[Development and effects of a labor nursing education program using a high-fidelity simulator for nursing students]

The efficacy of high-fidelity simulation on knowledge and performance in undergraduate nursing students: An umbrella review of systematic reviews and meta-analysis

OBJECTIVES

This umbrella review aimed to consolidate the evidence base on the impact of high-fidelity simulation on knowledge and performance among undergraduate nursing students.

DESIGN

Umbrella review with meta-analyses of pooled effect sizes, followed by an additional meta-analysis of primary studies from the included systematic reviews, excluding overlapping results.

DATA SOURCES

Systematic searches were performed up to August 2023 in PubMed, Embase, and Cochrane Library. We included reviews that compared high-fidelity simulation against other learning strategies.

REVIEW METHODS

The risk of bias was assessed for each included systematic review (ROBIS tool) and primary study (RoB 2 or ROBINS-I as appropriate). Random-effect meta-analyses of meta-analyses were performed to estimate the pooled effects of high-fidelity simulation on knowledge and performance. Further random-effect meta-analyses of primary studies were conducted, with overlapping studies excluded (12 %). Subgroup analyses were performed to provide a more comprehensive analysis of the findings. Trim-and-fill analyses were conducted to adjust for potential publication bias.

RESULTS

Six systematic reviews were included and encompassed 133 primary studies (2767 and 3231 participants concerning performance and knowledge, respectively). The adjusted pooled effects for knowledge (SMD = 0.877, 95 % CI: 0.182 to 1.572) and performance (SMD = 0.738, 95 % CI: 0.466 to 1.010) closely aligned with those obtained from meta-analyzing the primary studies for knowledge (SMD = 0.980) and performance (SMD = 0.540), both showing high statistical heterogeneity. Traditional lectures represented the more common comparison. The subgroup analysis revealed significant differences in effect sizes across geographic locations, topics, types of control, and how interventions were reported.

CONCLUSIONS

The results provide robust evidence supporting the integration of high-fidelity simulation into undergraduate nursing programs to enhance students' knowledge and performance. The high reported heterogeneity may be attributed to variations in study contexts or methodologies. Future research should explore the optimal use of high-fidelity simulation in different educational and cultural contexts.

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 a high-risk pregnancy emotive role-play program for nursing students: a quasi-experimental study

PURPOSE

This study aimed to develop an emotive role-play program for nursing students focusingon high-risk pregnancy and analyze its effects on communication skills, clinical performance, andemotional intelligence.

METHODS

A quasi-experimental nonequivalent comparison group design was adopted with 83nursing students (experimental group, 45; comparison group, 38) who participated voluntarily in anextracurricular program. The preliminary survey was conducted on November 3 and November 4,2020, and the follow-up survey was conducted on November 12, 2020, for the comparison groupand on November 27, 2020, for the experimental group. A program that included five role-play scenarios related to induced labor, preeclampsia, premature rupture of membranes, preterm labor, andinfertility was developed by a group of experts and presented to the experimental group over 11 totalhours across 3 days. Each student participated in a role-play scenario as a patient, family member, ornurse and observed three other scenarios. The comparison group received a workbook after the follow-up evaluation. The independent t-test was performed to analyze changes in communicationskills, clinical performance, and emotional intelligence.

RESULTS

Communication skills (t=1.84, p=.035) and clinical performance (t=2.75, p=.004) significantly increased in the experimental group compared to the comparison group. A significant difference was not observed between the experimental and comparison groups for emotional intelligence(t=1.36, p=.088).

CONCLUSION

The emotive role-play program concerning high-risk pregnancy was effective in improving nursing students' communication skills and clinical performance and can be used in nursingeducation related to high-risk pregnancy and childbirth.

The effects of maternal-child nursing clinical practicum using virtual reality on nursing students' competencies: a systematic review

PURPOSE

This study aimed to investigate the effects of virtual reality used in maternal-child nursing clinical practicums on nursing students' competencies through a systematic review.

METHODS

The inclusion criteria were peer-reviewed papers in English or Korean presenting analytic studies of maternal-child nursing practicums using virtual reality. An electronic literature search of the Cochrane Library, CINAHL, EMBASE, ERIC, PubMed, and Research Information Sharing System databases was performed using combinations of the keywords "nursing student," "virtual reality," "augmented reality," "mixed reality," and "virtual simulation" from February 4 to 15, 2022. Quality appraisal was performed using the RoB 2 and ROBINS-I tools for randomized controlled trials (RCTs) and non-RCTs, respectively.

RESULTS

Of the seven articles identified, the RCT study (n=1) was deemed to have a high risk of bias, with some items indeterminable due to a lack of reported details. Most of the non-RCT studies (n=6) had a moderate or serious risk of bias related to selection and measurement issues. Clinical education using virtual reality had positive effects on knowledge, skills, satisfaction, self-efficacy, and needs improvement; however, it did not affect critical thinking or self-directed learning.

CONCLUSION

This study demonstrated that using virtual reality for maternal-child nursing clinical practicums had educational effects on a variety of students' competencies. Considering the challenges of providing direct care in clinical practicums, virtual reality can be a viable tool that supplements maternal-child nursing experience. Greater rigor and fuller reporting of study details are required for future research.

Nursing simulation practicum for delivery care: A scoping review

OBJECTIVES

The purpose of this scoping review was to explore the state of the current body of knowledge on the use of nursing simulation for maternal nursing practicum with a focus on content and measured outcomes.

DESIGN

This is a scoping review.

DATA SOURCES

The literature search was performed using five databases (CINAHL, Cochrane, EMBASE, PubMed, and Web of Science).

REVIEW METHOD

The review was conducted on quantitative and reflection/review studies that evaluated or described nursing simulation for delivery care, published between 2000 and 2020 in English and Korean. Two authors independently reviewed the studies and their references for additional literature search. Selected studies were charted to describe the study characteristics, and content and outcome of nursing simulation for delivery care.

RESULTS

Fifteen articles were included in the review, of which twelve were intervention studies and three were reflection/review studies. The duration of the nursing simulations for delivery care ranged from 20 min to 4 h, with two to eight students in each simulation group. All nursing simulations focused on the normal, uncomplicated delivery process, with nine studies engaging in debriefing, but without pre- and/or post-assessments. The most frequently measured outcomes were knowledge, satisfaction, and clinical practice competency.

CONCLUSIONS

Studies investigating nursing simulation pedagogy for delivery care were scarce, with limitations in the study designs and large variations in nursing simulation time across studies. Scenarios for nursing simulation for delivery care were rudimentary, and they usually focused on normal uncomplicated deliveries. The development of scenarios for high-risk deliveries and integration of pre-and/or post-assessments and debriefing into the nursing simulation are recommended to improve learning outcomes.

Effects of high-fidelity simulation teaching on nursing students' knowledge, professional skills and clinical ability: A meta-analysis and systematic review

OBJECTIVE

This meta-analysis was designed to systematically determine the effect of high-fidelity simulation teaching on nursing students' knowledge level, professional skill level and clinical ability.

BACKGROUND

High-fidelity simulation is an increasingly popular pedagogical approach in nursing education. It provides students with opportunity to practice in a variety of simulations before entering clinical practice through a variety of real-life situational experiences and many institutions and educators have embraced this method for enhancing access to clinical skills. However, evidence for the effectiveness of the method in nursing teaching remains scarce.

DESIGN

A meta-analysis and systematic review.

METHODS

The following Chinese and English databases were searched for relevant articles: PubMed, Embase, Cochrane library, Web of Science, CNKI (China National Knowledge Infrastructure) and Wangfang. The search encompassed the establishment of these databases up until November 2021. Two reviewers separately entered the data into Review Manager Software 5.3.

RESULTS

A total of 15 studies were included in this study. High-fidelity simulation significantly increased nursing students' knowledge acquisition (SMD = 1. 37, 94％CI:0. 73-2. 00，P ＜0. 0001), enhanced nursing students'professional skills (SMD = 0. 90, 95％CI:0. 36-1. 44，P = 0. 0001). In terms of clinical practice ability outcomes, high-fidelity simulation significantly improved the levels of critical thinking ability (SMD = 0. 58, 95％CI:0. 09-1. 07，P ＜0. 00001), Clinical judgement ability (SMD = 1. 34, 95％CI:0. 38-2. 31，P＝0. 006) and communication skills (SMD = 2. 62, 95％CI:1. 84-3. 40，P ＜0. 001) of nursing students.

CONCLUSIONS

We found that high-fidelity simulation have strong educational effects in nursing education, helping nursing students to increase knowledge acquisition, enhance professional skills and cultivate their clinical practice ability (critical thinking ability, communication skills and clinical judgement ability). These findings can provide guidance for nursing educators, indicating that the use of High-fidelity simulation teaching represents an effective solution for transitioning students from the learning environment to clinical practice.

Comparison of Learning Transfer Using Simulation Problem-Based Learning and Demonstration: An Application of Papanicolaou Smear Nursing Education

The purpose of this study was to compare the effects of simulation problem-based learning (S-PBL), a type of learning that reflects various clinical situations, and demonstration-based learning, a conventional type of learning that shows clinical skill performance, of Papanicolaou smear education on the self-confidence, learner satisfaction, and critical thinking of nursing students. A quasi-experimental control group pretest-posttest design was used. Nursing students who were classified as advanced beginners were randomly allocated to the control group (n = 53) or the experimental group (n = 52). Students in the control group participated in a conventional demonstration of a Papanicolaou smear, while students in the experimental group participated in S-PBL. The students' self-confidence, learner satisfaction, and critical thinking were measured via a self-reported questionnaire. Compared with the control group, self-confidence, learner satisfaction, and critical thinking increase significantly more (p < 0.001) in the experimental group. S-PBL was found to be an effective strategy for improving learning transfer, applying learned nursing knowledge to simulated nursing situations. Thus, S-PBL is recommended to improve training in nursing education.