Sherrill Jeanne Smith

HIGH-FIDELITY SIMULATION: Factors Correlated with Nursing Student Satisfaction and SELF-CONFIDENCE

&NA; While available research suggests positive outcomes when using high‐fidelity simulation in nursing education, little is known about factors associated with these outcomes. This descriptive, correlational study examined the effects of a simulation experience on two outcomes (student satisfaction and self‐confidence) as well as factors correlating with these outcomes. This was accomplished by both descriptive statistical analysis (mean and standard deviation) in addition to correlational statistical analysis using bivariate statistics (Spearmans rho) and multiple linear regression. Results indicate that design characteristics, especially clear objectives and an appropriately challenging problem to solve, were significantly correlated with student satisfaction and self‐confidence.

The Use of High-Fidelity Simulation to Teach Home Care Nursing

The use of high-fidelity human patient simulation (HPS) is increasing in nursing education, yet little is known about its use in community health. This study examined an HPS home care experience to determine effects on three outcomes (student satisfaction, self-confidence, and learning). In addition, design characteristics of the simulation and demographic characteristics of students were examined for correlation with these outcomes. Senior baccalaureate students took part in the experience. Results indicated that students were very satisfied with the experience and felt it increased their confidence in providing care in the home, although learning outcomes were not high. Although no demographic characteristics were found to be correlated with outcomes, five design characteristics of a simulation were moderately correlated with the outcomes of satisfaction and self-confidence, especially support. It is recommended that nurse educators design HPS home care simulation experiences that provide student support prior to their first home care visit.

Preparing Nursing Students for Leadership Using a Disaster-Related Simulation.

Increasing numbers and severity of disasters across the globe require nurses to be prepared to provide leadership in disaster situations. To address this need, a combination of didactic and simulation exercises was used to provide a daylong experience emphasizing application of nursing leadership skills in disasters to senior baccalaureate students. Evaluation of learning outcomes demonstrated significant improvement in student self-efficacy related to leadership in disasters.

Decontamination training: with and without virtual reality simulation.

Nurses must be prepared to care for patients following a disaster, including patients exposed to hazardous contaminants. The purpose of this study was to examine the use of virtual reality simulation (VRS) to teach the disaster-specific skill of decontamination. A quasi-experimental design was used to assign nursing students from 2 baccalaureate nursing programs to 1 of 2 groups to learn the disaster skill of decontamination—printed written directions or VRS. Performance, knowledge, and self-efficacy were outcome measures. Although students in the treatment group had significantly lower performance scores than the control group (p = 0.004), students taking part in VRS completed the skill in a significantly shorter amount of time (p = 0.008). No significant group differences were found for self-efficacy (p = 0.172) or knowledge (p = 0.631). However, students in the VRS treatment group reported high levels of satisfaction with VRS as a training method. The disaster-specific skill of decontamination is a low-volume, high-risk skill that must be performed with accuracy to protect both exposed patients and providers performing decontamination. As frontline providers for casualties following a disaster event, emergency nurses must be prepared to perform this skill when needed. Preparation requires cost-effective, timely, and evidence-based educational opportunities that promote positive outcomes. Further investigation is needed to determine the benefits and long-term effects of VRS for disaster education.

Assessing Performance Outcomes of New Graduates Utilizing Simulation in a Military Transition Program

This multi-site, quasi-experimental study examined the performance outcomes of nurses (n = 152) in a military nurse transition program. A modified-performance instrument was used to assess participants in two high-fidelity simulation scenarios. Although results indicated a significant increase in scores posttraining, only moderate interrater reliability results were found for the new instrument. These findings have implications for nurse educators assessing performance-based outcomes of new nurses completing transition programs.

Learning and Retention Using Virtual Reality in a Decontamination Simulation.

AIMThe purpose of this study was to examine the longitudinal effects of virtual reality simulation (VRS) on learning outcomes and retention. BACKGROUNDDisaster preparation for health care professionals is seriously inadequate. VRS offers an opportunity to practice within a realistic and safe environment, but little is known about learning and retention using this pedagogy. METHODA quasiexperimental design was used to examine the use of VRS with baccalaureate nursing students in two different nursing programs in terms of the skill of decontamination. RESULTSResults indicate that VRS is at least as good as traditional methods and is superior in some cases for retention of knowledge and performance of skills. CONCLUSIONVRS may provide a valuable option for promoting skill development and retention. More research is needed to determine how to prepare nurses for skills that may not be required until months or even years after initial introduction.

National Disaster Health Consortium: Competency-Based Training and a Report on the American Nurses Credentialing Center Disaster Certification Development

As the largest profession of health care providers, nurses are an integral component of disaster response. Having clearly delineated competencies and developing training to acquire those competencies are needed to ensure nurses are ready when disasters occur. This article provides a review of nursing and interprofessional disaster competencies and development of a new interprofessional disaster certification. An overview of a standardized disaster training program, the National Disaster Health Consortium, is provided as an exemplar of a competency-based interprofessional disaster education program.

Impact of a TeamSTEPPS Essentials Presentation and an Interprofessional High-Fidelity Simulation on Nursing Students Attitudes towards Medical Team Operations

Introduction/Background Most medical care is delivered by teams but the majority of healthcare education is conducted in settings where students are segregated by discipline. Many medical errors are attributed to system failures which represent a breakdown in medical team function. The Agency for Healthcare Research and Quality (AHRQ) has promoted the TeamSTEPPS® program as a framework for educating healthcare personnel on the important aspects of medical team operations.1–3 We assessed differences in nursing students self-identified use of/intention to use TeamSTEPPS® medical teamwork skills at two points; before and after an interactive didactic presentation and after a series of three interprofessional high-fidelity simulations focusing on medical teamwork operations. Our research hypotheses included: 1) Nursing students will acknowledge a baseline low-to-moderate historical level of medical team skill utilization; 2) The TeamSTEPPS® Essentials presentation will produce a small but significant increase in nursing students intention to utilize medical team operation skills; 3) Nursing students will have a significant increase in their intention to utilize medical team operation skills following a series of three interprofessional high-fidelity simulation experiences and will identify factors which promote or inhibit effective interprofessional teamwork in the simulation experience and in their clinical sites. Methods A repeated measures design was used to assess past actions and future intentions regarding medical operation teamwork skills. Two cohorts of senior nursing students participating in a final capstone course (total n=177) were asked to anonymously complete the three researcher developed surveys based on the TeamSTEPPS® program. All surveys used the same eight five-point Likert-scale questions. The final survey included two additional Likert-scale questions and two open ended questions to assess student’s perception of potential opportunities to improve support of teamwork during the simulation activity and at their clinical sites. Each cohort completed the first survey via an audience response system prior to a one hour interactive TeamSTEPPS® Essentials session conducted by the PI. The students completed the second survey by audience response system immediately after completion of the TeamSTEPPS® session. Students were then scheduled in groups of 12 students to complete an interprofessional high-fidelity simulation session over the next eight weeks. All students completed a hands-on experience in subgroups of four in one emergency department (ED) scenario with an ED resident as the team leader (n=21 ED residents total) and observed two additional ED scenarios during a four hour simulation session. The debriefing following each scenario focused on teamwork skills, as well as task related skills. Participants completed the third and final survey immediately after the final debriefing. Differences between first and second surveys were compared using the t-test for paired responses from the same subject. Survey three Results were compared to Survey two using the t-test for responses from samples with equal variance. The study was approved by the affiliating university Institutional Review Board. Results With the exception of one question in the first cohort, both cohorts demonstrated a significant increase in Likert-scores from pre-presentation to post-presentation (p<0.05). There were no significant differences in scores from post-presentation to post-simulation in either cohort (p>0.05). Students in both cohorts perceived the simulation lab to be a significantly better environment for medical team operations than their clinical sites (p⩽0.01). Open-ended questions indicated students appreciated the opportunity to experience a safe environment for teamwork operations and practice TeamSTEPPS® tools with an actual medical provider. Conclusion A brief interactive TeamSTEPPS® presentation significantly enhanced student intentions to improve medical team behaviors. We could not demonstrate further enhancements following simulations. This may be due to the high post-presentation scores (>4.8 on a 5-point scale) or potentially because simulation is better suited to practicing teamwork skills than improving the intention to change. References 1. Agency for Healthcare Research and Quality (AHRQ). TeamSTEPPS® website. http://teamstepps.ahrq.gov/. Accessed June 28, 2013. 2. Bridges DR, et. al. Interprofessional collaboration: three best practice Models of interprofessional education. 2011 Medical Education Online 2011, 16: 6035 - DOI: 10.3402/meo.v16i0.6035. 3. Stewart M, Kennedy N. Undergraduate interprofession al education using high-fidelity paediatric simulation. 2010. THE CLINICAL TEACHER 2010; 7: 90–96 Disclosures None.