Christina Hunter and Dr. Patricia Ravert, Nursing
Introduction
Identified learning outcomes when using high-fidelity simulators in a nursing lab are 1) improving communication, 2) increasing psychomotor skills, 3) understanding classroom material, 4) developing critical thinking, and 5) facilitating teamwork (Bambini, Washburn, & Perkins, 2009; McGaghie, Issenberg, Petrusa, & Scalese, 2006). Nursing students in each semester develop different learning outcomes. Communication, improving nursing skills, and developing critical thinking are outcomes of simulation for novice students (Bambini et al.). However, data is limited on outcomes of simulation for other levels of nursing students. The purpose of this study is to determine students’ perceptions regarding learning outcomes and their development throughout the simulation experiences in the nursing program.
Methodology
A descriptive quantitative method was used in this study. Undergraduate baccalaureate nursing students at a private university in the mountain west in the second through fifth semester of the nursing program during winter semester 2010 participated in simulations. After consenting, students rated (1being the highest, 2 or 3) the above learning outcomes they perceived having improved or developed through their simulation experience. Quantitative data was analyzed for frequencies to determine similarities or differences between semesters. Qualitative data was analyzed using inductive and emergent processes.
Results
Students in each semester varied in which learning outcomes were obtained (see Figure 1). Fundamental students most frequently rated the learning outcome of increasing nursing skills whereas students in the other semesters most frequently rated the outcome of developing critical thinking. As students neared the end of the program, teamwork was rated more frequently each semester. Communication and increasing understanding of classroom material were not rated as frequently as any of the other learning outcomes in any semester.
Discussion
Each semester, students rated increasing nursing skills and developing critical thinking as two of the top three learning outcomes obtained during simulation experiences. Developing critical thinking was the highest ranked outcome overall. This study demonstrates simulation experiences are one of the best ways to help students develop critical thinking (Broussard, Myers & Lemoine, 2009).
Nursing fundamental students most frequently rated the learning outcome of increasing nursing skills whereas students in the other semesters most frequently rated the outcome of developing critical thinking. After students gain confidence in their own skill development, they are better able to critically think and become an effective team member. Students rated the outcome of facilitating teamwork higher in the semesters following nursing fundamentals. In fact, the learning outcome of facilitating teamwork was the only outcome that was consistently ranked higher throughout the simulation experiences (see Figure 1). This study determined as students near the end of the nursing program, the learning outcome of facilitating teamwork was achieved more frequently each semester.
Communication and increasing the understanding of classroom material were not rated as frequently as any of the other learning outcomes throughout the semesters. If the learning outcome for the simulation experience includes improving communication or increasing the understanding of classroom material, the experiences may need to be revised for such emphasis. For example, if improving communication is an objective, having students call the physician in each simulation would emphasize this objective.
Limitations of this study include participant group variability, small sample size, and students were not randomly selected. Further research should be done using a larger population with students from multiple nursing programs.
Conclusion
Simulations are successful in improving communication, increasing nursing skills, understanding classroom material, developing critical thinking, and facilitating teamwork (Bambini et al., 2009; Broussard et al., 2009; McGaghie et al., 2006). Each semester, students rated increasing nursing skills and developing critical thinking as two of the top three learning outcomes. Students developed teamwork more in later semesters. The least common outcomes of improving communication and understanding classroom material can be achieved if the experiences are revised for such emphasis. Although this study adds information to research on simulations and learning outcomes, further research is needed on a larger sample size.
These findings were presented at the Annual Nursing Research Conference at Brigham Young University on October 25, 2010. A manuscript was written and recently accepted for publication in an online undergraduate research journal.
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.
- Broussard, L., Myers, R., & Lemoine, J. (2009). Preparing pediatric nurses: The role of simulation based learning. Issues in Comprehensive Pediatric Nursing, 32, 4-15. doi:10.1080/01460860802610178
- McGaghie, W. C., Issenberg, S. B., Petrusa, E. R., & Scalese, R. J. (2006). Effect of practice on standardized learning outcomes in simulation-based medical education. Medical Education, 40(1), 792-797.