Brandon Lewis and Dr. Patricia Ravert, BYU College of Nursing
The use of human patient simulation (HPS) is needed more than ever in nursing curriculum today (Bambini, Washburn, & Perkins, 2009). One reason is that it allows students to practice critical thinking and decision-making skills in a safe environment (Howard, Ross, Mitchell, & Nelson, 2010; Medley & Horne, 2005). HPS also creates situations where other learning outcomes, such as communication, teamwork, a better understanding of classroom material, and improved psychomotor skills, are achieved (Bambini et al., 2009; McGaghie, Issenberg, Petrusa, & Scalese, 2006).
While the use of HPS is beneficial and its use continues to rise in education, it is important to evaluate how effective it promotes the desired learning outcomes, which can be achieved by analyzing student perceptions of simulation (Elfrink, Kirkpatrick, Nininger, & Schubert, 2010). The purpose of this study was to evaluate how effective a postoperative simulation experience meets learning outcomes for nursing students in the Brigham Young University College of Nursing during the 2011 fall semester. The learning outcomes evaluated were: improving communication, increasing nursing skills, understanding classroom material, developing critical thinking, and facilitating teamwork.
In order to evaluate the students’ perceptions of the learning outcomes, an IRB approved descriptive quantitative and qualitative survey was used. The 6-item survey allowed students to report their perceptions of how well the postoperative simulation experience achieved the learning outcomes. The survey used a rating scale from one to four, one being strongly disagree, two being disagree, three being agree, and four being strongly agree. The survey also included a qualitative section where the students could list strengths and weaknesses of the simulation as well as suggested changes. The results of the study were compared to a pilot study performed during the 2010-2011 school year.
There were 61 students who completed the survey. A majority of the students were female (92%) and predominately caucasion (96%). There were no statistically significant differences in the outcomes due top gender, ethincity, or years in college. The results confirmed what we purported, which was students perceive the postoperative simulations meet the learning outcomes. Although there were some minor differences between the pilot group and actual study group, the differences were not statistically significant and the mean of each learning outcome was above 3.39, indicating the participants agreed the simulation experiences achieved the learning outcomes. Both groups rated the outcomes of understanding classroom material the lowest with the mean of 3.47.
The qualitative data provided insight into why understanding classroom material was rated lower than the other learning objectives. Student comments indicate some of the material that was expected to be understood in lab had yet to be covered in the classroom, such as what peritonitis entails and how to manage a nasogastric tube.
A majority of the comments praised simulation and the wonderful opportunities it provides students to learn in a learning-conducive environment. Of the comments that addressed areas needing improvement, the time spent in simulation was the overall focus. Students perceived that there was not enough time to prepare for simulation, actually run the simulation, or debrief at the end.
The results of this study support the continued use of simulation for educational purposes in the Brigham Young University College of Nursing. The participants overwhelmingly agreed the learning outcomes were met through the simulation experiences. As a majority of qualitative data collected focused on time, a recommendation for future research would be to focus on the different aspects of simulation lab and how to maximize the benefit from each area. For example, different methods of report and debriefing could be analyzed to determine which methods facilitate learning the best.
References
- Bambini, D., Washburn, J., & Perkins, R. (2009). Outcomes of clinical simulation for novice nursing students: Communication, confidence, clinical judgment. Nursing Education Perspectives, 30(2), 79-82.
- Elfrink, V., Kirkpatrick, B., Nininger, J., & Schubert, C. (2010). Using learning outcomes to inform teaching practices in human patient simulation. Nursing Education Perspectives, 31(2), 97-100.
- Howard, V., Ross, C., Mitchell, A., & Nelson, G. (2010). Human patient simulators and interactive case studies: A comparative analysis of learning outcomes and student perceptions. CIN: Computers, Informatics, Nursing, 28(1), 42-48.
- McGaghie, W., Issenberg, S., Petrusa, E., & Scalese, R. (2006). Effect of practice on standardized learning outcomes in simulation-based medical education. Medical Education, 40(1), 792-797.
- Medley, C., Horne, C. (2005). Using simulation technology for undergraduate nursing education. The Journal of Nursing Education, 44, 1, 31-34