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The Henderson Repository is a free resource of the HonorSociety of Nursing, Sigma Theta Tau International. It isdedicated to the dissemination of nursing research, research-related, and evidence-based nursing materials. Take credit for allyour work, not just books and journal articles. To learn more,visit www.nursingrepository.org
Item type Presentation
Format Text-based Document
Title The Effect of Simulation Courseware on Critical Thinkingin Undergraduate Nursing Students: Multi-Site Pre-PostStudy
Authors Shin, Hyunsook; Shim, Kaka; Lee, Yuna; Ma, Hyunhee;Lim, Dahae; Kim, Hyojin; Kim, Hyejin
Downloaded 13-Jul-2018 17:37:31
Link to item http://hdl.handle.net/10755/602928
The effect of simulation courseware on critical thinking in nursing students:
Multi-site pre-post study
* Hyunsook Shin, PhD, RN, CPNP
* Kaka Shim, MSN, RN, Doctoral candidate
* Yu-nah Lee, MSN, RN, Doctoral student
* Hyunhee Ma, MSN, RN, Doctoral student
* Dahae Rim, BSN, RN, Master student
* Hyojin Kim, MSN, RN, Doctoral student
* Hyejin Kim, MSN, RN
* College of Nursing Science, Kyung Hee University
Introduction
• The use of simulations as opportunities for students
to enhance their critical thinking (CT)
• A systematic review of CT-focused simulation
strategies -> inconsistent findings for simulation’s
effects on students’ CT abilities
• Limitation: The working mechanism of simulation
strategies and CT as well as the simulation
exposure needed to enhance CT
Study Purpose
• To evaluate the effect of an integrated pediatric
nursing simulation used in a pediatric nursing
practicum on students' CT
• To identify the effects of differing numbers of
simulation exposures, or “dosing” levels, on CT in a
multi-site environment.
Methods
• Study Design
– A multi-site, pre-test, post-test design
• Participants
– A convenience sample (n = 237) of undergraduate
senior nursing students from three universities in Seoul,
Korea.
– Students enrolled in a pediatric nursing practicum
between February and December 2013 at each school
Simulation courseware
Scenarios
Evaluation tools
• Febrile nursing rubric
• Apnea checklist
• SET
Simulation equipment
• Manual: student, instructor
• Simulator
• AV system
Simulation ScenariosTopic Time frame Methods
Simulation scenario I
Introduction to the case
Simulation exercise
Rapport building (Interaction among nurse-parent-
child): First contact role play
SBAR
Self reflection with recorded video-clip
Debriefing
5 min
10 min
10 min
10 min
15 min
Student-led activity
Self reflective writing
Clinical inference web
Discussion
Simulation scenario II
Introduction to the case
Simulation exercise
Febrile infant with or without respiratory distress
SBAR
Self reflection with recorded video-clip
Debriefing
10 min
10 min
10 min
10 min
15 min
Student-led activity
Self reflective writing
Clinical inferential web
Discussion
Simulation scenario III
Introduction to the case
Simulation exercise
High-risk newborn care: apnea and resuscitation
SBAR
Self reflection with recorded video-clip
Debriefing
10 min
10 min
10 min
10 min
15 min
Student-led activity
Self reflective writing
Clinical inferential web
Discussion
Protocol: Simulation Operation
Pre-learning
Simulation orientation
Simulation operation
SBAR( writing
Watching the recorded video-clip
Debriefing
Data Collection
• Site preparation
– Faculty workshops:
• In-depth training in how to operate the simulation and
evaluate simulation performance
– Staff support:
• Trained research assistants from the research team
Group assignments
Groups of 10 students
Sim Operation:
2/3 students in each sub-group
Sim Operation:
2/3 students
Sim Operation:
2/3 students
Regular practicum
group:
20 students
Instruments
Critical Thinking Disposition Tool
• Yoon's CTD tool (2008)
• 27 items, 5-point Likert scale
• 7 subscales :
– Objectivity
– Prudence
– Systematicity
– intellectual eagerness/curiosity
– intellectual fairness
– healthy skepticism
– CT self-confidence
• Cronbach's α of .844
Simulation Effectiveness Tool
• To assess participant satisfaction with
the simulation
• 13 items, 3-point Likert scale
• Cronbach's α of .845.
Discussion I
• The effect of simulation sessions
• CT achievement
– Subcategories of prudence and intellectual eagerness
Significant predictors of clinical competency
– Increases in prudence and healthy skepticism ->
Enhanced maturity of judgment <-Reflective thinking
experience
Discussion II
• CT improvement during senior years
• The effects of differing exposures on CT
– Multiple exposures to the simulation courseware to
produce meaningful gains in CT among nursing students
Conclusions
• Multiple exposures to the courseware resulted in
significant CT gains in nursing students.
• These gains occurred in the CT subcategories of
prudence and intellectual eagerness, predictors of
clinical competency, and of healthy skepticism,
which along with prudence is an important element
of clinical judgment.