An evaluation of advanced simulation in nursing: A mixed-method study

doi:10.1016/j.colegn.2013.05.003

Collegian

Volume 21, Issue 4, December 2014, Pages 257-265

https://doi.org/10.1016/j.colegn.2013.05.003 Get rights and content

Summary

Purpose

This study aimed to evaluate the development of critical thinking disposition and skills of nursing students and to identify their issues and experience with the application of advanced simulation for experiential learning.

Design

The study was conducted with a mixed-method design.

Methods

Quantitative and qualitative data were respectively collected through pre-post questionnaires and focus group interviews over two semesters from a class of 132 undergraduate pre-registration nursing students in Hong Kong, who practised clinical skills with human patient simulator (HPS) during two adult nursing care courses.

Findings

Although there were significantly increased analyticity, confidence and overall critical thinking disposition scores, inquisitiveness decreased after the study period. From the qualitative results, advanced simulation with HPS was overall recognized to be interesting, useful, welcomed and preferred by students in this study.

Conclusions

While the result of overall critical thinking disposition score of students in this study showed a significantly increase (p = 0.000) after two semesters, outcomes might improve with higher frequencies of the advanced simulation exercises and measures taken to consider cultural background of the students in such teaching and learning process.

Clinical relevance

With the quantitative results and overall positive feedback from students, advanced simulation is reasonably considered for inclusion as a value-added adjunct to clinical learning.

Section snippets

Background and aims

The use of the high-fidelity human patient simulator (HPS) in medical education had demonstrated promising evidence regarding the development of better learning outcomes (Steadman et al., 2006). Unlike the medical discipline, the evaluation of such advanced simulation for teaching and assessment in nursing education has a relatively shorter history. In 2002, Nehring, Lashley, and Ellis emphasized the use of advanced simulation technology that aided teaching and learning in nursing education,

Methods

In order to achieve the aims, we utilized a mixed-method design of the core pre-post quantitative evaluation with a set of validated tools, and a supplementary qualitative investigation (Morse & Niehaus, 2009) informed by the orientation of naturalistic inquiry (Sandelowski, 2000). Qualitative data were collected through focus group interviews with students. With this mixed-method of study that used different sources and types of data, the results can be triangulated to produce a more

Students’ characteristics

As it is usual for a class of students in nursing, the majority of them were females; this also applied to those who participated in this study. The proportions of male and female participants in this study were 80% and 20% respectively. Nevertheless, gender difference was not associated with the results of CCTDI (linear regression, 95% CI, all p > 0.09). There were also no significant differences among other demographical factors, including age, religion and ethnic background. In fact, all of

Discussion

The percentages of CCTDI scores <280 and >350 at T1, T2 and T3 from this study were all unfavorable comparing with the exemplars of 267 undergraduate students from the US and Canada (Table 2). Although the sample size of this study is smaller than 267 for a powerful comparison, the differences are preliminary that they served to trigger some thoughts for discussion. Reasons of the differences were unclear but cultural differences and their possible relationships to the practice and experience

Limitations

Limitations of this study included the inability to obtain a case control group for comparison, the lower number of questionnaires that could be paired (n = 71–88) than the total number of student who provided consent (n = 132), and possibly the insufficient ‘dosage’ of simulation exercises for students to practise and enhance their critical thinking disposition. The need of more time for teachers to maximizing use of HPS for teaching (anecdotal comments received during ongoing training session)

Conclusions

As found in other studies (Corbridge et al., 2010, McCaughey and Traynor, 2010, Moule et al., 2008Reid-Searl et al., 2012, Ricketts, 2010, Rochester et al., 2012), high fidelity simulation with HPS for teaching and learning was recognized in this study as being interesting, useful, welcomed and preferred by students in general. Yet with relatively more antedoctal evidence like opinion polls in the current literature (Sanford, 2010), more empirical studies should be conducted to compare advanced

Acknowledgements

This project was funded by an Earmarked Teaching and Development Grant (2008/9), The University of Hong Kong (HKU). The author appreciates the valuable comments provided by Professor Agnes Tiwari and Dr. Felix K. H. Yuen (School of Nursing, HKU) for the initial proposal development of this study.

This project was funded by a Teaching Development Grants (TDG) Award for 4-Year Undergraduate Curriculum Reform 2008–2009, HKU; and a University Development Fund (UDF) 2007–2008, HKU, for the

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View full text

An evaluation of advanced simulation in nursing: A mixed-method study

Summary

Purpose

Design

Methods

Findings

Conclusions

Clinical relevance

Section snippets

Background and aims

Methods

Students’ characteristics

Discussion

Limitations

Conclusions

Acknowledgements

Nurse Education Today

Collegian

Nurse Education Today

Clinical Simulation in Nursing

Applied Nursing Research

Nurse Education Today

Nurse Education Today

Nurse Education Today

Collegian

Collegian

Critical thinking: A statement of expert consensus for purposes of educational assessment and instruction (the delphi report)

Human patient simulators: A new face in baccalaureate nursing education at Brigham Young University

Journal of Nursing Education

The role of metalearning in study processes

British Journal of Educational Psychology

The revised two-factor study process questionnaire: R-SPQ-2F

British Journal of Educational Psychology

High-fidelity nursing stimulation; impact on students’ self-confidence and clinical competence

International Journal of Nursing Education Scholarship

Simulators help RNs hone skills

Nursing spectrum: 2007 fall critical care specialty guide

The use of human patient simulators: best practices with novice nursing students

Nurse Educator

Online learning versus simulation for teaching principles of mechanical ventilation to nurse practitioner students

International Journal of Nursing Education Scholarship

Designing and conducting mixed methods research

Is critical thinking culturally biased?

Teaching Philosophy

Qualitative analysis: Practice and innovation

The California critical thinking disposition inventory (CCTDI). Test administration manual

Are college students predisposed to think?

Holistic critical thinking scoring rubric

Critical thinking assessment in nursing education programs: An aggregate data analysis

CCTDI test manual 2007 edition

The disposition toward critical thinking: Its character, measurement, and relationship to critical thinking skill

Informal Logic