The recognition of the possible value of simulation in nursing education has been grown. Overall, the literature supports the need to include simulation as a teaching strategy in nursing curriculum. Utilization of HFS for enhancing learning outcome in nursing education is a positive and innovative method. We especially highlight the importance of the high fidelity simulation in eliminating the passive role of students during the learning process. The learning process became more student centred rather than content centred. Satisfaction and con- fidence with safe controlled environments are influenced by knowledge, skill performance, and critical thinking abilities. The use of high-fidelity simulation into the undergraduate nursing education can improve the quality of learning, can help students for leadership, clinical judgment, manage care and promote decision-making. This can bridge the gap between theory and clinical practice among nurses for application and translation to bedside practice. Pre briefing and debriefing provide responding sessions to reflect knowledge and exchange vital elements in nursing care.
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The rapid uptake of simulation in the preparation of entry level practitioners is testament to the powerful impact of this learner-centred approach to understanding practice. The journey of becoming a healthcare practitioner is amplified after graduation as nurses begin to fully contextualise their course experiences with episodes of patient care. The transformation from novice to advanced beginner (Benner, 1984) requires clinical experiences that change the student’s capacity to act in complex situations. The aims are to shift the typical predominant focus on skill formation towards noticing the salient features of situations and responding and relating to patients and each other in meaningful ways. Students are required to learn skills of perception and action and form what Merleau-Ponty (1969) called a style of comportment in which they learn to adjust to the dynamics and possibilities of a particular situation. The actions and responsibilities of being a nurse or a doctor form a habitus (Bourdieu, 1990) of skills, expectations, perceptual acuity and nursing actions, which, over time, create the foundation for skilled, embodied nursing and medical practice (Merleau-Ponty, 1969).
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The present study provided meta-analytical data for evidence-based education through a comprehensive ana- lysis of simulation-based nursing education with diverse backgrounds and characteristics. Compared with our previous article “Effectiveness of patient simulation in nursing education: meta-analysis” , the current study included an additional electronic search of Korean data- bases such as RISS and the National Assembly Library of Korea database. Through this process, 20 Korean pa- pers were included additionally and half of papers were Korean. This could cause different result compared to previous one. In addition to including a reaction out- come according to fidelity levels, effect sizes based on outcomes and fidelity level were identified. A systematic search of the literature resulted in 40 published studies that were eligible for inclusion in this meta-analysis. These primary studies provided evidence of the effects of simulation-based nursing education in various evalu- ation and learning environments.
Structuring chapters 6 and 7 was a challenge, in terms of how to present the narratives. As discussed with regard to analysis of my data in Chapter 4, it was important to find a means of creating some balance and giving voice to the participants, whilst presenting their narratives with honesty and integrity. To this end, I start by introducing each participant, giving a brief biography, offering readers an opportunity to become acquainted with each of them in relation to their professional histories and their experiences of simulation in nursing. I wanted to stay true to the participants’ accounts, which revealed their understandings and views of simulation. I was concerned about fragmenting their accounts, wishing to remain as close to the personal account from participants as possible. Wellington et al., (2005) and Silverman (2006) caution against the inclusion of inconclusive anecdotal evidence, or attempting to make excessive claims from small fragments of interview data. This is not an issue confined to qualitative researchers alone. I would suggest that for any written report, regardless of its methodological origins, problems of misrepresentation and simplification exist. What is important is to achieve a balance between interpretation and honest representation of data. In order to address this, I met with participants to confirm accuracy and representation in the transcripts of their interviews. I also shared with them my developing interpretations of their learning through simulation. Many of the participants expressed a desire to read the completed thesis.
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Simulation-based teaching ingredients actual patient encounters with high fi- delity simulators, mimicking real-time patient scenarios in a realistic, controlled environment. The student learns to learn and practice without risk and thus re- duces the likelihood of medical errors. The nursing student also learns teamwork and behavioral skills, as multidisciplinary activity as a healthcare professional is essential. SBL offers multiple opportunities to rehearse and learn multiple times without causing undue harm to patients . The recognition of the possible val- ue of simulation in nursing education has been grown. Overall, the literature supports the need to include simulation as a teaching strategy in nursing curri- culum. Utilization of simulation for enhancing learning outcome in nursing education is a positive and innovative method .
DOI: 10.4236/ojn.2019.98064 866 Open Journal of Nursing controlled trial (RCT), pre-post intervention on 35 nursing students underwent training in the medical-surgical nursing education. They found that statistically significant improvements of the knowledge, confidence, critical thinking, and clinical competence to advanced cardiovascular life support. Williams and Song  also conducted a cross-sectional study among 33 nursing students, the au- thors showed simulated patients (SPs) improved students’ clinical competency. Other studies Kim & Jang  provide that competence improved after high- fidelity simulation education. Similarly, Danielle  shows that improved in clinical competence of students in a medical-surgical nursing course from mid- term to final. These, attributed that students with a high-level communication skills, self-efficacy (SE) and clinical competence have a positive impact on pa- tients outcome. Our results are in contrast to Blum et al .  carried out study on 53 bachelor sciences nursing students shows that no significant difference in self-confidence and clinical competence between the both groups (one used HFS and another used the traditional approach.
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It is acknowledged that employing a paired samples design for pre- and post-course measures do not allow for comparisons to be drawn between mental health simulation training and other educational modalities. While this study demonstrates the potential benefits of such training, further research comparing simulation to other educational interventions would be beneficial. The sample size of each professional group was limited and sampling methods could have been improved. Consequently the benefits to each individual profession were not examined, and future research to investigate the possibility of differences would be advisable, both through quantitative measures of learning outcomes and in depth qualitative analyses such as semi-structured interviews. Validated measures were not employed in this study, not least due to the fact that such measures for attitudes,
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Aim: This study examined the effects of the combination of high-fidelity simulation and hospital-based clinical instruction on maternity students’ clinical judgment/critical thinking skills. Background : Several researchers have explored the use of high-fidelity simulation to improve students’ critical thinking skills. However, no studies have examined the effects on senior maternity nursing students of hospital clinicalexperience and high-fidelity simulation. Method: A retrospective, comparative study design was used to examine data fromthe ATI content mastery series test(maternal newborn), focusing on clinical judgment/critical thinking scores. Results: The data indicated that senior nursing students who received instruction through high-fidelity simulation in addition to hospital-based instruction demonstrated greater critical thinking skills, as indicated than students who received taught hospital-based clinical instruction alone measured by higher clinical judgment/critical thinking in nursing scores on the ATI content mastery series test (maternal newborn). Conclusion: As indicated in the literature and suggested by the findings in this study suggest that high-fidelitysimulation may be an effective vehicle for enhancing critical thinking skills in the maternity high-risk unit.
An online search of the literature was carried out via Texas Woman’s University library. Databases including: CINAHL with Full Text, ProQuest Nursing, PubMed, Medline, and Scopus were utilized. The search was limited to English material only, research, and evidence-based peer reviewed articles. The inclusioncriteria was set togenerate articles from 1980-2014.Inclusion criteria consisted of: nursing simulation articles, quantitative, and qualitative guidelines. Medical-surgical simulation articlesand non-English material were excluded from the search criteria. Keywords and combination of words were used in order to conduct anevidence basedsearch. Search terms consisted of: nursing education, nurse education, simulator, simulation, simulations, confidence, competency, competencies, trainer, instructor, educator, and faculty.When searched, more than 50 research articles published between 1980 through 2014 were produced. The articles were considered beneficial if information regarding initial training, instructor confidence, and competencies were addressed in simulation. Websites were also used to find information on the topic including: Google Scholar, National League for Nursing (NLN), Society for Simulation in Healthcare (SSIH), and INACSL. Van Sell’s skill’s acquisition nursing theory was utilized to guide the creation of the decision tree.
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Data collection was carried out during 3 weeks of the Spring 2015 semester at a public university in an urban setting. The sample consisted of undergraduate senior nursing students who each participated in clinical simulation activities. Each simulation day was 4-hours long and was comprised of four separate scenario sessions during which three to four students participated in the action phase of the simulation. Student groups were debriefed using one method of debriefing; at the end of the simulation day, students were asked to complete the DASH-SV and Simulation and Debriefing Questionnaire. The students who received the DML debriefing method completed DML worksheets and submitted them to the researcher. The data were analyzed through descriptive statistics and independent-samples t test. The assumption of normal distribution was questionable given the small sample size. Levene’s test was used to address the assumption of
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There are several limitations of our study. First, the participants of this study were selected from one school, which might limit the generalizability to students of other majors or schools. Second, the participants did not have any prior clinical experience, there is challenge to develop SPs with standardized clinical experience, so the experimental effects may be confounded with a floor ef- fect. Future studies may be designed to control for prior levels of clinical judgment to examine experimental ef- fects of varied simulation teaching. Third, no sample size calculations were made, and no baseline measurements were taken. This may affect the quality and intentional analysis of the article.
The use of simulation and skills rehearsal as a vehicle for increasing opportunities for students to familiarise themselves with skills before rehearsing and consolidating these skills in practice was reported on Phase one of the Review for Fitness for practice (Long, 2006). The potential benefits of increased confidence in skill delivery gained through simulation have been identified previously. Two studies reporting on the development of confidence and self-efficacy amongst first year students found simulation beneficial. The students reported increased confidence in their ability to practise, feeling adequately prepared for their placement experiences (McConville, 2006; Morgan, 2006). There is minimal evidence reporting the potential impact of simulation training on patients, something that may usefully be explored through future research.
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Therefore, a plan was established to create multiple simulated scenarios. Each scenario was designed to focus on a distinct pediatric-specific concept. The scenarios would be implemented into existing curriculum with the objective of augmenting student learning. The primary intent of this study was to evaluate whether the introduc- tion of multiple simulation pediatric scenarios would have a positive impact on student pediatric specific nursing knowledge as measured by end of level test scores. The other purpose of this study was to determine the impact the scenarios had on student self-confidence as measured by the NLN Student Satisfaction and Self-Confidence in Learning Scale, (SSSCLS).
In referring to the Foucauldian theory relating to ‘aesthetics and subjectivity’, as presented by Danaher et al. (2000, p.136) Foucault speaks of ‘transformation of one’s self by ones own knowledge’. Foucault emphasised the importance of having the desire to be transformed by the work one does. In linking this theory to nursing and a nurses desire to provide competent care to patients, this theory suggests that valuing what one does for a job will result in nurses recognising those things that are available to them in practice that will assist the transformation of their nursing practices. Foucault suggests that believing in ones practice will assist the development of personal and professional attitudes about the importance of learning. Foucault also suggests that aesthetics is concerned with ways of presenting ourselves to ourselves and to others (Danaher et al., 2000). This challenges nurses to think about how they want to present themselves as a profession to consumers of health care, and how they want to present themselves to their own colleagues. In linking this to life long learning opportunities for nurses, nurses have an option to decide if they want to engage in certain learning opportunities such as postgraduate studies. However they are regulated to a point by their profession through mandatory learning situations such as unit based competency testing in the attempt to continually update current practices (Nicklin & Kenworthy, 2000).
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In the spring 2010, as part of NEPA IPEC’s second annual IPE conference, more than 300 health professional students from the region participated in a collaborative-care seminar day. Disciplines included internal medicine, nursing, diag- nostic imaging, pharmacy, paramedics, occupational therapy, nutritionists and physician assistant. Students were assigned to small groups (about 10–12 students) representing multiple professions. They worked through a case study which was facilitated by two faculty members of different health profes- sions per group. The collaborative-care seminar took place concurrently at four separate locations and represented all 17 health education degree programs from our consortium.
The remaining studies in this section report the effects of debriefing on student learning. Shinnick, Woo, Horwich, and Steadman (2011) evaluated the effect of simulation on learning by measuring heart-failure knowledge immediately after the simulation and then again after the simulation and debriefing. Heart-failure knowledge was measured using parallel forms of a 12-item multiple-choice exam. One-hundred-sixty-two prelicensure nursing students from three schools of nursing participated in the study. Data were collected on two sequential days, and a coin toss determined if the day was a comparison or experimental day. Shinnick et al. (2011) reported that although the groups were unequal due to the variability of cohort sizes at each site (Comparison n = 72 and Experimental n = 90). No statistically significant differences were found in age, gender, or baseline knowledge scores between groups. Additionally a priori power analysis estimated a desired sample size of 128 would allow detection of a moderate effect size (.25) on a paired sample t test for a power of.80.
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These pros have put revolve around the way that specialist of clinical aptitudes learning is required to twist up the readied orderly. They concentrated on it as a result of limited open entryways for clinical capacities getting ready in clinical practice. Student planning at clinical aptitudes inquiry about offices (CSLs) is a central part of the nursing direction. The examination highlighted that a sociocultural and perspective learning is masterminded in a circumstance. Everything considered, they inspected those creating understudy partners, fast introduction of advancements, based indicating procedures, and a move from education to a learning-center preparing for all effects on the students. The examination concluded that movements impact CSLs and drive nursing assets to acclimate to the changing learning condition .
Human Patient Simulator: This type of simulation utilizes a patient simulation in the form of mannequins/dolls with the ability to resemble the real conditions of the physiological system of the human body, so that it has a high level of trust resulting in a conducive interaction and learning experience for students . Moreover, the utilization of HPS simulation model is good in exploring stu- dents’ critical thinking skills, training the accuracy of clinical decision making and inter-professional relationships involved in the treatment of clinical cases   . The HPS model demands an interactive practice learning process and provides learning experience to the students. In addition, the utilization of HPS with a high level of trust in the learning process requires the availability of competent instructors/ lecturers with high financial capabilities/cost.
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Setting up IV pump drivers is an integral part of nursing practice. Figure 1 shows a first year nursing student tending to an IV pump driver as part of a residential school practical class. A component of a patient’s medication chart nurses are given an intravenous medication fluids order form. The role of the nurse is to disseminate this fluids order into the necessary volume and flow-rate settings of the IV pump driver. Critical competencies are tested by application of the fluids order to the prospective patient. These range from strict adherence to a patient’s rights, to the correct evaluation of a patient’s respiratory and cardiovascular clinical observations to take appropriate remedial action in a timely fashion.
In the current context of pressures of workload and litigation, skills acquisition in practice environments may be difficult to achieve in terms of available time and cost- effectiveness. However, it is important that nurse education recognises that skills laboratory simulation can only provide part of that learning experience. It should never replace time spent with patients but be an addition to clinical placement experience. Simulation clearly offers enormous potential for safely developing expertise in clinical skills. In order to be effective, however, such activity needs to be part of a broader picture, supporting and linking with actual clinical practice and having a solid theoretical foundation. All too often, simulation-based training seems dominated by technology, losing its links with the wider worlds of health care and the important focus of enabling students to learn to be nurses.
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