ABSTRACT A simulation clinical learning experience was initiated by a diploma school of nursing at a multidisciplinary training and research facility for simulation-based education. The simulation focused on pediatric and obstetrical scenarios. The purpose of this study was to investigate the impact simulation laboratory experiences have on critical thinking, student satisfaction, self-confidence, and cognitive learning. With 63 students participating over four semesters, a positive response was found for satisfaction and self-confidence in learning; there was also a significant increase in cognitive knowledge. No definitive conclusion regarding critical thinking was established, but a discovery was made regarding the importance of process during the simulation.
Key Words Diploma Nursing Education--Critical Thinking-Student Satisfaction--Self-Confidence--Cognitive Learning
OUR DIPLOMA SCHOOL OF NURSING, PART OF AN ADVANCED TEACHING COMMUNITY HOSPITAL AND MAJOR REGIONAL HEALTH SYSTEM, INITIATED A SIMULATION CLINICAL LEARNING EXPERIENCE AT A MULTIDISCIPLINARY TRAINING AND RESEARCH FACILITY FOR SIMULATION-BASED EDUCATION.
The convenience sample consisted of prelicensure students in the Growing Family Nursing course during a period of four semesters. A comparable group of students, who took the course during a summer semester and did not have the simulation experience, served as a control group for standardized testing. A small number of students in this nursing program are practical vocational nurses working toward the requirements to become registered nurses. The student population consists primarily of Caucasian women with an average age of 28. Most clinical experiences in this senior-level nursing course take place in specialty tertiary care hospitals and in the community.
The simulation, which focused on pediatric and obstetrical scenarios, was titled "Problem Based Pediatric and Obstetric Simulation for Nurses and Nursing Students" (Peter M.Winter Institute for Simulation Education and Research [WISER], www.wiser.pitt.edu/apps/courses/ coursebytype.asp). Eight scenarios for high-fidelity simulators were selected for students to experience during the simulation day.They represent some of the more common or high-risk complications students are likely to encounter: pediatric (bleeding tonsil, asthma exacerbation, airway distress-croup, and pyloric stenosis) and obstetric (postepidural maternal hypotension, preeclampsia, depressed neonate, and postpartum hemorrhage). For each scenario, the students were to use the nursing process to make an assessment and provide interventions. They were expected to apply principles of growth and development to meet the unique needs of the population.
A tool developed by the National League for Nursing (NLN) to measure satisfaction and self-confidence was used to assess the students after they completed the daylong simulation experience. The purpose of the study was to investigate the impact simulation lab experiences have on student satisfaction, self-confidence, cognitive learning, and critical thinking.
Literature Review As educators increase the use of technology in nursing education while emphasizing the acquisition of critical thinking skills, research is needed needs to investigate outcomes based upon the Laerdal study as reported by Jeffries and Rizzolo (2004). The need to examine the relationship between curriculum methods and critical thinking was emphasized by del Bueno (2005) and supported by McCartney (2005) and Tanner (2006).
Simulation is a useful means of teaching psychomotor skills in a controlled laboratory environment prior to patient contact (McCartney, 2005). It provides a method of role-playing that allows students to reinforce material learned in the classroom (Comer, 2005). It is particularly useful for specialty courses, including obstetrics (Robertson, 2006) and pediatrics, because the competition for clinical sites in these areas challenges educators to provide nursing students with a broad range of experiences. …