Evaluation of Three-Dimensional Computerized Simulation: Innovative Pedagogy to Prepare Graduate Nursing Students for Clinical Practice

2.50
Hdl Handle:
http://hdl.handle.net/10755/621619
Category:
Full-text
Format:
Text-based Document
Type:
Presentation
Level of Evidence:
N/A
Research Approach:
N/A
Title:
Evaluation of Three-Dimensional Computerized Simulation: Innovative Pedagogy to Prepare Graduate Nursing Students for Clinical Practice
Other Titles:
Simulation and Transition to Practice
Author(s):
Jenson, Carole E.
Lead Author STTI Affiliation:
Kappa Mu
Author Details:
Carole E. Jenson, DNP, APRN, CNS, ACNS-BC, CME, CCRN-K, Professional Experience: 2009-Present: Associate Professor, Graduate Programs in Nursing, Winona State University-Rochester 2007-Present: Teach advanced health assessment to gradate nursing students. 2013-Present:Certified Medical Examiner 1994-2009, Nurse Manager, Mayo Clinic, Rochester, MN 1984-1994, Staff Nurse, Mayo Clinic, Rochester, MN 1980-1984, Staff Nurse, St. Luke's Hospital, Duluth, MN Numerous awards in critical care and neurologic nursing Numerous presentations Several publications Author Summary: Associate Professor at Winona State University in Graduate Programs in nursing. Teaches in the graduate and doctoral programs. Certified medical examiner and independent APRN at local clinic. Presented on nursing topics related to Motivational interviewing, computerized technology, critical care, and neurological disorders locally, regionally, nationally, and internationally.
Abstract:

Introduction: Preparing graduate nursing students to respond to the complexities of a rapidly changing health care environment is a major challenge for nurse educators and nurse mentors. Clinical skill and patient assessment determine trajectory of patient’s health care, directly impacting patient outcomes. Assessment skills, clinical reasoning and decision making, and the ability to work with others are imperative for competent clinical practice. Literature reveals that many graduate nursing students are entering into clinical areas unprepared in the areas of patient assessment, diagnostic reasoning, clinical decision making, and team participation (Grossman & Conelius, 2015). Traditionally, these skills were practiced with direct patient care during clinical or job experiences. Decreased availability of clinical sites coupled with fewer clinical mentors further encourages the need for innovative pedagogy. To provide high quality and safe patient care in a cost effective manner, graduate students need to be prepared with assessment skills and ability to work with diverse populations and situations before entering the healthcare environment. Studies report that computerized simulation is interactive, enjoyable, stimulating for the learner, and one pedagogy that needs to be explored. Additionally, literature supports the benefits of patient simulation to improve clinical performance, problem-solving skills, and self-confidence. Simulation also allows for the student to experience consequences of their actions and improve self-awareness (Nuraini, Afifah, Agustini, and Pujasari, 2015). Three-dimensional computerized simulation (TDCS) is an on-line interactive program that simulates real-life nursing experiences using virtual patients, also referred to as Avatars. This program is computer accessed allowing unlimited practice at any time in a risk-free environment without compromising patient care. TDCS program requires students to interact with on-line virtual patients through therapeutic conversation. The virtual patients are culturally diverse and of various ages requiring students to incorporate knowledge of cultural and age appropriate care. Purpose: The purpose of this mixed method prospective study was to evaluate the use of a computerized simulation program as one pedagogy to prepare graduate nursing students for clinical practice. Impact of this study will provide a body of evidence regarding active learning in nursing. Literature Review: CINAL and PubMed databases were searched using the key words nursing education, computerized technology, and interactive learning. The search resulted in 467 returns and was further narrowed by restricting to peer reviewed, published in the last four years, and written in English. Twenty eight articles meet the restricted search criteria. Following review of articles, 20 were selected from the 28 to inform this project. Literature varies widely in level of evidence, with few high quality or high level of evidence studies available. Waltz, Jenkins, and Han (2014) conducted a literature review on learning methods in health and nursing education and the impact of active learning methods. Twenty two studies were reviewed and only one provided a randomized control trial. The authors concluded that there is insufficient empirical evidence regarding active learning methods in nursing. Design: Subjects consisted of graduate nursing students taking Advanced Health Assessment class at a Midwestern University over three semesters in 2014-2016 and clinical mentors from Midwestern Healthcare Facilities. Seventy graduate nursing students voluntarily participated in evaluating the use of TDCS. Seven of the surveys were eliminated for not answering all questions or not completing either the before use survey or the after use survey. Sixty three (N=63) students completed surveys in entirety. Methods: Integrative review of the literature was conducted on the use of computerized simulation as a teaching strategy for graduate nursing students. Selection of TDCS program used for this evaluation followed extensive research of companies that offered computerized simulation for healthcare. Selection criteria included: designed for advanced practice, user friendly, cost effective, and ability to provide feedback to the user. The program selected met criteria and program design correlated with the universities nursing curriculum. Evaluation of the program consisted of a 10 question survey using a five-point Likert scale ranging from strongly disagree to strongly agree. On the first class day of the semester, before students were introduced to TDCS, students were provided the opportunity to complete the survey. At the end of the semester, after using TDCS for fourteen weeks, the same survey was administered. Formative evaluation was conducted with students and student’s clinical mentors each semester. TDCS was used adjacent with face-to-face class time; the class met for 5.5 hours weekly. Surveys were evaluated using Bowkers Test for Symmetry of Disagreement and formative information was categorized into themes. Ethics:Study was approved by the University’s Institutional Review Board. Conclusions: Integrative literature review supports the need for testing innovative pedagogy to prepare students for clinical practice. Studies have demonstrated that computerized simulation may be beneficial in student’s perceived self-efficacy in a variety of skills, knowledge of leadership styles, and assessment and management of patients. Using values from Bowkers Test for Symmetry of Disagreement, the findings from the surveys demonstrated that nine of the questions were statistically significant with values between p<.0001 and p<.0062 for the use of TDCS to prepare graduate nursing students for clinical practice. One question was not statistically significant (p<.2367). Results from statistical analysis of the surveys and themes generated from formative evaluations will be presented. Recommendations and implications for clinical practice will be discussed.

Keywords:
computerized technology; interactive learning; nursing education
Repository Posting Date:
30-Jun-2017
Date of Publication:
30-Jun-2017
Other Identifiers:
INRC17M01
Conference Date:
2017
Conference Name:
28th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International
Conference Location:
Dublin, Ireland
Description:
Event Theme: Influencing Global Health Through the Advancement of Nursing Scholarship

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePresentationen
dc.evidence.levelN/Aen
dc.research.approachN/Aen
dc.titleEvaluation of Three-Dimensional Computerized Simulation: Innovative Pedagogy to Prepare Graduate Nursing Students for Clinical Practiceen_US
dc.title.alternativeSimulation and Transition to Practiceen
dc.contributor.authorJenson, Carole E.en
dc.contributor.departmentKappa Muen
dc.author.detailsCarole E. Jenson, DNP, APRN, CNS, ACNS-BC, CME, CCRN-K, Professional Experience: 2009-Present: Associate Professor, Graduate Programs in Nursing, Winona State University-Rochester 2007-Present: Teach advanced health assessment to gradate nursing students. 2013-Present:Certified Medical Examiner 1994-2009, Nurse Manager, Mayo Clinic, Rochester, MN 1984-1994, Staff Nurse, Mayo Clinic, Rochester, MN 1980-1984, Staff Nurse, St. Luke's Hospital, Duluth, MN Numerous awards in critical care and neurologic nursing Numerous presentations Several publications Author Summary: Associate Professor at Winona State University in Graduate Programs in nursing. Teaches in the graduate and doctoral programs. Certified medical examiner and independent APRN at local clinic. Presented on nursing topics related to Motivational interviewing, computerized technology, critical care, and neurological disorders locally, regionally, nationally, and internationally.en
dc.identifier.urihttp://hdl.handle.net/10755/621619-
dc.description.abstract<p><strong>Introduction:</strong><span> Preparing graduate nursing students to respond to the complexities of a rapidly changing health care environment is a major challenge for nurse educators and nurse mentors. Clinical skill and patient assessment determine trajectory of patient’s health care, directly impacting patient outcomes. Assessment skills, clinical reasoning and decision making, and the ability to work with others are imperative for competent clinical practice. Literature reveals that many graduate nursing students are entering into clinical areas unprepared in the areas of patient assessment, diagnostic reasoning, clinical decision making, and team participation (Grossman & Conelius, 2015). Traditionally, these skills were practiced with direct patient care during clinical or job experiences. Decreased availability of clinical sites coupled with fewer clinical mentors further encourages the need for innovative pedagogy. To provide high quality and safe patient care in a cost effective manner, graduate students need to be prepared with assessment skills and ability to work with diverse populations and situations before entering the healthcare environment. Studies report that computerized simulation is interactive, enjoyable, stimulating for the learner, and one pedagogy that needs to be explored. Additionally, literature supports the benefits of patient simulation to improve clinical performance, problem-solving skills, and self-confidence. Simulation also allows for the student to experience consequences of their actions and improve self-awareness (Nuraini, Afifah, Agustini, and Pujasari, 2015). Three-dimensional computerized simulation (TDCS) is an on-line interactive program that simulates real-life nursing experiences using virtual patients, also referred to as Avatars. This program is computer accessed allowing unlimited practice at any time in a risk-free environment without compromising patient care. TDCS program requires students to interact with on-line virtual patients through therapeutic conversation. The virtual patients are culturally diverse and of various ages requiring students to incorporate knowledge of cultural and age appropriate care. </span><strong>Purpose:</strong><span> The purpose of this mixed method prospective study was to evaluate the use of a computerized simulation program as one pedagogy to prepare graduate nursing students for clinical practice. Impact of this study will provide a body of evidence regarding active learning in nursing. </span><strong>Literature Review</strong><span>: CINAL and PubMed databases were searched using the key words nursing education, computerized technology, and interactive learning. The search resulted in 467 returns and was further narrowed by restricting to peer reviewed, published in the last four years, and written in English. Twenty eight articles meet the restricted search criteria. Following review of articles, 20 were selected from the 28 to inform this project. Literature varies widely in level of evidence, with few high quality or high level of evidence studies available. Waltz, Jenkins, and Han (2014) conducted a literature review on learning methods in health and nursing education and the impact of active learning methods. Twenty two studies were reviewed and only one provided a randomized control trial. The authors concluded that there is insufficient empirical evidence regarding active learning methods in nursing. </span><strong>Design:</strong><span> Subjects consisted of graduate nursing students taking Advanced Health Assessment class at a Midwestern University over three semesters in 2014-2016 and clinical mentors from Midwestern Healthcare Facilities. Seventy graduate nursing students voluntarily participated in evaluating the use of TDCS. Seven of the surveys were eliminated for not answering all questions or not completing either the before use survey or the after use survey. Sixty three (</span><em>N</em><span>=63) students completed surveys in entirety. </span><strong>Methods:</strong><span> Integrative review of the literature was conducted on the use of computerized simulation as a teaching strategy for graduate nursing students. Selection of TDCS program used for this evaluation followed extensive research of companies that offered computerized simulation for healthcare. Selection criteria included: designed for advanced practice, user friendly, cost effective, and ability to provide feedback to the user. The program selected met criteria and program design correlated with the universities nursing curriculum. Evaluation of the program consisted of a 10 question survey using a five-point Likert scale ranging from strongly disagree to strongly agree. On the first class day of the semester, before students were introduced to TDCS, students were provided the opportunity to complete the survey. At the end of the semester, after using TDCS for fourteen weeks, the same survey was administered. Formative evaluation was conducted with students and student’s clinical mentors each semester. TDCS was used adjacent with face-to-face class time; the class met for 5.5 hours weekly. Surveys were evaluated using Bowkers Test for Symmetry of Disagreement and formative information was categorized into themes. </span><strong>Ethics:</strong><span>Study was approved by the University’s Institutional Review Board. </span><strong>Conclusions: </strong><span>Integrative literature review supports the need for testing innovative pedagogy to prepare students for clinical practice. Studies have demonstrated that computerized simulation may be beneficial in student’s perceived self-efficacy in a variety of skills, knowledge of leadership styles, and assessment and management of patients. Using </span><em>p </em><span>values from Bowkers Test for Symmetry of Disagreement, the findings from the surveys demonstrated that nine of the questions were statistically significant with values between </span><em>p</em><span><.0001 and </span><em>p</em><span><.0062 for the use of TDCS to prepare graduate nursing students for clinical practice. One question was not statistically significant (</span><em>p</em><span><.2367). Results from statistical analysis of the surveys and themes generated from formative evaluations will be presented. Recommendations and implications for clinical practice will be discussed.</span></p>en
dc.subjectcomputerized technologyen
dc.subjectinteractive learningen
dc.subjectnursing educationen
dc.date.available2017-06-30T15:37:28Z-
dc.date.issued2017-06-30-
dc.date.accessioned2017-06-30T15:37:28Z-
dc.conference.date2017en
dc.conference.name28th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau Internationalen
dc.conference.locationDublin, Irelanden
dc.descriptionEvent Theme: Influencing Global Health Through the Advancement of Nursing Scholarshipen
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