Effects of an integrated problem-based learning and simulation course for nursing students

A Literature Review of Simulation-Based Nursing Education in Korea

This study reviewed the papers that studied the effect of simulation nursing education in the nursing field and examined the trend of simulation nursing education for nursing college students in Korea.

BACKGROUND

Simulation-based education started receiving attention as a pedagogical method in order to provide medical service of high quality in an ethical and safe environment. This has been of great importance during the coronavirus disease 2019 global pandemic. This literature review was conducted to suggest a direction for simulation-based nursing education in Korea.

METHODS

For literature searches, the authors used the following search terms in the Web of Science, CINAHL, Scopus, PubMed-'utilization', 'simulation,' 'nursing student', 'nursing education'. A final search was conducted on 6 January 2021. The materials for this study were collected through literature searches according to the PRISMA guidelines.

RESULTS

25 papers were selected as the final literature for analysis. The study was conducted for 48 percent of senior students in nursing college students in Korea (N = 12). High fidelity (HF) as the simulation type was 44 percent (N = 11). The simulation education subjects were composed of 52 percent adult health nursing (N = 13). According to educational goals described by Benzamine Bloom (1956), 90% in the psychomotor domain is considered a positive learning achievement.

CONCLUSIONS

Effectiveness in the psychomotor domain through simulation-based training is correlated with expert nursing. It is essential to develop a systematic debriefing model and methods to evaluate performance and learning in the short- and long-term to expand the effectiveness of simulation-based education in nursing.

Development of a curriculum integrating biostatistics and study design with core sciences in an organ system block

INTRODUCTION

The objectives of this study were to develop and evaluate a curriculum that integrated biostatistics and research design content with core sciences content within a pharmacy course.

METHODS

An inquiry curriculum was developed in 2019 and included lectures on biostatistics and research design with small group discussions of clinical research papers directly related to the core sciences content. Students' perceptions and pass rates between students who did (2019 cohort) and did not (2018 cohort) undergo the curriculum were compared. Test scores taken approximately one year after completion of each cohort's course were also compared.

RESULTS

Of 127 students in the 2019 cohort, 120 (94%) responded. Over 90% agreed or strongly agreed that inquiry and core sciences contents were integrated well. The 2019 cohort had a significantly higher pass rate than the 2018 cohort on two of three assessment questions evaluated: one multiple choice question (P = .037) and one short answer question (P = .013). After adjustments for baseline characteristics, retention study volunteers from the 2019 cohort had a significantly higher percent test score than those from the 2018 cohort (parameter estimate = 8.48%; P = .026).

CONCLUSIONS

An inquiry curriculum consisting of select biostatistics and research design topics can be integrated with a core sciences curriculum in a large integrated pharmacy course. Inclusion of this content increased student academic performance and retention of knowledge and skills.

Simulation Based-Learning from Simple to Complicated Clinical Situations for Midwifery Students

PURPOSE

A health professional's learning curriculum should lead to the acquisition of technical and non-technical skills. This study aims at demonstrating the impact of simulation-based learning (SBL) experience on the learning of midwifery students.

PATIENTS AND METHODS

Using an experimental design, the experimental group (n=14) received pretest, high fidelity simulation, then a post-test. Whereas the control group (n=14) received pretest, revision of the theoretical course instead of simulation, post-test 1, high fidelity simulation, then a post-test 2. The first scenario was about a normal childbirth when the midwifery students were in their 2nd year. And then the second one was about immediate postpartum hemorrhage when the students moved to their 3rd year.

RESULTS

During the simulation sessions, the experimental group had a higher mean score in the post-test than the control group. This indicated that the simulation significantly (p<0.001) increased the students' knowledge. Also, for both eutocic and dystocic delivery simulation experiments, students obtained higher score in the second simulation sessions (19.69 and 19.4 for eutocic and dystocic, respectively) than in the first session (11.23 and 9.12 for eutocic and dystocic, respectively; p<0.0001).

CONCLUSION

These findings confirm that SBL offers an opportunity for learners to be immersed in an environment that is closer to reality, thus improving learning in a safe environment.

Effects of a Simulation With Team-Based Learning on Knowledge, Team Performance, and Teamwork for Nursing Students

Simulation and team-based learning are reported as useful strategies in nursing education. However, empirical evidence on the effects of participating in an integrated course of team-based learning and simulation is limited. The aim of this study was to identify the effects of a nursing simulation program with team-based learning on knowledge, team performance, and teamwork among Korean nursing students. A one-group pretest-posttest design was used. Fourth-year students (N = 229) participated in a 32-hour nursing simulation program with team-based learning. Each of the three sessions of the program involved a 3-hour task training with video-assisted learning and skills performance assessment, 1-hour team-based learning, and 4-hour simulation session with a high-fidelity simulator. In addition to the knowledge test and performance assessment, participants completed a self-administered questionnaire on teamwork. Participants achieved higher scores in the Group Readiness Assurance Test than they did in the Individual Readiness Assurance Test. The posttest scores on team performance and teamwork were significantly higher than their pretest scores. The simulation with team-based learning induced favorable effects on participants' knowledge, performance, and teamwork. A curricular integration of simulation program with team-based learning is consistent with achieving outcomes-based learning in nursing education.

Degree in Nursing: education through problem-based learning

OBJECTIVE

To describe how undergraduate courses in Nursing are using the problem-based learning (PBL).

METHOD

Integrative literature review, from searches in the databases Education Resources Information Center (ERIC), Latin American and Caribbean Health Sciences Literature (Lilacs), and PubMed, from 2010 to 2015. 36 articles were analyzed.

RESULTS

A teaching method used in all continents, the PBL enables improvement of the critical thinking, autonomy, motivation for learning, active search attitude, ability to work in teams, and problem-solving. Difficulties and challenges relate to the training of students and teachers to understand the principles of the method.

FINAL CONSIDERATIONS

The benefits of PBL coincide with the needs of nursing training, but its applicability demands constant review in seeking to develop the skills necessary for this training.

[A Comparative Study on Learning Outcomes according to the Integration Sequences of S-PBL in Nursing Students: Randomized Crossover Design]

PURPOSE

This study aimed to compare the effects of simulation integrated with problem based learning (S-PBL) according to the sequences of problem-based learning (PBL) and high fidelity simulation training (HFS) on knowledge, clinical performance, clinical judgment, self-confidence, and satisfaction in fourth-grade nursing students.

METHODS

In this randomized crossover design study, four S-PBLs on medical-surgical nursing were applied alternatively to two randomly-assigned groups of 26 senior nursing students for 8 weeks. The collected data were analyzed using an independent t-test.

RESULTS

The method of administering PBL prior to HFS led to significantly higher scores on knowledge (t=2.28, p=.025) as compared to the method of administering HFS prior to PBL. However, the latter method led to significantly higher scores on clinical performance (t=-6.49, p<.001) and clinical judgment (t=-4.71, p<.001) as compared to the method of administering PBL prior to HFS. There were no differences in the effect of the two methods on self-confidence (t=1.53, p=.128) and satisfaction (t=1.28, p=.202).

CONCLUSION

The integration sequences of S-PBL was associated with different learning outcomes. Therefore, when implementing S-PBL, it is necessary to consider the educational goal to executes an appropriate sequence of integration.

Problem-Based Learning for Didactic Presentation to Baccalaureate Nursing Students

Nursing judgment is an essential component in the delivery of safe, quality patient care. Nurses must have the knowledge and skills to question authority, make judgments, substantiate evidence, and advocate for the patient. Traditional pedagogy in content-laden courses remains primarily lecture based. Incorporating active strategies to strengthen professional practice is essential. A pilot study assessed senior baccalaureate nursing students' perceptions of problem-based learning (PBL) and their readiness for self-directed learning. In addition, the authors analyzed the relationship between readiness for self-directed learning and course content mastery using PBL. Students completed the Self-directed Learning Readiness Scale, the Problem-Based Learning Environment Inventory, and course content mastery exams. Students reported positive experiences with PBL and readiness for self-directed learning. Readiness for self-directed learning and 2 of 5 exam scores were inversely, significantly related. Students' perceptions of their readiness for self-directed learning did not always correspond with course content mastery. Specifically, some students who perceived themselves as ready for self-directed learning did not perform well on course content exams. This inverse relationship has not been reported by other researchers and brings an interesting perspective to student perceptions and actual performance. Four themes emerged from students' narrative responses: Prepared Me for Real Life Professional Situations, Stimulated My Critical Thinking, Promoted Independent Problem Solving, and Supported Learning Retention. PBL as a pedagogical approach provides opportunities for nursing students to explore their professional independence while attempting to master content.

The mediating effect of self-reflection and learning effectiveness on clinical nursing performance in nursing students: A follow-up study

The effectiveness of simulation learning and the effects of anxiety in the simulated situation have been understudied. In addition, research on the association between learning effectiveness and students' clinical care performance in the hospital setting is very limited in Taiwan. The aim of this study is to examine the mediating effect of self-reflection and simulation learning effectiveness on the clinical nursing performance of nursing students. A Prospective, longitudinal, and correlational design was used. The study was conducted from December 2014 to July 2015. Participants were 293 nursing students in southern Taiwan. A structural model was specified and tested using partial least squares structural equation modeling to examine the relationships between the variables. The results revealed that the model was robust in terms of its measurement quality (reliability, validity, and goodness of fit), with the data's explaining 38.3% of variance in nursing competence. As self-reflection and learning effectiveness were added into the structural model, the effect of anxiety on nursing competence was still significant, but the regression coefficient (β) estimate of -0.41 (p<0.05) changed to β=-0.15 (p<0.050),indicating that self-reflection and learning effectiveness mediated the relationship between anxiety and nursing competence. Nursing competence was negatively affected by anxiety and positively affected by self-reflection (β=0.49, p<0.05) and simulation learning effectiveness (β=0.10, p<0.05). The teacher's encouraging learning can have a positive influence on students' self-reflection and learning effectiveness, which then decreases the effect of anxiety on nursing competence and further promotes students' clinical care ability.

Impact of high-fidelity simulation on the development of clinical judgment and motivation among Lebanese nursing students

BACKGROUND

High-fidelity simulation (HFS) offers a strategy to facilitate cognitive, affective, and psychomotor outcomes and motivate the new generation of students.

OBJECTIVES

The purpose of this study was to examine the impact of using high-fidelity simulation on the development of clinical judgment and motivation among Lebanese nursing students.

DESIGN

A post-test, quasi-experimental design was used.

SETTINGS

Two private universities in Lebanon were targeted to implement the intervention.

PARTICIPANTS

A convenience sample of 56 nursing students from two private universities in Lebanon were recruited.

METHODS

Data were collected using the Lasater Clinical Judgment Rubric and the Motivated Strategies for Learning questionnaires.

RESULTS

Nursing students exhibited significant improvement in clinical judgment and motivation due to exposure to HFS. There was a significant difference post HFS between the intervention group and the control group in clinical judgment intervention (t=5.23, p<0.001) and motivation for academic achievement (t=-6.71, p<0.001). The intervention group had a higher mean score of clinical judgment (29.5, SD=5.4) than the control group (22.1, SD=5.7) and, similarly, students had higher mean scores of motivation (198.6, SD=10.5) in the intervention group than in the control group (161.6, SD=20). The analysis related to differences between the intervention and control groups in motivation and clinical judgment; controlling for previous experience in health care services, the analysis showed no significant difference (Wilk's lambda =0.77, F=1.09, p=0.374).

CONCLUSION

There is a need for nursing educators to implement HFS in nursing curricula, where its integration can bridge the gap between theoretical knowledge and nursing practice and enhance critical thinking and motivation among nursing students.

The use of clinical case studies to develop clinical reasoning in sports therapy students: The students' perspective

Aims:

The aim of this study was to examine a cohort of second year undergraduate sports therapy students' perceptions regarding the effectiveness of clinical case studies in the development of clinical reasoning skills, and how clinical case studies may influence performance in a sports injury clinic.

Methods:

The study involved 55 students (23 male, 32 female) and used a mixed methods approach, involving a questionnaire with open ended questions, Likert scale questionnaire and interviews that aimed to determine students' perceptions of their performance. Five main areas were investigated with the open-ended questions: defining clinical reasoning; advantages and disadvantages of clinical case studies; the effectiveness of clinical case studies in comparison to real patients; and whether clinical case studies helped students working in a sports injury clinic. Students completed a 5-point Likert scale that asked three statements regarding the clinical environment. Following the questionnaire, a sample of 15 students were randomly selected for individual interviews.

Findings:

The results suggested that the students' responses were generally in favour of the use of clinical case studies to aid the development of confidence, communication and clinical reasoning.

Conclusions:

Clinical learning is unpredictable due to patient interaction, and therefore clinical case studies might be a learning tool that can be used to assist the journey to clinical competence.

Making the Case for Simulation-Based Assessments to Overcome the Challenges in Evaluating Clinical Competency

The use of simulation in nursing has increased substantially in the last few decades. Most schools of nursing have incorporated simulation into their curriculum but few are using simulation to evaluate clinical competency at the end of a semester or prior to graduation. Using simulation for such high stakes evaluation is somewhat novel to nursing. Educators are now being challenged to move simulation to the next level and use it as a tool for evaluating clinical competency. Can the use of simulation for high-stakes evaluation add to or improve our current evaluation methods? Using patient simulation for evaluation in contrast to a teaching modality has important differences that must be considered. This article discusses the difficulties of evaluating clinical competency, and makes the case for using simulation based assessment as a method of high stakes evaluation. Using simulation for high-stakes evaluation has the potential for significantly impacting nursing education.