[A Structural Model on the Nursing Competencies of Nursing Simulation Learners]

The mediating role of flow in the relationship between simulation design and simulation educational satisfaction in korean nursing students: a cross-sectional study

BACKGROUND

In Korea, there has been recent interest in nursing simulation education. In nursing, simulation education has many advantages, such as improving nursing students' problem-solving and judgment skills. Simulation education satisfaction is an indicator for evaluating educational performance from the learners' perspective and an important criterion for the development and progress of nursing education. Therefore, based on NLN/Jeffries simulation theory, this study aims to identify the relationship between simulation design and educational satisfaction and to confirm the mediating effect of flow.

METHODS

This cross-sectional study was conducted using 143 fourth-year nursing students who had participated in classes using simulations at three universities in Seoul, Daegu, and Jeonbuk. Data were collected from April 24 to May 3, 2023. Demographic data, simulation design scale (SDS), flow in simulation, and the educational satisfaction scale in simulation were collected via an online questionnaire. The collected data were analyzed through t-test, ANOVA, Scheffé test, and Pearson's correlation coefficient using SPSS 25.0. The mediating effect of flow was analyzed through the three-stage mediation effect procedure using hierarchical regression analysis and the Sobel test.

RESULTS

The simulation educational satisfaction had a statistically significant positive correlation with simulation design (r = .65, p < .001) and flow (r = .47, p < .001), and simulation design was positively correlated with the flow (r = .55, p < .001). The simulation design had a statistically significant effect on flow, which was the mediating variable (β = 0.55, p < .001). Additionally, simulation design had a statistically significant effect on simulation educational satisfaction (β = 0.56, p < .001). The significance of the mediating effect of flow on the relationship between simulation design and simulation educational satisfaction was investigated using the Sobel test, and the mediating effect of flow was found to be statistically significant (Z = 5.36, p < .001).

CONCLUSION

The significance of the current study lies in its confirmation of the link between simulation design and simulation educational satisfaction, as well as the mediating function of flow. Nursing students can achieve simulation educational satisfaction through simulation-based education if simulation educators follow best practices that improve flow through well-organized simulation design.

Does a preterm labor-assessment algorithm improve preterm labor-related knowledge, clinical practice confidence, and educational satisfaction?: a quasi-experimental study

PURPOSE

Preterm birth is increasing, and obstetric nurses should have the competency to provide timely care. Therefore, training is necessary in the maternal nursing practicum. This study aimed to investigate the effects of practice education using a preterm-labor assessment algorithm on preterm labor-related knowledge and clinical practice confidence in senior nursing students.

METHODS

A pre-post quasi-experimental design with three groups was used for 61 students. The preterm-labor assessment algorithm was modified into three modules from the preterm-labor assessment algorithm by March of Dimes. We evaluated preterm labor-related knowledge, clinical practice confidence, and educational satisfaction. Data were analyzed with the paired t-test and repeated-measures analysis of variance.

RESULTS

The practice education using a preterm-labor assessment algorithm significantly improved both preterm labor-related knowledge and clinical practice confidence (paired t=-7.17, p<.001; paired t=-5.51, p<.001, respectively). The effects of the practice education using a preterm-labor assessment algorithm on knowledge lasted until 8 weeks but decreased significantly at 11 and 13 weeks after the program, while the clinical practice confidence significantly decreased at 8 weeks post-program.

CONCLUSION

The practice education using a preterm-labor assessment algorithm was effective in improving preterm labor-related knowledge and clinical practice confidence. The findings suggest that follow-up education should be conducted at 8 weeks, or as soon as possible thereafter, to maintain knowledge and clinical confidence, and the effects should be evaluated.

Development and Effects of Leukemia Nursing Simulation Based on Clinical Reasoning

While the effects of simulation education and the importance of the clinical reasoning process have been well-reported, an acute myelocytic leukemia (AML) patient-care simulation program has yet to be formulated exclusively for the clinical experience of students. This study developed and subsequently applied a simulation program based on clinical reasoning for AML to improve the learning outcomes and describe the learning experience for nursing students. Following a mixed-methods framework, the program’s effects on students’ knowledge were quantitatively measured, while their learning experience was qualitatively measured using self-reflection through journal writing. Differences in the pre- and post-scores between the experimental and control groups were statistically significant for theoretical knowledge and clinical performance. In addition, content analysis of both groups’ journals revealed three themes: (1) transformation into a self-directed learner for understanding the clinical situation, (2) increased awareness of clinical reasoning ability, and (3) embodiment of the clinical reasoning process. Standardizing the developed program’s scenarios prompted the participants’ compliance and engagement, and effectively achieved the learning outcomes. This simulation program aided the assessment of nursing intervention’s effectiveness and suggested objective criteria according to clinical reasoning. Similar programs involving other clinical cases, not exclusive to leukemia, should be developed and evaluated.

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSION

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