The Effect of Nursing Simulation on the Clinical Judgment of Nursing Care for Patients with Increased Intracranial Pres-sure (IICP)
Background: Nursing educators commonly adopt simulations to educate nursing students and evaluate their clinical thinking, clinical reasoning, and clinical judgment. We aimed to determine the effectiveness of established nursing care simulations by evaluating, through video, a select number of nursing students in scenarios that simulate nursing care for Increased Intracranial Pressure (IICP) patients.
Methods: The participants were students in their senior year at a nursing college in South Korea in 2018. We adopted a mixed-method design by first conducting a nonequivalent control group pre-test/post-test research design, then analyzing the experimental group’s simulation videos. The participants consisted of 38 students in the experimental group and 39 students in the control group, and each group consisted of 9 teams. This study measured the level of anxiety (Cronbach’s α=0.780), critical thinking (Cronbach’s α=0.895), performance (Cronbach’s α=0.927), theoretical knowledge (Cronbach’s α=0.970), and analyzed clinical judgments by directly reviewing video from the experimental group. We used a mixed methods appraisal tool (MMAT) version 2018 as its research checklist.
Results: Confidence (P=0.000), theoretical knowledge (P=0.000), clinical performance (P=0.017) indicated statistically significant increases in the experimental group. We subsequently identified 10 clinical judgment processes, including “Identify the patient’s condition” to “Reassess the condition after symptoms improve” by analyzing the simulation videos.
Conclusion: Developing a simulation for nursing care is effective in honing students’ clinical judgment and enhancing their theoretical knowledge, confidence, and clinical performance.
2. Kim JY, Kyusik K, Jihoon K, et al (2019). Executive summary of stroke statistics in Korea 2018: A report from the epidemiology research council of the Korean stroke society. J Stroke, 21(1): 42–59.
3. Monahan FD, Sands JK, Neighbors M et al (2006). General Nursing Care of Nervous Sys-tem Patients. In: Phipps’ Medical-Surgical Nurs-ing. 8th ed. Elsevier Inc, Korea, pp. 1194–1202.
4. Korean Stroke Society [Internet] (2015). Clinical practice guidelines for stroke. Available from: https://www.neurology-jp.org/Journal/public_pdf/050110825.pdf
5. Han JH, Lee GE, An YH, et al (2013). Ef-fect of systematic educational program for the application of National Institutes of Health Stroke Scale (NIHSS) as a neu-rologic assessment tool in stroke patients. J Korean Clin Nurs Res, 19(1): 57–68.
6. Lee D, Park, J (2019). A review for concept clarification of critical thinking, clinical reasoning, and clinical judgment in nurs-ing education. J Korean Acad Soc Nurs Educ, 25(3): 378–387.
7. Kavanaugh JM, Szweda C (2017). A crisis in competency: The strategic and ethical im-perative to assessing new graduate nurs-es’ clinical reasoning. Nurs Educ Perspect, 38(2): 57–62.
8. Dickison P, Haerling KA, Lasater K (2019). Integrating the National Council of State Boards of Nursing Clinical Judgment Model into nursing educational frame-works. J Nurs Educ, 58(2): 72–78.
9. Lasater K (2007). High-fidelity simulation and the development of clinical judg-ment: Students’ experiences. J Nurs Educ, 46(6): 269–76.
10. Dillard N, Sideras S, Ryan M, et al (2009). A collaborative project to apply and evaluate the clinical judgment model through sim-ulation. Nurs Educ Perspect, 30(2): 99–104.
11. Kim EJ (2014). Nursing students’ clinical judgment skills in simulation: Using Tan-ner’s clinical judgment model. J Korean Acad Soc Nurs Educ, 20(2): 212–222.
12. Kim YH, Kang KA, Lee MN, et al (2015). Comparison of the problem solving abilities as simulation learning stage - Fo-cused on care for patients with asthma in emergency units. J Korea Contents Assoc, 15(1): 495–505.
13. Oh H, Song R, Ahn S (2019). Evaluating the applicability of clinical practicum with simulation used additionally in an under-graduate nursing curriculum. J Korea Con-vergence Soc, 10(10): 357–369.
14. Faul F, Erdfelder E, Buchner A, et al (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behav Res Methods, 41(4): 1149–60.
15. Beischel KP (2013). Variables affecting learn-ing in a simulation experience: A mixed methods study. Western J Nurs Res, 35(2): 226–247.
16. Han DW, Lee CH, Tak JK (1993). Standard-ization of Spielberger state anxiety testing. Student Guidance Research, 10(1): 214–222.
17. Yoon J. Development of an instrument for the measurement of critical thinking dis-position in nursing [PhD thesis]. Nursing Department, The Catholic University of Korea, Seoul, Republic of Korea; 2004
18. Jeffries PR, Rodgers B, Adamson K (2015). The NLN Jeffries Simulation Theory: Brief narrative description. Nurs Educ Per-spect, 36(5): 292–3.
19. Strauss A, Corbin JM (1990). Basics of Qualita-tive Research: Grounded Theory Procedures and Techniques. New Jersey: Sage Publications, Newbury Park, NJ.
20. Kim YH, Jang KS (2011). [Effect of a simu-lation-based education on cardio-pulmonary emergency care knowledge, clinical performance ability and problem solving process in new nurses]. J Korean Acad Nurs, 41(2): 245–55.
21. Hur HK, Park SM (2012). Effects of simula-tion-based education for emergency care of patients with dyspnea, on knowledge and performance confidence of nursing students. J Korean Acad Soc Nurs Educ, 18(1), 111–119.
22. Ryall T, Judd BK, Gordon CJ (2016). Simu-lation-based assessments in health pro-fessional education: A systematic review. J Multidiscip Healthc, 9: 69–82.
23. Park IH, Shin S (2015). The effects of video-based peer-assisted learning in standard-ized patients simulation: Pre and post-operative care. Korean J Adult Nurs, 27(1): 73–82.
24. McGaghie WC, Issenberg SB, Petrusa ER, et al (2010). A critical review of simulation-based medical education research: 2003–2009. Med Educ, 44(1): 50–63.
|Issue||Vol 50 No 10 (2021)|
|Clinical judgment Nursing care Adult nursing Critical thinking Simulation|
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