Do Simulation Roles Really Affect Clinical Decision-making Accuracy in an Acute Care Scenario?

2.50
Hdl Handle:
http://hdl.handle.net/10755/622537
Category:
Full-text
Format:
Text-based Document
Type:
Presentation
Level of Evidence:
N/A
Research Approach:
N/A
Title:
Do Simulation Roles Really Affect Clinical Decision-making Accuracy in an Acute Care Scenario?
Author(s):
Zulkosky, Kristen; White, Krista; Price, Amanda L.; Pretz, Jean
Lead Author STTI Affiliation:
Non-member
Author Details:
Kristen Zulkosky, PhD, RN, CNE, PA College of Health Sciences [PCHS]; Krista White, PhD, RN, CCRN-K, CNE, Georgetown University; Amanda Price, PhD, psychology –PA College of Health Sciences [PCHS]; Jean Pretz, PhD, psychology –Elizabethtown College
Abstract:

The purpose of this study was to assess the accuracy of on clinical decision making (CDM) among various roles in an acute-care simulation scenario in pre-licensure nursing students. This study utilized a mixed factorial design with decision point (shortness of breath [SOB] and rhythm change [atrial fibrillation, AFib]) and decision phase (cue acquisition, diagnosis, and action) as within-subjects factors and simulation role (observer, family, auxiliary nurse, and primary nurse) as a between-subjects factor. We assessed decision-making accuracy among fourth-semester Associate in Science in Nursing (ASN) students who were randomly assigned roles in a simulation scenario.

 

Examination of CDM Accuracy across stopping points and simulation role indicated that students’ role had an impact on decision making performance. During the AFib situation, mean levels of cue acquisition accuracy differed across role: observers (67%), medication and education nurses (50%), primary nurse (46%), and family members (41%). The significant role effect (p = 0.03) in the AFib situation indicated observers were statistically more accurate with cue acquisition than family members. Overall CDM accuracy in the AFib stopping point, though not statistically significant (p = 0.07), revealed observers were most accurate in the CDM process while family members were the least accurate.

 

We found the simulation experience for observers to be beneficial to the CDM process, contradicting common beliefs held by nurse educators and students who view active roles in simulation as most valuable. It is worthwhile for students to rotate roles because active and passive roles each hold value.

Keywords:
simulation; simulation roles; Clinical decision-making; acute care
Repository Posting Date:
17-Aug-2017
Date of Publication:
17-Aug-2017
Conference Date:
2017
Conference Name:
INACSL Conference 2017
Conference Host:
INACSL
Conference Location:
Washington DC
Description:
INACSL Conference 2017: Nursing Simulation, Marriott Wardman Hotel, Washington DC

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.titleDo Simulation Roles Really Affect Clinical Decision-making Accuracy in an Acute Care Scenario?en_US
dc.contributor.authorZulkosky, Kristenen
dc.contributor.authorWhite, Kristaen
dc.contributor.authorPrice, Amanda L.en
dc.contributor.authorPretz, Jeanen
dc.contributor.departmentNon-memberen
dc.author.detailsKristen Zulkosky, PhD, RN, CNE, PA College of Health Sciences [PCHS]; Krista White, PhD, RN, CCRN-K, CNE, Georgetown University; Amanda Price, PhD, psychology –PA College of Health Sciences [PCHS]; Jean Pretz, PhD, psychology –Elizabethtown Collegeen
dc.identifier.urihttp://hdl.handle.net/10755/622537-
dc.description.abstract<p>The purpose of this study was to assess the accuracy of on clinical decision making (CDM) among various roles in an acute-care simulation scenario in pre-licensure nursing students. This study utilized a mixed factorial design with decision point (shortness of breath [SOB] and rhythm change [atrial fibrillation, AFib]) and decision phase (cue acquisition, diagnosis, and action) as within-subjects factors and simulation role (observer, family, auxiliary nurse, and primary nurse) as a between-subjects factor. We assessed decision-making accuracy among fourth-semester Associate in Science in Nursing (ASN) students who were randomly assigned roles in a simulation scenario.</p> <p>&nbsp;</p> <p>Examination of CDM Accuracy across stopping points and simulation role indicated that students&rsquo; role had an impact on decision making performance. During the AFib situation, mean levels of cue acquisition accuracy differed across role: observers (67%), medication and education nurses (50%), primary nurse (46%), and family members (41%). The significant role effect (p = 0.03) in the AFib situation indicated observers were statistically more accurate with cue acquisition than family members. Overall CDM accuracy in the AFib stopping point, though not statistically significant (p = 0.07), revealed observers were most accurate in the CDM process while family members were the least accurate.</p> <p>&nbsp;</p> <p>We found the simulation experience for observers to be beneficial to the CDM process, contradicting common beliefs held by nurse educators and students who view active roles in simulation as most valuable. It is worthwhile for students to rotate roles because active and passive roles each hold value.</p>en
dc.subjectsimulationen
dc.subjectsimulation rolesen
dc.subjectClinical decision-makingen
dc.subjectacute careen
dc.date.available2017-08-17T20:27:40Z-
dc.date.issued2017-08-17-
dc.date.accessioned2017-08-17T20:27:40Z-
dc.conference.date2017en
dc.conference.nameINACSL Conference 2017en
dc.conference.hostINACSLen
dc.conference.locationWashington DCen
dc.descriptionINACSL Conference 2017: Nursing Simulation, Marriott Wardman Hotel, Washington DCen
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