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Baccalaureate nursing students' experiences with high-fidelity simulation: protocol for a qualitative systematic review.

ABSTRACT: Introduction: High-fidelity simulation (HFS) can bridge the gap between theoretical knowledge and nursing practice and improve safety and quality of patient care in baccalaureate nursing education. Although inconsistent assessment instruments or lack of high-quality research designs affect the strength of the evidence and limit the generalisability of the results, quantitative studies generally demonstrate the effectiveness of HFS in baccalaureate nursing education. Synthesis of the existing evidence of baccalaureate nursing students' experiences with HFS is crucial for the improvement and revision of simulation design and teaching.

Methods and analysis: A comprehensive search for qualitative studies on baccalaureate nursing students' experiences with HFS will be conducted in the following databases: PubMed, Embase, CINAHL, ProQuest, Web of Science, PsycINFO, the Cochrane library, China Biology Medicine disc, China National Knowledge Infrastructure and VIP Database for Chinese Technical Periodicals. This review considered studies reported in English or Chinese, and studies that were conducted between January 2000 and December 2019 in view of the launch of International Nursing Association for Clinical Simulation and Learning. The literature search will be conducted by two independent reviewers, and any disagreement will be adjudicated by discussion or with a third reviewer. The two independent reviewers will use the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research to assess the methodological validity, following which the JBI standardised data extraction tools will be used to extract relevant data. The JBI meta-aggregation method will be subsequently used to synthesise the data, eventually forming themes, categories and synthesised findings. The final synthesised findings will establish confidence levels based on the JBI ConQual approach.

Ethics and dissemination: This review does not require formal ethical review since it is based on available published literature. Findings will be disseminated through publication in a peer-reviewed journal, and, if possible, presented in scientific conferences.

SUBMITTER: Zhu Y

PROVIDER: S-EPMC7725085 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Baccalaureate nursing students' experiences with high-fidelity simulation: protocol for a qualitative systematic review.

Zhu Yuxuan Y Geng Cong C Pei Xianbo X Chen Xiaoli X

BMJ open 20201208 12

<h4>Introduction</h4>High-fidelity simulation (HFS) can bridge the gap between theoretical knowledge and nursing practice and improve safety and quality of patient care in baccalaureate nursing education. Although inconsistent assessment instruments or lack of high-quality research designs affect the strength of the evidence and limit the generalisability of the results, quantitative studies generally demonstrate the effectiveness of HFS in baccalaureate nursing education. Synthesis of the exist ...[more]

PMID: 33293391

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Project description:BackgroundThe COVID-19 pandemic mandated the reconstruction of educational programs globally. For nursing students in need of practical learning and training as a part of their curriculum, the pandemic also caused restrictions and alterations in practical placements and limited access to simulation training at campuses. The aim of this study is therefore, to describe and explore how the COVID- 19 pandemic influenced baccalaureate nursing students' experiences of learning and their social life as a student.MethodWe used a mixed method study design including quantitative data from one of the universities (University of Agder) from a national Norwegian survey of baccalaureate nursing students and qualitative data from focus-group interviews from the same university. The quantitative survey included 396 baccalaureate nursing students (response rate, 46%). We arranged five focus groups with a total of 23 students (15 females and 8 males). The students took part in one of the focus-group interviews. The quantitative data were analyzed using chi-square test for categorical data and ANOVA tests for continuous data, while the qualitative data were analyzed using Systematic Text Condensation and an editing analysis style.ResultsMost students (70%) were concerned about the quality of the education program. In clinical placement, 83% of students had cared for patients with confirmed COVID-19 or unclear COVID-19 status. The qualitative data revealed three main themes: missing the social dimension of learning; worries and challenges in clinical placement; and experiencing normal instructive days in clinical placement. The general picture emerging from our analysis is the importance of social interactions for learning.ConclusionAs the COVID-19 pandemic continues, our findings of students' worries about the quality of the education program and not reaching learning outcomes must be taken into consideration. Social interaction is considered crucial and fundamental for student learning. A follow-up study following baccalaureate completion is necessary to explore the consequences over time of disrupted education.

Project description:Simulation sessions can produce high-fidelity emergency situations that facilitate the learning process. These sessions may also generate a complex stress response in the learners. This prospective observational study assessed psychological, physiological, immunological, and humoral levels of stress during high-fidelity simulation training. Fifty-six undergraduate medicine students who took part in a medical simulation session were assigned team roles (physician, nurse or assistant). Subsequently, each participant was assessed before the scenario (T0), after the procedure (T1), and two hours later (T2). Psychological stress and anxiety were measured at T0 and T1, using the State-Trait Anxiety Inventory (STAI) and Dundee Stress State Questionnaire (DSSQ). Cortisol, testosterone, secretory immunoglobulin class A (sIgA), alpha-amylase, and oxygen saturation level were measured at T0, T1, and T2, as was the physiological response indicated by heart rate (HR) and blood pressure (BP). It was found that the onset of task performance was related to increased anticipatory worry and higher oxygen saturation. The participants reported decreased worry, followed by increased emotional distress after the simulation training (T1). Participants trait anxiety predicted the intensity of worry, distress and task engagement. In contrast, no clear relationships were found between trait anxiety and biological stress markers. Testosterone levels were growing significantly in each phase of measurement, while physiological responses (BP, HR) increased at T1 and declined at T2. The levels of stress markers varied depending on the assigned roles; however, the trajectories of responses were similar among all team members. No evidence for prolonged cortisol response (T1, T2) was found based on psychological stress at the onset of simulation (T0). Regression analysis followed by receiver operating characteristics analyses showed uncertain evidence that initial state anxiety and worry predicted the levels of sIgA. Medical students are relatively resilient in terms of stress responses to medical simulation. The observed stress patterns and interrelationships between its psychological, physiological, hormonal, and immunological markers are discussed in accordance with theoretical concepts, previous research work, and further recommendations.

Project description:ObjectiveThe purpose was to analyse the effectiveness of high-fidelity patient simulation (HFPS) based on life-threatening clinical condition scenarios on undergraduate and postgraduate nursing students' learning outcomes.DesignA systematic review and meta-analysis were conducted based on the Cochrane Handbook for Systematic Reviews of Interventions and its reporting was checked against the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist.Data sourcesPubMed, Scopus, CINAHL with Full Text, Wiley Online Library and Web of Science were searched until July 2017. Author contact, reference and citation lists were checked to obtain additional references.Study selectionTo be included, available full-texts had to be published in English, French, Spanish or Italian and (a) involved undergraduate or postgraduate nursing students performing HFPS based on life-threatening clinical condition scenarios, (b) contained control groups not tested on the HFPS before the intervention, (c) contained data measuring learning outcomes such as performance, knowledge, self-confidence, self-efficacy or satisfaction measured just after the simulation session and (d) reported data for meta-analytic synthesis.Review methodThree independent raters screened the retrieved studies using a coding protocol to extract data in accordance with inclusion criteria.Synthesis methodFor each study, outcome data were synthesised using meta-analytic procedures based on random-effect model and computing effect sizes by Cohen's d with a 95% CI.ResultsThirty-three studies were included. HFPS sessions showed significantly larger effects sizes for knowledge (d=0.49, 95%?CI [0.17 to 0.81]) and performance (d=0.50, 95%?CI [0.19 to 0.81]) when compared with any other teaching method. Significant heterogeneity among studies was detected.ConclusionsCompared with other teaching methods, HFPS revealed higher effects sizes on nursing students' knowledge and performance. Further studies are required to explore its effectiveness in improving nursing students' competence and patient outcomes.

Project description:IntroductionPsychological factors such as anxiety and confidence that students have in the patient care situation are important in that this affects the actual clinical performance. Students who are just starting clinical practice have a lack of clinical knowledge, skill proficiency, and patient communication skills, so they experience anxiety and lack of confidence in clinical setting. Practice in a safe environment, such as simulation education, can help students perform more settled and competently in patient care. The purpose of this study was to analyze the effect of high-fidelity simulation experience on anxiety and confidence in medical students.Materials and methodsThis study enrolled 37 5th-year students at Ajou University School of Medicine in 2020. Two simulation trainings were implemented, and a survey was conducted to measure students' level of anxiety and confidence before and after each simulation. Based on the research data, a paired t-test was conducted to compare these variables before and after the simulation, and whether this was their first or second simulation experience.ResultsStudents had a significantly lower level of anxiety and a significantly higher level of confidence after the simulation than before. In addition, after one simulation experience, students had less anxiety and more confidence before the second simulation compared to those without simulation experience.ConclusionsWe confirmed that medical students need to be repeatedly exposed to simulation education experiences in order to have a sense of psychological stability and to competently deliver medical treatment in a clinical setting. There is a practical limitation in that medical students do not have enough opportunities to meet the patients during clinical practice in hospitals. Therefore, in order to produce excellent doctors, students should have the expanded opportunities to experience simulation education so they can experience real-world medical conditions.

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Baccalaureate nursing students' experiences with high-fidelity simulation: protocol for a qualitative systematic review.

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Baccalaureate nursing students' experiences with high-fidelity simulation: protocol for a qualitative systematic review.

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