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EVALUATION OF A SIMULATION-ENHANCED OBSTETRIC CLINICAL EXPERIENCE ON LEARNING OUTCOMES FOR KNOWLEDGE, SELF-EFFICACY, AND TRANSFER

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Date Issued:
2010
Abstract/Description:
Simulation using computerized patient mannequins may be a useful mechanism to teach safe and effective nursing care, thus improving the quality of education for nurses. As nursing program enrollments grow, clinical placement is becoming more difficult and may not offer consistent learning opportunities that reinforce safe and effective nursing practice. This study applied Ford, Smith, Weissbein, Gully, and SalasÂÂÂÂ' (1998) model of learning transfer as the theoretical framework to design a simulated obstetric clinical learning experience to augment the current clinical practice model, an approach that may lead to an improved educational experience. The purpose of this study was to compare learning outcomes of two clinical teaching strategies for obstetric clinical content for undergraduate nursing students: standard clinical instruction and a simulation-enhanced clinical experience. A mixed-method approach was used. A randomized cluster design was chosen to compare the learning outcomes for students participating in a simulation-enhanced clinical experience versus students participating in a traditional clinical rotation. From the study population of 124 students, 40 participated in the simulation-enhanced clinical group, with the remainder of students serving as controls. Four instruments (Obstetric Nursing Self-Efficacy instrument, Goal Orientation Scale, Proxy Measure, and examination knowledge items) were used to measure student characteristics or achievement of outcomes. Learning outcomes for self-efficacy, knowledge, skills, and transfer were compared between the groups using ANCOVA, independent sample t-test, and chi-square analyses. A qualitative descriptive analysis of clinical evaluations for all students was also conducted. Demographic characteristics between the groups were not statistically different. The analysis of covariance (ANCOVA) revealed no difference in ONSE posttest scores between the groups after adjusting for goal orientation and ONSE pretest scores. An alternative ANCOVA for sequence (time in semester when the simulation occurred) and group was not significant. However, after adjustment for the covariate of ONSE pretest scores, ONSE posttest scores varied with sequencing (p <.05); students who had the simulated experience during the first half of the semester (M=67.27) scored higher than those in the second half (M=60.89) when pretest scores were used as a covariate. No differences were found between the experimental and control groups for knowledge or skills. The narrative analysis revealed broad variation in comments on the clinical evaluation form among clinical instructors. Attitude, knowledge attainment, skill acquisition, helpfulness, and professional role attributes were common themes related to student clinical performance. The findings from the study contribute to a growing body of literature evaluating the efficacy of simulation to augment clinical nursing practice experience. Data suggest there is little difference in learning outcomes for students participating in a simulation-enhanced clinical group versus the traditional clinical rotation. This finding supports that at least 15% of clinical hours could occur in a simulated clinical environment. A model driven method of simulation design and delivery could support learning in a way that will allow for efficient and effective use of simulation to support safe and effective obstetric nursing care.
Title: EVALUATION OF A SIMULATION-ENHANCED OBSTETRIC CLINICAL EXPERIENCE ON LEARNING OUTCOMES FOR KNOWLEDGE, SELF-EFFICACY, AND TRANSFER.
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Name(s): Guimond, Mary, Author
Sole, Mary Lou, Committee Chair
University of Central Florida, Degree Grantor
Type of Resource: text
Date Issued: 2010
Publisher: University of Central Florida
Language(s): English
Abstract/Description: Simulation using computerized patient mannequins may be a useful mechanism to teach safe and effective nursing care, thus improving the quality of education for nurses. As nursing program enrollments grow, clinical placement is becoming more difficult and may not offer consistent learning opportunities that reinforce safe and effective nursing practice. This study applied Ford, Smith, Weissbein, Gully, and SalasÂÂÂÂ' (1998) model of learning transfer as the theoretical framework to design a simulated obstetric clinical learning experience to augment the current clinical practice model, an approach that may lead to an improved educational experience. The purpose of this study was to compare learning outcomes of two clinical teaching strategies for obstetric clinical content for undergraduate nursing students: standard clinical instruction and a simulation-enhanced clinical experience. A mixed-method approach was used. A randomized cluster design was chosen to compare the learning outcomes for students participating in a simulation-enhanced clinical experience versus students participating in a traditional clinical rotation. From the study population of 124 students, 40 participated in the simulation-enhanced clinical group, with the remainder of students serving as controls. Four instruments (Obstetric Nursing Self-Efficacy instrument, Goal Orientation Scale, Proxy Measure, and examination knowledge items) were used to measure student characteristics or achievement of outcomes. Learning outcomes for self-efficacy, knowledge, skills, and transfer were compared between the groups using ANCOVA, independent sample t-test, and chi-square analyses. A qualitative descriptive analysis of clinical evaluations for all students was also conducted. Demographic characteristics between the groups were not statistically different. The analysis of covariance (ANCOVA) revealed no difference in ONSE posttest scores between the groups after adjusting for goal orientation and ONSE pretest scores. An alternative ANCOVA for sequence (time in semester when the simulation occurred) and group was not significant. However, after adjustment for the covariate of ONSE pretest scores, ONSE posttest scores varied with sequencing (p <.05); students who had the simulated experience during the first half of the semester (M=67.27) scored higher than those in the second half (M=60.89) when pretest scores were used as a covariate. No differences were found between the experimental and control groups for knowledge or skills. The narrative analysis revealed broad variation in comments on the clinical evaluation form among clinical instructors. Attitude, knowledge attainment, skill acquisition, helpfulness, and professional role attributes were common themes related to student clinical performance. The findings from the study contribute to a growing body of literature evaluating the efficacy of simulation to augment clinical nursing practice experience. Data suggest there is little difference in learning outcomes for students participating in a simulation-enhanced clinical group versus the traditional clinical rotation. This finding supports that at least 15% of clinical hours could occur in a simulated clinical environment. A model driven method of simulation design and delivery could support learning in a way that will allow for efficient and effective use of simulation to support safe and effective obstetric nursing care.
Identifier: CFE0003414 (IID), ucf:48374 (fedora)
Note(s): 2010-12-01
Ph.D.
Graduate Studies, School of Nursing
Masters
This record was generated from author submitted information.
Subject(s): nursing education
clinical education
clinical simulation
simulation evaluation
nursing simulation
Persistent Link to This Record: http://purl.flvc.org/ucf/fd/CFE0003414
Restrictions on Access: campus 2015-12-01
Host Institution: UCF

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