Methods

  The project was implemented into a second year medical-surgical nursing course. The activity was offered as a supplemental learning activity. Participation was optional to students as the activity had not been formally addressed in the course syllabus. A total of 29 students (47%) chose to participate in the activity. Following the classroom presentation of the material, a high-fidelity simulation exercise of impending MI was introduced. The scenario of a hospitalized patient was presented who experienced chest pain. High-fidelity simulation allowed mannequin-student verbal communication, physical findings, and EKG monitor changes which occur in this population of patients. Prompt recognition of this high-risk patient scenario and action taken is imperative for optimal patient outcomes. The exercise allowed students to experience and practice this high-risk finding in a safe environment.

Analysis

  The DNP student chose to model the project design and evaluation from the leader in nursing educational standards. Jefferies (2007) discusses the tools developed by the National League of Nursing (NLN) in evaluating simulation activities. After approval from NLN, four of the tools were used in evaluating the project.

  The Educational Practices in Simulation Scale (EPSS), a 16-item instrument designed to measure four educational practices: active learning, collaboration, diverse ways of learning, and expectations was obtained after simulation experience from the learners. The Student Satisfaction with Learning Scale and the Self-Confidence in Learning Using Simulations Scale, which measures student confidence in skills practiced and knowledge about caring for the type of patient presented in the simulation, was obtained after the simulation experience from the learners. The Simulation Design Scale (SDS), a 20-item tool that measures objectives, student support, problem solving, fidelity, and guided reflection/debriefing was obtained after simulation experience from the learners. The SDS, which is designed to evaluate specific features of the simulation, was utilized to provide feedback for future simulation designs. A debriefing exercise followed the simulation exercise to allow for student reflection of the experience and help promote learning from the activity. Observation of the simulation exercise by instructors also provided appraisal of group dynamics, and attitude and communication skills, as they related to the scenario presented.

  Overall findings from students suggest that 1) learning time was perceived to be more productive, 2) the teaching methods were useful, motivating and effective, and most importantly, 3) helped students become more confident in developing skills and knowledge to perform necessary tasks in a clinical setting.

Conclusion

  Assisting nursing students, novice nurses, or seasoned nurses who encounter unfamiliar territory to understand the practices of nursing is a responsibility of educators, mentors, and leaders of nursing. As technology enables more effective teaching activities to be utilized, it is important to evaluate their effectiveness. Results from this project suggest that students feel better prepared and more confident in caring for future patients. The project represents the beginning of changes in the teaching methods used at the institution. Based on the results from the project, the institution will incorporate additional simulation activities into the curriculum in an effort to increase student confidence and competency.
 
 

References

Duke University Medical Center (2005) Patient Safety-Quality Improvement- Methods of Quality Improvement. Retrieved June 2, 2008, from http://patientsafetyed.duhs.duke.edu/module_a/module_overview.html

Godfrey, M.M., Nelson, E.C., Wasson, J.H., Mohr, J.J. and Batalden P.B. (2003). Microsystems in healthcare. Joint Commission Journal on Quality and Safety. 29(4), 159-170.

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Jefferies, P.R. (2007). Simulation in nursing education: From conceptualization to evaluation. New York: National League for Nursing.

Jefferies, P.R. (2005). A framework for designing, implementing, and evaluating simulations used as teaching strategies in nursing. Nursing Education Perspectives, 26(2), 96- 103.

Newhouse, R.P., Pettit, J.C., Poe, S., and Rocco, L. (2006). The slippery slope: Differentiating between quality improvement and research. Journal of Nursing Administration. 36(4), 211-219.

Roueche, J.E., Baker III, G.A. and Rose, R.R. (1989). Shared vision: Transformational leadership in American community colleges. Washington, D.C.: The Community College Press.

Titler, M. (2007). Translating research into practice. American Journal of Nursing, 107(6), 26- 30.

Steadman, R., Coates, W., Huang, Y., Matevosian, R., Larmon, B., McCullough, L. & Ariel, D. (2006). Simulation-based training is superior to problem-based learning for the acquisition of critical assessment and management skills. Critical Care Medicine, 34(1), 151-157.

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