Clinical simulation scenarios: An educational intervention that improves nursing students' critical thinking and decision making

2.50
Hdl Handle:
http://hdl.handle.net/10755/163652
Category:
Abstract
Type:
Presentation
Title:
Clinical simulation scenarios: An educational intervention that improves nursing students' critical thinking and decision making
Author(s):
Kreamer, Carolyn; Solomon, Martha O.; Gardner, Eileen
Author Details:
Carolyn Kreamer, Associate Professor, Messiah College, Department of Nursing, Lewisberry, Pennsylvania, USA, email: kreamer@messiah.edu; Martha O. Solomon; Eileen Gardner
Abstract:
The purpose of this educational research was to test the effectiveness of clinical simulation scenarios that engaged junior and senior baccalaureate nursing students in active clinical decision making in an on-campus clinical skills laboratory. The specific aim of this study was to determine if a clinical simulation scenario utilized in a skills laboratory would improve students' abilities to think critically, make clinical decisions and increase their self-confidence in selected clinical evaluation criteria. Four of the eight components of Paul and Elder's Elements of Thought model are incorporated in the clinical simulation scenarios: 1) Question at Issue, 2) Information, 3) Interpretation and Inference, and 4) Implications and Consequences. Faculty assisted students in developing critical thinking by encouraging them to be inquisitive and active learners, providing opportunities for them to frame problems and design creative solutions, helping them reflect on their thinking process, and using complex case studies. In this one-group pretest-posttest designed study, 25 senior and 50 junior baccalaureate nursing students participated in clinical simulation scenarios consisting of two distinct learning experiences designed for their respective educational levels. The scenarios consisted of case studies with a series of interactive learning strategies that required the students to engage in both cognitive processes and psychomotor activities on a clinical simulator model attached to technical equipment such as a cardiac monitor, mechanical ventilator, or intravenous infuser. The scenarios included pertinent patient information, diagnostic study results, and descriptive clinical vignettes. A series of questions following the vignettes required students to think critically and to manipulate or apply technology on the clinical simulator or technical equipment to solve nursing care problems as the patients' conditions worsened. Students were required to make nursing care decisions based upon the patients' clinical status prior to and during their admissions to hospital units. To assess students' perceptions of their improvement in critical thinking and decision making, pretests and posttests were administered on 13 clinical evaluation criteria. Analyses of pretest and posttest scores using paired t-tests for each individual group indicated statistically significant improvement in senior students' scores in ten of the clinical evaluation criteria, and in seven of the clinical evaluation criteria in the junior students' scores. Criteria common to both groups that showed improvement with this educational intervention were grasping pathophysiologic concepts, assessing abnormal findings, assessing patient priorities, identifying patient problems, adapting and responding to clinical changes, and managing patient care. Although implications from this study for nursing education are limited due to its small sample size and threats to internal validity due to its design, results support the potential utility of clinical simulation scenarios to improve students' critical thinking and clinical decision making. Since the improvement in clinical evaluation criteria demonstrated congruency with the concepts of the Elements of Thought model, this model could prove useful to educators who are designing instructional strategies to enhance students' critical thinking.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2002
Conference Name:
14th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
University Park, Pennsylvania, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleClinical simulation scenarios: An educational intervention that improves nursing students' critical thinking and decision makingen_GB
dc.contributor.authorKreamer, Carolynen_US
dc.contributor.authorSolomon, Martha O.en_US
dc.contributor.authorGardner, Eileenen_US
dc.author.detailsCarolyn Kreamer, Associate Professor, Messiah College, Department of Nursing, Lewisberry, Pennsylvania, USA, email: kreamer@messiah.edu; Martha O. Solomon; Eileen Gardneren_US
dc.identifier.urihttp://hdl.handle.net/10755/163652-
dc.description.abstractThe purpose of this educational research was to test the effectiveness of clinical simulation scenarios that engaged junior and senior baccalaureate nursing students in active clinical decision making in an on-campus clinical skills laboratory. The specific aim of this study was to determine if a clinical simulation scenario utilized in a skills laboratory would improve students' abilities to think critically, make clinical decisions and increase their self-confidence in selected clinical evaluation criteria. Four of the eight components of Paul and Elder's Elements of Thought model are incorporated in the clinical simulation scenarios: 1) Question at Issue, 2) Information, 3) Interpretation and Inference, and 4) Implications and Consequences. Faculty assisted students in developing critical thinking by encouraging them to be inquisitive and active learners, providing opportunities for them to frame problems and design creative solutions, helping them reflect on their thinking process, and using complex case studies. In this one-group pretest-posttest designed study, 25 senior and 50 junior baccalaureate nursing students participated in clinical simulation scenarios consisting of two distinct learning experiences designed for their respective educational levels. The scenarios consisted of case studies with a series of interactive learning strategies that required the students to engage in both cognitive processes and psychomotor activities on a clinical simulator model attached to technical equipment such as a cardiac monitor, mechanical ventilator, or intravenous infuser. The scenarios included pertinent patient information, diagnostic study results, and descriptive clinical vignettes. A series of questions following the vignettes required students to think critically and to manipulate or apply technology on the clinical simulator or technical equipment to solve nursing care problems as the patients' conditions worsened. Students were required to make nursing care decisions based upon the patients' clinical status prior to and during their admissions to hospital units. To assess students' perceptions of their improvement in critical thinking and decision making, pretests and posttests were administered on 13 clinical evaluation criteria. Analyses of pretest and posttest scores using paired t-tests for each individual group indicated statistically significant improvement in senior students' scores in ten of the clinical evaluation criteria, and in seven of the clinical evaluation criteria in the junior students' scores. Criteria common to both groups that showed improvement with this educational intervention were grasping pathophysiologic concepts, assessing abnormal findings, assessing patient priorities, identifying patient problems, adapting and responding to clinical changes, and managing patient care. Although implications from this study for nursing education are limited due to its small sample size and threats to internal validity due to its design, results support the potential utility of clinical simulation scenarios to improve students' critical thinking and clinical decision making. Since the improvement in clinical evaluation criteria demonstrated congruency with the concepts of the Elements of Thought model, this model could prove useful to educators who are designing instructional strategies to enhance students' critical thinking.en_GB
dc.date.available2011-10-27T11:11:23Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:11:23Z-
dc.conference.date2002en_US
dc.conference.name14th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationUniversity Park, Pennsylvania, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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