High-Fidelity Simulation of Pediatric Emergency Care: An Eye-Opening Experience for Baccalaureate Nursing Students

Is high-fidelity simulation-based training in emergency nursing effective in enhancing clinical decision-making skills? A mixed methods study

AIM

To evaluate the effects of a high-fidelity simulation-based training in emergency nursing and the relationships between study outcomes. The objectives were to: (1) evaluate the effects of high-fidelity simulation-based training in emergency nursing on final-year nursing students' generic capabilities, self-confidence and anxiety during clinical decision-making; (2) examine the relationships between the outcomes of generic capabilities and clinical decision-making skills; (3) examine participants' satisfaction with the simulation experience; and (4) explore their experiences and opinions of the training module.

BACKGROUND

Following the emergence of coronavirus disease 2019, safety and other considerations have limited the clinical training opportunities available to nursing students. This has resulted in the increased use of high-fidelity simulations to provide clinical training for nursing students. However, evidence of the effects of such training modalities on generic capabilities, clinical decision-making skills and learning satisfaction remains lacking. In particular, the effectiveness of high-fidelity simulations of emergency clinical situations in training has not been closely evaluated.

DESIGN

A mixed methods study incorporating quasi-experimental and qualitative components.

METHODS

We recruited a convenience sample of 255 final-year pre-registration nursing students (183 bachelor and 72 master students) from a government-funded local university in Hong Kong. Four case scenarios of emergency nursing were developed and simulated in the simulation wards of the study institution in May and June 2021. We assessed the pre- and post-intervention outcomes of generic capabilities and clinical decision-making skills. We also explored the participants' post-intervention satisfaction, experiences and opinions.

RESULTS

Post-intervention, the participants reported significant improvements in generic capabilities, self-confidence and anxiety during clinical decision-making. They expressed a high level of satisfaction with the simulation experience. Additionally, we detected significant relationships between generic capabilities and clinical decision-making skills. Qualitative data analysis yielded four themes that either confirmed or complemented the quantitative findings.

CONCLUSIONS

This study provides evidence of the effectiveness of high-fidelity simulation-based training in emergency nursing in enhancing students' learning outcomes. Further studies should include a control group, evaluate students' knowledge and skills, and retention of knowledge to confirm the true impact of such training.

Creating psychological safety in interprofessional simulation for health professional learners: a scoping review of the barriers and enablers

Interprofessional simulation-based education (IP-SBE) supports the acquisition of interprofessional collaborative competencies. Psychologically safe environments are necessary to address socio-historical hierarchies and coercive practices that may occur in IP-SBE, facilitating fuller student participation. A scoping review was conducted to understand the barriers and enablers of psychological safety within IP-SBE. Research papers were eligible if they included two or more undergraduate and/or post-graduate students in health/social care qualifications/degrees and discussed barriers and/or enablers of psychological safety within simulation-based education. Sources of evidence included experimental, quasi-experimental, analytical observational, descriptive observational, qualitative, and mixed-methodological peer-reviewed studies. English or English-translated articles, published after January 1, 1990, were included. Data were extracted by two members of the research team. Extraction conflicts were resolved by the principal investigators. In total, 1,653 studies were screened; 1,527 did not meet inclusion criteria. After a full-text review, 99 additional articles were excluded; 27 studies were analyzed. Psychological safety enablers include prebriefing-debriefing by trained facilitators, no-blame culture, and structured evidenced-based simulation designs. Hierarchy among/between professions, fear of making mistakes, and uncertainty were considered barriers. Recognition of barriers and enablers of psychological safety in IP-SBE is an important first step towards creating strategies that support the full participation of students in their acquisition of IPC competencies.

Development and evaluation of a pediatric nursing competency-building program for nursing students in South Korea: a quasi-experimental study

PURPOSE

The present study aimed to develop and examine the effectiveness of a pediatric nursing competency-building program for nursing students.

METHODS

This was a quasi-experimental study with a nonequivalent control group pretest-posttest design conducted between October and December 2021. The participants included 40 nursing students (20 each in the experimental and control groups) at a university in a South Korean city. The pediatric nursing competency-building program integrated problem-based learning and simulation into clinical field practice. The experimental group participated in the program, while the control group did not. Data were analyzed using the x2 test, the independent t-test, and repeated-measures analysis of variance.

RESULTS

Pediatric nursing competency and clinical performance showed a greater increase in the experimental group than in the control group. However, the change in problem-solving ability in the experimental group was not significantly different from that in the control group.

CONCLUSION

The pediatric nursing competency-building program effectively improved students' pediatric nursing competency and clinical performance.

Engaging Children as Simulated Patients in Healthcare Education

STATEMENT

The value of "simulation" as a learning strategy is well established among healthcare professionals (Educ Prim Care 2015; 26(4):242-7). The use of "simulated patients (SPs)" to present real-world scenarios provides opportunities for students to develop "soft skills," including interpersonal communication, critical thinking, and problem solving. These skills are particularly relevant in pediatric care, where healthcare providers must consider the patient's cognitive development, emotional state, and familial context. This article focuses on middle childhood (6-12 years) a distinctive developmental stage between 2 major developmental transition stages: infancy and adolescence. Middle childhood is associated with compulsory school attendance, developing skills in self-discipline, conflict resolution, and decision-making. Child SPs can play an important role in healthcare education providing direct insight into this unique period of development. They can contribute to the design and delivery of simulations to increase fidelity and provide meaningful real-time feedback to learners on children's experience of the healthcare system. Despite children's expertise and particular care delivery needs, documented simulations using child SPs are limited. This article considers the role of child SPs to support a case for further research into the value of engaging middle years children in the development and delivery of "simulation-based learning experiences". It addresses the gap in child-focused education, the challenges inherent in working with children and outlines strategies and guidelines for effective practice.

Baccalaureate nursing students' experiences with high-fidelity simulation: protocol for a qualitative systematic review

INTRODUCTION

High-fidelity simulation (HFS) can bridge the gap between theoretical knowledge and nursing practice and improve safety and quality of patient care in baccalaureate nursing education. Although inconsistent assessment instruments or lack of high-quality research designs affect the strength of the evidence and limit the generalisability of the results, quantitative studies generally demonstrate the effectiveness of HFS in baccalaureate nursing education. Synthesis of the existing evidence of baccalaureate nursing students' experiences with HFS is crucial for the improvement and revision of simulation design and teaching.

METHODS AND ANALYSIS

A comprehensive search for qualitative studies on baccalaureate nursing students' experiences with HFS will be conducted in the following databases: PubMed, Embase, CINAHL, ProQuest, Web of Science, PsycINFO, the Cochrane library, China Biology Medicine disc, China National Knowledge Infrastructure and VIP Database for Chinese Technical Periodicals. This review considered studies reported in English or Chinese, and studies that were conducted between January 2000 and December 2019 in view of the launch of International Nursing Association for Clinical Simulation and Learning. The literature search will be conducted by two independent reviewers, and any disagreement will be adjudicated by discussion or with a third reviewer. The two independent reviewers will use the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research to assess the methodological validity, following which the JBI standardised data extraction tools will be used to extract relevant data. The JBI meta-aggregation method will be subsequently used to synthesise the data, eventually forming themes, categories and synthesised findings. The final synthesised findings will establish confidence levels based on the JBI ConQual approach.

ETHICS AND DISSEMINATION

This review does not require formal ethical review since it is based on available published literature. Findings will be disseminated through publication in a peer-reviewed journal, and, if possible, presented in scientific conferences.

Male nursing students' experiences of simulation used to replace maternal-child clinical learning in Qatar

BACKGROUND

In today's health care context, nurse educators teach with limited clinical placement availability, competition for available spaces and increasingly complex clients.

SETTING

As part of the baccalaureate of nursing program at the University of Calgary in Qatar, students are required to complete 208 h of maternal-child clinical. Unfortunately, due to social and cultural norms in this predominantly Muslim country, male nursing students are prohibited from practicing with mothers and babies in Qatar. In order to address this need, we developed a fully simulated clinical practice module for these male students.

OBJECTIVES

The aim of the current study was to better understand the learning experiences of the students undertaking this experience.

DESIGN

The authors developed and implemented a fully simulated, campus-based, maternity clinical experience that used a variety of levels of fidelity, incorporated the tenets of Kolb's (1984) experiential learning theory, and Jeffries' (2005) simulation design framework. Post-simulation debriefing sessions were recorded and transcribed. Typed weekly reflections were provided. All data was blinded.

PARTICIPANTS

A convenience sample of ten adult, male participants was obtained.

METHODS

Using an inductive qualitative approach, researchers analyzed transcripts of debriefing sessions and reflective journals.

RESULTS

The main themes were knowledge application, clinical judgement, communication, and crossing cultural barriers.

CONCLUSIONS

Themes from this study can be used to support and/or change existing practices in a way that supports learner-centered, experiential teaching practices.