A comparative assessment of nursing students' cognitive knowledge of blood transfusion using lecture and simulation

Effectiveness of Simulation-Based Education for Caring Patients with COVID-19

PURPOSE

The role of medical staff gained immense significance in the context of the prolonged coronavirus disease (COVID-19) pandemic. However, few studies had explored the impact of simulation-based education on the ability of nursing students to care for the patients of COVID-19. This study provided nursing students with simulation-based education in caring for the patients of COVID-19 and confirmed its effectiveness.

METHODS

This study used a non-equivalent control group pretest-posttest design. The participants were recruited from the nursing departments of two universities in Korea through convenience sampling. A total of 79 participants were included: 37 in the intervention group and 42 in the control group. The intervention group received four sessions of simulation training based on the National League for Nursing Jeffries simulation theory.

RESULTS

The intervention group showed an improvement compared to the control group in terms of knowledge related to coronavirus, confidence in performing infection control skills, and perception of preparedness for caring for the patients of COVID-19, with a high-level of satisfaction and self-confidence in learning. There was no significant difference between the two groups in terms of anxiety.

CONCLUSION

This simulation is expected to be a significant strategy for alleviating the global burden in terms of staff safety and patient outcomes by improving the competencies of prospective medical staff in responding to pandemics.

Improving nurses' blood transfusion knowledge and skills

The World Health Organization (2019) has determined that patient safety is a global public health challenge. In UK clinical areas, policies and procedures are in place for the safe prescribing and delivery of blood and blood product transfusions, yet patient safety incidences continue. Undergraduate nurse education and training may provide the underlying knowledge to practitioners, while postgraduate standalone training sessions support skill development. However, over time, without regular experience, competence will diminish. Nursing students may have little exposure to transfusion practice and COVID-19 may have exacerbated this challenge with a reduction in placement availability. The use of simulation to support theory with follow-up and ongoing drop-in training sessions may help to inform practitioners and improve patient safety in the management and delivery of blood and blood product transfusion.

Learning practical nursing skills in simulation centers - A narrative review

Background

Practical skills are complex procedures integrating communication and caring, as well as technical and manual aspects. Simulation at a simulation/skills center offers a wide range of learning activities and aims to imitate patient situations.

Objectives

To investigate the international research literature on practical skills learning in simulation/skills centers in nursing education. Research questions: 1. What are the range and type of practical skills studied? 2. What learning activities are focused on in the studies included in the review? 3. What are the learning outcomes and how are they assessed?

Design

Narrative review.

Methods

We searched electronically and included studies from Medline Ovid, CINAHL, Eric, Embase, Academic Search Premiere, and Cochrane. Unique indexing terms and search strategies were developed for each database. The criteria for inclusion were bachelor nursing students as the study population and practical nursing skills learning in simulation/skills centers. We used Rayyan QCRIt for the initial screening and the Mixed Method Appraisal Tool for quality assessment. We used a narrative approach to synthesize the diverse range of studies.

Findings

One hundred and twenty-one studies from 26 countries published between January 2013 and March 2022 were included. The amount of quantitative research was overwhelming (n = 108). A total of 50 different practical skills were represented. The studies focused on which learning modalities resulted in the best learning outcomes. Only 8.5% (n = 7) of the included studies concerned students' learning processes. Skill performance (n = 101), knowledge (n = 57), confidence (n = 34), and satisfaction (n = 32) were the main learning outcomes measured.

Discussion

The quality assessment indicated that 10 of the studies achieved 100% on the mixed method appraisal tool criteria. In many of the studies with quasi-experimental and randomized controlled trial designs, the intervention group received some form of educational treatment while the control group received no treatment. The choice of no treatment for the control group in pedagogical research seems to disregard the inherent purpose and effect of teaching and learning.

Conclusion

Heterogeneity in the use of learning modalities and measuring instruments precludes the possibility of building on other research. Technical skills were the preferred choice of skill, while skills that involved a fair measure of communication and collaboration were only sparingly studied. Students' learning processes were barely touched on in the included studies. More focus should be placed on this area in further research, since the choice of learning modalities may affect the students' learning processes in significant ways.

Effectiveness of a combined web-based and simulation-based continuing education on home-care professionals' competence to evaluate older people's acute care needs in Finland

Home-care professionals need competences to ensure that they evaluate their older peoples' health conditions, especially in acute care situations. This study aims to investigate the effectiveness of combined web-based and simulation-based continuing education on home-care professionals' competence regarding evaluating older people's needs for acute care. A quasi-experimental pre-test-post-test study was conducted with home-care professionals who were working in older people's care in Finland. Home-care professionals (N = 254) had participated in combined web-based and simulation-based continuing education in 2017-2019. Data were collected using a questionnaire developed for this study before (n = 171) and after (n = 83) the education. The data were analysed statistically. The mean competence score was 3.22 ± 0.51 before the education and 3.92 ± 0.57 after the education. Improvements were detected in overall competence and in all eight subscales. Improvements were highest in health assessment and consultation and the lowest in type 2 diabetes, but this was already the highest level of self-assessed competence in the pre-test assessment. The combined web-based and simulation-based continuing education was effective in increasing the home-care professionals' competence in evaluating older people's needs for acute care. Evaluating older people's needs for acute care should be embedded in curricula and continuing education programmes.

The Development and Effectiveness of Combining Case-Based Online Lecture and Simulation Programs to Facilitate Interprofessional Function Care Training in Nursing Homes

The aim of this study was to (1) develop a case-based combination of online lectures and simulations for function-focused care by nursing home interdisciplinary caregivers and (2) evaluate participants' increasing shared team and task knowledge by surrogate measures of team process and team performance. The study comprised the following steps: (1) the design of a learning module using a shared understanding of function-focused care as a shared mental model; (2) the establishment of two computer programs for online lectures and simulations using cases involving older adults with disabilities; and (3) testing the educational programs using a repeated-measures design. Participants were 61 interdisciplinary caregivers from seven nursing homes in four regions. Data from participants' team process and team performance were collected pre test, post online lecture, and post simulation. Repeated-measures analysis of variance showed that the mean scores for scales of "transactive memory system," "knowledge sharing and utilization," "team outcomes," "motivation for learning transfer," "self-efficacy," "interpersonal understanding," "proactivity in problem solving," and "function-focused care knowledge" differed significantly between the time points. The results indicate that a case-based program of a combination of online lectures and simulations elicits significant improvements in participants' team process and team performance.

Assessment the knowledge of blood transfusion in Iranian nurses of Tehran's hospitals

OBJECTIVE

To investigate the knowledge of nurses about pre and post blood transfusion processes.

BACKGROUND

To ensure a safe blood transfusion, apart from the role of blood banking to perform safe donation, attention must be paid to equally important but rather neglected factors including nursing practice and knowledge of blood transfusion.

METHOD AND MATERIALS

Data was collected using a valid blood transfusion questionnaire consisting of 43 questions. We analysed data using SPSS 22. Percentages and analytical statistics such as Mann-Whitney, Kruskal-Wallis were used to report the results. The significant level of p-value was assumed to be <0.05.

RESULTS

In this study, 325 nurses participated and their knowledge scores ranged from 24% to 85% (mean 56.16, standard deviation: 5.92) and the majority of nurses lacked knowledge in pre-transfusion activities. The analysis also revealed there was a significant correlation between the knowledge score and academic degree. Out of all nurses, 48% (N = 156) declared that they need further training in haemovigilance. As the minimum and maximum scored questions, it was revealed that only 39 nurses (12%) have enough knowledge to act properly in case of ambiguous orders; on the other hand, 94% (N = 304) have sufficient knowledge of the agents administered with transfusion. A large proportion of the involved nurses are unaware of the risk of improper identification.

CONCLUSION

All the efforts taken to prepare a safe and matched blood unit would be futile by inattentive administration of blood. That is why mandatory ongoing blood transfusion training for nurses is required urgently.

Structured simulations improves students' knowledge acquisition and perceptions of teaching effectiveness: A quasi-experimental study

AIMS

To determine the effect of adding structured simulation to a traditional classroom lecture format on students' knowledge acquisition and their evaluation of faculty teaching effectiveness, compared to traditional classroom lectures alone.

BACKGROUND

There is a critical lack of high-quality clinical placements/experiences in nursing education, particularly in clinical specialty populations, such as paediatrics. Simulation has been shown to help students practice in a safe environment. However, less is known about the outcomes of embedding simulation in didactic class sessions or classroom lectures. Additionally, data on the impact of simulation as a teaching pedagogy on faculty teaching effectiveness is limited.

DESIGN

Post-test, nonequivalent control group quasi-experimental study.

METHODS

Students in two prelicensure nursing programs participated in a 10-week term paediatric nursing course taught by the same faculty member on two different campuses. The students at one campus, designated as the control group (n = 43), received four hours of traditional, lecture-only, instructions. The group at a second campus, the intervention group (n = 44), received the same lectures with added structured simulations. Students' knowledge acquisition and their evaluation of faculty teaching effectiveness were measured in both groups using the same standardised assessment measures. The CONSORT checklist was followed.

RESULTS

Students' knowledge acquisition scores and their evaluation scores of faculty teaching effectiveness were significantly higher in the intervention (simulation) group compared to the control group. A significantly higher number of students in the simulation group scored above the national average Nursing Care of Children score as compared to students in the control group.

CONCLUSIONS

Integrating simulation with didactic instruction enhanced students' knowledge acquisition and improved their opinion of faculty teaching effectiveness.

RELEVANCE TO CLINICAL PRACTICE

Augmenting lecture with simulation may provide students with learning experiences that they may not have during clinical rotation due to a lack of paediatric clinical placement sites and differences between sites.

Development of clinical competence in nursing in simulation: the perspective of Bloom's taxonomy

OBJECTIVES

to investigate the scientific evidence on the use of Bloom's taxonomy for developing competence in nursing professionals and students in clinical simulation.

METHODS

integrative review of the National Library of Medicine (NLM), National Institutes of Health (NIH), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin American and Caribbean Literature in Health Sciences (LILACS), Web of Science and SCOPUS databases, using the Rayyan application.

RESULTS

a total of 871 studies were identified; four composed the sample. The development of clinical competence occurred through the coordination of knowledge, skills, and attitudes. To develop the cognitive domain, the objectives of knowledge and comprehension of the Bloom's taxonomy were mobilized. The psychomotor domain required development of the skills demanded by the proposed clinical care. The affective domain was developed through will and motivation to learn.

CONCLUSIONS

it is possible to develop clinical competence in nursing by adopting Bloom's taxonomy in each phase of clinical simulation.

Nurses' hemovigilance knowledge and performance after teach-back, concept map, and lecture: A quasi-experimental study

Objectives

This study aimed to compare the effects of teaching by three methods of teach-back, concept map, and lecture on knowledge and performance of nurses in hemovigilance process.

Methods

This quasi-experimental study was performed on 108 Iranian nurses. In the lecture group, the educational intervention was conducted during a 4-hour session; and in the concept map and teach-back groups, it was performed in two 2-hour sessions. The nurses’ knowledge and performance were measured by “routine blood transfusion knowledge questionnaire (RBTKQ)” and “self-reporting performance-evaluator questionnaire”.

Results

After the interventions, knowledge was significantly higher in the teach-back and the concept map groups compared to the lecture group (p = 0.001), but the performance in the lecture group was higher than the other two groups (p = 0.01). No statistically significant differences were found between teach-back and concept map groups.

Conclusion

Teach-back and concept map methods were effective in improving the nurses’ hemovigilance knowledge, while the lecture was associated with a significant increase in their performance. Therefore, integrating the hemovigilance teaching methods is suggested.

The Impact of a New Pedagogical Intervention on Nursing Students' Knowledge Acquisition in Simulation-Based Learning: A Quasi-Experimental Study

Simulation-based learning is an effective technique for teaching nursing students' skills and knowledge related to patient deterioration. This study examined students' acquisition of theoretical knowledge about symptoms, pathophysiology, and nursing actions after implementing an educational intervention during simulation-based learning. A quasi-experimental study compared theoretical knowledge among two groups of students before and after implementation of the intervention. The intervention introduced the following new components to the existing technique: a knowledge test prior to the simulation, video-recording of the performance, and introduction of a structured observation form used by students and facilitator during observation and debriefing. The intervention group had significantly higher scores on a knowledge test conducted after the simulations in comparison to the scores in the control group. In both groups scores were highest on knowledge of symptoms and lowest on knowledge of pathophysiology; the intervention group had significantly higher scores than the control group on both topics. Students' theoretical knowledge of patient deterioration may be enhanced by improving the students' prerequisites for learning and by strengthening debriefing after simulation.

Blood transfusion in Intensive Care Units: knowledge of the nursing team*

Objetivo: Evaluar el conocimiento de los profesionales del equipo de enfermería de Unidades de Cuidados Intensivos sobre transfusión desangre y los factores asociados a ésta.Metodología: Se trata de un estudio transversal y cuantitativo, el cual se realizó en tres hospitales. La muestra, no sistemática, se constituyó por 104 profesionales de enfermería que laboran en las Unidades de Cuidados Intensivos de estas instituciones de salud. Para la recolección de los datos, se utilizó un instrumento de tipo check-list desarrollado y validado por las autoras.Resultados: La puntuación global de conocimiento presentó una media de 50,4%. Los factores asociados al conocimiento fueron Entrenamiento u orientación y seguimiento de protocolos/directrices para llevar a cabo el proceso de transfusión; Frecuencia de los procedimientos de transfusión de sangre realizados por el profesional; y El factor autoconfianza. Para las etapas: etapa pré-transfusão, etapa de transfusão y etapa póst-transfusão, los resultados fueron 48,3%, 52,2% y 58,3%, respectivamente.Conclusiones: El presente estudio evidenció no sólo que los profesionales de enfermería poseen un mejor conocimiento de las complicaciones postransfusionales, sino también que la auto-confianza, el uso de protocolos, los programas de entrenamiento y tener sólo un empleo son factores asociados a un mejor conocimiento y a la vigilancia durante la realización del procedimiento.

The value of simulation-based learning in pre-licensure nurse education: A state-of-the-art review and meta-analysis

Simulation modalities are numerous in nursing education, with a need to reveal their range and impact. We reviewed current evidence for effectiveness of medium to high fidelity simulation as an education mode in pre-licensure/pre-registration nurse education. A state-of-the-art review and meta-analyses was conducted based on a systematic search of publications in English between 2010 and 2015. Of 72 included studies, 43 were quantitative primary studies (mainly quasi-experimental designs), 13 were qualitative studies and 16 were reviews of literature. Forty of 43 primary studies reported benefits to student learning, and student satisfaction was high. Simulation programs provided multi-modal ways of learning. A meta-analysis (8 studies, n = 652 participants) identified that simulation programs significantly improved clinical knowledge from baseline. The weighted mean increase was 5.0 points (CI: 3.25-6.82) on a knowledge measure. Other objectively rated measures (eg, trained observers with checklists) were few. Reported subjective measures such as confidence and satisfaction when used alone have a strong potential for results bias. Studies presented valid empirical evidence, but larger studies are required. Simulation programs in pre-licensure nursing curricula demonstrate innovation and excellence. The programs should be shared across the discipline to facilitate development of multimodal learning for both pre-licensure and postgraduate nurses.

Designing and evaluating the effectiveness of a serious game for safe administration of blood transfusion: A randomized controlled trial

BACKGROUND

Preparing nursing students for the knowledge and skills required for the administration and monitoring of blood components is crucial for entry into clinical practice. Serious games create opportunities to develop this competency, which can be used as a self-directed learning strategy to complement existing didactic learning and simulation-based strategies.

AIM

To describe the development and evaluation of a serious game to improve nursing students' knowledge, confidence, and performance in blood transfusion.

METHOD

An experiential gaming model was applied to guide the design of the serious game environment. A clustered, randomized controlled trial was conducted with 103 second-year undergraduate nursing students who were randomized into control or experimental groups. After a baseline evaluation of the participants' knowledge and confidence on blood transfusion procedure, the experimental group undertook a blood transfusion serious game and completed a questionnaire to evaluate their learning experience. All participants' clinical performances were evaluated in a simulated environment.

RESULTS

The post-test knowledge and confidence mean scores of the experimental group improved significantly (p<0.001) after the serious game intervention compared to pre-test mean scores and to post-test mean scores of the control group (p<0.001). However, no significance difference (p=0.11) was found between the experimental and control groups on the post-test performance mean scores. The participants evaluated the serious game positively.

CONCLUSION

The study provided evidence on the effectiveness of a serious game in improving the knowledge and confidence of nursing students on blood transfusion practice. The features of this serious game could be further developed to incorporate additional scenarios with repetitive exercises and feedback to enhance the impact on clinical performance. Given the flexibility, practicality, and scalability of such a game, they can serve as a promising approach to optimize learning when blended with high-fidelity simulation.