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Item type Presentation

Format Text-based Document

Title The Effect of Simulation Courseware on Critical Thinkingin Undergraduate Nursing Students: Multi-Site Pre-PostStudy

Authors Shin, Hyunsook; Shim, Kaka; Lee, Yuna; Ma, Hyunhee;Lim, Dahae; Kim, Hyojin; Kim, Hyejin

Downloaded 13-Jul-2018 17:37:31

Link to item http://hdl.handle.net/10755/602928

The effect of simulation courseware on critical thinking in nursing students:

Multi-site pre-post study

* Hyunsook Shin, PhD, RN, CPNP

* Kaka Shim, MSN, RN, Doctoral candidate

* Yu-nah Lee, MSN, RN, Doctoral student

* Hyunhee Ma, MSN, RN, Doctoral student

* Dahae Rim, BSN, RN, Master student

* Hyojin Kim, MSN, RN, Doctoral student

* Hyejin Kim, MSN, RN

* College of Nursing Science, Kyung Hee University

Introduction

• The use of simulations as opportunities for students

to enhance their critical thinking (CT)

• A systematic review of CT-focused simulation

strategies -> inconsistent findings for simulation’s

effects on students’ CT abilities

• Limitation: The working mechanism of simulation

strategies and CT as well as the simulation

exposure needed to enhance CT

Study Purpose

• To evaluate the effect of an integrated pediatric

nursing simulation used in a pediatric nursing

practicum on students' CT

• To identify the effects of differing numbers of

simulation exposures, or “dosing” levels, on CT in a

multi-site environment.

Methods

• Study Design

– A multi-site, pre-test, post-test design

• Participants

– A convenience sample (n = 237) of undergraduate

senior nursing students from three universities in Seoul,

Korea.

– Students enrolled in a pediatric nursing practicum

between February and December 2013 at each school

Simulation courseware

Scenarios

Evaluation tools

• Febrile nursing rubric

• Apnea checklist

• SET

Simulation equipment

• Manual: student, instructor

• Simulator

• AV system

Simulation ScenariosTopic Time frame Methods

Simulation scenario I

Introduction to the case

Simulation exercise

Rapport building (Interaction among nurse-parent-

child): First contact role play

SBAR

Self reflection with recorded video-clip

Debriefing

5 min

10 min

10 min

10 min

15 min

Student-led activity

Self reflective writing

Clinical inference web

Discussion

Simulation scenario II

Introduction to the case

Simulation exercise

Febrile infant with or without respiratory distress

SBAR

Self reflection with recorded video-clip

Debriefing

10 min

10 min

10 min

10 min

15 min

Student-led activity

Self reflective writing

Clinical inferential web

Discussion

Simulation scenario III

Introduction to the case

Simulation exercise

High-risk newborn care: apnea and resuscitation

SBAR

Self reflection with recorded video-clip

Debriefing

10 min

10 min

10 min

10 min

15 min

Student-led activity

Self reflective writing

Clinical inferential web

Discussion

Protocol: Simulation Operation

Pre-learning

Simulation orientation

Simulation operation

SBAR( writing

Watching the recorded video-clip

Debriefing

Data Collection

• Site preparation

– Faculty workshops:

• In-depth training in how to operate the simulation and

evaluate simulation performance

– Staff support:

• Trained research assistants from the research team

Group assignments

Groups of 10 students

Sim Operation:

2/3 students in each sub-group

Sim Operation:

2/3 students

Sim Operation:

2/3 students

Regular practicum

group:

20 students

Data collection procedure

Instruments

Critical Thinking Disposition Tool

• Yoon's CTD tool (2008)

• 27 items, 5-point Likert scale

• 7 subscales :

– Objectivity

– Prudence

– Systematicity

– intellectual eagerness/curiosity

– intellectual fairness

– healthy skepticism

– CT self-confidence

• Cronbach's α of .844

Simulation Effectiveness Tool

• To assess participant satisfaction with

the simulation

• 13 items, 3-point Likert scale

• Cronbach's α of .845.

Participant characteristics

Comparison of variables among schools: learning outcomes.

CT scores in pre- and post-CT

Comparisons of subcategory scores in pre- and post-CT

Discussion I

• The effect of simulation sessions

• CT achievement

– Subcategories of prudence and intellectual eagerness

Significant predictors of clinical competency

– Increases in prudence and healthy skepticism ->

Enhanced maturity of judgment <-Reflective thinking

experience

Discussion II

• CT improvement during senior years

• The effects of differing exposures on CT

– Multiple exposures to the simulation courseware to

produce meaningful gains in CT among nursing students

Conclusions

• Multiple exposures to the courseware resulted in

significant CT gains in nursing students.

• These gains occurred in the CT subcategories of

prudence and intellectual eagerness, predictors of

clinical competency, and of healthy skepticism,

which along with prudence is an important element

of clinical judgment.

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