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EVALUATION OF A SIMULATION-ENHANCED OBSTETRIC CLINICAL EXPERIENCE ON LEARNING OUTCOMES FOR KNOWLEDGE, SELF-EFFICACY, AND TRANSFER
Title
EVALUATION OF A SIMULATION-ENHANCED OBSTETRIC CLINICAL EXPERIENCE ON LEARNING OUTCOMES FOR KNOWLEDGE, SELF-EFFICACY, AND TRANSFER.
Creator
Guimond, Mary, Sole, Mary Lou, University of Central Florida
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...
Show moreSimulation 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.
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Date Issued
2010
Identifier
CFE0003414, ucf:48374
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0003414
The Effectiveness of Virtual Humans vs Pre-Recorded Humans in a Standardized Patient Performance Assessment
Title
The Effectiveness of Virtual Humans vs Pre-Recorded Humans in a Standardized Patient Performance Assessment.
Creator
Palathinkal, Joel, Kincaid, John, Shumaker, Randall, Allred, Kelly, Smith, Roger, University of Central Florida
Abstract / Description
A Standardized Patient (SP) is a trained actor who portrays a particular illness to provide training to medical students and professionals. SPs primarily use written scripts and additional paper-based training for preparation of practical and board exams. Many institutions use various methods for training such as hiring preceptors for reenactment of scenarios, viewing archived videos, and computer based training. Currently, the training that is available can be enhanced to improve the level...
Show moreA Standardized Patient (SP) is a trained actor who portrays a particular illness to provide training to medical students and professionals. SPs primarily use written scripts and additional paper-based training for preparation of practical and board exams. Many institutions use various methods for training such as hiring preceptors for reenactment of scenarios, viewing archived videos, and computer based training. Currently, the training that is available can be enhanced to improve the level of quality of standardized patients. The following research is examining current processes in standardized patient training and investigating new methods for clinical skills education in SPs. The modality that is selected for training can possibly affect the performance of the actual SP case.This paper explains the results of a study that investigates if there is a difference in the results of an SP performance assessment. This difference can be seen when comparing a virtual human modality to that of a pre-recorded human modality for standardized patient training. The sample population navigates through an interactive computer based training module which provides informational content on what the roles of an SP are, training objectives, a practice session, and an interactive performance assessment with a simulated Virtual Human medical student. Half of the subjects interact with an animated virtual human medical student while the other half interacts with a pre-recorded human. The interactions from this assessment are audio-recorded, transcribed, and then graded to see how the two modalities compare. If the performance when using virtual humans for standardized patients is equal to or superior to pre-recorded humans, this can be utilized as a part task trainer that brings standardized patients to a higher level of effectiveness and standardization. In addition, if executed properly, this tool could potentially be used as a part task trainer which could provide savings in training time, resources, budget, and staff to military and civilian healthcare facilities.
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Date Issued
2011
Identifier
CFE0004149, ucf:49037
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0004149
An Empirical Evaluation of an Instrument to Determine the Relationship Between Second-Year Medical Students' Perceptions of NERVE VP Design Effectiveness and Students' Ability to Learn and Transfer Skills from NERVE
Title
An Empirical Evaluation of an Instrument to Determine the Relationship Between Second-Year Medical Students' Perceptions of NERVE VP Design Effectiveness and Students' Ability to Learn and Transfer Skills from NERVE.
Creator
Reyes, Ramsamooj, Hirumi, Atsusi, Sivo, Stephen, Campbell, Laurie, Cendan, Juan, University of Central Florida
Abstract / Description
Meta-analyses and systematic reviews of literature comparing the use of virtual patients (VPs) to traditional educational methods support the efficacy of VPs (Cook, Erwin, (&) Triola, 2010; Cook (&) Triola, 2009; McGaghie, Issenberg, Cohen, Barsuk, (&) Wayne, 2011). However, VP design research has produced a variety of design features (Bateman, Allen, Samani, Kidd, (&) Davies, 2013; Botezatu, Hult, (&) Fors, 2010a; Huwendiek (&) De Leng, 2010), frameworks (Huwendiek et al., 2009b) and...
Show moreMeta-analyses and systematic reviews of literature comparing the use of virtual patients (VPs) to traditional educational methods support the efficacy of VPs (Cook, Erwin, (&) Triola, 2010; Cook (&) Triola, 2009; McGaghie, Issenberg, Cohen, Barsuk, (&) Wayne, 2011). However, VP design research has produced a variety of design features (Bateman, Allen, Samani, Kidd, (&) Davies, 2013; Botezatu, Hult, (&) Fors, 2010a; Huwendiek (&) De Leng, 2010), frameworks (Huwendiek et al., 2009b) and principles (Huwendiek et al., 2009a) that are similar in nature, but appear to lack consensus. Consequently, researchers are not sure which VP design principles to apply and few validated guidelines are available. To address this situation, Huwendiek et al. (2014) validated an instrument to evaluate the design of VP simulations that focuses on fostering clinical reasoning. This dissertation examines the predictive validity of one instrument proposed by Huwendiek et al. (2014) that examines VP design features. Empirical research provides evidence for the reliability and validity of the VP design effectiveness measure. However, the relationship between the design features evaluated by the instrument to criterion-referenced measures of student learning and performance remains to be examined. This study examines the predictive validity of Huwendiek et al.'s (2014) VP design effectiveness measurement instrument by determining if the design factors evaluated by the instrument are correlated to medical students' performance in: (a) quizzes and VP cases embedded in Neurological Examination Rehearsal Virtual Environment (NERVE), and (b) NERVE-assisted virtual patient/standardized patient (VP/SP) differential diagnosis and SP checklists. It was hypothesized that students' perceptions of effectiveness of NERVE VP design are significantly correlated to the achievement of higher student learning and transfer outcomes in NERVE.The confirmatory factor analyses revealed the effectiveness of NERVE VP design was significantly correlated to student learning and transfer. Significant correlations were found between key design features evaluated by the instrument and students' performance on quizzes and VP cases embedded in NERVE. In addition, significant correlations were found between the NERVE VP design factors evaluated by Huwendiek et al.'s (2014) instrument and students' performance in SP checklists. Findings provided empirical evidence supporting the reliability and predictive validity of Huwendiek et al.'s (2014) instrument.Future research should examine additional sources of validity for Huwendiek et al.'s (2014) VP design effectiveness instrument using larger samples and from other socio-cultural backgrounds and continue to examine the predictive validity of Huwendiek et al.'s (2014) instrument at Level 2 (Learning) and Level 3 (Application) of Kirkpatrick's (1975) four-level model of training evaluation.
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Date Issued
2016
Identifier
CFE0006166, ucf:51150
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0006166
A Simulation-Based Evaluation Of Efficiency Strategies For A Primary Care Clinic With Unscheduled Visits
Title
A Simulation-Based Evaluation Of Efficiency Strategies For A Primary Care Clinic With Unscheduled Visits.
Creator
Bobbie, Afrifah, Karwowski, Waldemar, Thompson, William, Elshennawy, Ahmad, Mikusinski, Piotr, University of Central Florida
Abstract / Description
In the health care industry, there are strategies to remove inefficiencies from the health delivery process called efficiency strategies. This dissertation proposed a simulation model to evaluate the impact of the efficiency strategies on a primary care clinic with unscheduled "walk-in" patient visits. The simulation model captures the complex characteristics of the Orlando Veteran's Affairs Medical Center (VAMC) primary care clinic. This clinic system includes different types of patients,...
Show moreIn the health care industry, there are strategies to remove inefficiencies from the health delivery process called efficiency strategies. This dissertation proposed a simulation model to evaluate the impact of the efficiency strategies on a primary care clinic with unscheduled "walk-in" patient visits. The simulation model captures the complex characteristics of the Orlando Veteran's Affairs Medical Center (VAMC) primary care clinic. This clinic system includes different types of patients, patient paths, and multiple resources that serve them. Added to the problem complexity is the presence of patient no-shows characteristics and unscheduled patient arrivals, a problem which has been until recently, largely neglected. The main objectives of this research were to develop a model that captures the complexities of the Orlando VAMC, evaluate alternative scenarios to work in unscheduled patient visits, and examine the impact of patient flow, appointment scheduling, and capacity management decisions on the performance of the primary care clinic system. The main results show that only a joint policy of appointment scheduling rules and patient flow decisions has a significant impact on the wait time of scheduled patients. It is recommended that in the future the clinic addresses the problem of serving additional walk-in patients from an integrated scheduling and patient flow viewpoint.
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Date Issued
2016
Identifier
CFE0006443, ucf:51462
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0006443