scores obtained were higher than 90%) and positive perceptions about clinical simulation sessions. Most of the students (85.6%) acquired the necessary nursing competencies for adequate management of the reversible causes of cardiac arrest.

CONCLUSION

Clinical simulation methodology is a useful tool for the learning process and acquisition of nursing competencies related to emergency situations management. This methodology prepares nursing students for their clinical placements and future careers in emergency care. Therefore, it is recommended to extend clinical simulation training to emergency qualified nursing staff and advanced practitioners.

Results of cross-faculty 'capstone' assessments involving nursing and performing arts students

This article describes how 'capstone' assessments were created to provide two different student groups, nursing and performing arts students, with a lived experience of learning together about their own fields of practice. Capstone assessments combine 'live' human simulation with self-reflection and peer review. A capstone assessment is the integration of a body of relatively fragmented knowledge and learning to form a unified whole and can be used as a transitional assessment and a bridging experience to connect knowledge between modules or courses. The capstone assessments involved two faculties and four modules, three nursing and one performing arts. Case studies were designed to represent real-life situations that students were likely to encounter during their careers, either playing a patient as an actor or performing a caring role as a nurse. Assessments for the capstone simulation were formative, and involved the students engaging in self-reflection and peer review. Videos were available to enhance the self-reflection and peer-review process. Evaluation was undertaken through verbal feedback during debrief, written feedback, video footage and nursing student and acting student peer review. The experience of capstone assessments for two diverse student groups provided valuable learning from their own and from a different group outside their subject area.

Using reusable learning objects (rlos) in injection skills teaching: Evaluations from multiple user types

BACKGROUND

Clinical skills are a critical component of pre-registration nurse education in the United Kingdom, yet there is widespread concern about the clinical skills displayed by newly-qualified nurses. Novel means of supporting clinical skills education are required to address this.

METHODS

A package of Reusable Learning Objects (RLOs) was developed to supplement pre-registration teaching on the clinical skill of administering injection medication. RLOs are electronic resources addressing a single learning objective whose interactivity facilitates learning. This article evaluates a package of five injection RLOs across three studies: (1) questionnaires administered to pre-registration nursing students at University of Nottingham (UoN) (n=46) evaluating the RLO package as a whole; (2) individual RLOs evaluated in online questionnaires by educators and students from UoN; from other national and international institutions; and healthcare professionals (n=265); (3) qualitative evaluation of the RLO package by UoN injection skills tutors (n=6).

RESULTS

Data from all studies were assessed for (1) access to, (2) usefulness, (3) impact and (4) integration of the RLOs. Study one found that pre-registration nursing students rate the RLO package highly across all categories, particularly underscoring the value of their self-test elements. Study two found high ratings in online assessments of individual RLOs by multiple users. The global reach is particularly encouraging here. Tutors reported insufficient levels of student-RLO access, which might be explained by the timing of their student exposure. Tutors integrate RLOs into teaching and agree on their use as teaching supplements, not substitutes for face-to-face education.

CONCLUSION

This evaluation encompasses the first years postpackage release. Encouraging data on evaluative categories in this early review suggest that future evaluations are warranted to track progress as the package is adopted and evaluated more widely.

The impact of simulation-based learning on students' English for Nursing Purposes (ENP) reading proficiency: a quasi-experimental study

AIM

This is a report of a study which evaluated simulation-based learning as a teaching strategy for improving participants' ENP reading proficiency in the senior college program of students whose first language is Chinese, not English.

BACKGROUND

Simulation-based learning is known to be one of most effective teaching strategies in the healthcare professional curricula, which brings a clinical setting into the classroom. However, developing English reading skills for English written nursing journals through simulation-based learning in the nursing curricula, is largely unknown.

METHOD

We used a quasi-experimental approach with nonequivalent control group design to collect the causal connections between intervention and outcomes. 101 students were enrolled in this study (response rate 92.6%) of these 48 students volunteered for the intervention group, and 53 students for the control group.

RESULTS

The findings indicated that the intervention group had significantly higher mean scores in ENP reading proficiency with unknown words in the article (p=.004), vocabulary (p<.001), and comprehension (p<.001) compared to the control group. Also, the intervention students showed more improvement in their English reading, both from quantitative and qualitative findings.

CONCLUSION

Simulation-based learning may have some advantages in improving the English reading ability on English written nursing journals among nursing students. However, the benefits to the students of this study is still to be determined, and further exploration is needed with well designed research and a universal method of outcome measurement.