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Chung SY, Park BK, Kim MJ, Rudolph JW, Fey M, Simon R. Testing reliability and validity of the Korean version of Debriefing Assessment for Simulation in Healthcare (K-DASH). Adv Simul (Lond) 2024; 9:32. [PMID: 39113142 PMCID: PMC11308559 DOI: 10.1186/s41077-024-00305-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 07/13/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Use of the Debriefing Assessment for Simulation in Healthcare (DASH©) would be beneficial for novice debriefers with less or no formal training in debriefing. However, the DASH translated into Korean and tested for psychometrics is not yet available. Thus, this study was to develop a Korean version of the DASH student version (SV) and test its reliability and validity among baccalaureate nursing students in Korea. METHODS The participants were 99 baccalaureate nursing students. Content validity using content validity index (CVI), construct validity using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and internal consistency using Cronbach's alpha coefficient were assessed. RESULTS Both Item-CVIs and Scale-CVI were acceptable. EFA supported the unidimensional latent structure of Korean DASH-SV and results of CFA indicated 6 items converged within the extracted factor, significantly contributing to the factor (p ≤ .05). Items were internally consistent (Cronbach's α = 0.82). CONCLUSION The Korean version of the DASH-SV is arguably a valid and reliable measure of instructor behaviors that could improve faculty debriefing and student learning in the long term.
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Affiliation(s)
- Seon-Yoon Chung
- College of Nursing, University of Wisconsin Oshkosh, 800 Algoma Blvd, Oshkosh, WI, 54901, USA
| | - Bu Kyung Park
- College of Nursing, Kyungpook National University, 640 Gukchaebosang-Ro Jung-Gu, Daegu, 41944, Korea.
| | - Myoung Jin Kim
- Mennonite College of Nursing, Illinois State University, Campus, Box 5810, Normal, IL, 61790, USA
| | - Jenny W Rudolph
- Center for Medical Simulation, Boston, USA
- Massachusetts General Hospital-Institute for Health Professions, Boston, USA
- Harvard Medical School, Massachusetts General Hospital, Boston, USA
| | - Mary Fey
- Center for Medical Simulation, Boston, USA
| | - Robert Simon
- Center for Medical Simulation, Boston, USA
- Harvard Medical School, Massachusetts General Hospital, Boston, USA
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Bresolin P, Steindal SA, Bingen HM, Zlamal J, Gue Martini J, Petersen EK, Nes AAG. Technology-Supported Guidance Models to Stimulate Nursing Students' Self-Efficacy in Clinical Practice: Scoping Review. JMIR Nurs 2024; 7:e54443. [PMID: 38457802 PMCID: PMC10960213 DOI: 10.2196/54443] [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: 11/09/2023] [Revised: 02/09/2024] [Accepted: 02/21/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND In nursing education, bridging the gap between theoretical knowledge and practical skills is crucial for developing competence in clinical practice. Nursing students encounter challenges in acquiring these essential skills, making self-efficacy a critical component in their professional development. Self-efficacy pertains to individual's belief in their ability to perform tasks and overcome challenges, with significant implications for clinical skills acquisition and academic success. Previous research has underscored the strong link between nursing students' self-efficacy and their clinical competence. Technology has emerged as a promising tool to enhance self-efficacy by enabling personalized learning experiences and in-depth discussions. However, there is a need for a comprehensive literature review to assess the existing body of knowledge and identify research gaps. OBJECTIVE The aim of this study is to systematically map and identify gaps in published studies on the use of technology-supported guidance models to stimulate nursing students' self-efficacy in clinical practice. METHODS This scoping review followed the framework of Arksey and O'Malley and was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR). A systematic, comprehensive literature search was conducted in ERIC, CINAHL, MEDLINE, Embase, PsycINFO, and Web of Science for studies published between January 2011 and April 2023. The reference lists of the included papers were manually searched to identify additional studies. Pairs of authors screened the papers, assessed eligibility, and extracted the data. The data were thematically organized. RESULTS A total of 8 studies were included and four thematic groups were identified: (1) technological solutions for learning support, (2) learning focus in clinical practice, (3) teaching strategies and theoretical approaches for self-efficacy, and (4) assessment of self-efficacy and complementary outcomes. CONCLUSIONS Various technological solutions were adopted in the guidance models to stimulate the self-efficacy of nursing students in clinical practice, leading to positive findings. A total of 7 out of 8 studies presented results that were not statistically significant, highlighting the need for further refinement of the applied interventions. Nurse educators play a pivotal role in applying learning strategies and theoretical approaches to enhance nursing students' self-efficacy, but the contributions of nurse preceptors and peers should not be overlooked. Future studies should consider involving users in the intervention process and using validated instruments tailored to the studies' intervention objectives, ensuring relevance and enabling comparisons across studies.
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Affiliation(s)
- Paula Bresolin
- Federal University of Santa Catarina, Santa Catarina, Brazil
| | - Simen A Steindal
- VID Specialized University, Oslo, Norway
- Lovisenberg Diacinal University College, Oslo, Norway
| | | | | | | | | | - Andréa Aparecida Gonçalves Nes
- Lovisenberg Diacinal University College, Oslo, Norway
- Ethics of Care, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Niu Y, Xi H, Liu J, Sui X, Li F, Xu H, Zhao L, Li Y, Zhang S, Guo L. Effects of blended learning on undergraduate nursing students' knowledge, skills, critical thinking ability and mental health: A systematic review and meta-analysis. Nurse Educ Pract 2023; 72:103786. [PMID: 37793247 DOI: 10.1016/j.nepr.2023.103786] [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: 03/29/2023] [Revised: 09/03/2023] [Accepted: 09/20/2023] [Indexed: 10/06/2023]
Abstract
AIM This study aimed to evaluate the effects of blended learning on nursing students. The primary outcomes include knowledge and skills, and the secondary outcomes include critical thinking ability, mental health, blended learning design, and nursing students' attitudes toward blended learning. BACKGROUND Blended learning combines the advantages of online learning and traditional face-to-face learning, and makes up for the disadvantages of simple online learning or traditional learning. The effects of blended learning on the knowledge, skills, critical thinking ability, and mental health of nursing students were unknown. DESIGN Systematic review and meta-analysis. METHODS The present systematic review and meta-analysis was applied according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. Publications were searched in PubMed, Web of Science, EMBASE, ERIC, CINAHL and the Cochrane's Library before February 2023. Two researchers independently retrieved articles and evaluated quality. The meta-analysis was performed using Stata 12.0 software according to PRISMA guidelines. The risk of bias in the selected studies was evaluated using the Revised Cochrane risk-of-bias tool for randomized trials. Heterogeneity was assessed by I2 and P statistics. Standardized mean difference (SMD) and 95% confidence intervals (CIs) were used as effective indicators. RESULTS A total of 26 studies involving 2823 nursing students were included in the present study. The results showed that blended learning courses were designed based on learning theory. Blended learning was more effective on the knowledge (SMD = 0.73, 95%CI [0.37, 1.09]) and skills (SMD = 0.86, 95% CI [0.35, 1.37]) compared with non-blended learning for nursing students. Critical thinking ability improved significantly through BL (SMD = 2.23, 95% CI [0.85, 3.61]). In addition, blended learning had a positive impact on nursing students' mental health. Nursing students were very satisfied with blended learning. CONCLUSIONS The results of this study indicated that blended learning had a positive impact on nursing students. In the future, the optimal ratio of online to offline learning in blended learning should also be explored.
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Affiliation(s)
- Yirou Niu
- School of Nursing, Jilin University, No. 965, Xinjiang Street, Chaoyang, Changchun, Jilin, China
| | - Huihui Xi
- School of Nursing, Jilin University, No. 965, Xinjiang Street, Chaoyang, Changchun, Jilin, China
| | - Jinshu Liu
- School of Pharmaceutcal Sciences, Jilin University, No. 1163, Xinmin Street, Chaoyang, Changchun, Jilin, China
| | - Xin Sui
- School of Nursing, Jilin University, No. 965, Xinjiang Street, Chaoyang, Changchun, Jilin, China
| | - Feng Li
- School of Nursing, Jilin University, No. 965, Xinjiang Street, Chaoyang, Changchun, Jilin, China
| | - Haiyan Xu
- School of Nursing, Jilin University, No. 965, Xinjiang Street, Chaoyang, Changchun, Jilin, China
| | - Lijing Zhao
- School of Nursing, Jilin University, No. 965, Xinjiang Street, Chaoyang, Changchun, Jilin, China
| | - Yuewei Li
- School of Nursing, Jilin University, No. 965, Xinjiang Street, Chaoyang, Changchun, Jilin, China
| | - Shuang Zhang
- School of Nursing, Jilin University, No. 965, Xinjiang Street, Chaoyang, Changchun, Jilin, China
| | - Lirong Guo
- School of Nursing, Jilin University, No. 965, Xinjiang Street, Chaoyang, Changchun, Jilin, China.
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Youhasan P, Lyndon MP, Chen Y, Henning MA. Implementation of a Web-Based Educational Intervention for Promoting Flipped Classroom Pedagogy: A Mixed-Methods Study. MEDICAL SCIENCE EDUCATOR 2023; 33:91-106. [PMID: 37008440 PMCID: PMC10060460 DOI: 10.1007/s40670-022-01706-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 06/19/2023]
Abstract
Introduction Flipped classroom pedagogy (FCP) is recognised as an effective and efficient teaching-learning method. However, nursing students and teachers may be hesitant to adopt FCP due to technophobia and time constraints linked to academic and clinical responsibilities. This necessitates the provision of promotional training for adopting FCP. However, there is a dearth of research regarding how the practice of FCP could be promoted and in demonstrating its efficacy in developing countries. Thus, this study aimed to examine the educational impact of a web-based education intervention, branded as the Flipped Classroom Navigator (FCN), for promoting FCP in nursing education in Sri Lanka. Methods This mixed-methods study employed pre- and post-training knowledge tests, the Instructional Materials Motivation Survey (IMMS), the Perceived Transfer of Learning Questionnaire survey, and collected students' and teachers' open-ended responses to evaluate the impact of the FCN. Fifty-five undergraduate nursing students and 15 university teachers participated in the study from two state universities in Sri Lanka. Repeated-measures ANOVA, t-tests, Levene's test of homogeneity, Cohen's d, and an inductive thematic approach were employed in the data analysis. Results Post-training knowledge test scores were significantly higher than the pre-training knowledge test scores indicating improved understanding of FCP. Participants were also highly motivated to learn in the FCN instructional materials. Participants exhibited positive attitudes towards FCN training with transfer of learning to their teaching-learning practice. The inductive thematic analysis identified the following themes: user experiences, FCN learning content, behaviour changes, and suggested improvements. Conclusion Overall, the FCN enhanced both students' and teachers' knowledge and understanding of FCP in undergraduate nursing education. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-022-01706-7.
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Affiliation(s)
- Punithalingam Youhasan
- Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, The University of Auckland, Building 507, Level 2, Room 2001, 28 Park Avenue, Grafton, Auckland, 1023 New Zealand
- Department of Medical Education & Research, Faculty of Health-Care Sciences, Eastern University, Sri Lanka, Batticaloa, Sri Lanka
| | - Mataroria P. Lyndon
- Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, The University of Auckland, Building 507, Level 2, Room 2001, 28 Park Avenue, Grafton, Auckland, 1023 New Zealand
| | - Yan Chen
- Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, The University of Auckland, Building 507, Level 2, Room 2001, 28 Park Avenue, Grafton, Auckland, 1023 New Zealand
| | - Marcus A. Henning
- Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, The University of Auckland, Building 507, Level 2, Room 2001, 28 Park Avenue, Grafton, Auckland, 1023 New Zealand
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Impact of flipped classroom approach on undergraduate nursing student's critical thinking skills. J Prof Nurs 2022; 42:201-208. [DOI: 10.1016/j.profnurs.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 07/06/2022] [Accepted: 07/09/2022] [Indexed: 11/17/2022]
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Youhasan P, Chen Y, Lyndon M, Henning MA. Assess the feasibility of flipped classroom pedagogy in undergraduate nursing education in Sri Lanka: A mixed-methods study. PLoS One 2021; 16:e0259003. [PMID: 34739516 PMCID: PMC8570468 DOI: 10.1371/journal.pone.0259003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/08/2021] [Indexed: 11/24/2022] Open
Abstract
Background The nursing education system has evolved with an increased emphasis on student-centred education, such as implementing flipped classroom pedagogy. Given the promising positive educational outcomes, the trend of using flipped classroom pedagogy has become increasingly popular in undergraduate nursing education. However, little is known about how these flipped classroom methods impact on nursing educational practices in limited-resource settings situated in South Asia. Objective To assess the feasibility of implementing flipped classroom pedagogy in undergraduate nursing education from the nursing students’ perspective. Methods This mixed-methods study employed a quantitative survey and six focus group discussions conducted in three state universities in Sri Lanka. The Nursing Students’ Readiness for Flipped Classroom (NSR-FC) questionnaire was used to collect quantitative data. The semi-structured focus group discussions were conducted by using 18 reflective and open-ended questions. Descriptive statistics and multivariate analysis of variance methods were employed when analysing quantitative data. An inductive thematic analysis approach was used to summarize the focus group discussions. Results The questionnaire survey revealed that nursing students reported high levels of personal, technical, and pedagogical readiness across all three universities, while environmental readiness was perceived as low. The inductive thematic analysis identified three themes, namely: enablers, challenges, and benefits. Specifically, nursing students valued the student-centred approach. They were ready to utilize their own devices to overcome limited technological provision; however, a short training session about how to engage in the flipped classroom was desirable. Also, their exposure to basic educational technology was perceived as adequate and they were aware of the positive outcomes of flipped classroom pedagogy. Conclusion Nursing students were ready to enrol in a flipped classroom programme. The provision of technological resources in the education environment was identified as a great challenge for flipped classroom implementation. Overall, the findings indicate there are promising feasibilities for the flipped classroom implementation.
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Affiliation(s)
- Punithalingam Youhasan
- Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Department of Medical Education & Research, Faculty of Health-Care Sciences, Eastern University, Batticaloa, Sri Lanka
- * E-mail: ,
| | - Yan Chen
- Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Mataroria Lyndon
- Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Marcus A. Henning
- Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Yu Z, Hu R, Ling S, Zhuang J, Chen Y, Chen M, Lin Y. Effects of blended versus offline case-centred learning on the academic performance and critical thinking ability of undergraduate nursing students: A cluster randomised controlled trial. Nurse Educ Pract 2021; 53:103080. [PMID: 34044341 DOI: 10.1016/j.nepr.2021.103080] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 05/03/2021] [Accepted: 05/10/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This study aimed to compare the effect of blended and offline case-centred learning on medical nursing education for undergraduate nursing students. BACKGROUND Technological advancements are rapidly changing nursing education in higher educational settings. Educational reform, especially regarding methods of teaching, has been the focus of nursing educators in recent years. DESIGN The research was conducted between September 2018 and July 2019 in China. METHODS Second-year undergraduate nursing students in two classes were enrolled for this study by cluster sampling. The study outcomes were academic performance and critical thinking ability, measured using the Critical Thinking Disposition Inventory-Chinese Version. RESULTS Students in the experimental class showed significantly higher improvements in academic performance than those in the control class. Compared with the control class, the pre-post difference in competency in critical thinking self-confidence in the experimental class was significantly greater (p = 0.037). In the experimental class, there was a significant improvement over the baseline in the dimension of critical thinking self-confidence (p = 0.022). In the control class, there was a significant improvement over the baseline in the total score (p = 0.029) and two of the seven dimensions: truth-seeking (p = 0.016) and systematicity (p = 0.005). CONCLUSIONS The use of blended case-centred learning showed promising results in improving students' academic performance. Both blended and offline case-centred learning were indicated to be effective educational approaches to improve the critical thinking ability of undergraduate nursing students and could be implemented for other nursing subjects in the future.
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Affiliation(s)
- Zhenzhen Yu
- School of Nursing, Fujian Medical University, No. 1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou, China
| | - Rong Hu
- School of Nursing, Fujian Medical University, No. 1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou, China.
| | - Shen Ling
- School of Nursing, Fujian Medical University, No. 1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou, China
| | - Jiayuan Zhuang
- School of Nursing, Fujian Medical University, No. 1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou, China
| | - Yimin Chen
- School of Nursing, Fujian Medical University, No. 1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou, China
| | - Meijing Chen
- School of Nursing, Fujian Medical University, No. 1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou, China
| | - Yazhu Lin
- School of Nursing, Fujian Medical University, No. 1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou, China
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Youhasan P, Chen Y, Lyndon M, Henning MA. Exploring the pedagogical design features of the flipped classroom in undergraduate nursing education: a systematic review. BMC Nurs 2021; 20:50. [PMID: 33752654 PMCID: PMC7983379 DOI: 10.1186/s12912-021-00555-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 02/24/2021] [Indexed: 12/16/2022] Open
Abstract
Background In recent years, technological advancement has enabled the use of blended learning approaches, including flipped classrooms. Flipped classrooms promote higher-order knowledge application – a key component of nursing education. This systematic review aims to evaluate the empirical evidence and refereed literature pertaining to the development, application and effectiveness of flipped classrooms in reference to undergraduate nursing education. Methods A PRISMA systematic review protocol was implemented to investigate the literature pertaining to the development, implementation and effectiveness of flipped classroom pedagogy in undergraduate nursing education. Seven databases (Scopus, PsycINFO, CINAHL, ERIC, MEDLINE, Cochrane, Web of Science) were utilised to survey the salient literature. Articles were appraised with respect to their level of evidence, the origin of study, study design, the aims/s of the study, and the key outcomes of the study. A qualitative synthesis was then conducted to summarise the study findings. Results The initial search identified 1263 potentially relevant articles. After comprehensively reviewing the initial catchment using several analytical phases, 27 articles were considered for the final review, most of which were conducted in the USA and South Korea. A range of research designs were applied to measure or discuss the outcomes and design features of the flipped classroom pedagogy when applied to undergraduate nursing education. The review indicated that a common operational flipped classroom model involves three key components, namely pre-classroom activities, in-classroom activities and post-classroom activities, guided by two instructional system design principles. The review predominantly identified positive learning outcomes among undergraduate nursing students, after experiencing the flipped classroom, in terms of skills, knowledge and attitudes. However, a few studies reported contrasting findings, possibly due to the incompatibility of the flipped classroom pedagogy with the traditional learning culture. Conclusions Current evidence in this systematic review suggests that incorporating the flipped classroom pedagogy could yield positive educational outcomes in undergraduate nursing education. There are promising pedagogical models available for adapting or developing the flipped classroom pedagogy in undergraduate nursing education.
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Affiliation(s)
- Punithalingam Youhasan
- Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand. .,Department of Medical Education & Research, Faculty of Health-Care Sciences, Eastern University, Sri Lanka, Batticaloa, Sri Lanka.
| | - Yan Chen
- Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Mataroria Lyndon
- Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Marcus A Henning
- Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Yang SY. Effectiveness of neonatal emergency nursing education through simulation training: Flipped learning based on Tanner's Clinical Judgement Model. Nurs Open 2021; 8:1314-1324. [PMID: 33432731 PMCID: PMC8046145 DOI: 10.1002/nop2.748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/22/2020] [Accepted: 11/12/2020] [Indexed: 11/10/2022] Open
Abstract
Aim To examine the effects of neonatal simulation‐based practice by applying flipped learning based on Tanner's clinical judgement model to pre‐simulation briefing for nursing students. Design A quasi‐experimental non‐equivalent control group pre‐ and postintervention design. Methods Using Tanner's clinical judgment model, flipped learning was developed and applied to the pre‐simulation briefing curriculum prior to the neonatal nursing simulation exercise. Flipped learning was compared with a general pre‐simulation briefing with 65 South Korean students. From September 7, 2019, to October 25, 2019. Results The experimental group's critical thinking, self‐confidence and clinical judgement ability increased, but knowledge, satisfaction and anxiety did not differ from that of the control group. Pre‐simulation briefing design focuses on improving students’ environmental comfort and reducing anxiety rather than developing complex reasoning skills and clinical judgement abilities. Applying flipped learning based on Tanner's clinical judgement model to pre‐simulation briefing increased critical thinking, self‐confidence and clinical judgement ability.
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Affiliation(s)
- Sun-Yi Yang
- College of Nursing, Konyang University, Daejeon, Korea
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