Exploring the use of high-fidelity simulation training to enhance clinical skills

Changes in nursing students' self-reported professional competence in simulation-based education and clinical placement: A longitudinal study

BACKGROUND

A primary learning outcome for nursing students is to achieve the professional competence necessary to provide safe and high-quality care in complex and specialized health services. Simulation-based education (SBE) and clinical placement are two educational settings in which nursing students' professional competence can be facilitated as a learning outcome.

OBJECTIVES

The study objectives were to investigate changes in nursing students' self-reported professional competence in SBE and clinical placement and the transfer of this competence from SBE to clinical placement. We also aimed to investigate which competence areas were highest and lowest rated.

DESIGN

A quantitative longitudinal survey design was applied.

SETTINGS

The study took place from May 2019 to January 2020 in a simulation center at a Norwegian university and clinical placement in hospital units.

PARTICIPANTS

Bachelor nursing students (N = 38) in their second and third year of a four-year part-time Norwegian nursing bachelor's degree program.

METHODS

The Nurse Professional Scale Short Form (NPC Scale-SF) consisting of six competence areas was used to measure nursing students' self-reported professional competence across four time points. Paired sample t-test and descriptive statistics were used to analyse data.

RESULTS

For changes in the longitudinal perspective, students' self-reported professional competence increased significantly. In the transfer perspective, from SBE to clinical placement, four competence areas declined significantly. Value-based nursing care were scored highest, whilst Development, leadership, and organization of nursing care were scored lowest score at all time-points.

CONCLUSIONS

Findings indicate that nursing students' self-reported professional competence increased in the longitudinal perspective. Supporting students in transfer of professional competence should be addressed in SBE and clinical placement, whilst nursing education should be strengthened concerning development, leadership, and organization of nursing care.

Effects of simulation-based education for neonatal resuscitation on medical students' technical and non-technical skills

Simulation is a learner-centered practice that helps develop and maintain knowledge, skills, and competencies. This study evaluated the effect of neonatal resuscitation simulation-based education for medical students in the fifth year (part of the regular clinical clerkship program) on the perceived performance of their technical and non-technical skills. In addition, we analyzed the difference between instructor's and learners' evaluations of technical skills after the simulation. A one-group pretest-posttest design was adopted. The simulation-based education of the neonatal resuscitation program (NRP) was conducted for 40 medical students from July to November 2020 at a medical school in South Korea. The simulation-based education comprised 5 minutes of pre-briefing, 10 minutes of running the simulation, and 30 minutes of debriefing (using a recorded video). The perceived performance of students' technical and non-technical skills before and after the simulation was compared by collecting and analyzing the pre- and post-questionnaires. The perceived performance of technical (p = .001) and non-technical skills (p < .001) was found to have significantly increased after the simulation. Particularly, the performance of technical skills, such as diagnostic (p = .007) and therapeutic actions (p < .001) and non-technical skills, such as leadership (p < .001), teamwork (p = .001), and task management (p = .020) improved significantly. There was no significant difference in the evaluations of the technical performance of the instructor and learners after the simulation (p = .953). Simulation-based education can improve technical skills, such as diagnostic and therapeutic actions for neonatal resuscitation. It is also effective in enhancing non-technical skills, such as leadership, teamwork, and task management. Further, after the simulation-based education, students can fully self-evaluate through objective reflection and improve their clinical competency.

Can a high-fidelity simulation tutorial improve written examination results? Review of a change in teaching practice

BACKGROUND

Undergraduate nursing students prefer technology-based learning. Simulation has been used in nursing education to provide skills acquisition and clinical exposure. Can high-fidelity simulation (HFS) be used to teach tutorial content to prepare students for a written examination?

AIMS

To design a pilot HFS tutorial.

METHOD

203 second year undergraduate nurses were timetabled to attend an HFS tutorial. Examination results at first attempt were compared with the previous cohort's results.

RESULTS

81% of the students from the HFS tutorial cohort passed at the first attempt compared with 85% from the previous cohort.

CONCLUSION

The HFS tutorial needs to be developed further, incorporating simulation standards, to further assess its ability to improve a student's written examination results. Students found the post-simulation discussion difficult and wanted guidance in how to participate. Involvement of the university's skills and simulation team would be recommended for future cohorts to assist with design and facilitation.

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.

Providing interprofessional education for pre and post-registration nurses

During an episode of care, a patient may be attended by a variety of healthcare professionals. In addition, healthcare service provision can be complex, and patients may feel that elements of their care have been missed or delayed due to inadequate collaboration and communication between the staff involved. Interprofessional education (IPE) involves students from two or more professions learning about each other's roles and skills. Increasing calls for integrated and joined-up healthcare services mean that staff will be increasingly required to collaborate with colleagues, with the aim of providing joined-up care. This article explains the background to IPE, how it can be implemented in practice and the barriers that nurses should consider to ensure effective implementation.

The development and pilot testing of an ACP simulation-based communication-training program: Feasibility and acceptability

The lack of knowledge of advance care planning and training of communication skills among nurses in Taiwan is one of the main reasons for the low rate of advance directive signing. However, there is no specific and effective solution to this problem. The purposes of this study were (1) to develop and pilot testing of an advance care planning simulation-based communication training program and (2) to evaluate the feasibility and acceptability of the program. This study was conducted in three phases. Phase 1: Developing an advance care planning simulation-based communication training program; Phase 2: Conducting a pilot test; Phase 3: Evaluating the feasibility and acceptability of the program. Twelve convenient participants from a medical center in central Taiwan were selected. The participants believed that team-based learning was beneficial for several reasons. First, it helped to clarify the participants’ understanding of advance care planning and improve their communication skills. Second, role-playing, as one of the components, was helpful for discovering their own shortcomings in communication skills while debriefing enabled them to identify their blind spots in the communication process. Finally, the reflection log documented their weekly performance so they were able to reflect upon their weekly performance, improve their performance, and become more confident. All twelve participants signed the consent form and completed the whole training program. The participants were satisfied with the program, affirming that the timing and content of the program were appropriate and that the expected learning outcomes could be achieved. According to participant feedback, the program was beneficial in improving their knowledge of advance care planning and confidence in communication. Thus, it is feasible and acceptable to introduce communication of advance care planning programs into the staff training protocols of healthcare organizations.

Clinical trial registration:NCT04312295.

Raising rare disease awareness using red flags, role play simulation and patient educators: results of a novel educational workshop on Raynaud phenomenon and systemic sclerosis

BACKGROUND

As lack of awareness of rare diseases (RDs) among healthcare professionals results in delayed diagnoses, there is a need for a more efficient approach to RD training during academic education. We designed an experimental workshop that used role-play simulation with patient educators and focused on teaching "red flags" that should raise the suspicion of an RD when faced with a patient with frequently encountered symptoms. Our objective was to report our experience, and to assess the improvement in learners' knowledge and the satisfaction levels of the participants.

RESULTS

The workshop consisted of 2 simulated consultations that both started with the same frequent symptom (Raynaud phenomenon, RP) but led to different diagnoses: a frequent condition (idiopathic RP) and an RD (systemic sclerosis, SSc). In the second simulated consultation, the role of the patient was played by a patient educator with SSc. By juxtaposing 2 seemingly similar situations, the training particularly highlighted the elements that help differentiate SSc from idiopathic RP. When answering a clinical case exam about RP and SSc, students that had participated in the workshop had a higher mean mark than those who had not (14 ± 3.7 vs 9.6 ± 5.5 points out of 20, p = 0.001). Participants mostly felt "very satisfied" with this training (94%), and "more comfortable" about managing idiopathic RP and SSc (100%). They considered the workshop "not very stressful" and "very formative" (both 71%). When asked about the strengths of this training, they mentioned the benefits of being put in an immersive situation, allowing a better acquisition of practical skills and a more interactive exchange with teachers, as well as the confrontation with a real patient, leading to a better retention of semiological findings and associating a relational component with this experience.

CONCLUSIONS

Through the use of innovative educational methods, such as role-play simulation and patient educators, and by focusing on teaching "red flags", our workshop successfully improved RP and SSc learning in a way that satisfied students. By modifying the workshop's scenarios, its template can readily be applied to other clinical situations, making it an interesting tool to teach other RDs.

Using simulated patients as a learning strategy to support undergraduate nurses to develop patient-teaching skills

BACKGROUND

An increase in the number of patients with long-term conditions has required a greater focus on nurse-led educational interventions to enable patients to develop self-management strategies. However, patient education is frequently taken for granted, and nurses sometimes consider that their undergraduate training does not prepare them to participate in effective patient teaching.

AIM

The study aimed to formatively evaluate a simulated role-play scenario facilitated with third-year nursing students to support the development of patient-teaching skills.

METHOD

The study combined two approaches to simulation, using high-fidelity and mid-fidelity simulation scenarios sequentially. This enabled students (n=20) to apply the communication strategies learnt to both a skills-based procedural situation and a patient-teaching simulation. A five-item pro forma with four open questions and one closed question was used for formative evaluation.

FINDINGS

The results indicated that using a simulated patient to practise patient-teaching skills was perceived by the students to be a valuable method of learning that they could transfer to clinical practice.

CONCLUSION

The findings suggested that facilitating learning with a simulated patient is useful in replicating authentic verbal and practical interactions with a patient in practice.

Nurses' Competence Caring for Hospitalized Patients With Ventricular Assist Devices

BACKGROUND

Nursing care is an essential component of the delivery of high-quality patient care for advanced heart failure patients with ventricular assist devices (VADs). However, there is little information about how VAD patient care competence is formed, and there are no empirical data regarding the bed nurses' competence.

OBJECTIVES

The aim of this study was to explain how nurses perceived their competence related to VAD technology and how they utilized resources to equip themselves for the management of patients with implantable VADs.

METHODS

An exploratory correlational research design was used in this study. Online surveys including demographic and work characteristics questionnaires as well as VAD Innovation in Nursing Appraisal Scale (knowledge, adoption, and communication) were completed by 237 critical-care unit and progressive care unit (PCU) nurses.

RESULTS

Ventricular assist device knowledge, adoption, and communication of innovation mean scores were 3.9 ± 0.6, 3.9 ± 0.8, and 3.7 ± 0.9, respectively, indicating moderate/high levels. Critical-care unit nurses reported higher levels of knowledge (3.7 vs 3.6) and adoption (4.0 vs 3.8; P < .05) of innovation than did the PCU nurses, with no differences in communication. Compared with PCU nurses, critical-care unit nurses were more likely to seek VAD competence-related information using mass media. Innovation and adoption were associated with years of nursing experience and some hospital characteristics.

CONCLUSION

Critical-care unit nurses have higher self-reported VAD care competence than PCU nurses. Further research is needed to confirm the findings and link nurse competence with VAD patient outcomes.