Problem-solving skills of senior student nurses: an exploratory study using simulation

Skills for safe practice - A qualitative study to evaluate the use of simulation in safeguarding children teaching for pre-registration children's nurses

Safeguarding children teaching is a required component in all pre-registration nursing curricula. A structured approach to this teaching as part of preparation for registration as a children's nurse was developed jointly by the Course Leader and the Designated Nurse for Safeguarding Children. This approach aims to equip children's nurses with the necessary theoretical knowledge and practical skills needed for safe practice. A key element in this curriculum is simulation, where students must assess injuries on manikins, select and complete appropriate documentation, and perform a nursing handover. Simulation has recognised value in nurse education but its use in safeguarding children teaching for student children's nurses has not previously been widely reported. This small-scale qualitative study explored the student experience and the impact of simulation teaching in the development of relevant knowledge and the core safeguarding skill set of observation, interpretation, documentation and communication. The methodology for this small, qualitative study was triangulated, comprising observation of the simulation teaching and two sets of semi-structured interviews. The resultant data was investigated using thematic analysis. The outcome of the study suggested that students were able to transfer learning from the simulation into clinical practice, and that simulation as an approach to safeguarding children teaching resonated with the students' preferred learning style and merits further consideration and evaluation.

Effect of case-based learning on the development of graduate nurses' problem-solving ability

Case-based learning (CBL) is a teaching strategy which promotes clinical problem-solving ability. This research was performed to investigate the effects of CBL on problem-solving ability of graduate nurses. This research was a quasi-experimental design using pre-test, intervention, and post-test with a non-synchronized, non-equivalent control group. The study population was composed of 190 new graduate nurses from university hospital A in Korea. Results of the research indicate that there was a statistically significant difference in objective problem-solving ability scores of CBL group demonstrating higher scores. Subjective problem-solving ability was also significantly higher in CBL group than in the lecture-based group. These results may suggest that CBL is a beneficial and effective instructional method of training graduate nurses to improve their clinical problem-solving ability.

Evaluating high-fidelity human simulators and standardized patients in an undergraduate nursing health assessment course

BACKGROUND

An undergraduate nursing health assessment course provided three experiential modalities for practicing health assessment skills: high-fidelity human simulators (HFS), standardized patients (SP) and community volunteers (CV). Previous research has examined the impact of each distinct modality on learning outcomes. However, few studies have compared these learning strategies. This study investigates learners' satisfaction, self-efficacy and performance behaviors among three learning approaches.

METHOD

Forty-four undergraduate nursing students were randomly assigned to perform focused respiratory assessments on a HFS, SP or CV. Participants completed the Health Assessment Educational Modality Evaluation (HAEME) survey to assess self-efficacy and modality satisfaction. A performance checklist evaluated assessment skills.

RESULTS

Performance behaviors were significantly greater with HFS, but learners were significantly less satisfied with this modality. Significant differences in students' self-efficacy were not found across the three modalities.

CONCLUSIONS

Significantly lower satisfaction with HFS may reflect learners' perceived lack of realism. However, HFS may provide a low-stress opportunity for novice learners to practice skills. Results support the integration of distinct experiential learning modalities in an undergraduate nursing health assessment course.

Problem solving strategies integrated into nursing process to promote clinical problem solving abilities of RN-BSN students

A set of problem solving strategies integrated into nursing process in nursing core courses (PSNP) was developed for students enrolled in a post-RN baccalaureate nursing program (RN-BSN) in a university in Taiwan. The purpose of this study, therefore, was to evaluate the effectiveness of PSNP on students' clinical problem solving abilities. The one-group post-test design with repeated measures was used. In total 114 nursing students with 47 full-time students and 67 part-time students participated in this study. The nursing core courses were undertaken separately in three semesters. After each semester's learning, students would start their clinical practice, and were asked to submit three written nursing process recordings during each clinic. Assignments from the three practices were named post-test I, II, and III sequentially, and provided the data for this study. The overall score of problem solving indicated that score on the post-test III was significantly better than that on post-test I and II, meaning both full-time and part-time students' clinical problem solving abilities improved at the last semester. In conclusion, problem-solving strategies integrated into nursing process designed for future RN-BSN students are recommendable.

Senior student nurses information seeking skills: a comparative study

Information seeking is one of the key skills in the problem-solving process. This paper explores and compares the information seeking skills of senior student nurses (n = 253) from three pre-registration nurse education programmes: Registered General Nurse (RGN); diploma Registered Nurse (Diploma RN); and integrated degree. Skills were explored using a paper and pencil simulation exercise. Study findings revealed both similarities and differences between the groups. Few students displayed a holistic approach when acquiring information and the rationale for information requests was cited infrequently. The integrated degree programme participants displayed a more systematic approach to information acquisition, while more RGN programme participants referred to the use of a model. The most favoured model to aid data acquisition was Roper et al.'s [The Elements of Nursing, third ed., Churchill Livingstone, Edinburgh, 1996] Activities of Living Model. The study findings are discussed in the wider context of professional education and practice and the potential for further development of information seeking skills on pre-registration nurse education programmes is noted.

Clinical simulations: development and validation

Simulations used as an educational strategy can mimic clinical reality bringing real life activity into the learning environment. This paper presents a conceptual approach to simulation development and validation that is applied to develop assessment simulations for both childbirth and triage situations. A process-based method of presenting information to the learner in the assessment phase is incorporated in simulations developed from actual clinical cases. The uncertain conditions of assessment are recognized as mirroring practice reality and validation of this construct and that of expertise are considered. Use of these simulations has the potential to provide learners with the opportunity to experience dimensions of simulated practice reality and educators with an experiential strategy that can be used to prepare students and also clinicians who are unfamiliar with new clinical practice areas.