Using Standardized Patients in Nursing Education: Effects on Students’ Psychomotor Skill Development

Use of standardized patients in patient education practices of senior nursing students: A mixed-methods study

BACKGROUND

There is a need for innovative teaching practices in nursing education due to many factors, such as global changes, the rapid development of technology, the increasing number of students, and the recent pandemic.

OBJECTIVES

This research was conducted using standardized patients to evaluate the attitudes and skills of senior nursing students toward patient education practices following the implementation of a patient education training program.

DESIGN

Mixed-methods design.

SETTINGS

The study was conducted at a nursing faculty.

PARTICIPANTS

The sample of the study consisted of 47 senior nursing students.

INTERVENTION

The students participating in the study were given a four-hour patient education training that included the preparation of patient education, preparation of materials, and effective presentation.

METHODS

A descriptive information form prepared by the researchers, the Patient Education Implementation Scale (PEIS), the Turkish version of the Patient Education Materials Assessment Tool for Printable Materials (PEMATTR-P), and the presentation skill evaluation form (PSEF) were used to collect quantitative data. Semi-structured interview forms were utilized to collect qualitative data. SPSS for Windows v. 25.0 and MAXQDA20 were used for the data analyses. Results with a p value of <0.05 were considered statistically significant.

RESULTS

The post-test mean PEIS scores of the students increased in the total scale and in all subdimensions. A significant difference was found in the understandability and actionability of patient education materials evaluated with PEMATTR-P (p < 0.05). The mean PSEF score of the students was 85.14 ± 9.25 points. Within the scope of the research, two main themes, namely emotions and efficacy, were determined.

CONCLUSIONS

This study confirms that structured patient education training, including the use of standardized patients, is important for supporting and developing nursing senior students' attitudes and skills toward patient education.

Nursing students satisfaction and self-confidence with standardized patient palliative care simulation focusing on difficult conversations

OBJECTIVES

Lack of experience communicating with patients and families at the end of life are key concerns for nursing students. Palliative care simulation using standardized patients (SPs) focusing on difficult conversations may lead to increased self-confidence in providing palliative and end-of-life care in clinical practice. There is currently a paucity of research on SP palliative care simulations in undergraduate nursing education. The objective of this research was to assess 3rd year undergraduate nursing students' levels of satisfaction and self-confidence with palliative and end-of-life care simulations focusing on difficult conversations, as measured by the Student Satisfaction and Self-Confidence in Learning Scale (SSSCLS) and the Simulation Design Scale (SDS).

METHODS

A descriptive post-intervention study. Four palliative care simulation days, consisting of 2 clinical scenarios, were conducted over 4 weeks. The first simulation was an outpatient palliative care clinic scenario, and the second was an inpatient hospital scenario. Nursing students enrolled in a 3rd year nursing palliative care elective (n = 51) at an Australian university were invited to participate. Students who attended simulation days were eligible to participate (n = 31). Immediately post-simulation, students were invited to complete the SSSCLS and the SDS. Fifty-seven surveys were completed (simulation 1, n = 28; simulation 2, n = 29). The data were analyzed using descriptive statistics.

RESULTS

Results showed that students had high levels of self-confidence in developing palliative care and communication skills after both simulation experiences and high levels of satisfaction with the SP simulations.

SIGNIFICANCE OF RESULTS

The lack of published literature on palliative care and end-of-life SP simulation highlights the need to collect further evidence to support this as an innovative approach to teaching palliative care. SP palliative care simulation focusing on difficult conversations assists in developing students' communication skills and improves satisfaction and self-confidence with palliative and end-of-life care.

A Modified Guideline for High-Fidelity Patient Simulation to Improve Student Satisfaction and Self-Confidence in Learning: A Mixed Study

The coronaviral pandemic has led to a shift in traditional teaching methods to more innovative approaches, such as high-fidelity patient simulation (HFPS), which can improve students' clinical judgment and decision making for quality patient care. A modified guideline was introduced to enhance students' satisfaction and self-confidence in learning through HFPS. The study involved 189 baccalaureate nursing students, with 92 in the intervention group and 97 in the control group. The intervention group received the modified HFPS guideline, while the control group received standard treatment with basic instruction. After the HFPS debriefing session, students provided narrative feedback on their learning experiences. The quantitative results showed that students in the intervention group reported a significant improvement in satisfaction and self-confidence in learning compared to the control group. The modified HFPS guideline provided clear guidance for students to learn and apply knowledge and skills more effectively, leading to increased engagement during interactive simulation sessions. The results suggest that the HFPS guideline should be added to the curriculum to enhance students' satisfaction and self-confidence in learning, even for junior students. After the pandemic, innovative teaching methods, such as HFPS, can be necessary and beneficial for healthcare professional training.

Evaluation of the effectiveness of artificial intelligence assisted interactive screen-based simulation in breast self-examination: An innovative approach in nursing students

BACKGROUND

Breast self-examination is important in the early diagnosis of breast cancer. The use of traditional education methods is insufficient for student nurses to gain breast self-examination skills in nurse education. New and different education methods are needed to gain skills in nurse education.

OBJECTIVE

The aim of this study was to evaluate the effectiveness of artificial intelligence-assisted screen-based simulations practice and standard patient simulation in teaching breast self-examination skills in nursing undergraduate students.

DESIGN

This study was a comparative intervention trial.

SETTINGS

This study was conducted at a university in XX, in XXX in the first semesters of the academic years 2022-2023.

METHODS

This study enlisted 103 students enrolled in first year in a nursing department. Students were randomized into artificial intelligence-assisted screen-based simulations practice group (n = 52) and standard patient simulation group (n = 51). Data were collected using student description form, breast self-examination checklist, student satisfaction and self-confidence in learning scale, Spielberger's state and trait anxiety inventory.

RESULTS

The highest score regarding the total score means of breast self-examination skills belonged to the standard patient simulation group, and the differences between the groups were found to be statistically significant (p < 0.05). Although the mean score of anxiety levels of the students' artificial intelligence-assisted screen-based simulations practice group was higher than the standard patient simulation (p < 0.05). The mean score of the students' satisfaction with the simulation was higher in artificial intelligence-assisted screen-based simulations practice group than the standard patient simulation group (p < 0.05).

CONCLUSIONS

The results of the research showed that the use of artificial intelligence-assisted simulation learning increased students' satisfaction, but at the same time students' anxiety increased. In addition, artificial intelligence-assisted simulation learning is not as effective as standard patient simulation learning in gaining breast self-examination skills.

An Innovative Nurse Practitioner Curricular Design Using an Adaptive Learning Platform, Adaptive Case Studies, and Telehealth Simulations: A Feasibility Study

Introduction

This project explored the feasibility of implementing an innovative cross-curricular framework using an adaptive learning (AL) platform and telehealth simulations.

Objective

To determine the feasibility of implementing an innovative cross-curricular framework using an AL platform and telehealth simulations.

Methods

A mixed-method pilot study was conducted using novel AL modules, adaptive case studies, and telehealth simulation.

Results

Quantitative data analysis demonstrated significant correlations within and across demographics using the Technology Acceptance Model (TAM) and Simulation Effectiveness Tool-Modified (SET-M). Specifically, significant correlations are evident between TAM ease of use items 1-6, 8, and 10 and TAM usefulness 1, 3, and 9, with SET-M items 3 and 5-15. Thematic analysis revealed that participants felt that the overall project was worthwhile and increased confidence in telehealth.

Conclusion

Participants found the technology used in this study was easy and useful, and they indicated a positive experience with telehealth simulation. Overall, this study demonstrated that implementation of AL using our paradigm is feasible and supports further investigation into implementing a cross-curricular framework using an AL platform and telehealth simulations.

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.

The Effect of Two Different Simulation Modalities in Palliative Care Teaching on Nursing Students' Knowledge, Satisfaction, Self-confidence, and Skills: A Randomized Controlled Trial

Nursing students from developing countries have limited opportunities to experience palliative care. Standardized patient and low-fidelity simulations can provide realistic palliative care experiences for students. However, limited research is available on simulation-based education in Palestine. Testing and using these two types of simulation methods may be the best solution for developing countries that lack adequate resources. This study aimed to test the effects of low-fidelity simulation compared with standardized patient simulation in palliative care teaching on nursing students' knowledge, satisfaction, confidence, and skills. The study was a randomized controlled trial of 70 nursing students in their sophomore year. Students' knowledge was assessed with the Palliative Care Quiz for Nursing test; satisfaction and confidence with the Learner Satisfaction and Self-confidence in Learning; and skills rated by two researchers. Students' knowledge improved significantly on the posttest compared with the pretest, without significant differences between both groups. The findings showed that the utilization of the two methods in students' clinical training for scenario has the same effect on the satisfaction and confidence. The skills of the standardized patient group improved significantly more than the low-fidelity group. The study revealed that both simulation modalities are effective for palliative care nursing students.

Low-fidelity simulation vs. standardized patients in prevention and management of pressure injury education

AIM

This study aims to compare the impact of standardized patient and low-fidelity simulation methods on the success, satisfaction, and self-confidence levels of nursing students in prevention and management of pressure injury education.

METHODS

The study was designed as a randomized, controlled experimental study with pretest and posttest control groups. Eighty-one nursing students that met the inclusion criteria were randomly assigned to intervention (standardized patient; n = 40) and control (low-fidelity mannequin simulator; n = 41) groups. A descriptive characteristics form, the Student Satisfaction and Self-Confidence in Learning Scale, and the Simulation Design Scale were used for data collection. Implementation skills and knowledge levels of the students were evaluated by using a skills control list and pretest and posttest measurements, respectively.

RESULTS

The posttest knowledge score of the students in the standardized patient group, which was measured after the simulation education, was higher (p < 0.05). We did not find any statistically significant difference between the two groups in terms of the scores obtained from the Students Satisfaction and Self-Confidence in Learning Scale and its subscales (p > 0.05). Compared to the low-fidelity mannequin group, the standardized patient group obtained higher scores from the Simulation Design Scale and its Objectives/Information subscale (p < 0.05). Regarding the skills needed in the implementation phases of pressure injury, the standardized patient group was more successful in terms of communication skills (p < 0.05).

CONCLUSION

If the simulation design is well-planned, the use of a standardized patient and a low-fidelity mannequin have similar impacts on student satisfaction and self-confidence. However, the success scores and communication skills of the students in the standardized patient group were higher.

The Role of Standardized Patient Programs in Promoting Equity, Diversity, and Inclusion: A Narrative Review

PURPOSE

Integrating equity, diversity, and inclusion (EDI) in curricula for training health professionals is a frequent institutional goal. The use of standardized (or simulated) patient programs (SPPs) to support EDI in health sciences training is not well described. Here the authors present a theoretical model based on a synthesis of the literature for using SPPs in EDI training, along with a narrative review of the available literature.

METHOD

The authors searched PubMed, Scopus, Science Direct, and Google Scholar databases for studies published between January 2000 and October 2019 describing the use of SPPs to support EDI in health sciences education. Studies were included if they described standardized patient (SP) education involving EDI and reported empiric data about its design, delivery, or effectiveness. The authors conducted a narrative review and provided a synthesis of the available literature, identifying key themes.

RESULTS

Out of 117 studies identified, 17 met the inclusion criteria. Most studies (53%; n = 9) focused on cultural competence; many focused on communication with diverse patients (29%; n = 5) or health inequity (18%; n = 3). Studies employed portrayal of diversity (71%; n = 12) or learning objectives supported by diversity (29%; n = 5) as approaches to EDI relevant to SP training. Three primary themes emerged: improving cultural competence, effective communication with diverse patients, and highlighting health inequalities.

CONCLUSIONS

This review outlines approaches to EDI-based SPPs, with the perspectives and priorities of institutional approaches in mind. SP education around specific EDI issues is reported; however, programmatic approaches to EDI by SPPs are lacking. More research is needed to provide further evidence for the challenges, effectiveness, and outcomes of developing and implementing EDI-based SPPs in health sciences education.

Views of nursing students on using standardized patient and in-class case analysis in ethics education

BACKGROUND

It is important to use student-centred, active teaching strategies in ethics education to develop students' skills in dealing with ethical problems.

OBJECTIVES

This study sought the opinions, suggestions, and thoughts of students receiving ethics education with in-class case analysis (ICCA) and standardized patient (SP) practice.

RESEARCH DESIGN AND PARTICIPANTS

A phenomenological and interpretive design based on qualitative interviews was used. The sample was 86 nursing students in 8 focus groups.

RESULTS

The mean age of participants was 21.40 ± 0.844, and most of the participants were female (n = 76). Themes obtained from the student interviews were 1) impact on knowledge, skills and emotions, 2) learning process, 3) decision making process, 4) recommendations for the future practice.

CONCLUSIONS

The students stated that both teaching methods were beneficial in ethics education; they understood the subject better, gained multi-directional thinking skills, and their awareness of ethical problems increased. Thus, ICCA and SP practice are teaching methods that should be used in nursing ethics education.

The effect of using standardized patients in the Simulated Hospital Environment on first-year nursing students psychomotor skills learning

BACKGROUND

The aim of this study was to determine the effect of using standardized patients in the Simulated Hospital Environment on first-year nursing students' psychomotor skills.

METHODS

This semi-experimental study was carried out in the one-group pretest-posttest design. Students performed the psychomotor skills in the Non-Simulated Clinical Skill Laboratory and Simulated Hospital Environment. The skill performances of the students were evaluated with the Objective Structured Clinical Assessment form. At the same time, students' views on both environments were received.

RESULTS

Students' mean Objective Structured Clinical Assessment score in the Simulated Hospital Environment (69.42 ± 10.94) was significantly higher than their mean score in the Non-Simulated Clinical Skill Laboratory (57.07 ± 10.05) (p < 0.05). The differences in scores were particularly significant in the stages of meeting the patient, performing the procedure in accordance with the steps and ending the procedure. The majority of the students stated that they could not do some applications in the Non-Simulated Clinical Skill Laboratory in a similar way to the hospital clinic (85.9%), and they felt like they were in a real hospital clinic in the Simulated Hospital Environment (100%).

CONCLUSIONS

The results showed that students developed psychomotor skills more fully in a learning environment designed in a similar way to a real hospital clinic setting.

Effect of simulation-based teaching on nursing skill performance: a systematic review and meta-analysis

Objective

To summarize and produce aggregated evidence on the effect of simulation-based teaching on skill performance in the nursing profession. Simulation is an active learning strategy involving the use of various resources to assimilate the real situation. It enables learners to improve their skills and knowledge in a coordinated environment.

Methods

Systematic literature search of original research articles was carried out through Google Scholar, Medline, and Cochrane Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Studies conducted on simulation-based teaching and skill performance among nursing students or clinical nursing staff from 2010 to 2019, and published in the English language, were included in this study. Methodological quality was assessed by Joanna Briggs Institute, and the risk of bias was also assessed by Cochrane risk of bias and the risk of bias assessment tool for non-randomized studies (ROBINS-I) checklists.

Results

Initially, 638 titles were obtained from 3 sources, and 24 original studies with 2209 study participants were taken for the final analysis. Of the total studies, 14 (58.3%) used single group prep post design, 7 (29.1%) used high fidelity simulator (HFS), and 7 (29.1%) used a virtual simulator (VS). Twenty (83.3%) studies reported improved skill performance following simulation-based teaching. Simulation-based teaching improves skill performance among types of groups (single or double), study regions, high fidelity (HF), low fidelity (LF), and standard patient (SP) users. But the effect over virtual and medium fidelity simulators was not statistically significant. Overall, simulation-based teaching improves the skill performance score among the experimental group (d = 1.01, 95% confidence interval [CI] [0.69–1.33], Z = 6.18, P < 0.01, 93.9%). Significant heterogeneity and publication bias were observed during the pooled analysis.

Conclusions

Simulation did improve skill performance among the intervention groups, but the conclusion is uncertain due to the significant heterogeneity. The large extent of difference among original research has necessitated the development of well-defined assessment methods for skills and standardized simulation set-up for proper assessment of their effects.

Skill acquisition of safe medication administration through realistic simulation: an integrative review

OBJECTIVE

to investigate evidence that indicates the contribution of realistic high, medium or low fidelity simulation to acquire knowledge, skills and attitudes in safe medication administration by nursing students.

METHODS

an integrative review of experimental studies from MEDLINE, LILACS, Web of Science, Scopus and Science Direct. The descriptors "nursing students", "simulation", "high fidelity simulation training", "medication errors" and "pharmacology" were used to identify 14 studies that answered the research question, and were assessed for accuracy methodological level and level of evidence.

RESULTS

there was a sample of quasi-experimental studies, (level 3 of evidence; 78.6%) and randomized clinical trials (level 2 of evidence; 21.4%), whose expressive majority showed superiority of the simulation strategy over the traditional methodology (71.4%).

CONCLUSION

using low and high fidelity simulators, standardized patients and virtual simulation can promote acquisition of essential skills for patient safety.

An Interprofessional Branching Simulation to Introduce RN First Assistant Students to Their Role in the Perioperative Setting

Simulation can be an effective tool for educating health profession students and can enhance interprofessional education by involving roles across multiple disciplines. Perioperative nurse educators at one institution used a five-part branching simulation of preoperative, intraoperative, and postoperative events for a single patient undergoing a procedure to introduce RN first assistant (RNFA) students to their role in the perioperative environment. The simulation participants included student RN anesthetists, a surgeon, an RN circulator (played by an actor), and a standardized patient. The objectives for this simulation were to assess the implementation of the didactic RNFA curriculum and to enhance the RNFA students' transition into their role in the perioperative setting. The simulation and multiple debriefings reinforced the concepts of role acquisition, surgical conscience, closed-loop communication, and interprofessional collaboration. Perioperative nurse educators can use this type of educational activity to teach these concepts to their students.

Effects of using standardized patients on nursing students’ moral skills

Background:

Nurses and nursing students increasingly confront ethical problems in clinical practice. Moral sensitivity, moral reasoning, and ethical decision-making are therefore important skills throughout the nursing profession. Innovative teaching methods as part of the ethics training of nursing students help them acquire these fundamental skills.

Aim:

This study investigated the effects and potential benefits of using standardized patients in ethics education on nursing baccalaureate students’ moral sensitivity, moral reasoning, and ethical decision-making by comparing this method with in-class case analyses.

Research design:

This is a quasi-experimental study.

Participants and research context:

The sample comprised 89 students in Hacettepe University’s Faculty of Nursing. Following lectures describing the theoretical components of ethics, students were randomly assigned to two working groups, one using standardized patients and the other using in-class case analyses. Data were collected using the Moral Sensitivity Questionnaire, Rest’s Defining Issues Test, and the Nursing Dilemma Test. All data were analysed using IBM SPSS Statistics Version 23.

Ethical considerations:

Ethical approval and official permission were obtained. All participating students completed informed consent forms.

Findings:

According to the results, the moral sensitivity of students in the standardized patient group significantly improved over time compared to those in the case analysis group, while the mean scores of students in both groups for moral reasoning and ethical decision-making were not statistically significant.

Conclusion:

Based on our results, we recommend the use of both standardized patients and case analysis as appropriate teaching methods in ethics education.

Examining Knowledge, Skill, Stress, Satisfaction, and Self-Confidence Levels of Nursing Students in Three Different Simulation Modalities

PURPOSE

The aim of this study was to compare the effect of different simulation modalities on knowledge, skill, stress, satisfaction, and self-confidence levels of students receiving undergraduate education in three nursing schools.

METHOD

This was an experimental study. Students applied the scenario of "Respiratory Sounds Assessment" which was prepared according to three different simulation modalities. In the study, the standardized patient, high-fidelity simulation, and partial task trainer were used as simulation modalities.

RESULTS

An increase was observed in postpractice knowledge levels of the three groups which had similar knowledge levels before the practice. Virtual Analog Scale stress levels of the students in the standardized patient group were higher than those of others. The students' mean scores of satisfaction in learning were higher in the standardized patient group. The students in the partial task trainer group had lower scores of self-confidence in learning. Skill scores of the students were lower in the standardized patient practice than those in others.

CONCLUSION

Simulation-based experiences give students the opportunity of experiencing situations they may experience in the actual practice beforehand. Therefore, this may increase their performance in real practices, as reality increases in the standardized patient group.

An Innovative Educational Trio for Physical Assessment in an Undergraduate Nursing Course

ABSTRACT

Effective teaching methods are critical to the acquisition of physical assessment skills. This article describes the combined use of deliberate practice, standardized patient simulation, and peer evaluation in improving physical assessment skills among first-semester nursing students. Students prepared for a physical assessment check-off by using deliberate practice throughout the semester; they then received peer feedback after a standardized patient simulation. Students felt the integrated experience improved their physical assessment performance. Incorporating this innovative educational trio can provide opportunities for physical assessment skill enhancement.

Effect of an educational program for the knowledge and quality of blood pressure recording

OBJECTIVE

to evaluate the effect of an educational program on blood pressure recording for nursing professionals in relation to theoretical knowledge and the quality of these records.

METHOD

quasi-experimental study conducted in a hospital service located in the city of São Paulo. The theoretical knowledge of 101 professionals was measured using a validated questionnaire before and after the educational intervention; the quality of blood pressure records was evaluated using a validated form which was applied to 354 records in the pre-intervention period and 288 in the post-intervention period. The educational program was based on active teaching-learning methodologies and consisted of two strategies: expository/dialogue class and a board game. The Wilcoxon, Mann-Whitney, Fisher and Chi-Square tests were used for comparisons, adopting a level of significance of α=0.05.

RESULTS

the median of the professionals' scores increased from 19 to 22 points in the post-intervention period (p<0.001). There was an improvement in the quality of the blood pressure recordings regarding the variables: cuff size (p<0.001), arm used in the procedure (p<0.001) and patient position (p<0.001).

CONCLUSION

the educational program showed positive results in the promotion of knowledge among nursing professionals and in the improvement of the quality of blood pressure recording.

A Systematic Review of the Use of Standardized Patients as a Simulation Modality in Nursing Education

AIM

The objective of the study was to search, extract, appraise, and synthesize studies using standardized patients (SPs) in nursing academia to determine how this modality of simulation is being used.

BACKGROUND

SPs are a common simulation modality used in nursing education.

METHOD

This review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses. Five databases were searched as well as keywords to retrieve nonindexed citations for the period January 2011 to September 2016. The inclusion criteria included nurses, a simulated experience with SPs, and original research published in English.

RESULTS

Sixty-five studies were identified and analyzed.

CONCLUSION

More randomized controlled trials and studies with power analyses and validated measurement instruments are needed. Studies that compare SPs to high-fidelity simulators are also desired to determine optimal student learning outcomes and standardize best practices in simulation.

Differences in Psychomotor Skills Teaching and Evaluation Practices in Undergraduate Nursing Programs

AIM

The purpose of this study was to understand the methods faculty use to teach and evaluate psychomotor skill performance in associate and baccalaureate nursing programs, resources available to students to master these skills, and policies and procedures related to summative evaluation of psychomotor skills.

BACKGROUND

Despite the importance of psychomotor skills competency in registered nursing programs, published methods for teaching and evaluating competency vary. The literature does not support a particular strategy for teaching or evaluation.

METHOD

In this primarily quantitative descriptive study, participants completed a 28-item questionnaire developed by the authors based on a review of the literature and personal teaching experience.

RESULTS

All respondents indicated that their institutions conducted summative assessment of psychomotor skills; however, the methods for teaching and evaluation varied widely.

CONCLUSION

Well-designed control studies and consensus guidelines from professional nursing education organizations would assist faculty in implementing consistent, effective, evidence-based strategies.

Improving clinical judgment by simulation: a randomized trial and validation of the Lasater clinical judgment rubric in Chinese

BACKGROUND

The development and assessment of clinical judgment ability are essential in nursing education. The Lasater Clinical Judgment Rubric (LCJR) was shown to be valid in evaluating nursing students' learning outcomes and skills in western cultures but has not been validated in mainland China. This study aimed to compare a simulation-teaching model with a traditional teaching method in enhancing the clinical judgment ability of nursing undergraduate students and to validate the Chinese version of the Lasater Clinical Judgment Rubric (C-LCJR).

METHODS

Four classes of nursing students (n = 157) at Hubei University of Chinese Medicine, China, were randomly assigned to two control and two experimental classes. The experimental classes were taught using simulation teaching with standardized patients, while the control classes were taught using traditional teaching methods. At the end of the experiment, students in both kinds of classes evaluated their clinical judgment using the C-LCJR. Teachers also rated the students but without knowing who had received the simulation teaching. Confirmatory factor analysis and a Multiple Indicators Multiple Causes (MIMIC) model with Bayesian estimation was fit to the rating data to investigate measurement properties and experimental effects.

RESULTS

Compared to the control classes, students in the experimental classes performed better in all subdomains of C-LCJR (noticing, interpreting, responding, and reflecting). The measurement properties of the C-LCJR were found to be satisfactory with high factor loadings and reliabilities and no bias from age, gender, and raters.

CONCLUSIONS

The simulation teaching model is more effective than the traditional (non-simulation-based) teaching method in improving clinical judgment of Chinese nursing students. The C-LCJR is a valid and reliable instrument for measuring clinical judgment in nursing students in China.

Instructor-led vs. peer-led debriefing in preoperative care simulation using standardized patients

BACKGROUND

Debriefing involves the active participation of learners to identify and close gaps in knowledge and skills. Varied debriefing methods are used in simulation, but no empirical studies have examined the effectiveness of peer-led debriefing in simulation using standardized patients. The purpose of this study was to compare the effects of two debriefing methods (instructor-led vs. peer-led) on nursing skills, knowledge, self-confidence, and quality of debriefing among undergraduate nursing students in South Korea.

METHOD

A nonequivalent control group pretest-posttest design was used. Fifty-seven third-year nursing students were randomly assigned to instructor-led (n = 26) or peer-led (n = 31) debriefing groups after a simulation of preoperative care. Structured questions and areas for discussion guided debriefing in both groups. Self-administered questionnaires were used to collect data on students' knowledge and self-confidence in providing preoperative care. Faculty evaluated students' nursing skills during pre- and post-simulation practice. Students evaluated the quality of the debriefings.

RESULTS

Nursing skills for preoperative care (p < .001) and the quality of debriefing (p < .001) were statistically higher in the instructor-led group compared to the peer-led group. There were no statistically significant differences in knowledge (p = .445) and self-confidence (p = .686). Knowledge and self-confidence from pre-test to posttest were improved in both groups.

CONCLUSION

The instructor-led debriefing showed improved nursing skills and higher quality debriefing. However, peer-led debriefing led by a non-trained peer also rendered positive results. Thus, peer-led debriefing may be considered a useful strategy for improving nursing students' self-confidence.