Academic journal article Nursing Education Perspectives

TEACHING NURSING PSYCHOMOTOR SKILLS in a Fundamentals Laboratory: A Literature Review

Academic journal article Nursing Education Perspectives

TEACHING NURSING PSYCHOMOTOR SKILLS in a Fundamentals Laboratory: A Literature Review

Article excerpt

RESEARCH

ABSTRACT

Aim. The aim of this article is to determine the most effective methods of teaching psychomotor skills.

Background. Research has pointed to a gap between nursing practice and nursing education. Due to a number of conditions, nursing students are learning basic skills in laboratories, rather than clinical settings.

Method. A literature review was conducted to evaluate studies published since 1995 that compared alternative and traditional methods of teaching skills to novice nursing students.

Results. Of the 13 studies found, most assessed computer-related methods. A few examined alternatives, such as the use of standardized patients, high-fidelity manikins, and a mental-imaging technique.

Conclusion. Based on this limited evidence, it appears that teaching methods providing access to online interactive materials were significantly more effective than others. Three studies found that a combination of traditional lecture and demonstration methods plus computer use was more effective than either method alone.

Key Words Psychomotor Skills - Fundamentals - Learning - Nursing Education - Teaching

THE TRADITIONAL NURSING FUNDAMENTALS COURSE INTRODUCES BASIC PSYCHOMOTOR SKILLS FOR PATIENT CARE. Boxer and Kluge (2000) identified those skills beginning registered nurses (RNs) perform most often: universal precautions for infection control, vital sign assessment, intravenous therapy management, medication administration, and patient hygiene. Patient care and safety can be compromised when such basic skills are deficient (Bloomfield, Roberts, & While, 2010). Patients have reported that the proficiency and efficiency with which the practitioner performs skills can produce or reduce patient anxiety (Bjørk, 1995).

Reimbursement structures are shifting to "pay-for-performance" systems, which depend on nurses to ensure that hospitals meet certain measures for quality, efficiency, and patient satisfaction (Lutz & Root, 2007). Bjørk (1995) found in a literature review that over a 40- year period, patients had the stable perception that good nursing care involves the practical, technical, or manual aspects of physical care.

Yet Benner, Sutphen, Leonard, and Day (2009) reported that there is a significant gap between nursing practice and nursing education. Internationally, students and educators have expressed concerns about this gap and the inadequate skills of new graduates (Bloomfield et al., 2010; Borneuf & Haigh, 2010; Heslop, McIntyre, & Ives, 2001; Lofmark, Smide, & Wikblad, 2006; Spitzer & Perrenoud, 2006). Gerrish (2000) reported that some new graduates had deficits in skills involving medication administration, giving injections, and managing intravenous fluids. There is also debate about the adequacy of the traditional teaching methods of lecture and demonstration used to teach clinical nursing skills (Bloomfield et al., 2010), methods that allow students to learn directly from subject experts (Bloomfield et al., 2010) but that may not meet the diverse needs of students (Jeffries, Rew, & Cramer, 2002).

The teaching of clinical skills has begun to shiftfrom clinical settings to skills laboratories. Benner et al. (2009) point out that hospitals care primarily for physiologically unstable patients, while the less acutely ill are cared for in the home and community. Also, the well-documented nursing shortage and the increasing need for care in our aging society are pressuring United States nursing programs to expand, at the same time that schools are struggling with a faculty shortage (Benner et al.). The use of skills laboratories for teaching basic nursing skills is increasing because of the demands of caring for increasingly acutely ill patients in hospitals, shorter hospital stays, staffshortages, an increased number of students, and an increased ratio of students to faculty, which limits teaching opportunities in many clinical areas (Bloomfield et al. …

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