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van der Vloed M, Eide H, Gladhus L, Byermoen KR, Egilsdottir HÖ, Heyn LG. Exploring dialogue in virtual simulation in nursing education - An observational study. PEC INNOVATION 2024; 4:100294. [PMID: 38884002 PMCID: PMC11177192 DOI: 10.1016/j.pecinn.2024.100294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 03/08/2024] [Accepted: 05/23/2024] [Indexed: 06/18/2024]
Abstract
Objectives Simulation is an important learning activity in nursing education. There is little knowledge about dialogue and communication between students and facilitators in a virtual simulation setting. The current study, conducted in Norway, explores the dialogic teaching approaches applied by facilitators in a virtual classroom and adapt an analytic tool from a physical classroom in lower education to a virtual classroom in higher education. Methods Sixteen virtual simulation sessions of groups with nursing students were video-taped. The videos were coded with a coding scheme developed for physical classrooms and adapted to the virtual setting. The dialogic approaches from the facilitator were analysed using descriptive analysis. Results The most frequently used approaches from the facilitator were categorised as asking ("Big questions") and listening ("Wait time after a question"). The most frequent pattern seen in the use of dialogic approaches fall under the category listening. Conclusions The coding scheme is suitable to analyse facilitators' dialogic approaches in a virtual setting in nursing education. Further research should examine how the facilitator can strategically deploy dialogic approaches in other types of simulations with students. Innovation The coding scheme was developed from lower to higher education, and from a physical to a virtual setting.
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Affiliation(s)
- Maarten van der Vloed
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, Drammen 3045, Norway
- Ede Christian University of applied sciences, Oude Kerkweg JS Ede, Netherlands
| | - Hilde Eide
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, Drammen 3045, Norway
| | - Lise Gladhus
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, Drammen 3045, Norway
| | - Kirsten Røland Byermoen
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, Drammen 3045, Norway
| | - Hugrun Ösp Egilsdottir
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, Drammen 3045, Norway
| | - Lena Günterberg Heyn
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, Drammen 3045, Norway
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Stretton T, Cochrane T, Sevigny C, Rathner J. Exploring mobile mixed reality for critical thinking in nursing and healthcare education: A systematic review. NURSE EDUCATION TODAY 2024; 133:106072. [PMID: 38134813 DOI: 10.1016/j.nedt.2023.106072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 11/28/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND The shortage of nursing and healthcare clinical placements has prompted the investigation of ways to supplement authentic learning. Mobile mixed reality has become increasingly available, however, the affordances and design principles for the facilitation of critical thinking are yet to be explored. OBJECTIVE To examine how mobile mixed reality facilitates critical thinking in nursing and healthcare higher education. DESIGN Systematic review. REVIEW METHODS A search in seven databases (MEDLINE, PsychINFO, AMED, ERIC, Scopus, Cochrane, and Web of Science) was conducted with 3488 titles and abstracts screened. The quality of the included studies was evaluated using the Mixed Methods Assessment Tool (MMAT). RESULTS A total of 12 studies with 1108 participants were included. The breadth of healthcare disciplines was limited to five disciplines that utilised bespoke scenarios on head-mounted displays. Most scenarios were emergency or critical response, with limited time for pre-brief, debrief, or overall user time. Only two studies directly measured critical thinking, with others including indirect reference to diagnoses, interpretation, analysis, or evaluation of healthcare scenarios. Affordances and design principles for the future development of mobile mixed reality for critical thinking in nursing and healthcare higher education are identified. CONCLUSIONS While some pedagogical affordances of mobile mixed reality can be identified in a narrow number of healthcare disciplines, there remain to be limited valid measures of critical thinking used to quantify effectiveness. Future studies would benefit from considering scenarios beyond emergency and critical responses, including longitudinal studies that reflect the development of critical thinking over time, and exploration of co-designed scenarios with and by nursing and healthcare students.
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Affiliation(s)
- Todd Stretton
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
| | - Thomas Cochrane
- Centre for the Study in Higher Education, University of Melbourne, Melbourne, Australia. https://twitter.com/thomcochrane
| | - Charles Sevigny
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Joseph Rathner
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
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Wang HY, Huang CY, Hu SH, Cheng SF. Using "board games" to improve the effectiveness of extracorporeal membrane oxygenation care for nurses in intensive care unit. Nurse Educ Pract 2024; 75:103895. [PMID: 38232676 DOI: 10.1016/j.nepr.2024.103895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/04/2024] [Accepted: 01/08/2024] [Indexed: 01/19/2024]
Abstract
AIM The purpose of this study was to evaluate the effectiveness of ECMO care board games facilitated teaching approach (ECMO care board games) in enhancing ECMO care knowledge, clinical reasoning and learning engagement among intensive care unit (ICU) nurses. BACKGROUND ECMO is a highly complex, relatively low-incidence, high-risk clinical life support device system used in the intensive care unit (ICU). Its usage has increased nearly tenfold over the past 30 years. Traditionally, ECMO education has been delivered through classroom teaching, which has demonstrated limited effectiveness in promoting nurses' learning engagement, clinical reasoning competency and confidence. The literature suggests that well-designed board games can enhance learning engagement, stimulate higher-level thinking and improve the effectiveness and confidence of nurses' learning. DESIGN A quasi-experimental study two-group repeated measure design. METHODS A purposive sample of 73 ICU nurses from two campuses of one medical center was recruited (37 in the experimental group and 36 in the control group). The experimental group received ECMO care training through ECMO care board games facilitated teaching approach, whereas the control group completed the training through a traditional teaching approach. Instruments used for data collection include a demographic information sheet, ECMO Care Knowledge Scale, Clinical Reasoning Scale (Huang et al., 2023) and Learning Engagement Scale (Ciou , 2020). Both groups completed a pre-test before the training, a post-test one week after the training and a second post-test three weeks after the training. RESULTS Prior to the intervention, there were no significant differences between the two groups in ECMO care knowledge and learning engagement. However, there was a significant difference in clinical reasoning. One week after the intervention, the experimental group demonstrated significantly higher scores in ECMO care knowledge, clinical reasoning and learning engagement than the control group (p <0.01). Three weeks after the intervention, the experimental group showed significantly higher scores in ECMO care knowledge, clinical reasoning and learning engagement (p <0.001). CONCLUSIONS The content for ECMO care is complex and difficult. Board games can enhance ECMO care knowledge, clinical reasoning and learning engagement. This teaching strategy may be applied to learning challenging subjects in the future to improve learning effectiveness. The clinical reasoning framework is conducive to guiding nurses' learning. In future continuing education, board games designed based on the clinical reasoning framework and tailored to the focus of in-service education can effectively enhance nurses' learning effectiveness.
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Affiliation(s)
- Hsin-Yi Wang
- Department of Nursing, Mackay Memorial Hospital, 3F., No. 9, Aly. 12, Ln. 3, Minquan Rd., Tamsui Dist., New Taipei City 251033, Taiwan, ROC
| | - Chu-Yu Huang
- School of Nursing, Cedarville University, 251 N. Main St., Cedarville, OH 45314, USA
| | - Sophia H Hu
- Department of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Su-Fen Cheng
- Department of Allied Health Education and Digital Learning, National Taipei University of Nursing and Health Sciences, No. 365, Mingde Rd., Beitou District, Taipei City 11219, Taiwan, ROC.
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Pérez-Perdomo A, Zabalegui A. Teaching Strategies for Developing Clinical Reasoning Skills in Nursing Students: A Systematic Review of Randomised Controlled Trials. Healthcare (Basel) 2023; 12:90. [PMID: 38200996 PMCID: PMC10779280 DOI: 10.3390/healthcare12010090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/13/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Clinical reasoning (CR) is a holistic and recursive cognitive process. It allows nursing students to accurately perceive patients' situations and choose the best course of action among the available alternatives. This study aimed to identify the randomised controlled trials studies in the literature that concern clinical reasoning in the context of nursing students. METHODS A comprehensive search of PubMed, Scopus, Embase, and the Cochrane Controlled Register of Trials (CENTRAL) was performed to identify relevant studies published up to October 2023. The following inclusion criteria were examined: (a) clinical reasoning, clinical judgment, and critical thinking in nursing students as a primary study aim; (b) articles published for the last eleven years; (c) research conducted between January 2012 and September 2023; (d) articles published only in English and Spanish; and (e) Randomised Clinical Trials. The Critical Appraisal Skills Programme tool was utilised to appraise all included studies. RESULTS Fifteen papers were analysed. Based on the teaching strategies used in the articles, two groups have been identified: simulation methods and learning programs. The studies focus on comparing different teaching methodologies. CONCLUSIONS This systematic review has detected different approaches to help nursing students improve their reasoning and decision-making skills. The use of mobile apps, digital simulations, and learning games has a positive impact on the clinical reasoning abilities of nursing students and their motivation. Incorporating new technologies into problem-solving-based learning and decision-making can also enhance nursing students' reasoning skills. Nursing schools should evaluate their current methods and consider integrating or modifying new technologies and methodologies that can help enhance students' learning and improve their clinical reasoning and cognitive skills.
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Heyn LG, Brembo EA, Byermoen KR, Cruaud C, Eide H, Flo J, Nordsteien A, Overgaard G, Egilsdottir HÖ. Exploring facilitation in virtual simulation in nursing education: A scoping review. PEC INNOVATION 2023; 3:100233. [PMID: 38033419 PMCID: PMC10687044 DOI: 10.1016/j.pecinn.2023.100233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 11/10/2023] [Accepted: 11/18/2023] [Indexed: 12/02/2023]
Abstract
Objective To systematically map existing research regarding the reflective feedback in virtual simulation in undergraduate nursing education. Methods A scoping review was conducted based on the Arksey and O'Malley framework and the PRISMA-ScR. Results We included 41 studies from 15 different countries. The simulation interventions allowed for interaction between the student and the virtual patient, the software, faculty, peers, or a combination of two or more of these. Students valued reflective feedback during and after the simulation. Conclusions Our review emphasizes the importance of a human in the loop. Feedback before, during, and after the simulation is possible in virtual simulation where the facilitator can pause the virtual scenario and stimulate reflections during the simulation to obtain deep learning. Virtual simulation provides opportunities to give feedback from the software, such as cues or direct feedback. Innovation There is a lack of focus on the feedback process and there is a need to revitalize the role of facilitators in a virtual simulation to determine their relative contribution in this process. Several studies reported the usefulness or the effect of virtual simulation on learning processes, but most lacked emphasis on investigating the significance of including a human in the loop.
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Affiliation(s)
- Lena Günterberg Heyn
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, 3045 Drammen, Norway
| | - Espen Andreas Brembo
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, 3045 Drammen, Norway
| | - Kirsten Røland Byermoen
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, 3045 Drammen, Norway
| | - Caroline Cruaud
- Unit for Digitalisation and Education, University of South-Eastern Norway, Campus Drammen, Grønland 58, 3045 Drammen, Norway
| | - Hilde Eide
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, 3045 Drammen, Norway
| | - Jill Flo
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, 3045 Drammen, Norway
| | - Anita Nordsteien
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, 3045 Drammen, Norway
| | - Grith Overgaard
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, 3045 Drammen, Norway
| | - Hugrun Ösp Egilsdottir
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, 3045 Drammen, Norway
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Deschênes MF, Maheu-Cadotte MA, Fontaine G, Dionne É. Scoring Methods in Script Concordance Tests: An Exploratory Psychometric Study. J Nurs Educ 2023; 62:549-555. [PMID: 37812827 DOI: 10.3928/01484834-20230815-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
BACKGROUND Despite the increasingly popular role of script concordance test (SCT) scoring methods in the evaluation of clinical reasoning, studies examining these methods in nursing are relatively scarce. This study explored the psychometric properties of five SCT scoring methods. METHOD An SCT was administered to 12 experts and 43 learners. Scores were calculated using five methods and descriptive statistics. Differences in scores were assessed with the Mann-Whitney U test, and Spearman correlation coefficients were calculated for the different methods. RESULTS The median scores of both experts and learners differed substantially according to the scoring method used. Learners' scores were statistically different from experts' scores (p < .01) for each method. Spearman coefficients (range, 0.44 to 0.95) were positive for the different methods. CONCLUSION Further research is needed to refine the influence of SCT scoring methods for use in certifying assessment of clinical reasoning in nursing. [J Nurs Educ. 2023;62(10):549-555.].
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Fontenot J, Leigh G, Watson C, Stueben F, Arceneaux S, Johnson S, St Romain A. Teaching Prelicensure Nursing Students Reasoning in Clinical Experiences: A Pilot Study. J Nurs Educ 2023; 62:467-470. [PMID: 37561899 DOI: 10.3928/01484834-20230612-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
BACKGROUND Clinical experiences are foundational learning components for prelicensure nursing students. Given the complexities of modern nursing practice in an aging America, clinical educators must teach nursing students to reason when engaging in patient care. Contemporary pedagogy to enhance reasoning relies on case studies and simulation. Specific and standardized methods for clinical education are largely absent in the literature. METHOD This pilot study measured the clinical reasoning ability of nursing students using the Health Sciences Reasoning Test (HSRT). Participants completed the test before their first clinical day and again after their last clinical day. Pre- and posttest HSRT scores were analyzed by control and intervention groups as well as student levels. RESULTS Posttest HSRT scores improved significantly in the intervention group at the end of the semester. CONCLUSION The PREP framework is a novel approach to clinical education and improved the clinical reasoning of prelicensure nursing students. [J Nurs Educ. 2023;62(8):467-470.].
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Ng MSP, Jabir AI, Ng TDR, Ang YI, Chia JL, Tan DNH, Lee J, Mahendran DCJ, Tudor Car L, Chia CLK. Evaluating TESLA-G, a gamified, telegram-delivered, quizzing platform for surgical education in medical students: protocol for a pilot randomised controlled trial. BMJ Open 2023; 13:e068740. [PMID: 37380211 PMCID: PMC10410996 DOI: 10.1136/bmjopen-2022-068740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 05/18/2023] [Indexed: 06/30/2023] Open
Abstract
INTRODUCTION Online multiple-choice question (MCQ) quizzes are popular in medical education due to their ease of access and ability for test-enhanced learning. However, a general lack of motivation among students often results in decreasing usage over time. We aim to address this limitation by developing Telegram Education for Surgical Learning and Application Gamified (TESLA-G), an online platform for surgical education that incorporates game elements into conventional MCQ quizzes. METHODS AND ANALYSIS This online, pilot randomised control trial will be conducted over 2 weeks. Fifty full-time undergraduate medical students from a medical school in Singapore will be recruited and randomised into an intervention group (TESLA-G) and an active control group (non-gamified quizzing platform) with a 1:1 allocation ratio, stratified by year of study.We will evaluate TESLA-G in the area of endocrine surgery education. Our platform is designed based on Bloom's taxonomy of learning domains: questions are created in blocks of five questions per endocrine surgery topic, with each question corresponding to one level on Bloom's taxonomy. This structure promotes mastery while boosting student engagement and motivation. All questions are created by two board-certified general surgeons and one endocrinologist, and validated by the research team. The feasibility of this pilot study will be determined quantitatively by participant enrolment, participant retention and degree of completion of the quizzes. The acceptability of the intervention will be assessed quantitatively by a postintervention learner satisfaction survey consisting of a system satisfaction questionnaire and a content satisfaction questionnaire. The improvement of surgical knowledge will be assessed by comparing the scores of preintervention and postintervention knowledge tests, which consist of separately created questions on endocrine surgery. Retention of surgical knowledge will be measured using a follow-up knowledge test administered 2 weeks postintervention. Finally, qualitative feedback from participants regarding their experience will be obtained and thematically analysed. ETHICS AND DISSEMINATION This research is approved by Singapore Nanyang Technological University (NTU) Institutional Review Boards (Reference Number: IRB-2021-732). All participants will be expected to read and sign a letter of informed consent before they are considered as recruited into the study. This study poses minimal risk to participants. Study results will be published in peer-reviewed open-access journals and presented in conference presentations. TRIAL REGISTRATION NUMBER NCT05520671.
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Affiliation(s)
| | - Ahmad Ishqi Jabir
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Tony De Rong Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yi-Ian Ang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jeng Long Chia
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - James Lee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- University Surgical Cluster, National University Hospital, Singapore
| | - Dinesh Carl Junis Mahendran
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of General Medicine, Khoo Teck Puat Hospital, Singapore
| | - Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Clement Luck Khng Chia
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Department of General Surgery, Khoo Teck Puat Hospital, Singapore
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Jans C, Bogossian F, Andersen P, Levett-Jones T. Examining the impact of virtual reality on clinical decision making - An integrative review. NURSE EDUCATION TODAY 2023; 125:105767. [PMID: 36906980 DOI: 10.1016/j.nedt.2023.105767] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/01/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Clinical decision making is an essential cognitive skill in nursing. It is a process undertaken daily by nurses as they make judgements about patient care and manage complex issues as they arise. Virtual reality is an emerging technology that is increasingly being used pedagogically to teach non-technical skills including CDM, communication, situational awareness, stress management, leadership, and teamwork. OBJECTIVE The objective of this integrative review are to synthesise the research findings regarding the impact of virtual reality on clinical decision making in undergraduate nurses. DESIGN An integrative review using Whittemore and Knafl's framework for integrated reviews. DATA SOURCES An extensive search was conducted of healthcare databases including CINAHL, Medline and Web of Science between 2010 and 2021 using the terms virtual reality, clinical decision and undergraduate nursing. REVIEW METHODS The initial search located 98 articles. After screening and checking for eligibility, 70 articles were critically reviewed. Eighteen studies were included in the review and were critically appraised using the Critical Appraisal Skills Program checklist for qualitative papers and McMaster's Critical appraisal form for quantitative papers. RESULTS Research in the use of VR has demonstrated its potential to improve undergraduate nurses' critical thinking, clinical reasoning, clinical judgement and clinical decision-making skills. Students perceive these teaching modalities to be beneficial to the development of their clinical decision-making ability. There is lack of research related to the use of immersive virtual reality in developing and enhancing undergraduate nursing students' clinical decision-making skills. CONCLUSION Current research on the impact of virtual reality on the development of nursing CDM has demonstrated positive results. VR is one pedagogical approach that could further assist, however, there are no identified studies that focus on its impact in developing CDM, therefore further studies are required to address this gap in the literature.
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Affiliation(s)
- Carley Jans
- School of Nursing, University of Wollongong, Faculty of Science, Medicine and Health, Australia.
| | - Fiona Bogossian
- School of Health, University of the Sunshine Coast, 1 Moreton Parade, Petrie QLD, 4502, Australia.
| | - Patrea Andersen
- Centre for Health and Social Practice, Waikato Institute of Technology, Private Bag 3036, Waikato Mail Centre, Hamilton 3240, New Zealand.
| | - Tracy Levett-Jones
- School of Nursing & Midwifery, University of Technology Sydney, Faculty of Health, 235 Jones St, Ultimo, NSW 2007, Australia.
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Wu CS, Chen MF, Hwang HL, Lee BO. Effectiveness of a nursing board games in psychiatric nursing course for undergraduate nursing students: An experimental design. Nurse Educ Pract 2023; 70:103657. [PMID: 37207376 DOI: 10.1016/j.nepr.2023.103657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 03/23/2023] [Accepted: 05/04/2023] [Indexed: 05/21/2023]
Abstract
AIM To examine the effectiveness of a psychiatric nursing board game in an undergraduate psychiatric nursing course. BACKGROUND Didactic teaching fails to assist students in deepening their understanding of abstract concepts in psychiatric nursing. The game-based learning of professional courses can address the demands of digital-age students, which may improve their learning outcomes. DESIGN A parallel two-arm experimental design was adopted in a nursing college in southern Taiwan. METHODS The participants were fourth-year students enroled in a college nursing programme in southern Taiwan. Simple random sampling was used to divide the class into intervention and control groups. The former participated in an eight-week game-based intervention course, while the latter continued to receive traditional instruction. In addition to collecting the students' demographic data, three structural questionnaires were developed to examine the variation in students' nursing knowledge and attitudes toward psychiatric nursing, as well as their learning satisfaction before and after the intervention. RESULTS There were a total of 106 participants, with 53 in each group. After the intervention, the two groups were significantly different in terms of their psychiatric nursing knowledge, attitudes and self-reported learning satisfaction. The intervention group's scores were significantly higher than those of the control group across all three dimensions. This suggests the positive effects of the board game intervention on students' learning outcomes. CONCLUSION The research outcome can be applied in formative and undergraduate nursing education in teaching psychiatric nursing globally. The game-based learning materials developed can be used to train psychiatric nursing teachers. Future studies should recruit a larger sample and increase the follow-up time for assessing students' learning outcomes, as well as examine the similarities and differences in the learning outcomes of students from different educational systems.
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Affiliation(s)
- Chia-Shan Wu
- Department of Nursing, National Tainan Junior College of Nursing, Tainan, Taiwan
| | - Mei-Fang Chen
- Department of Nursing, National Tainan Junior College of Nursing, Tainan, Taiwan
| | - Huei-Lih Hwang
- Department of Nursing, National Tainan Junior College of Nursing, Tainan, Taiwan
| | - Bih-O Lee
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Medical Education and Humanizing Health Professional Education, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Taylor C, Heaton L, Parrish TL, Salamonson Y. Utility of online interactive case studies in preparation for the first clinical placement among nursing students: A cross-sectional study. TEACHING AND LEARNING IN NURSING 2023. [DOI: 10.1016/j.teln.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
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Qiao J, Huang CR, Liu Q, Li SY, Xu J, Li L, Redding SR, Ouyang YQ. Effectiveness of Non-Immersive Virtual Reality Simulation in Learning Knowledge and Skills for Nursing Students: Meta-analysis. Clin Simul Nurs 2023. [DOI: 10.1016/j.ecns.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Exploring the activities and outcomes of digital teaching and learning of practical skills in higher education for the social and health care professions: a scoping review. DISCOVER EDUCATION 2023; 2:2. [PMID: 36619252 PMCID: PMC9809526 DOI: 10.1007/s44217-022-00022-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/05/2022] [Indexed: 01/04/2023]
Abstract
Higher education for health care professionals faces numerous challenges. It is important to develop and apply methods supporting education, especially the practical skills. This scoping review aimed to explore the activities and learning outcomes of digital technology in practical skills teaching and learning in higher education for the social and health professions. Scoping review recommendations and the PRISMA-ScR checklist were applied. Randomized controlled trials published between 2016 and 2021 involving students in higher education who were taking courses in the social sciences and health care and reported interventions with digital technology activities and practices in practical teaching and learning were included. The CINAHL Plus, PubMed, Scopus, ERIC, and Sociological Abstracts/Social Services Abstracts databases were searched. Teaching methods were blended, e-learning or other online-based, and digital simulation-based activities. Teaching and learning environments, methods, resources, and activity characteristics varied, making a summary difficult. Interventions were developed in a face-to-face format prior to digitalization. The outcomes were measured at the knowledge level, not at the performance level. One-third of the studies showed a significant improvement in practical skills in the intervention group in comparison to the control conditions. The use of digital technology in the learning and teaching process have potential to develop of students' skills, knowledge, motivation, and attitudes. The pedagogy of technology use is decisive. The development of new digital methods for teaching and learning practical skills requires the engagement of students and teachers, in addition the researchers.
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Hage R, Fourré A, Ramonfosse L, Leteneur S, Jones M, Dierick F. Description and rules of a new card game to learn clinical reasoning in musculoskeletal physiotherapy. J Man Manip Ther 2022:1-10. [DOI: 10.1080/10669817.2022.2132346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Affiliation(s)
- Renaud Hage
- TFTM, Manual Therapy Center, Brussels, Belgium
- CeREF-Technique, Haute Ecole Louvain en Hainaut, Mons, Belgium
| | - Antoine Fourré
- TFTM, Manual Therapy Center, Brussels, Belgium
- Department of Neurosciences, Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium
- Faculty of Medicine and Health Sciences, Rehabilitation Sciences and Physiotherapy (MOVANT), University of Antwerp, Antwerp, Belgium
| | - Laura Ramonfosse
- FoRS, Haute Ecole de Namur-Liège-Luxembourg, Marche-en-Famenne, Belgium
| | - Sébastien Leteneur
- Université Polytechnique Hauts-de-France, LAMIH, CNRS, UMR 8201, Valenciennes, France
| | - Mark Jones
- Allied Health and Human Performance Academic Unit, University of South Australia, Adelaide, Australia
- International Centre for Allied Health Evidence, University of South Australia, Adelaide, Australia
| | - Frédéric Dierick
- CeREF-Technique, Haute Ecole Louvain en Hainaut, Mons, Belgium
- Laboratoire d’Analyse du Mouvement et de la Posture (LAMP), Centre National de Rééducation Fonctionnelle et de Réadaptation – Rehazenter, Luxembourg, Luxembourg
- Faculté des Sciences de la Motricité, UCLouvain, Ottignies-Louvain-la-Neuve, Belgium
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15
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Utilizing educational technology in enhancing undergraduate nursing students' engagement and motivation: A scoping review. J Prof Nurs 2022; 42:262-275. [DOI: 10.1016/j.profnurs.2022.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/17/2022] [Accepted: 07/21/2022] [Indexed: 11/19/2022]
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16
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Thangavelu DP, Tan AJQ, Cant R, Chua WL, Liaw SY. Digital serious games in developing nursing clinical competence: A systematic review and meta-analysis. NURSE EDUCATION TODAY 2022; 113:105357. [PMID: 35429749 DOI: 10.1016/j.nedt.2022.105357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This review aimed to synthesise evidence from experimental studies of the application of digital serious games in developing nursing clinical competence. DESIGN Systematic review and meta-analysis. DATA SOURCES Eight databases were searched for randomized controlled trials and quasi-experimental studies published in English from 2000 to 2021. REVIEW METHODS Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were adopted in this review. Quality appraisal was conducted using Cochrane's Risk of Bias tool and the Joanna Brigg's Institute Critical Appraisal Tool for Quasi-Experimental Designs. A narrative synthesis of studies, and a meta-analysis and subgroup analysis, was performed on the study outcomes. RESULTS 22 experimental studies including 13 randomized controlled trials and nine quasi-experimental studies were included. Of these, 19 studies examined nursing students and three examined qualified nurses. These studies applied serious games to develop nursing competencies in management of nursing care, clinical reasoning skills, procedural skills, legal practice and quality improvement. Compared with control groups, serious games improved knowledge (SMD = 1.30, 95% CI [0.75, 1.86]) and skills (SMD = 0.38, 95% CI [0.17, 0.60]). Subgroup analysis for both knowledge and skills outcomes demonstrated that serious games were more effective than control groups with either no intervention or other educational interventions. A large effect size (SMD = 1.13, 95% CI [0.91, 1.34]) was found in favour of serious games for improving knowledge scores in management of nursing care. CONCLUSION The reviewed studies identified a broad application of digital serious games for developing nursing competencies. The knowledge and skills performance outcomes supported the use of serious games, which were found to be superior to conventional educational interventions. More serious games are required to be incorporated into undergraduate and continuing nursing education for workplace training, with more rigorous studies examining the effect of serious games in improving the quality and safety of clinical nursing practice.
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Affiliation(s)
| | - Apphia J Q Tan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Robyn Cant
- School of Health, Federation University Australia, Berwick, Victoria, Australia
| | - Wei Ling Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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17
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Montalbano L, Gallo L, Ferrante G, Malizia V, Cilluffo G, Fasola S, Alesi M, La Grutta S. Serious Games: A new Approach to Foster Information and Practices About Covid-19? Front Robot AI 2022; 9:830950. [PMID: 35677083 PMCID: PMC9168068 DOI: 10.3389/frobt.2022.830950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Abstract
The current Covid-19 pandemic poses an unprecedented global challenge in the field of education and training. As we have seen, the lack of proper information about the virus and its transmission has forced the general population and healthcare workers to rapidly acquire knowledge and learn new practices. Clearly, a well-informed population is more likely to adopt the correct precautionary measures, thus reducing the transmission of the infection; likewise, properly educated healthcare workers are better equipped to manage the emergency. However, the need to maintain physical distancing has made it impossible to provide in-presence information and training. In this regard, new technologies have proved to be an invaluable resource by facilitating distance learning. Indeed, e-learning offers significant advantages because it does not require the physical presence of learners and teachers. This innovative method applied to serious games has been considered potentially effective in enabling rapid and large-scale dissemination of information and learning through content interactivity. We will review studies that have observed the development and use of serious games to foster information and practices about Covid-19 aimed at promoting behavioral changes in the population and the healthcare personnel involved on the front line.
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Affiliation(s)
- L. Montalbano
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy, Palermo, Italy
- *Correspondence: L. Montalbano,
| | - L. Gallo
- Institute for High Performance Computing and Networking (ICAR), National Research Council of Italy, Napoli, Italy
| | - G. Ferrante
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Division, University of Verona, Verona, Italy
| | - V. Malizia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy, Palermo, Italy
| | - G. Cilluffo
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy, Palermo, Italy
| | - S. Fasola
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy, Palermo, Italy
| | - M. Alesi
- Department of Psychology, Educational Science and Human Movement (SPPEFF), University of Palermo, Palermo, Italy
| | - S. La Grutta
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy, Palermo, Italy
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18
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Gasteiger N, van der Veer SN, Wilson P, Dowding D. How, for Whom, and in Which Contexts or Conditions Augmented and Virtual Reality Training Works in Upskilling Health Care Workers: Realist Synthesis. JMIR Serious Games 2022; 10:e31644. [PMID: 35156931 PMCID: PMC8893595 DOI: 10.2196/31644] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/16/2021] [Accepted: 10/12/2021] [Indexed: 01/20/2023] Open
Abstract
Background Using traditional simulators (eg, cadavers, animals, or actors) to upskill health workers is becoming less common because of ethical issues, commitment to patient safety, and cost and resource restrictions. Virtual reality (VR) and augmented reality (AR) may help to overcome these barriers. However, their effectiveness is often contested and poorly understood and warrants further investigation. Objective The aim of this review is to develop, test, and refine an evidence-informed program theory on how, for whom, and to what extent training using AR or VR works for upskilling health care workers and to understand what facilitates or constrains their implementation and maintenance. Methods We conducted a realist synthesis using the following 3-step process: theory elicitation, theory testing, and theory refinement. We first searched 7 databases and 11 practitioner journals for literature on AR or VR used to train health care staff. In total, 80 papers were identified, and information regarding context-mechanism-outcome (CMO) was extracted. We conducted a narrative synthesis to form an initial program theory comprising of CMO configurations. To refine and test this theory, we identified empirical studies through a second search of the same databases used in the first search. We used the Mixed Methods Appraisal Tool to assess the quality of the studies and to determine our confidence in each CMO configuration. Results Of the 41 CMO configurations identified, we had moderate to high confidence in 9 (22%) based on 46 empirical studies reporting on VR, AR, or mixed simulation training programs. These stated that realistic (high-fidelity) simulations trigger perceptions of realism, easier visualization of patient anatomy, and an interactive experience, which result in increased learner satisfaction and more effective learning. Immersive VR or AR engages learners in deep immersion and improves learning and skill performance. When transferable skills and knowledge are taught using VR or AR, skills are enhanced and practiced in a safe environment, leading to knowledge and skill transfer to clinical practice. Finally, for novices, VR or AR enables repeated practice, resulting in technical proficiency, skill acquisition, and improved performance. The most common barriers to implementation were up-front costs, negative attitudes and experiences (ie, cybersickness), developmental and logistical considerations, and the complexity of creating a curriculum. Facilitating factors included decreasing costs through commercialization, increasing the cost-effectiveness of training, a cultural shift toward acceptance, access to training, and leadership and collaboration. Conclusions Technical and nontechnical skills training programs using AR or VR for health care staff may trigger perceptions of realism and deep immersion and enable easier visualization, interactivity, enhanced skills, and repeated practice in a safe environment. This may improve skills and increase learning, knowledge, and learner satisfaction. The future testing of these mechanisms using hypothesis-driven approaches is required. Research is also required to explore implementation considerations.
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Affiliation(s)
- Norina Gasteiger
- Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester, United Kingdom.,Centre for Health Informatics, Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, United Kingdom.,Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, United Kingdom
| | - Sabine N van der Veer
- Centre for Health Informatics, Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Paul Wilson
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, United Kingdom
| | - Dawn Dowding
- Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester, United Kingdom
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19
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Ryan GV, Callaghan S, Rafferty A, Higgins MF, Mangina E, McAuliffe F. Learning Outcomes of Immersive Technologies in Health Care Student Education: Systematic Review of the Literature. J Med Internet Res 2022; 24:e30082. [PMID: 35103607 PMCID: PMC8848248 DOI: 10.2196/30082] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/11/2021] [Accepted: 10/26/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND There is a lack of evidence in the literature regarding the learning outcomes of immersive technologies as educational tools for teaching university-level health care students. OBJECTIVE The aim of this review is to assess the learning outcomes of immersive technologies compared with traditional learning modalities with regard to knowledge and the participants' learning experience in medical, midwifery, and nursing preclinical university education. METHODS A systematic review was conducted according to the Cochrane Collaboration guidelines. Randomized controlled trials comparing traditional learning methods with virtual, augmented, or mixed reality for the education of medicine, nursing, or midwifery students were evaluated. The identified studies were screened by 2 authors independently. Disagreements were discussed with a third reviewer. The quality of evidence was assessed using the Medical Education Research Study Quality Instrument (MERSQI). The review protocol was registered with PROSPERO (International Prospective Register of Systematic Reviews) in April 2020. RESULTS Of 15,627 studies, 29 (0.19%) randomized controlled trials (N=2722 students) were included and evaluated using the MERSQI tool. Knowledge gain was found to be equal when immersive technologies were compared with traditional learning modalities; however, the learning experience increased with immersive technologies. The mean MERSQI score was 12.64 (SD 1.6), the median was 12.50, and the mode was 13.50. Immersive technology was predominantly used to teach clinical skills (15/29, 52%), and virtual reality (22/29, 76%) was the most commonly used form of immersive technology. Knowledge was the primary outcome in 97% (28/29) of studies. Approximately 66% (19/29) of studies used validated instruments and scales to assess secondary learning outcomes, including satisfaction, self-efficacy, engagement, and perceptions of the learning experience. Of the 29 studies, 19 (66%) included medical students (1706/2722, 62.67%), 8 (28%) included nursing students (727/2722, 26.71%), and 2 (7%) included both medical and nursing students (289/2722, 10.62%). There were no studies involving midwifery students. The studies were based on the following disciplines: anatomy, basic clinical skills and history-taking skills, neurology, respiratory medicine, acute medicine, dermatology, communication skills, internal medicine, and emergency medicine. CONCLUSIONS Virtual, augmented, and mixed reality play an important role in the education of preclinical medical and nursing university students. When compared with traditional educational modalities, the learning gain is equal with immersive technologies. Learning outcomes such as student satisfaction, self-efficacy, and engagement all increase with the use of immersive technology, suggesting that it is an optimal tool for education.
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Affiliation(s)
- Grace V Ryan
- Perinatal Research Centre, Obstetrics and Gynaecology, School of Medicine, University College Dublin, Dublin, Ireland
| | - Shauna Callaghan
- Perinatal Research Centre, Obstetrics and Gynaecology, School of Medicine, University College Dublin, Dublin, Ireland
| | - Anthony Rafferty
- Perinatal Research Centre, Obstetrics and Gynaecology, School of Medicine, University College Dublin, Dublin, Ireland
| | - Mary F Higgins
- Perinatal Research Centre, Obstetrics and Gynaecology, School of Medicine, University College Dublin, Dublin, Ireland
| | - Eleni Mangina
- School of Computer Science, University College Dublin, Dublin, Ireland
| | - Fionnuala McAuliffe
- Perinatal Research Centre, Obstetrics and Gynaecology, School of Medicine, University College Dublin, Dublin, Ireland
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20
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Allen LM, Hay M, Palermo C. Evaluation in health professions education-Is measuring outcomes enough? MEDICAL EDUCATION 2022; 56:127-136. [PMID: 34463357 DOI: 10.1111/medu.14654] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 08/18/2021] [Accepted: 08/23/2021] [Indexed: 05/28/2023]
Abstract
INTRODUCTION In an effort to increase the rigour of evaluation in health professions education (HPE), a range of evaluation approaches are used. These largely focus on outcome evaluation as opposed to programme evaluation. We aim to review and critique the use of outcome evaluation models, using the Kirkpatrick Model as an example given its wide acceptance and use, and advocate for the use of programme evaluation models that help us understand how and why outcomes are occurring. METHODS We systematically searched OVID medline, Scopus, CINAHL and Pubmed, and hand searched six leading HPE journals to provide an overview of the use of the Kirkpatrick Model as well as a range of programme evaluation models in HPE. In addition to this, we synthesised the existing critiques of the Kirkpatrick Model as an example of outcome evaluation, to highlight the limitations of such models. RESULTS The use of the Kirkpatrick Model in HPE is widespread and increasing; however, studies focus on categorising outcomes, rather than explaining how and why they occur. The main criticisms of the model are as follows: it is outcomes focused and fails to consider factors that can impact training outcomes; it assumes positive casual linkages between the levels; there is an assumption that the higher-level outcomes are more important; and unintended impacts are not considered. The use of the Kirkpatrick Model by the MERSQI, BEME and WHO contribute to the myth that the Kirkpatrick Model is the gold standard for programme evaluation. DISCUSSION Moving forward, evaluations of HPE interventions must shift from focusing largely on measuring outcomes of interventions with little consideration for how and why these outcomes are occurring to programme evaluation that investigates what contributes to these outcomes. Other models that facilitate the evaluation of the complex processes that occur in HPE should be used instead of Kirkpatrick's.
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Affiliation(s)
- Louise M Allen
- Monash Centre for Professional Development and Monash Online Education, Monash University, Clayton, Victoria, Australia
| | - Margaret Hay
- Monash Centre for Professional Development and Monash Online Education, Monash University, Clayton, Victoria, Australia
| | - Claire Palermo
- Monash Centre for Scholarship in Health Education, Monash University, Clayton, Victoria, Australia
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21
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Xu Y, Lau Y, Cheng LJ, Lau ST. Learning experiences of game-based educational intervention in nursing students: A systematic mixed-studies review. NURSE EDUCATION TODAY 2021; 107:105139. [PMID: 34563963 DOI: 10.1016/j.nedt.2021.105139] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 08/25/2021] [Accepted: 09/06/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND To meet the evolving needs of today's nursing students and the demand for 21st century skills in modern healthcare, game-based learning has received increasing attention. It can improve learning outcomes, while enhancing learning experiences by promoting engagement and motivation. OBJECTIVE To explore the learning experiences of using game-based education in nursing students. DATA SOURCES Electronic databases of PubMed, EMBASE, Cochrane Library, CINAHL (EBSCOhost), and Scopus were searched from inception till January 2021. REVIEW METHODS Quantitative, qualitative, and mixed-methods studies were included, involving the use of games for education among nursing students. Both published and unpublished studies in English language without restrictions to the year of publication. Methodological quality of included studies was assessed using the mixed methods appraisal tool. Data synthesis used a convergent synthesis approach. Narrative synthesis was used for quantitative findings and thematic synthesis for qualitative findings. A result-based convergent synthesis was adopted to integrate both results. RESULTS A total of 53 studies were included among 4612 nursing students across 16 countries. These included 32 quantitative studies, 7 qualitative studies, and 14 mixed-methods studies, with methodological quality ranging from low to high. The findings from this review demonstrate that game-based education interventions can enhance nursing students' learning experiences. Three themes emerged from both quantitative and qualitative syntheses: 1) motivators of learning, 2) facilitators of engagement, and 3) affective response. CONCLUSIONS Game-based education is promising in promoting positive learning experiences among nursing students. This can better inform educators and healthcare leaders when considering gaming as an alternative education approach in motivating and engaging students in learning. Future research should provide greater focus on examining the use of specific games under similar contexts.
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Affiliation(s)
- Yaqi Xu
- Ward 10A, Department of Nursing, Tan Tock Seng Hospital, National Healthcare Group, Singapore.
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Ling Jie Cheng
- Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
| | - Siew Tiang Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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22
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Abstract
BACKGROUND The script concordance approach aims at triggering judgments in simulated contexts of uncertainty. PROBLEM Nursing students need to be prepared to manage the uncertainty of clinical practice. APPROACH The purpose of this article is to describe the theoretical foundation and the pedagogical use of the script concordance approach, as well as to present the current state of nursing evidence on the subject. The script concordance approach includes (1) script concordance testing, which is a quantitative examination that evaluates clinical reasoning; (2) a face-to-face script concordance activity; and (3) a digital educational strategy based on script concordance delivered via an online teaching/learning platform that aims to support clinical reasoning development. CONCLUSIONS Relying on questioning and experts' modeling, the script concordance offers an innovative pedagogical approach that approximates the uncertainty of clinical practice.
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23
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Gasteiger N, van der Veer SN, Wilson P, Dowding D. Upskilling health and care workers with augmented and virtual reality: protocol for a realist review to develop an evidence-informed programme theory. BMJ Open 2021; 11:e050033. [PMID: 34226234 PMCID: PMC8258595 DOI: 10.1136/bmjopen-2021-050033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 06/10/2021] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Augmented reality (AR) and virtual reality (VR) are increasingly used to upskill health and care providers, including in surgical, nursing and acute care settings. Many studies have used AR/VR to deliver training, providing mixed evidence on their effectiveness and limited evidence regarding contextual factors that influence effectiveness and implementation. This review will develop, test and refine an evidence-informed programme theory on what facilitates or constrains the implementation of AR or VR programmes in health and care settings and understand how, for whom and to what extent they 'work'. METHODS AND ANALYSIS This realist review adheres to the Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) standards and will be conducted in three steps: theory elicitation, theory testing and theory refinement. First, a search will identify practitioner, academic and learning and technology adoption theories from databases (MEDLINE, Scopus, CINAHL, Embase, Education Resources Information Center, PsycINFO and Web of Science), practitioner journals, snowballing and grey literature. Information regarding contexts, mechanisms and outcomes will be extracted. A narrative synthesis will determine overlapping configurations and form an initial theory. Second, the theory will be tested using empirical evidence located from the above databases and identified from the first search. Quality will be assessed using the Mixed Methods Appraisal Tool (MMAT), and relevant information will be extracted into a coding sheet. Third, the extracted information will be compared with the initial programme theory, with differences helping to make refinements. Findings will be presented as a narrative summary, and the MMAT will determine our confidence in each configuration. ETHICS AND DISSEMINATION Ethics approval is not required. This review will develop an evidence-informed programme theory. The results will inform and support AR/VR interventions from clinical educators, healthcare providers and software developers. Upskilling through AR/VR learning interventions may improve quality of care and promote evidence-based practice and continued learning. Findings will be disseminated through conference presentations and peer-reviewed journal articles.
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Affiliation(s)
- Norina Gasteiger
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Division of Informatics, Imaging and Data Sciences, Centre for Health Informatics, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Division of Population Health, Health Services Research and Primary Care, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Sabine N van der Veer
- Division of Informatics, Imaging and Data Sciences, Centre for Health Informatics, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Paul Wilson
- Division of Population Health, Health Services Research and Primary Care, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Dawn Dowding
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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24
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A Combination of Self-debriefing and Instructor-led Debriefing Improves Team Effectiveness in Health Science Students. Nurse Educ 2021; 46:E7-E11. [PMID: 32433378 DOI: 10.1097/nne.0000000000000845] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Debriefing is considered a critical component of simulation-based learning, but the differences between different debriefing methods remain unclear. PURPOSE The purpose of the study was to investigate the effectiveness of the debriefing assessment, problem-solving process, and team effectiveness among students who received instructor-led debriefing, self-debriefing, and combined debriefing. METHODS An experimental design was conducted with 250 students (nursing, physiotherapy, and occupational therapy). Differences in the Debriefing Experience Scale (DES), Problem Solving Inventory (PSI), and Communication and Teamwork Skills (CATS) assessment between the groups were measured. RESULTS In nursing students, the combined debriefing group had the highest scores for the CATS assessment (P < .001) and for the coordination (P < .001), cooperation (P = .012), and communication (P = .002) categories. No significant differences were observed between debriefing groups for DES or PSI. CONCLUSIONS Combined debriefing improves communication and team skills in students. Educators might promote combined debriefing after simulation sessions as it seems to improve team effectiveness.
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25
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Treal T, Jackson PL, Jeuvrey J, Vignais N, Meugnot A. Natural human postural oscillations enhance the empathic response to a facial pain expression in a virtual character. Sci Rep 2021; 11:12493. [PMID: 34127724 PMCID: PMC8203793 DOI: 10.1038/s41598-021-91710-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/21/2021] [Indexed: 01/10/2023] Open
Abstract
Virtual reality platforms producing interactive and highly realistic characters are being used more and more as a research tool in social and affective neuroscience to better capture both the dynamics of emotion communication and the unintentional and automatic nature of emotional processes. While idle motion (i.e., non-communicative movements) is commonly used to create behavioural realism, its use to enhance the perception of emotion expressed by a virtual character is critically lacking. This study examined the influence of naturalistic (i.e., based on human motion capture) idle motion on two aspects (the perception of other’s pain and affective reaction) of an empathic response towards pain expressed by a virtual character. In two experiments, 32 and 34 healthy young adults were presented video clips of a virtual character displaying a facial expression of pain while its body was either static (still condition) or animated with natural postural oscillations (idle condition). The participants in Experiment 1 rated the facial pain expression of the virtual human as more intense, and those in Experiment 2 reported being more touched by its pain expression in the idle condition compared to the still condition, indicating a greater empathic response towards the virtual human’s pain in the presence of natural postural oscillations. These findings are discussed in relation to the models of empathy and biological motion processing. Future investigations will help determine to what extent such naturalistic idle motion could be a key ingredient in enhancing the anthropomorphism of a virtual human and making its emotion appear more genuine.
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Affiliation(s)
- Thomas Treal
- CIAMS, Université Paris-Saclay, 91405, Orsay, France.,CIAMS, Université D'Orléans, 45067, Orléans, France
| | - Philip L Jackson
- École de Psychologie, Université Laval, Québec, Canada.,Centre Interdisciplinaire de Recherche en Réadaptation Et Intégration Sociale (CIRRIS), Québec, Canada.,CERVO Research Center, Québec, Canada
| | - Jean Jeuvrey
- CIAMS, Université Paris-Saclay, 91405, Orsay, France.,CIAMS, Université D'Orléans, 45067, Orléans, France
| | - Nicolas Vignais
- CIAMS, Université Paris-Saclay, 91405, Orsay, France.,CIAMS, Université D'Orléans, 45067, Orléans, France
| | - Aurore Meugnot
- CIAMS, Université Paris-Saclay, 91405, Orsay, France. .,CIAMS, Université D'Orléans, 45067, Orléans, France.
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26
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Luo Y, Geng C, Chen X, Zhang Y, Zou Z, Bai J. Three learning modalities' impact on clinical judgment and perceptions in newly graduated registered nurses: A quasi-experimental study. Nurs Health Sci 2021; 23:538-546. [PMID: 33864331 DOI: 10.1111/nhs.12842] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/31/2021] [Accepted: 04/13/2021] [Indexed: 11/30/2022]
Abstract
Newly graduated registered nurses face numerous challenges stemming from high patient workload, complicated interpersonal relationships, and a lack of nursing competence, which can lead to transitional shocks. Clinical judgment and confidence are well-known keys to successful role transitions for these nurses. Simulation training is proposed as a new modality for enhancing comprehensive clinical competence of nurses, but current evidence on the impact of different simulations on nurses' clinical judgment and confidence are still limited or inconsistent. This study compared the impact of three types of learning modalities on newly graduated registered nurses' clinical judgment, perceptions of self-confidence, and evaluations of the design features of the learning modalities. A quasi-experimental design was used. Fifty-nine participants were randomly assigned to three groups: (1) high-fidelity simulation, (2) virtual simulation, and (3) case study. Scales were used after the simulation. The virtual simulation group showed a higher level of clinical judgment. The high-fidelity simulation group felt more confident than the virtual simulation and case study groups. Both the high-fidelity simulation group and virtual simulation group reported higher scores in the domain of fidelity.
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Affiliation(s)
- Yiqing Luo
- Wuhan University School of Health Sciences, Wuhan, China
| | - Cong Geng
- Wuhan University School of Health Sciences, Wuhan, China
| | - Xiaoli Chen
- Wuhan University School of Health Sciences, Wuhan, China
| | | | - Zhijie Zou
- Wuhan University School of Health Sciences, Wuhan, China
| | - Jinbing Bai
- Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, Georgia, USA
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27
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Hu H, Xiao Y, Li H. The Effectiveness of a Serious Game Versus Online Lectures for Improving Medical Students' Coronavirus Disease 2019 Knowledge. Games Health J 2021; 10:139-144. [PMID: 33434099 DOI: 10.1089/g4h.2020.0140] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objective: The sudden disruption of university teaching caused by the coronavirus disease 2019 (COVID-19) pandemic has forced universities to switch to online teaching. It is vital for graduating medical students to learn about COVID-19 because they are likely to treat COVID-19 patients after graduation. We developed a COVID-19 lesson for medical students that used either an online lecture or a serious game that we designed. The aim of this study is to explore the effectiveness of a serious game versus online lectures for improving medical students' COVID-19 knowledge. Materials and Methods: From our university's database of knowledge scores, we collected the prelesson, postlesson, and final test knowledge scores of the students who participated in the lesson and conducted a retrospective comparative analysis. Results: An analysis of scores concerning knowledge of COVID-19 from prelesson and postlesson tests shows that both teaching methods produce significant increases in short-term knowledge, with no statistical difference between the two methods (P > 0.05). The final test scores, however, show that the group of students who used the game-based computer application scored significantly higher in knowledge retention than did the online lecture group (P = 0.001). Conclusion: In the context of the disruption of traditional university teaching caused by the COVID-19 pandemic, the serious game we designed is potentially an effective option for online medical education about COVID-19, particularly in terms of its capacity for improved knowledge retention.
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Affiliation(s)
- Hai Hu
- Emergency Management Office, West China Hospital, Sichuan University, Sichuan, P.R. China.,National Emergency Medical Rescue Base of China, Sichuan University, Sichuan, P.R. China.,International Emergency Medical Team (Type III), Sichuan, P.R. China
| | | | - Hao Li
- Institute for Disaster Management and Reconstruction, Sichuan University and the Hong Kong Polytechnic University, Sichuan, P.R. China.,Disaster Medicine Center of Sichuan University, Sichuan, P.R. China
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Arruzza E, Chau M. A scoping review of randomised controlled trials to assess the value of gamification in the higher education of health science students. J Med Imaging Radiat Sci 2020; 52:137-146. [PMID: 33153931 DOI: 10.1016/j.jmir.2020.10.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/07/2020] [Accepted: 10/08/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION In today's ever-changing technological landscape, novel pedagogical methods are very attractive for medical radiation educators trying to enhance their students' educational experience. This scoping review aimed to assess the evidence regarding the value of gamification as part of health science undergraduate education, in comparison to conventional teaching curriculum. METHODS A comprehensive systematic literature search was conducted in MEDLINE, EMC are and Cochrane databases. Articles were eligible if they were randomised controlled trials comparing the use of gamification for undergraduate health profession students, with conventional teaching methods. Outcomes included knowledge (ie., information acquisition), skills (ie., knowledge application) and perceived benefit. Screening, data extraction and critical appraisal was conducted by two reviewers independently. RESULTS Eleven RCT studies were included (n = 997). Three of eight reporting studies discovered significant findings for knowledge acquisition scores favouring the intervention group. Varying results were demonstrated in the skills domain across six studies. Perceived benefits including student motivation and satisfaction levels demonstrated positive findings in all but one of six reporting studies. DISCUSSION Educators should supplement methods with gamified learning rather than replace them, consider group-based gamification, and employ methods at irregular intervals. CONCLUSION The findings of this review suggest that gamification may be advantageous for health science undergraduates. Gamification positively impacts student satisfaction and motivation, though its capacity to enhance students' knowledge acquisition and application necessitates further research.
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Affiliation(s)
- Elio Arruzza
- UniSA Allied Health & Human Performance, University of South Australia, South Australia, Australia.
| | - Minh Chau
- UniSA Allied Health & Human Performance, University of South Australia, South Australia, Australia
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Fens T, Dantuma-Wering CM, Taxis K. The Pharmacy Game-GIMMICS ® a Simulation Game for Competency-Based Education. PHARMACY 2020; 8:pharmacy8040198. [PMID: 33114442 PMCID: PMC7712308 DOI: 10.3390/pharmacy8040198] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/16/2020] [Accepted: 10/21/2020] [Indexed: 01/27/2023] Open
Abstract
The profile of the profession of pharmacists has profoundly changed over the last decades. Pharmacy education has moved towards competency-based education. The pharmacy game, called GIMMICS®, developed at the University of Groningen, is unique in combining simulation with serious gaming to teach a wide range of competencies. In this article, we describe the learning goals, the assessment methods, the teaching tools, and the students’ view of the pharmacy game. The learning goals are to train the competencies of collaboration, leadership, communication, and pharmaceutical expertise. The core of the game is the simulation of community pharmacy practice activities, such as patient counseling, processing of prescriptions, and collaboration with other health professionals. Students are assessed individually and as a pharmacy team. The pharmacy team, with the largest number of patients wins the game. Student evaluations show that they value the course. Currently, seven universities from around the globe have adopted the pharmacy game in their curriculum, adjusting the course to their country’s pharmacy practice and educational system.
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Affiliation(s)
- Tanja Fens
- Department of PharmacoTherapy, -Epidemiology and -Economics, Groningen Institute of Pharmacy, School of Science and Engineering, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (C.M.D.-W.); (K.T.)
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
- Correspondence:
| | - Claudia M. Dantuma-Wering
- Department of PharmacoTherapy, -Epidemiology and -Economics, Groningen Institute of Pharmacy, School of Science and Engineering, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (C.M.D.-W.); (K.T.)
| | - Katja Taxis
- Department of PharmacoTherapy, -Epidemiology and -Economics, Groningen Institute of Pharmacy, School of Science and Engineering, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (C.M.D.-W.); (K.T.)
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Blanié A, Amorim MA, Meffert A, Perrot C, Dondelli L, Benhamou D. Assessing validity evidence for a serious game dedicated to patient clinical deterioration and communication. Adv Simul (Lond) 2020; 5:4. [PMID: 32514382 PMCID: PMC7251894 DOI: 10.1186/s41077-020-00123-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 05/14/2020] [Indexed: 11/25/2022] Open
Abstract
Background A serious game (SG) is a useful tool for nurse training. The objectives of this study were to assess validity evidence of a new SG designed to improve nurses’ ability to detect patient clinical deterioration. Methods The SG (LabForGames Warning) was developed through interaction between clinical and pedagogical experts and one developer. For the game study, consenting nurses were divided into three groups: nursing students (pre-graduate) (group S), recently graduated nurses (graduated < 2 years before the study) (group R) and expert nurses (graduated > 4 years before the study and working in an ICU) (group E). Each volunteer played three cases of the game (haemorrhage, brain trauma and obstructed intestinal tract). The validity evidence was assessed following Messick’s framework: content, response process (questionnaire, observational analysis), internal structure, relations to other variables (by scoring each case and measuring playing time) and consequences (a posteriori analysis). Results The content validity was supported by the game design produced by clinical, pedagogical and interprofessional experts in accordance with the French nurse training curriculum, literature review and pilot testing. Seventy-one nurses participated in the study: S (n = 25), R (n = 25) and E (n = 21). The content validity in all three cases was highly valued by group E. The response process evidence was supported by good security control. There was no significant difference in the three groups’ high rating of the game’s realism, satisfaction and educational value. All participants stated that their knowledge of the different steps of the clinical reasoning process had improved. Regarding the internal structure, the factor analysis showed a common source of variance between the steps of the clinical reasoning process and communication or the situational awareness errors made predominantly by students. No statistical difference was observed between groups regarding scores and playing time. A posteriori analysis of the results of final examinations assessing study-related topics found no significant difference between group S participants and students who did not participate in the study. Conclusion While it appears that this SG cannot be used for summative assessment (score validity undemonstrated), it is positively valued as an educational tool. Trial registration ClinicalTrials.gov ID: NCT03092440
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Affiliation(s)
- Antonia Blanié
- Centre de simulation LabForSIMS, Faculté de médecine Paris Saclay, 94275 Le Kremlin Bicêtre, France.,Département d'Anesthésie-Réanimation chirurgicale, CHU Bicêtre, 94275 Le Kremlin Bicêtre, France.,CIAMS, Université Paris-Saclay, 91405 Orsay Cedex, France.,CIAMS, Université d'Orléans, 45067 Orléans, France
| | - Michel-Ange Amorim
- CIAMS, Université Paris-Saclay, 91405 Orsay Cedex, France.,CIAMS, Université d'Orléans, 45067 Orléans, France
| | - Arnaud Meffert
- Centre de simulation LabForSIMS, Faculté de médecine Paris Saclay, 94275 Le Kremlin Bicêtre, France.,Département d'Anesthésie-Réanimation chirurgicale, CHU Bicêtre, 94275 Le Kremlin Bicêtre, France
| | | | | | - Dan Benhamou
- Centre de simulation LabForSIMS, Faculté de médecine Paris Saclay, 94275 Le Kremlin Bicêtre, France.,Département d'Anesthésie-Réanimation chirurgicale, CHU Bicêtre, 94275 Le Kremlin Bicêtre, France.,CIAMS, Université Paris-Saclay, 91405 Orsay Cedex, France.,CIAMS, Université d'Orléans, 45067 Orléans, France
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