RESUMO
INTRODUCTION: Continuous performance improvement (PI) programs are essential for excellent trauma care. We incorporated PI identified from trauma cases into an in-situ simulation-based medical education curriculum. This is a proof-of-concept study exploring the efficacy of high-fidelity pediatric trauma simulations in improving self-reported provider comfort and knowledge for identified trauma PI issues. METHODS: This study was performed at an American College of Surgeons-verified Level I Pediatric Trauma Center. Several clinical issues were identified during the trauma PI process, including management of elevated intracranial pressure in traumatic brain injury and the use of massive transfusion protocol. These issues were incorporated into a simulation-based medical education curriculum and high-fidelity in-situ trauma mock codes were held. In-depth debriefing sessions were led by a senior faculty member after the simulations. The study participants completed pre- and postsimulation surveys. Univariate statistics are presented. RESULTS: Twenty three providers completed surveys for the pediatric trauma simulations. Self-reported provider confidence Likert scale improved from pre- to postsimulation (P = 0.02) and trauma experience and knowledge scores improved from 82% presimulation to 93% postsimulation (P = 0.02). CONCLUSIONS: High-fidelity pediatric trauma simulations enhance provider comfort, knowledge, and experience in trauma scenarios. By integrating high-fidelity trauma simulations to address clinical issues identified in the trauma PI process, provider education can be reinforced and practiced in a controlled environment to improve trauma care. Future studies evaluating the implementation of clinical pathways and patient outcomes are needed to demonstrate the effectiveness of simulations in PI pathways.
Assuntos
Competência Clínica , Melhoria de Qualidade , Humanos , Competência Clínica/estatística & dados numéricos , Currículo , Treinamento por Simulação/métodos , Centros de Traumatologia , Pediatria/educação , Masculino , Feminino , Ferimentos e Lesões/terapia , Treinamento com Simulação de Alta Fidelidade/métodosRESUMO
INTRODUCTION: High-fidelity simulation (HFS) provides a high level of interactivity and realistic experience for the learner by means of using full scale computerised patient simulators. It imitates clinical experience in a controlled and safe environment that closely resembles reality. The purpose of this study was to compare the efficacy of HFS versus video-assisted lecture (VAL) based education in enhancing and consolidating retention of skills among undergraduate medical students. MATERIALS AND METHODS: A randomised controlled trial (RCT) study involving 111 undergraduate medical students was conducted where the competency of skills was assessed by objective structured clinical examination (OSCE) in the first, fourth and seventh/eighth weeks. A cohort of 12-14 students was enrolled for each session. The randomisation of the participants into control (VAL-based teaching) and intervention (HFS-based teaching) groups was achieved by implementing the computer-based random sequence generation method. VAL-based teaching module was a fully interactive face-to-face teaching session where a prerecorded video clip was used. The video clip detailed the diagnosis of tension pneumothorax in an acute medical emergency and its management by performing needle decompression on a high-fidelity patient simulator (METIman). HFS-based teaching module was delivered as a fully interactive hands-on training session conducted on the same METIman to demonstrate the diagnosis of tension pneumothorax in an acute medical emergency and its management by performing needle decompression. OSCE scores were compared as the denominator of learning (enhancement and retention of skills) between two groups who underwent training with either VAL-based or HFS-based teachings. The OSCE assessments were used to evaluate the participants' performance as a group. These scores were used to compare the enhancement and medium-term retention of skills between the groups. The outcome was measured with the mean and standard deviation (SD) for the total OSCE scores for skills assessments. We used General Linear Model two-way mixed ANOVA to ascertain the difference of OSCE marks over assessment time points between the control and the intervention groups. ANCOVA and two-way mixed ANOVA were used to calculate the effect size and the partial Eta squared. p value less than 0.05 was taken to be statistically significant. RESULTS: The two-way mixed ANOVA showed no statistically significant difference in mean OSCE scores between intervention and control groups (p=0.890), although the mean score of the intervention group was better than the control group. CONCLUSION: Our study demonstrated that HFS was not significantly effective over VAL-based education in enhancing skills and consolidating retention among undergraduate medical students. Further research is needed to determine its suitability for inclusion in the course curriculum considering the cost-effectiveness of implementing HFS that may supplement traditional teaching methods.
Assuntos
Competência Clínica , Educação de Graduação em Medicina , Humanos , Educação de Graduação em Medicina/métodos , Feminino , Masculino , Estudantes de Medicina , Treinamento com Simulação de Alta Fidelidade/métodos , Avaliação Educacional , Adulto Jovem , AdultoRESUMO
OBJECTIVE: to compare the decision-making of Nursing students, before and after theoretical training on basic life support, using the practice of high-fidelity simulation and medium-fidelity simulation. METHOD: an experimental study was developed, pre- and post-test type, with quantitative, descriptive and inferential analysis, with theoretical training on basic life support and clinical simulation practices, and with evaluation of knowledge and decision-making of Nursing students, at three different moments - before the simulation scenario (T0), after the simulation scenario (T1) and after clinical teaching (T2). RESULTS: 51 students participated in the research, with an average age of 20.25±3.804, of which 92.2% were female. Statistically significant differences (F=6.47; p=0.039) were evident regarding the definition of the problem and development of objectives in decision-making in the experimental group. CONCLUSION: Nursing students demonstrate an adequate level of knowledge and a good decision-making process, based on the most current instruments produced by scientific evidence, in clinical simulation scenarios in basic life support, and this innovative methodology should be deepened in the Nursing teaching. HIGHLIGHTS: (1) Clinical simulation promotes good decision-making of Nursing students.(2) Students demonstrated adequate knowledge about basic life support.(3) Knowledge and practice define the fidelity of clinical simulation.(4) Basic life support can be developed by high-fidelity simulation.
Assuntos
Estudantes de Enfermagem , Humanos , Feminino , Masculino , Adulto Jovem , Tomada de Decisões , Treinamento por Simulação/métodos , Educação em Enfermagem/métodos , Treinamento com Simulação de Alta Fidelidade/métodos , AdultoRESUMO
OBJECTIVE: Increasingly, medical schools integrate clinical skills into early didactic coursework. The Stop the Bleed® Campaign emphasizes prehospital hemorrhage control to reduce preventable deaths; however, this course overlooks team interactions. We assessed the impact of high-fidelity simulation during medical student orientation on identification and treatment of life-threatening hemorrhage in a team setting. DESIGN: In this mixed method, prospective pre-, post-, and follow-up survey analysis assessing student knowledge and attitudes, student teams encountered a standardized patient in a prehospital environment with pulsatile bleeding from an extremity wound. Individual students completed surveys assessing previous experience, willingness and ability to assist bleeding person(s), and knowledge and attitudes about tourniquets. Postscenario, faculty preceptors made qualitative observations on teamwork. SETTING: Medical student orientation at a tertiary care academic medical center with long-term follow-up. PARTICIPANTS: Medical students (Nâ¯=â¯150). RESULTS: Ninety students (60%) completed both pre- and postsimulation questionnaires. Sixteen (17%) students had previous tourniquet training experience although none had applied a tourniquet outside of training. Postsimulation, students reported increased likelihood of providing treatment until additional help arrived (pâ¯=â¯0.035), improved ability to identify life-threatening hemorrhage (p < 0.001), and more favorable opinions about tourniquet use (p < 0.001) and potential for limb-salvage (pâ¯=â¯0.018). Long-term follow-up respondents (nâ¯=â¯34, 23%) reported increased ability to identify life-threatening hemorrhage (pâ¯=â¯0.010) and universal willingness to intervene until additional help arrived. Follow-up survey responses elicited themes in hemorrhage control including recognition of the importance of continuous pressure, appropriate use of tourniquets, a desire for repeated team training, and the recognition of clerkship rotations as an optimal setting for skill reinforcement. Preceptors noted variable team responses but uniformly endorsed the exercise. CONCLUSIONS: High-fidelity bleeding simulation during medical student orientation improved students' knowledge and attitudes about treating life-threatening hemorrhage and served as an introduction to team-based emergency care. Future studies should further explore team training and hemorrhage control education.
Assuntos
Competência Clínica , Educação de Graduação em Medicina , Hemorragia , Humanos , Hemorragia/terapia , Hemorragia/prevenção & controle , Estudos Prospectivos , Educação de Graduação em Medicina/métodos , Feminino , Masculino , Seguimentos , Autorrelato , Torniquetes , Treinamento com Simulação de Alta Fidelidade/métodos , Estudantes de MedicinaRESUMO
BACKGROUND: Medical students in the U.S. must demonstrate urgent and emergent care competence before graduation. Urgent and emergent care competence involves recognizing, evaluating and initiating management of an unstable patient. High-fidelity (HF) simulation can improve urgent and emergent care skills, but because it is resource intense, alternative methods are needed. STUDY OBJECTIVE: Our primary purpose was to use program evaluations to compare medical student experiences with HF and virtual reality (VR) simulations as assessment platforms for urgent and emergent care skills. METHODS: During their emergency medicine clerkship, students at The Ohio State University College of Medicine must demonstrate on HF manikins, competence in recognizing and initiating care of a patient requiring urgent or emergent care. Students evaluated these simulations on a five-point quality scale and answered open-ended questions about simulation strengths and weaknesses. Faculty provided feedback on student competence in delivering urgent or emergent care. In 2022, we introduced VR as an alternative assessment platform. We used Wilcoxon Signed Ranks and Boxplots to compare ratings of HF to VR and McNemar Test to compare competence ratings. Comments were analyzed with summative content analysis or thematic coding. RESULTS: We received at least one evaluation survey from 160 of 216 (74.1%) emergency medicine clerkship students. We were able to match 125 of 216 (57.9%) evaluation surveys for students who completed both. Average ratings of HF simulations were 4.6 of 5, while ratings of VR simulations were slightly lower at 4.4. Comments suggested that feedback from both simulation platforms was valued. Students described VR as novel, immersive, and good preparation for clinical practice. Constructive criticism identified the need for additional practice in the VR environment. Student performance between platforms was significantly different with 91.7% of students achieving competence in HF, but only 65.5% in VR (p≤.001, odds-ratio = 5.75). CONCLUSION: VR simulation functions similarly to HF for formative assessment of urgent and emergent care competence. However, using VR simulation for summative assessment of urgent and emergent care competence must be considered with caution because students require considerable practice and acclimation to the virtual environment.
Medical students found value in using virtual reality simulation as a platform for practice and feedback in a formative assessment arrangement.Students described the virtual reality simulation as immersive and good preparation for clinical practice.Technical difficulties were common and the student learning curve for acclimating and learning how to function in the virtual environment was noteworthy.
Assuntos
Competência Clínica , Medicina de Emergência , Estudantes de Medicina , Realidade Virtual , Humanos , Estudantes de Medicina/estatística & dados numéricos , Medicina de Emergência/educação , Estágio Clínico/métodos , Educação de Graduação em Medicina/métodos , Avaliação Educacional/métodos , Manequins , Ohio , Treinamento com Simulação de Alta Fidelidade/métodos , Avaliação de Programas e Projetos de SaúdeRESUMO
Patient safety education is necessary for the provision of high-quality medical services. A significant aspect of patient safety education is simulation training, which allows medical students to experience realistic clinical environments. This study aimed to verify the effectiveness of patient safety education using simulation training. We retrospectively analyzed the results of a 30-question questionnaire survey on the perceptions of patient safety before and after simulation training, which was completed by 40 medical students who participated in clinical practice between June and December 2021. A paired t-test was performed by calculating the mean and standard deviation for each item. We found that students' overall perceptions of patient safety improved after training. Specifically, after simulation training, attitudes toward patient safety were maintained at the same level as before training, while students' self-efficacy of patient safety increased. Simulation training is effective in improving students' perceptions of patient safety, and increasing students' confidence can improve their clinical performance. To maintain this effect, repeated learning is required, and theoretical classes and simulation training should be used appropriately for patient safety education in the future.
Assuntos
Segurança do Paciente , Estudantes de Medicina , Humanos , Estudantes de Medicina/psicologia , Feminino , Masculino , Inquéritos e Questionários , Estudos Retrospectivos , Treinamento por Simulação/métodos , Adulto , Adulto Jovem , Percepção , Competência Clínica , Autoeficácia , Treinamento com Simulação de Alta Fidelidade/métodos , Atitude do Pessoal de SaúdeRESUMO
BACKGROUND: Clinical judgment is the hallmark of safe patient care. Nurse educators continue to explore best practices to assist prelicensure nursing students in developing clinical judgment. PURPOSE: The 3-part purpose of this study was to identify what students learned about themselves related to clinical judgment after viewing their video-recorded high-fidelity simulation scenarios, to assess if video recording is an effective post-debriefing teaching strategy, and to evaluate if the 2021 American Association of Colleges of Nursing (AACN) Domains can be assessed longitudinally. METHODS: Qualitative interpretive description study of 37 prelicensure nursing students. RESULTS: Ten codes were derived from 314 excerpts: communication, body language, confidence in self, putting data together, collaboration, leadership, safety, skillfulness, areas of improvement, and growth. CONCLUSIONS: Longitudinal data showcased the development of clinical judgment, effectiveness of self-evaluation of video recorded simulations as a teaching strategy, and assessment of 5 AACN Domains.
Assuntos
Competência Clínica , Bacharelado em Enfermagem , Pesquisa em Educação em Enfermagem , Estudantes de Enfermagem , Gravação em Vídeo , Humanos , Estudantes de Enfermagem/psicologia , Estudantes de Enfermagem/estatística & dados numéricos , Bacharelado em Enfermagem/métodos , Feminino , Pesquisa em Avaliação de Enfermagem , Masculino , Julgamento , Pesquisa Qualitativa , Treinamento com Simulação de Alta Fidelidade/métodos , Adulto , Adulto Jovem , Estudos Longitudinais , Autoavaliação (Psicologia)RESUMO
OBJECTIVE: To improve our previous simulation-based training module by using sustainable material to mold an anatomically accurate terrain and reproducing major vascular injuries encountered during robot-assisted nephrectomy. METHODS: The simulator was built with a pump, gauge, and valve linked via silicone tubing. Artificial blood was made from cornstarch, water, and red dye, and pumped through 3D-Med artificial vessels with the dimensions of an average renal artery. Silicone was used to emulate the pliability of organic tissue and mold an anatomically accurate terrain. Eight urologic residents participated in the pilot simulation. We employed validated assessment tools including Non-Technical Skills for Surgeons and Objective Structured Assessment of Technical Skills forms to guide debrief sessions moderated by an expert physician after individual performance evaluations. RESULTS: The apparatus demonstrated high reproducibility across all simulation scenarios, enhancing resident problem-solving skills. Residents' pre-simulation surveys revealed significant concern regarding their acute hemorrhage management. Residents' post-simulation survey demonstrated average realism scores increased from 4.375 to 4.75. Residents also felt the simulator enhanced learning, offering valuable practice and knowledge applicable to their surgical specialty. CONCLUSION: The management of acute hemorrhage during robot-assisted surgery remains a space for additional surgical education and training. Our simulation successfully provided a reliable, reproducible training for residents to practice their technical and non-technical skills in managing acute hemorrhage.
Assuntos
Perda Sanguínea Cirúrgica , Competência Clínica , Internato e Residência , Procedimentos Cirúrgicos Robóticos , Humanos , Procedimentos Cirúrgicos Robóticos/educação , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Perda Sanguínea Cirúrgica/prevenção & controle , Treinamento por Simulação/métodos , Treinamento com Simulação de Alta Fidelidade/métodos , Urologia/educação , Nefrectomia/educação , Nefrectomia/métodos , Nefrectomia/efeitos adversos , Modelos AnatômicosRESUMO
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.
Assuntos
Competência Clínica , Bacharelado em Enfermagem , Estudantes de Enfermagem , Revisões Sistemáticas como Assunto , Humanos , Estudantes de Enfermagem/estatística & dados numéricos , Estudantes de Enfermagem/psicologia , Bacharelado em Enfermagem/métodos , Competência Clínica/normas , Competência Clínica/estatística & dados numéricos , Treinamento com Simulação de Alta Fidelidade/métodosRESUMO
OBJECTIVE: To evaluate the effect of high-fidelity simulation of pediatric emergencies compared to case-based discussion on the development of self-confidence, theoretical knowledge, clinical reasoning, communication, attitude, and leadership in undergraduate medical students. METHODS: 33 medical students were allocated to two teaching methods: high-fidelity simulation (HFS, n = 18) or case-based discussion (CBD, n = 15). Self-confidence and knowledge tests were applied before and after the interventions and the effect of HFS on both outcomes was estimated with mixed-effect models. An Objective Structured Clinical Examination activity was conducted after the interventions, while two independent raters used specific simulation checklists to assess clinical reasoning, communication, attitude, and leadership. The effect of HFS on these outcomes was estimated with linear and logistic regressions. The effect size was estimated with the Hedge's g. RESULTS: Both groups had an increase in self-confidence (HFS 59.1 × 93.6, p < 0.001; CDB 50.5 × 88.2, p < 0.001) and knowledge scores over time (HFS 45.1 × 63.2, p = 0.001; CDB 43.5 × 56.7, p-value < 0.01), but no difference was observed between groups (group*time effect in the mixed effect models adjusted for the student ranking) for both tests (p = 0.6565 and p = 0.3331, respectively). The simulation checklist scores of the HFS group were higher than those of the CBD group, with large effect sizes in all domains (Hedges g 1.15 to 2.20). CONCLUSION: HFS performed better than CBD in developing clinical reasoning, communication, attitude, and leadership in undergraduate medical students in pediatric emergency care, but no significant difference was observed in self-confidence and theoretical knowledge.
Assuntos
Competência Clínica , Educação de Graduação em Medicina , Estudantes de Medicina , Humanos , Educação de Graduação em Medicina/métodos , Feminino , Masculino , Emergências , Pediatria/educação , Treinamento com Simulação de Alta Fidelidade/métodos , Comunicação , Avaliação Educacional , Adulto Jovem , Autoimagem , Raciocínio ClínicoRESUMO
AIM: To conduct an umbrella review of the effectiveness of using high-fidelity simulation in nursing student teaching, thereby supporting continuous improvement in teaching practitioners' implementation of high-fidelity simulation intervention strategies. BACKGROUND: Several systematic reviews have investigated the effectiveness of high-fidelity simulation in nursing student teaching in recent years. However, conclusions vary and a systematic assessment is lacking. DESIGN: This review encompasses an umbrella review. METHODS: A search of PubMed, Embase, Cochrane Library, Web of Science and OVID databases was conducted to retrieve data on an umbrella review of high-fidelity simulation effectiveness in nursing student teaching from database inception to November 2023. The quality of the included systematic reviews was independently assessed by two reviewers using the AMSTAR 2 and PRISMA scales. Outcome indicators from the included systematic reviews were graded using the GRADE system. RESULTS: Twelve systematic reviews focusing on high-fidelity simulation effectiveness in nursing student teaching were included. Notably, all 12 systematic reviews exhibited very-low methodological quality, with 9 exhibiting some degree of reporting deficiencies, 2 exhibiting severe information deficiencies and 1 reporting relatively complete information. A total of 22 outcome indicators and 53 pieces of evidence were included. The results revealed 15 pieces of low-quality evidence and 38 pieces of very-low-quality evidence. Mounting evidence suggests that high-fidelity simulation teaching effectively enhances nursing students' theoretical performance, practical skills and various clinical comprehensive abilities, highlighting a positive teaching effect. However, further validation through high-quality, large-sample studies is warranted. CONCLUSION: The overall evidence quality of the current systematic reviews evaluating high-fidelity simulation effectiveness in nursing student teaching is low. Additionally, the methodological quality and the degree of reporting standardization require further improvement. Therefore, high-quality, large-sample randomized controlled trials are essential for further substantiating high-fidelity simulation effectiveness in nursing student teaching.
Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , Humanos , Estudantes de Enfermagem/estatística & dados numéricos , Bacharelado em Enfermagem/métodos , Ensino , Treinamento com Simulação de Alta Fidelidade/métodos , Competência Clínica/normas , Revisões Sistemáticas como Assunto , Treinamento por Simulação/métodosRESUMO
To prepare medical students appropriately for the management of toxicological emergencies, we have developed a simulation-based medical education (SBME) training in acute clinical toxicology. Our aim is to report on the feasibility, evaluation and lessons learned of this training. Since 2019, each year approximately 180 fifth-year medical students are invited to participate in the SBME training. The training consists of an interactive lecture and two SBME stations. For each station, a team of students had to perform the primary assessment and management of an intoxicated patient. After the training, the students completed a questionnaire about their experiences and confidence in clinical toxicology. Overall, the vast majority of students agreed that the training provided a fun, interactive and stimulating way to teach about clinical toxicology. Additionally, they felt more confident regarding their skills in this area. Our pilot study shows that SBME training was well-evaluated and feasible over a longer period.
Assuntos
Competência Clínica , Estudos de Viabilidade , Estudantes de Medicina , Toxicologia , Humanos , Estudantes de Medicina/psicologia , Projetos Piloto , Toxicologia/educação , Treinamento com Simulação de Alta Fidelidade/métodos , Inquéritos e Questionários , Educação de Graduação em Medicina/métodos , Treinamento por Simulação/métodosRESUMO
BACKGROUND: Participant roles can vary with simulation. Some roles involve providing direct care during the simulation, whereas other roles involve observing the simulation either in the simulation environment or in another room with audiovisual capabilities. PURPOSE: To determine whether learning outcomes are comparable for students regardless of role played in a simulation. METHODS: A quasi-experimental design was used to determine whether knowledge acquisition was influenced by role assignment (primary or secondary nurse, family member, or observer) when participating in a high-fidelity simulation among 267 study participants. RESULTS: There was a statistically significant increase in the mean score for knowledge acquisition for all participants ( P < .001). There was no difference in knowledge acquisition based on the role assignment in the simulation ( F = 0.28, P = .84). CONCLUSIONS: Knowledge acquisition is possible regardless of the role played in a high-fidelity simulation.
Assuntos
Pesquisa em Educação em Enfermagem , Pesquisa em Avaliação de Enfermagem , Estudantes de Enfermagem , Humanos , Estudantes de Enfermagem/psicologia , Estudantes de Enfermagem/estatística & dados numéricos , Feminino , Masculino , Competência Clínica , Adulto , Bacharelado em Enfermagem/métodos , Aprendizagem , Treinamento com Simulação de Alta Fidelidade/métodos , Adulto Jovem , Treinamento por Simulação , Avaliação Educacional/estatística & dados numéricosRESUMO
OBJECTIVE: The most effective training methods are experiential, including those focused on experiences and emotions. Clinical simulation, especially high-fidelity simulation, is one of the most effective methodologies for the acquisition of competencies in care like palliative care. The simulation with actors can train future healthcare science professionals: in technical, intellectual, or interpersonal skills. The objective is to evaluate high-fidelity simulation with actors as a tool in palliative care training for nursing students. METHOD: Over three years, the study was conducted in a Faculty of Nursing of the south of Spain with nursing students. A mixed methods study with sequential explanatory design in three moments was conducted: (1) Quasi-experimental study in a single group (nâ¯=â¯12) before and after attending the palliative care course with Clinical Simulation with actors to assess the communication skills (CICAA scale), (2) Qualitative study with phenomenological perspective after Clinical Simulation (174 reflective students' narratives), (3) Cross-sectional observational study, one year later, to assess the transfer of knowledge and skills to the clinical practice (71 students). RESULTS: Students who interacted with actors in Clinical Simulation improved their communication skills and the ability to establish an effective helping relationship with both end-of-life patients and their families. The students perceived the Clinical Simulation as an innovative learning methodology that is useful to encourage reflection and transfer of learning during their clinical internship. CONCLUSIONS: Standardization of the use of active learning methodologies is recommended for a better acquisition of transversal skills such as communication skills in palliative care.
Assuntos
Treinamento com Simulação de Alta Fidelidade , Treinamento por Simulação , Estudantes de Enfermagem , Humanos , Cuidados Paliativos , Treinamento com Simulação de Alta Fidelidade/métodos , Estudantes de Enfermagem/psicologia , Estudos Transversais , Treinamento por Simulação/métodosRESUMO
BACKGROUND: The constant increase in the aging population will lead to a greater demand for high-quality nursing care for this population over the coming years. Early detection and proper treatment of great geriatric syndromes are essential and, consequently, geriatric nurses must acquire the necessary competencies for their adequate management. OBJECTIVES: To evaluate the acquisition of the necessary nursing competencies for adequate management of great geriatric syndromes through high-fidelity simulation training and to explore undergraduate nursing students' perceptions about this training. METHODS: 80 undergraduate nursing students participated in a mixed methods study. The simulated scenarios recreated older patients with diagnoses of great geriatric syndromes using standardized patients. Nursing competencies were evaluated using a verification list. 10 focus groups were interviewed to explore their perceptions, conducting a qualitative study with an interpretative approach. RESULTS: Most of the students (86.55 %) acquired the necessary nursing competencies for adequate management of great geriatric syndromes. The nursing students stated that they improved their communication skills (provide solutions to older patients; facilitate and redirect the clinical interview; contrast the information given to the patient), psychological resources (psychological support; physical contact and accompaniment; empathy and persuasion), and geriatric knowledge (identify their lack of knowledge; recognize their limits in terms of healthcare and refer to other health professionals; know the patient's conditions) to provide quality care for older people diagnosed with great geriatric syndromes. CONCLUSIONS: The use of high-fidelity simulation training including standardized patients makes it easier for nursing students to acquire the necessary nursing competencies for adequate management of great geriatric syndromes and improve their clinical skills. Geriatric nursing education should focus on equipping nursing students with the necessary clinical skills, integrating high-fidelity simulation training in geriatric study plans to train students in the nursing care to be provided to older patients, and preparing them for real clinical practice.
Assuntos
Bacharelado em Enfermagem , Educação em Enfermagem , Treinamento com Simulação de Alta Fidelidade , Treinamento por Simulação , Estudantes de Enfermagem , Humanos , Idoso , Treinamento com Simulação de Alta Fidelidade/métodos , Bacharelado em Enfermagem/métodos , Estudantes de Enfermagem/psicologia , Síndrome , Educação em Enfermagem/métodos , Competência ClínicaRESUMO
AIM: The study aimed to establish the impact of high-fidelity simulation (HFS) in the objective structured clinical examination (OSCE) of nursing students enrolled in four undergraduate courses (medical-surgical, critical-care, maternal-health and paediatric nursing). DESIGN: This quasi-experimental research study was performed during the midterm and final OSCEs of nursing students at the institution, and their OSCE performance was assessed. METHODS: The students were divided into two: those who were exposed to HFS in addition to their clinical training and the other group who underwent clinical training without HFS exposure. RESULTS: The combined mean midterm and final OSCE results of the group of nursing students with HFS exposure and those without HFS exposure were 92.58 and 82.66, respectively, with a mean between-group difference of 9.92% (p < .01). Our findings reveal that the HFS exposure in addition to clinical training enhanced the students' OSCE performance.
Assuntos
Bacharelado em Enfermagem , Treinamento com Simulação de Alta Fidelidade , Estudantes de Enfermagem , Criança , Humanos , Treinamento com Simulação de Alta Fidelidade/métodos , Competência Clínica , Bacharelado em Enfermagem/métodos , Avaliação EducacionalRESUMO
BACKGROUND: Nursing education suffers from a lack of high-quality clinical experiences for students, especially among medical specialty groups such as cancer patients, in Saudi Arabia. A paucity of empirical evidence is supporting simulation in education and the transfer of psychomotor skills to patient care. In particular, although generally recognized as an essential oncology nursing skill, effective strategies for teaching the management of chemotherapy extravasation to students have not been investigated. PURPOSE: To investigate the effects of high-fidelity simulation (HFS) technology on the competency of nursing students in the management of chemotherapy extravasation and the transfer of this skill from traditional learning labs to clinical settings. METHODS: A quasi-experimental study comprising a two-group pretest-posttest with repeated measures was used. The intervention was a scenario-based, HFS. Third-year students (n = 68) from a nursing program were randomly allocated to either intervention or control groups. Competency was measured in both groups using the same standardized assessment checklist. RESULTS: Competency scores were lower in the control group compared to the intervention group at both posttesting times. These results, however, were not statistically significant. There was no statistically significant difference between the groups regarding skill transfer. CONCLUSIONS: Nursing faculty can use either HFS or traditional learning methods to effectively teach students how to manage chemotherapy extravasation and transfer this skill to clinical settings.
Assuntos
Bacharelado em Enfermagem , Treinamento com Simulação de Alta Fidelidade , Neoplasias , Estudantes de Enfermagem , Competência Clínica , Bacharelado em Enfermagem/métodos , Treinamento com Simulação de Alta Fidelidade/métodos , Humanos , Neoplasias/tratamento farmacológico , TecnologiaRESUMO
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.
Assuntos
Bacharelado em Enfermagem , Educação em Enfermagem , Treinamento com Simulação de Alta Fidelidade , Estudantes de Enfermagem , Competência Clínica , Bacharelado em Enfermagem/métodos , Treinamento com Simulação de Alta Fidelidade/métodos , HumanosRESUMO
OBJECTIVES: To explore the effects of different lengths of the three key steps (prebriefing, simulation, and debriefing) of high-fidelity simulation (HFS) on the knowledge and skills of undergraduate nursing students. DESIGN: A systematic review and meta-analysis. DATA SOURCES: A systematic search was conducted for Chinese and English publications from the Web of Science, PubMed, Embase, Cochrane, and two Chinese databases (Wanfang and CNKI) up to November 24, 2021. REVIEW METHODS: Two independent raters screened the retrieved studies and extracted data based on a coding protocol from the studies that met the inclusion criteria. Data were synthesized using meta-analytic procedures based on a random-effect model and computing effect sizes by standard mean differences (SMD) with a 95% confidence interval (CI). RESULTS: Forty-four studies were included, and 23 studies were analyzed. High-fidelity simulation (HFS) with debriefing of 10â¯min or less (SMDâ¯=â¯1.18), simulation of 15-20â¯min (SMDâ¯=â¯1.43), and debriefing of 11-30â¯min (SMDâ¯=â¯1.19) showed larger effect sizes for knowledge, while HFS with debriefing of >10â¯min (SMDâ¯=â¯0.91), simulation of 15â¯min or less (SMDâ¯=â¯0.89), and over 30â¯min of debriefing cultivation (SMDâ¯=â¯0.84) showed larger effect sizes for skill. CONCLUSIONS: During the prebriefing, simulation, and debriefing, shorter sessions are more effective for improving knowledge in BSN students, whereas longer sessions are most effective for improving skills in BSN students. Nurse educators can schedule HFS to meet the expectations of learning outcomes based on the actual situation.