Jina Oh

Comparison of knowledge, confidence in skill performance (CSP) and satisfaction in problem-based learning (PBL) and simulation with PBL educational modalities in caring for children with bronchiolitis.

BACKGROUNDnIn most nursing curricula, simulation and problem-based learning (PBL) are used separately as individual learning methods. Nursing educators are in a unique position to improve students clinical performance and critical thinking skills by utilizing varied educational modalities.nnnPURPOSEnThis study attempted to compare changes in nursing students knowledge, confidence in skill performance (CSP), and satisfaction resulting from training using three educational modalities.nnnPARTICIPANTSnData from a convenient sample of 205 senior nursing students from three nursing schools in Seoul and Chuncheon, South Korea, was obtained between September 1 and December 10, 2013.nnnMETHODSnThis comparison study used three groups: the PBL group, simulation with the PBL group, and the control group. For data analysis, descriptive statistics, paired t-test, one-way ANOVA, and post-hoc tests (Duncan test) were performed.nnnRESULTSnNo significant difference in the students baseline knowledge of patient care for patients with bronchiolitis was found. There were significant differences in the mean scores of knowledge (F=14.718, p<.001), CSP (F=12.693, p<.001), and students satisfaction (F=93.471, p<.001) among the three groups.nnnCONCLUSIONnThe positive impact of PBL and a combined learning method in this study suggests that it can be an effective approach in pediatric nursing practice. These results provide a much-needed template and starting point for educators introducing active learning approaches for pediatric nursing courses.

Development of a simulation evaluation tool for assessing nursing students' clinical judgment in caring for children with dehydration.

BACKGROUNDnThe lack of reliable and valid tools to evaluate learning outcomes during simulations has limited the adoption and progress of simulation-based nursing education.nnnPURPOSESnThis study had two aims: (a) to develop a simulation evaluation tool (SET(c-dehydration)) to assess students clinical judgment in caring for children with dehydration based on the Lasater Clinical Judgment Rubric (LCJR) and (b) to examine its reliability and validity.nnnPARTICIPANTSnUndergraduate nursing students from two nursing schools in South Korea participated in this study from March 3 through June 10, 2014.nnnMETHODSnThe SET(c-dehydration) was developed, and 120 nursing students clinical judgment was evaluated. Descriptive statistics, Cronbachs alpha, Cohens kappa coefficient, and confirmatory factor analysis (CFA) were used to analyze the data.nnnRESULTSnA 41-item version of the SET(c-dehydration) with three subscales was developed. Cohens kappa (measuring inter-observer reliability) of the sessions ranged from .73 to .95, and Cronbachs alpha was .87. The mean total rating of the SET(c-dehydration) by the instructors was 1.92 (±.25), and the mean scores for the four LCJR dimensions of clinical judgment were as follows: noticing (1.74±.27), interpreting (1.85±.43), responding (2.17±.32), and reflecting (1.79±.35). CFA, which was performed to test construct validity, showed that the four dimensions of the SET(c-dehydration) was an appropriate framework.nnnCONCLUSIONnThe SET(c-dehydration) provides a means to evaluate clinical judgment in simulation education. Its reliability and validity should be examined further.

The effects of massage therapy on physical growth and gastrointestinal function in premature infants: A pilot study.

To promote the growth and development of premature infants, effective and tender care is required in neonatal intensive care units (NICUs). The purpose of this study was to test the potential effects of massage therapy on increasing physical growth and promoting gastrointestinal function in premature infants. Twenty subjects were divided into two groups in the NICU of one general hospital located in South Korea. The experimental group (n = 10) were given massage therapy and the control group (n = 10) received routine care. Massage therapy was performed twice daily for 14 days, for 15 minutes per session. In the physical growth, height and chest circumference were significantly increased in the experimental group. In assessing gastrointestinal function, frequency of pre-feed gastric residual was significantly decreased and numbers of bowel movements were significantly increased in the experimental group. This study showed massage therapy has the potential effects on increasing physical growth and gastrointestinal function in premature infants. The massage in the NICU might be utilized as a part of developmental care, but more research needs to be done. NICU nurses need to be trained in massage therapy techniques to provide more effective clinical care for premature infants.

Development and evaluation of simulation-based fever management module for children with febrile convulsion

BACKGROUNDnA reliable and valid checklist for the evaluation of simulation learning outcomes has great value in nursing education. This study focuses on simulation-based fever management module including checklist for febrile convulsion in pediatric nursing.nnnPURPOSESnThis study has two aims; (a) to develop a simulation-based fever management module for treating children with febrile convulsion, and (b) to evaluate students performance and satisfaction.nnnPARTICIPANTSnA convenient sample of 147 senior nursing students from two nursing schools in South Korea participated in this study from April 29 to June 14, 2013.nnnMETHODSnThis study was a three-stage process: developing the simulation-based module including algorithm with scenarios, items in checklist, and contents of debriefing (Stage I), performing simulation and debriefing for nursing students (Stage II), and evaluating the evaluation checklist of simulation performance and satisfaction of nursing students (Stage III). Student satisfaction was measured using the Satisfaction of Simulations Experience [SSE] scale. Debriefing data were analyzed using the Matrix Method.nnnRESULTSnA scenario script was created to treat the patients health issues. The algorithm proceeded as follows: identification of patients condition (Step I), nursing interventions (Step II), and outcome evaluation and feedback (Step III). The total mean score of the evaluation checklist was 2.67 (±.32). The debriefing categories were as follows: non-technical skills, self-efficacy, critical thinking, and technical skills. The total mean score of the SSE was 4.48 (±.42).nnnCONCLUSIONnThis study provides a blueprint for simulation-based practice for both nursing educators and nursing students. Further studies of checklists used in different contexts would be valuable for expanding upon this research.

Effectiveness of simulation with team-based learning in newborn nursing care.

This study determines the effect of simulation with team-based learning (TBL) on newborn nursing care. This randomized controlled trial included 74 nursing students from one university located in Seoul, South Korea. Participants were categorized into two groups according to educational modality: one group involved both simulation and TBL, and the other involved simulation alone. Learning attitudes, academic achievement, and simulation performance were examined to assess effectiveness. The mean difference in learning attitudes between the two groups was non-significant. Low academic achievement differed significantly between the two groups (tu2009=u20093.445, Pu2009=u20090.002). There was no significant difference in mean scores for simulation performance between the two groups. In this study, simulation with TBL was effective in improving learning outcomes. In current nursing education, various learning methods are employed within complex nursing situations and require flexibility and problem-solving approaches.

Nursing students' preferences of strategies surrounding cinenurducation in a first year child growth and development courses: A mixed methods study

BACKGROUNDnUse of film in the classroom (cinenurducation) promotes nursing students motivation and understanding of concepts about child growth and development; however, consensus has not been reached regarding students preferred strategies and what they view as effective.nnnOBJECTIVEnTo identify nursing students preferences for pedagogical strategies surrounding film use in a Child Growth and Development course.nnnDESIGNnA mixed methods study encompassing a concurrent triangulation strategy was undertaken.nnnSETTINGS AND PARTICIPANTSnEighty-three students attending the first year nursing class in the fall semester 2012 at a private University in South Korea participated.nnnMETHODSnFilms or film clips were shown either before or after pedagogical strategies including lecture, presentation, personal essay, group report, or group discussion, followed by a questionnaire to assess student preferences and their opinions on the impact of strategies on motivation and learning. A focus group with 10 participants provided their opinions.nnnRESULTSnAlthough the preference for the time when films were watched showed no significant difference (t=.388, p=.699), participants preferred the following pedagogical methods: watching films with a group, saying this was more effective compared to watching films alone (t=5.488, p<.001); full movie over film clips (t=2.869, p=.005); and personal essay over group report (t=2.755, p=.007). Focus group participants also stated that it was more effective to watch the entire movie rather than film clips with the group, and preferred personal essays to group reports.nnnCONCLUSIONSnUse of nursing students preferred learning strategies surrounding cinenurducation helped them gain conceptual knowledge in a Child Growth and Development course.

Evaluation of the Effects of Flipped Learning of a Nursing Informatics Course

BACKGROUNDnThis study evaluated the effects of flipped learning in a nursing informatics course.nnnMETHODnSixty-four undergraduate students attending a flipped learning nursing informatics course at a university in South Korea participated in this study in 2013. Of these, 43 students participated at University A, and 46 students participated at University B, as a comparison group. Three levels of Kirkpatricks evaluation model were used: level one (the students satisfaction), level two (achievement on the course outcomes), and level three (self-perceived nursing informatics competencies).nnnRESULTSnStudents of the flipped learning course reported positive effects above the middle degree of satisfaction (level one) and achieved the course outcomes (level two). In addition, self-perceived nursing informatics competencies (level three) of the flipped learning group were higher than those of the comparison group.nnnCONCLUSIONnA flipped learning nursing informatics course is an effective teaching strategy for preparing new graduate nurses in the clinical setting. [J Nurs Educ. 2017;56(8):477-483.].

Board #134 - Research Abstractthe Effect of Hybrid Learning with Nuring Students’ Clinical Competency: Simulation Combined with Problem-based Learning (submission #8610)

Hypothesis In most nursing curricula, simulation and PBL (problem-based learning) are used solely and separately as teaching and learning tools. Nurse educators should facilitate complex clinical experiences and utilize more complex and mixed education strategies to enhance nursing students’ clinical reasoning in order to improve the comprehensiveness and accuracy of nursing students’ clinical judgment. In the present study, simulation is combined with PBL as a hybrid framework or a learning strategy including lectures, discussion using problem-based learning modules, self-directed learning, and real situation practice with human patient simulators [HPS] (Lee et al., 2009). Moreover, there is no research in pediatric nursing literature that examines the effect of hybrid learning with combined simulation and problem-based learning. Hence, the purpose of this study is to test students’ clinical competency to assess the effectiveness of the combined teaching method. Methods The bronchiolitis module in the present study was designed based on the PBL and Simulation Model Framework (Barrows and Tamblyn, 1980; Jeffries, 2005). The Hybrid learning combining simulation with PBL was used to assess clinical competency including knowledge, confidence, and students’ satisfaction. This is a comparison study with three education modalities: PBL group (experimental group 1, E1), simulation with PBL group (experimental group 2, E2), and control group (C). We used descriptive, paired t-test statistics, one-way ANOVA, and post-hoc test (Duncan test) for data analysis using SPSS version 18.0 program. A convenient sample of 195 senior nursing students from three nursing schools located in Seoul and Chuncheon, South Korea participated in this study from Sep 1st to Dec 10th, 2013. Results There were no statistically significant differences between the groups in prior simulation experiences (&khgr;2=.396, p=.529), and baseline knowledge (7.80±1.11 versus 7.79±1.99, t=.020, p=.984). There were significant difference in the mean score of knowledge difference (post-pre) among E1 (1.42±2.49), E2 (1.77±2.11), and C (0.44±2.74) (F=14.718, p<.001). There were significant difference in the mean score of confidence among E1 (3.69±0.30), E2 (3.57±0.33), and C (3.38±0.44) (F=12.693, p<.001). There were significant differences in the mean satisfaction total score among E1 (4.67±0.39), E2 (4.17±0.53), and C (3.48±0.62) (F=93.471, p<.001). Conclusion This result could provide a much-need template or starting point for educators who desire to introduce simulation combined with PBL as a teaching-learning strategy in pediatric nursing courses. It is also necessary to monitor the effectiveness of combined simulation with PBL education. New approaches and strategies combined simulation with PBL for teaching critical thinking, clinical assessment, effective communication, and technical skills will be required to meet the demands of the new roles and responsibilities faced by nurse educators and their students. References 1. Barrows, HS, Tamblyn RM. Problem based learning. An approach to medical education. New York: Springer; 1980. 2. Jeffries PR. Simulation in Nursing Education: From Conceptualization to Evaluation. NY: National League of Nursing; 2007. 3. Jeffries P R, Norton B. Selecting Learning Experiences to Achieve Curriculum Outcomes. In D. M. Billings & J. A. Halstead (eds.), Teaching in Nursing: A Guide for Faculty (2nd ed., pp. 187-212). Elsevier, MO; 2005. 4. Lasater K. Clinical judgment development: Using simulation to create an assessment rubric. Journal of Nursing Education 2007; 46: 496-503. 5. Lee WS. Cho KC, Yang SH, Roh YS, Lee GY. Effects of problem-based learning combined with simulation on the basic nursing competency of nursing students. Journal of Korean Academy Fundamental Nursing 2009; 16(1): 64-72. 6. Levett-Jones T, McCoy M, Lapkin S, Noble D, Hoffman K, Dempsey J, eds. The development and psychometric testing of the satisfaction with simulation experience scale. Nurse Education Today 2011; 31: 705-710. Disclosures None

Board 182 - Program Innovations Abstract Development And Evaluation Of Simulation-Based Fever Management Module For Children With Febrile Convulsion (Submission #479)

Introduction/Background Simulation-based education gives students an opportunity to lessen the gap between academic and clinical settings, learn core nursing skills and enhance self-confidence through learning. Student performance evaluation is a very important step during simulation-based practice.23 Although a module may be well developed, a standardized evaluation checklist is essential for confirming the effectiveness of simulation-based practice. To enhance the effectiveness of simulations in nursing education, a reliable and valid evaluation instrument is needed to measure student performance. Furthermore, a valid instrument is required for the simulation to be considered a formalized implementation and evaluation tool. Fever is a common symptom found in children with disease in pediatric care units. Fever in children has been acknowledged as a common occurrence in pediatric nursing. Students may frequently encounter children with febrile convulsions in a clinical setting. Simulation modules may provide a comprehensive understanding of fever and fever management. However, there is no evaluation checklist to measure systematically simulation-based performance of students dealing with febrile convulsions. Furthermore, students satisfaction with the simulation is important for meaningful learning and facilitating active participation.22 Therefore, a simulation-based fever management module for children with febrile convulsions is needed, since this is one of the most frequent problems experienced by a student in a clinical nursing setting. This study focuses on pediatric nursing education and nursing practice. The following research issues were addressed: a) to develop a simulation-based fever management module for pediatric febrile convulsions and b) to evaluate students performances and satisfaction. Methods The development of the simulation-based fever management module and evaluation checklist for treating children with febrile convulsions was a three-stage process. Stage I: developing the simulation-based module; Stage II: developing programs for nursing students; and Stage III: evaluating the simulation-based module and validating the dimensions.The module included an algorithm with the scenario, evaluation checklist and debriefing plan. For scenario development, we collected information on nursing care from child health nursing textbooks and nursing journals. This scenario was based on a real febrile convulsion case that had occurred in a general hospital. The evaluation checklist focused on the attainment of nursing goals based on nursing processes rather than outcomes. The categories were divided into assessment, problem identification, intervention and evaluation. The evaluation checklist score was based on a 4-point Likert scale. The higher the evaluation checklist score, the higher the performance rating. The researchers developed the following debriefing questions: a) What did you learn?; b) How did you feel?; c) What did you do?; d) What were your strong and weak points? Debriefing was conducted at the end of the study and took about 20-30 minutes per group of 3-4 students. Students’ satisfaction with the clinical simulation was measured using the Satisfaction of Simulations Experience [SSE] scale developed by Levett-Jones and colleagues (2011). This scale consists of 18 items: debrief and reflection (9 items), clinical reasoning (5 items), and clinical learning (4 items). Each item was scored on a 5-point Likert scale. Higher scores indicated higher satisfaction. The target population for this study included undergraduate students. One hundred forty-seven nursing students were selected from two universities located in Seoul, South Korea. Data were collected from April 29, 2013 to June 14, 2013. Each simulation lasted 20-30 minutes, with both the simulation and simulation class taking about two hours per group. In addition, an SSE was used to measure student satisfaction with the simulation. Collected data were analyzed using SPSS 18.0 for Windows to calculate descriptive statistics for the evaluation checklist and the SSE. Debriefing data were analyzed using the Matrix Method. A scenario script was formulated to treat the patient’s health issues. The algorithm proceeded as follows: identification of patients’ condition (Step I), nursing intervention (Step II), and outcome evaluation and feedback (Step III). To test the internal consistency and reliability of the evaluation checklist and each subscale, Cronbach’s alpha coefficient was measured. Cronbach’s alpha for the evaluation checklist was .865; each subcategory ranged from .706 to .808. The evaluation checklist consisted of four categories based on nursing processes: assessment, problem identification, intervention and evaluations. The total mean score of the evaluation checklist was 2.67 (± .32). The mean score of each category was as follows: assessment, 2.35 (± .37); problem identification, 2.94 (± .46); intervention, 2.89 (± .40); and evaluation, 2.82 (± .56). The categories were as follows: non-technical skill (30.7%), self-efficacy (29.8%), critical thinking (21.8%), and technical skill (17.8%). The most frequent categories, in order, were teamwork and collaboration (n = 27), reflection (n = 26), situation recognition (n = 21), core nursing skills (n = 21), emotional support (n = 21), and therapeutic communication (n = 21). The total mean score of SSE was 4.48 (± .42). The mean score for debrief and reflection was 4.55 (± .43), clinical reasoning was 4.39 (± .50), and clinical learning was 4.43 (±.48). Results: Conclusion This study was able to develop more reliable algorithms and evaluation tools for fever management in nursing care. This study identified a nursing care module for children with febrile convulsions. The implications for nursing education include determining how nursing students care for patients using critical thinking and nursing skills. This study also provides a blueprint for simulation-based practice for both nursing educators and nursing students. Furthermore, this study recommends developing an evaluation checklist for other nursing education programs. A large sample size in more than one geographic location will provide valid and reliable data for this module and the evaluation checklist. In addition, this study highlights the need for the full integration of simulations into nursing curricula. References 1. Abdo, A., Ravert, P. 2006. Student satisfaction with simulation experiences. Clinical Simulation in Nursing Education, 2, e13-e16. 2. Berragan, L. 2011. 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C., Parmenter, G., Riet, P. J., Jeong, S. 2012. The experience of end of life care simulation at rural Australian university. Nurse Education Today, 32, 319-329. 10. Hockenberry, M. J. 2005. Wong’s Essentials of Pediatric Nursing. 7th ed. Elsevier Mosby, St. Louis, MO. 11. Jeffries, P. R. 2007. Simulation in Nursing Education: From Conceptualization to Evaluation. National League of Nursing, NY. 12. Jeffries, P. R., Norton, B. 2005. Selecting Learning Experiences to Achieve Curriculum Outcomes. In D. M. Billings & J. A. Halstead (eds.), Teaching in Nursing: A Guide for Faculty (2nd ed., pp. 187-212). Elsevier, MO. 13. Potts, N. L., Mandleco, B. L. 2011. Pediatric Nursing: Caring for Children and Their Families. 3rd ed. Delma Cengage Learning; NY. 14. Levett-Jones, T., McCoy, M., Lapkin, S., Noble, D., Hoffman, K., Dempsey, J., Arthur, C., Roche, J. 2011. The development and psychometric testing of the satisfaction with simulation experience scale. 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A practical framework for evaluating the impact of clinical simulation experience in prelicensure nursing education. Clinical Simulation in Nursing, 4, e69-e78. 23. Reed, S. J. 2010. Designing a simulation for student evaluation using Scriven’s key evaluation checklist. Clinical Simulation in Nursing, 6 (2), e41-e44. 24. Roh, Y. S., Lee, W. S., Chung, H. S., Park, Y. M. 2013. The effects of simulation-based resuscitation training on nurses’ self-efficacy and satisfaction. Nurse Education