Longitudinal evaluation of an unresponsive patient educational module for undergraduate nursing students using high-fidelity patient simulation

2.50
Hdl Handle:
http://hdl.handle.net/10755/306277
Category:
Abstract
Type:
Research Study
Level of Evidence:
Quasi-Experimental Study, Other
Research Approach:
Quantitative Research
Title:
Longitudinal evaluation of an unresponsive patient educational module for undergraduate nursing students using high-fidelity patient simulation
Author(s):
Luctkar-Flude, Marian
Lead Author STTI Affiliation:
Tau Gamma
Author Details:
Marian Luctkar-Flude, RN, MScN, PhD(c), email: mfl1@queensu.ca, faculty page [Please cut and paste the following link into a browser]: http://nursing.queensu.ca/fac_index.php?fld_UserID=43, Tau Gamma Chapter
Abstract:

Background: Even upon graduation, undergraduate nursing students may not be confident or proficient in performing critical assessments and interventions for an unresponsive patient. This is concerning as a nursing student or new graduate may be the first to find an unresponsive patient in a clinical setting. However, this knowledge and skills were not introduced until 3rd year of a 4th year BNSc program. Performance by 4th year students was noted to be inadequate. As a result, a high-fidelity simulation educational module for 2nd year undergraduate nursing students on critical assessments and interventions for the unresponsive patient was introduced into a health assessment course in the fall term 2010. A longitudinal study was designed to evaluate learning outcomes as students progressed through the nursing program.

Purpose: The purpose of the current study is to compare outcomes between 2 cohorts of nursing students through the curriculum. Cohort 1 received standard education in years 3 and 4 of the program which included four unresponsive patient scenarios. In addition, cohort 2 received an experimental simulation session on critical assessments and interventions for the unresponsive patient in year 2.  It was hypothesized that the new module would improve knowledge, skill and confidence in 3rd and 4th year repetitions of the unresponsive patient scenarios, as this cohort of students progresses through the nursing program.

Methods: Learner self-confidence with critical assessment and interventions for the unresponsive patient was measured each year with a researcher-developed Likert-scale (Cronbach’s alpha=.87). Learner knowledge was assessed by a written test. A performance checklist was used to assess whether critical behaviours were performed and the time to performance (inter-rater reliability=93%) for 4 scenarios: hypoglycemia, narcotic overdose, unwitnessed ventricular fibrillation and witnessed ventricular fibrillation. Standard univariate measures such as means, standard deviations, ranges and medians were calculated to describe outcomes. Comparisons of groups were conducted using the Mann-Whitney U test for ordinal data, and analysis of variance (ANOVA) and appropriate post-hoc analysis for interval data.

Results: There were no significant differences between the cohorts in terms of the knowledge pre-test scores or satisfaction with the scenarios. However, Learners in cohort 2 who participated in the unresponsive patient simulation scenarios in year 2 of the program demonstrated significantly higher knowledge on the post-test in year 3 (p=.035), and significantly greater self-confidence in year 4 (p=.05). Performance checklist scores were significantly higher for the cohort 2 learners for all 4 unresponsive patient scenarios (p=.001). Critical performance times were improved in the cohort 2 learners in both year 3 and year 4 and reached statistical significance in 12 of the 20 most critical skills that were timed (p=.001 to p=.031) including asking for a glucometer reading, asking for Narcan and initiating chest compressions as required.

Conclusions: The addition of a simulation educational module in year 2 of a 4-year BNSc program resulted in improved knowledge, skill performance and self-confidence by nursing students in years 3 and 4. These results suggest that these students will be better prepared to respond appropriately to unresponsive patient situations encountered during their clinical rotations and upon graduation.

Keywords:
patient simulation; nursing education; emergency nursing education; patient assessment; basic life support
MeSH:
Education, Nursing--methods; Nursing Education Research--methods
CINAHL Headings:
Simulations
Repository Posting Date:
4-Dec-2013
Date of Publication:
4-Dec-2013
Conference Date:
2013
Conference Name:
40th Annual PNEG Conference on Professional Nursing Education and Development (PNEG2013)
Conference Host:
Professional Nurse Educators Group (PNEG)
Conference Location:
Kansas City, Missouri, U.S.A.
Sponsors:
Sigma Theta Tau International
Description:
Recipient of Joan K. Stout, RN, Research Grant, 2012-2013.
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.; The Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the STTI grant. No further peer-review has taken place upon the completion of the STTI grant final report and its appearance in this repository.

Full metadata record

DC FieldValue Language
dc.language.isoenen
dc.type.categoryAbstracten
dc.typeResearch Studyen
dc.evidence.levelQuasi-Experimental Study, Otheren
dc.research.approachQuantitative Researchen
dc.titleLongitudinal evaluation of an unresponsive patient educational module for undergraduate nursing students using high-fidelity patient simulationen
dc.contributor.authorLuctkar-Flude, Marianen
dc.contributor.departmentTau Gammaen
dc.author.detailsMarian Luctkar-Flude, RN, MScN, PhD(c), email: mfl1@queensu.ca, faculty page [Please cut and paste the following link into a browser]: http://nursing.queensu.ca/fac_index.php?fld_UserID=43, Tau Gamma Chapteren
dc.identifier.urihttp://hdl.handle.net/10755/306277en
dc.description.abstract<p><strong><span style="text-decoration: underline;">Background:</span></strong><strong> </strong>Even upon graduation, undergraduate nursing students may not be confident or proficient in performing critical assessments and interventions for an unresponsive patient. This is concerning as a nursing student or new graduate may be the first to find an unresponsive patient in a clinical setting.<strong> </strong>However, this knowledge and skills were not introduced until 3<sup>rd</sup> year of a 4<sup>th</sup> year BNSc program. Performance by 4<sup>th</sup> year students was noted to be inadequate.<strong> </strong>As a result, a high-fidelity simulation educational module for 2nd year undergraduate nursing students on critical assessments and interventions for the unresponsive patient was introduced into a health assessment course in the fall term 2010. A longitudinal study was designed to evaluate learning outcomes as students progressed through the nursing program.</p> <p><strong><span style="text-decoration: underline;">Purpose:</span></strong> The purpose of the current study is to compare outcomes between 2 cohorts of nursing students through the curriculum. Cohort 1 received standard education in years 3 and 4 of the program which included four unresponsive patient scenarios. In addition, cohort 2 received an experimental simulation session on critical assessments and interventions for the unresponsive patient in year 2.  It was hypothesized that the new module would improve knowledge, skill and confidence in 3rd and 4th year repetitions of the unresponsive patient scenarios, as this cohort of students progresses through the nursing program.</p> <p><strong><span style="text-decoration: underline;">Methods:</span></strong> Learner self-confidence with critical assessment and interventions for the unresponsive patient was measured each year with a researcher-developed Likert-scale (Cronbach’s alpha=.87). Learner knowledge was assessed by a written test. A performance checklist was used to assess whether critical behaviours were performed and the time to performance (inter-rater reliability=93%) for 4 scenarios: hypoglycemia, narcotic overdose, unwitnessed ventricular fibrillation and witnessed ventricular fibrillation. Standard univariate measures such as means, standard deviations, ranges and medians were calculated to describe outcomes. Comparisons of groups were conducted using the Mann-Whitney U test for ordinal data, and analysis of variance (ANOVA) and appropriate post-hoc analysis for interval data.</p> <p><strong><span style="text-decoration: underline;">Results:</span></strong><strong> </strong>There were no significant differences between the cohorts in terms of the knowledge pre-test scores or satisfaction with the scenarios. However, Learners in cohort 2 who participated in the unresponsive patient simulation scenarios in year 2 of the program demonstrated significantly higher knowledge on the post-test in year 3 (p=.035), and significantly greater self-confidence in year 4 (p=.05). Performance checklist scores were significantly higher for the cohort 2 learners for all 4 unresponsive patient scenarios (p=.001). Critical performance times were improved in the cohort 2 learners in both year 3 and year 4 and reached statistical significance in 12 of the 20 most critical skills that were timed (p=.001 to p=.031) including asking for a glucometer reading, asking for Narcan and initiating chest compressions as required.</p> <p><strong><span style="text-decoration: underline;">Conclusions:</span></strong> The addition of a simulation educational module in year 2 of a 4-year BNSc program resulted in improved knowledge, skill performance and self-confidence by nursing students in years 3 and 4. These results suggest that these students will be better prepared to respond appropriately to unresponsive patient situations encountered during their clinical rotations and upon graduation.</p>en_GB
dc.subjectpatient simulationen_GB
dc.subjectnursing educationen_GB
dc.subjectemergency nursing educationen_GB
dc.subjectpatient assessmenten_GB
dc.subjectbasic life supporten_GB
dc.subject.meshEducation, Nursing--methodsen
dc.subject.meshNursing Education Research--methodsen
dc.subject.cinahlSimulationsen
dc.date.available2013-12-04T19:49:26Zen
dc.date.issued2013-12-04en
dc.date.accessioned2013-12-04T19:49:26Zen
dc.conference.date2013en
dc.conference.name40th Annual PNEG Conference on Professional Nursing Education and Development (PNEG2013)en_GB
dc.conference.hostProfessional Nurse Educators Group (PNEG)en_GB
dc.conference.locationKansas City, Missouri, U.S.A.en_GB
dc.description.sponsorshipSigma Theta Tau Internationalen
dc.descriptionRecipient of Joan K. Stout, RN, Research Grant, 2012-2013.en_GB
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.en
dc.description.noteThe Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the STTI grant. No further peer-review has taken place upon the completion of the STTI grant final report and its appearance in this repository.en
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