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