Fostering Critical Thinking Through Simulation: An Integrative Review, Sarah Knapp, Raymonta Green

Master of Science in Nursing Final Projects

Over the past decade simulation has become a staple of nursing education with increasing use during the COVID-19 pandemic. Both manikin-based and virtual simulation are used to increase the preparedness of nursing students for their roles at the bedside. With the increasing experience-complexity gap, it is important that students enter the workforce prepared to effectively care for patients. Simulation allows students to work with a patient scenario without the possibility of injury; in simulation, mistakes are opportunities instead of harm. This integrative review searched the literature questioning if in pre-licensure Bachelor of Science in Nursing students, do virtual simulation and …

Investigating Students’ Lived Experience With Prebriefing Structure And Elements In Nursing Simulation Education, Meghan Liebzeit

UNLV Theses, Dissertations, Professional Papers, and Capstones

Prebriefing is a growing body of knowledge in nursing simulation education. It is recognized as an important factor in the simulation experience, however the practice of prebriefing varies widely making it difficult to understand what methods best prepare students for the simulation scenario. While research over the last decade has identified prebriefing increases confidence, skills, and clinical judgment, what content is important to include in prebriefing, or how it promotes the achievement of outcomes is under recognized.Implementing an intervention based on a pedagogically sound eight-week simulation clinical course, developed with the theoretical underpinnings of Vygotsky’s Zone of Proximal Development, Kolb’s …

Impact Of Personalized Interactive Storytelling On Suspension Of Disbelief In Clinical Simulation, Audra Renee-Smith Xenakis

Electronic Theses and Dissertations

The literature review found suspension of disbelief (SOD) in clinical simulation heavily weighted on educators alone within high-fidelity environments. The project examined a co-created narrative background story applied to a simulated patient’s clinical profile to determine achieving an improved connectedness toward the simulated patient leading to enhanced SOD and enhanced levels of learning and reaction. The studied population was third-semester associate degree nursing students over 18 years of age with prior clinical simulation experience who were not repeating the semester. The research methodology used a quantitative experimental design with cluster sampling, randomization, and post-Likert-scored questionnaires. The intervention group co-created personalized …

Educator Preparedness In The Use Of Simulation In Nursing Education, Marcelene E. Hart

Walden Dissertations and Doctoral Studies

AbstractNurse educators lack preparation when using simulation as a teaching modality in educating nurses and nursing students within their clinical environment. The purpose of this basic qualitative study was to understand nurse educators’ perceptions of the challenges in preparing for simulation-based training experiences for nurses and nursing students. Vygotsky’s constructivist theory was used as the conceptual framework for the study to emphasize students’ innate ability to learn using active and hands-on processes through simulation experiences. Questions were developed to explore the challenges nurse educators encounter when preparing for simulation activities. Survey questionnaire invitations were sent through email to hundreds of …

Educator Preparedness In The Use Of Simulation In Nursing Education, Marcelene E. Hart

Walden Dissertations and Doctoral Studies

AbstractNurse educators lack preparation when using simulation as a teaching modality in educating nurses and nursing students within their clinical environment. The purpose of this basic qualitative study was to understand nurse educators’ perceptions of the challenges in preparing for simulation-based training experiences for nurses and nursing students. Vygotsky’s constructivist theory was used as the conceptual framework for the study to emphasize students’ innate ability to learn using active and hands-on processes through simulation experiences. Questions were developed to explore the challenges nurse educators encounter when preparing for simulation activities. Survey questionnaire invitations were sent through email to hundreds of …

Improving The Competency Of Nurse Educators In The Use Of Simulation, Pricilla H. Wyatt

Electronic Theses and Dissertations

Simulation in nursing education programs is widely used as an active clinical learning strategy. This teaching methodology is a standard supplement to clinical experiences for nursing students to meet the requirements of clinical components within their degree program; however, the faculty of a small liberal arts-based Bachelor of Science in Nursing program was not using simulation to its fullest potential. Therefore, the purpose of this DNP project was to introduce the use of evidence-based practice simulation guidelines recommended by the National Council of State Boards of Nursing. The study sample of 16 included 10 full-time faculty, five part-time adjunct faculty, …

The Use Of Simulation With The School Of Nursing And Health Professions (Sonhp) Prelicensure Students To Support Affirming Practice With Transgender Communities, Genevieve Charbonneau

Doctoral Dissertations

This dissertation investigates how prelicensure nursing students are prepared to address healthcare disparities with transgender patients, specifically through simulation scenarios at the University of San Francisco School of Nursing and Health Professions Simulation Center.

A critical review of current literature reveals how microaggressions against transgender communities create and sustain barriers to equitable healthcare. The qualitative study was designed to explore the lived experience of prelicensure nursing students who are actively seeking to understand the healthcare needs of transgender patients in the San Francisco Bay Area.

This was a qualitative research study including data that suggests that using simulation scenarios featuring …

A Telehealth Palliative Care Objective Structured Clinical Examination, Lindsey Q. Mcintyre

Dissertations

Problem: Palliative care is a service focused on symptom management and improved quality of life for persons with serious or chronic illnesses and is widely underutilized. Although advanced practice registered nurses (APRNs) possess a unique skillset to contribute to palliative care, there is minimal reporting on palliative care training for this professional group. The purpose of this clinical scholarship project was to implement the End-of-Life Nursing Education Consortium (ELNEC) online training program for APRN students in the BSN-DNP program and evaluate its effect on student performance during a telehealth objective structured clinical examination (OSCE).

Methods: An observational, descriptive …

Integrating Ethics And The Opioid Crisis Via Simulation: An Ethical Debriefing For Nursing Students, Raigan A. J. Shackelford

Senior Honors Projects, 2020-current

Over the past three decades, opioid medication misuse and abuse has skyrocketed. The increase in improper use has created the need for more frequent exercise of ethical reasoning skills in practice. This study was designed to determine the effect of an ethics-centered debriefing exercise following a standardized simulation scenario concerning opioid misuse/abuse on nursing students’ value of and perceived confidence in ethical reasoning skills. 18 senior level BSN students at James Madison University in Harrisonburg, VA, participated in an ethics- focused debriefing exercise following the simulated scenario. The debriefing was constructed using the ANA Code of Ethics and James Madison …

Professional Nurse Attitudes Of Poverty Before And After Participation In A Poverty Simulation, Beth Mueller

Walden Dissertations and Doctoral Studies

Implicit bias in healthcare toward those living in poverty may contribute to inequalities in care and increase the likelihood of patient noncompliance. The purpose of this study was to determine if participation in a poverty simulation had an impact on the attitudes of professional nurses toward those in poverty. Mezirow’s transformational theory was used to guide the study by allowing the learner to examine meaning and revise perspective after participation in an online module. This module included an online poverty simulation created by The United Way of Connecticut titled Making Tough Choices as well as a pre- and post-simulation survey …

The Development, Implementation, And Evaluation Of A Sexual Assault Nurse Examiner Training Program, Shantee Henry

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Sexual assault is a growing concern in the United States. Appropriate care of its survivors is essential to controlling the short and long-term effects of this trauma. A sexual assault nurse examiner (SANE) is a registered nurse that acquires additional training specializing in the comprehensive care of sexual assault survivors. Research indicates that there are not enough SANEs to provide coverage for the increasing number of sexual assaults, especially in rural areas. To increase the number of certified SANEs in rural areas, the Health Resources and Services Administration (HRSA) of the U.S. government provided funds through a grant that was …

Simulation Impact On Medication Administration Safety: A Simulation Quality Improvement Project, Stacy Simpson

Doctor of Nursing Practice Projects

Background: Two medication simulations increasing in rigor, patient acuity, and distractions were implemented among undergraduate nursing students.

Objectives: To increase nursing student confidence, knowledge, and competence when administering medications.

Design: Two medication administration simulations were implemented and data was collected from students via a pre-simulation quiz, observation during the simulation via a Clinical Simulation Evaluation Tool, and student evaluation of the simulation with a modified version of the Simulation Evaluation Tool Likert scale.

Settings: Gaston Community College nursing simulation lab.

Participants: 53 undergraduate nursing students enrolled in NUR 101 and 42 students in NUR 102 …

Utilizing Simulation To Implement Cognitive Aids In The Operating Room, Kaitlyn Brown

Doctor of Nursing Practice Projects

Background: Operating room crises require prompt, efficient action to avoid detrimental outcomes. Research shows that crisis checklists or other cognitive aids assist anesthesia providers in taking prompt action while improving efficiency by decreasing treatment steps missed during critical events.

Objectives: The purpose of this project was to evaluate the effectiveness of incorporating cardiac arrest and malignant hyperthermia crisis checklists into the operating room using high-fidelity simulation-based education.

Methods: Researchers implemented the Stanford Emergency Manual Cognitive Aids for cardiac arrest and malignant hyperthermia to anesthesia staff at a community hospital in southern Illinois with 18 participants. Implementation consisted of an education …

Simulation Facilitator Competency: Validity And Reliability Of A Self-Assessment Tool, Mary (Molly) Kellgren

Theses and Dissertations

The use of simulation as a teaching and learning strategy continues to grow in nursing education. Standards of Best Practice, certification criteria, and simulation theory support the notion that facilitation of simulation requires a specialized skill set that differs from traditional classroom and clinical teaching. The discipline of nursing has already established valid and reliable tools for teachers within the classroom and clinical environments to complete self- and/or peer evaluation to inform teaching effectiveness. The National League for Nursing/Kellgren Simulation Facilitator (NLN/KSF) tool fills a gap in the literature by providing a valid and reliable tool to self-assess comprehensive facilitator …

Simulation As Replacement For Traditional Clinical In Pre-Licensure Nursing Education: Outcomes Of Different Ratios Of Replacement Time For Traditional Clinical With Simulation, Tiffany Zyniewicz

Dissertations

The use of simulation in nursing education has grown over the last 30 years. The National Council of State Boards of Nursing National Simulation Study indicated that up to 50% of traditional clinical hours can be replaced with simulation at a 1:1 replacement ratio and produce the same outcomes. A review of the literature indicated that there is no standard replacement ratio for simulation time to traditional clinical time being used in pre-licensure nursing education in the United States. The purpose of this study was to explore the outcomes of utilizing a 1:1 simulation-to-traditional clinical time replacement ratio and a …

Use Of A Checklist To Facilitate The Recognition Of A Transfusion Associated Adverse Event, Susan Scott

Doctoral Dissertations

Transfusions are the most common procedure that hospitalized patients undergo. One of the risks associated with a transfusion is a transfusion related adverse event (TAAE). Transfusion associated adverse events can occur in any patient receiving a transfusion. Some patients are at risk of certain TAAEs (e.g., heart failure patients at risk of transfusion associated circulatory overload) while other events (e.g., allergic reactions) cannot always be anticipated. The severity of a TAAE can range from mildly uncomfortable to life threatening. Nurses need to be able to identify the signs and symptoms of a possible TAAE and intervene immediately by stopping the …

Simulated Clinical Experience: An Investigation Of Emotion Understanding And Management, Neena White Jones

Walden Dissertations and Doctoral Studies

Many investigators have documented that lack of emotional intelligence (EI) in professional nursing correlates with patient dissatisfaction, negative patient outcomes, and litigation. However, much less information is available to nurse educators for an effective instructional strategy to increase EI skills, specifically emotion understanding and management (the most influential branches of EI) in nursing students. Grounded in the theory of EI and the theory of simulation, the purpose of this quantitative quasi experimental study was to introduce educational technology as a useful strategy for influencing EI in a convenience sample of 88 second semester students in a baccalaureate program. Research questions …

Simulation As A Remediation Tool For Clinically At-Risk Associate Degree Nursing Students, Janna G. Lock

Walden Dissertations and Doctoral Studies

Evidence-based remediation options are limited for nursing students who fail their clinical competency evaluations. Scholarly literature provides a paucity of studies related to the use of simulation-based technology to remediate nursing students. The research question focused on the difference in the initial competency demonstration evaluation scores of associate degree nursing students compared to the reevaluation scores after remediation with simulation-based technology. Benner's novice to expert and Kolb's experiential learning theories were used to explain how nurses acquire and develop skills. The researcher used a quantitative one-group pretest posttest design to examine archival data from 149 nursing students from a South-Central …

Examining The Relationship Between The Use Of Simulation In Nursing Education Andsafety With Medication Adminstration In The Clinical Setting, Deborah A. Eremita

Electronic Theses and Dissertations

EXAMINING THE RELATIONSHIP BETWEEN THE USE OF SIMULATION IN

NURSING EDUCATION AND SAFETY WITH

MEDICATION ADMINISTRATION

IN THE CLINICAL SETTING

Deborah A. Eremita

Thesis Advisors: Dr. Ann Sossong and Dr. Patricia Poirier

An Abstract of the Dissertation Presented

in Partial Fulfillment of the Requirements for the

Degree Interdisciplinary Doctor of Philosophy

In Nursing and Education

May 2018

Medication errors represent a significant threat to patient safety. Administration of medications is a primary role of nursing practice and a critical component of nursing education curricula. Safe medication is a challenging process to teach nursing students. Simulation may provide students with a …

Use Of Simulation For Tracheostomy Care, A Low Volume, High Risk Nursing Procedure, Vijaya Ramakrishnan

Walden Dissertations and Doctoral Studies

Often, education regarding low volume and high-risk procedures, like tracheostomy, are ignored. Lack of experience, skills, and human resources can lead to decreases in confidence levels, diminished quality of care, and potentially an adverse event. The purpose of this DNP project was to prepare simulation-based education on the tracheostomy procedure and provide hands-on education to bedside nurses. The project answered the question: To what extent will a simulation-based teaching method adequately prepare staff nurses in a post-acute surgical unit to perform this high risk low volume procedure? The Johns Hopkins evidence-based model method was used to assist in translation of …

Graduate Nurse's Perspective Of Simulation To Address The Theory-Practice Gap In Nursing, Joset Elaine Brown

Walden Dissertations and Doctoral Studies

Graduate nurses are being employed to provide care in high acuity care areas, and this becomes a problem of significance as the literature suggests that graduate nurse's experience a deficit in integrating theoretical concepts in the clinical environment, described as the theory-practice gap; which can result in a risk to patient safety and the potential for negative outcomes. Cognitive constructivism was the conceptual framework that guided this study. A qualitative phenomenological design was used to explore the lived experiences of 13 graduate nurses employed at a community hospital in northern New Jersey. After recruiting the participants through purposive sampling, semi-structured …

Scenario-Based Communication Simulation Curriculum And Plan, Sandra Imperial

Walden Dissertations and Doctoral Studies

The Joint Commission reported that communication failures in United States hospitals contribute to 30% of all malpractice claims, and in 2008, The Joint Commission listed the improvement of effective communication among healthcare providers as a National Patient Safety Goal. The purpose of this practice-focused project was to develop a scenario-based communication simulation for implementation approval by a panel of experts. The approved curriculum was designed to integrate a communication-based simulation scenario into the nurse residency program of a large, urban medical center to improve new graduate nurse communication skills, increase nurse communication competency and self-efficacy, and decrease communication errors. Kolb's …

Effect Of Implementation Of Simulation On Critical Thinking Skills In Undergraduate Baccalaureate Nursing Students, Joanne M. Knoesel

Dissertations, Theses, and Capstone Projects

Human patient simulation (HPS) is a time and cost intensive teaching modality that is used widely in nursing education, and has been implemented with little evidence to support its efficacy (Jeffries & Rizzolo, 2006). Researchers note the lack of reliable tools to measure learning using this teaching modality, and consequentially there is a paucity of research linking critical thinking and simulation (Jeffries, 2007; Kneebone, 2003; Nehring, 2008). Nursing clinical decision making affects patient outcomes. Critical thinking is a key factor in clinical decision making. A review of the relevant literature is equivocal on the use of simulation in undergraduate nursing …

Clinical Simulation And Nursing Student Perceptions Of Satisfaction, Self-Confidence, And Critical Thinking, Jaime Magnetico

Walden Dissertations and Doctoral Studies

Although the number of nursing programs has increased in Florida, the number of hospital sites available for clinical experiences have not, resulting in limited clinical time for each nursing program. To address this shortage of clinical time, local colleges are increasing the use of simulations in the curriculum. Guided by andragogy, this sequential mixed methods study was conducted to explore differences in students' perceptions of satisfaction, self-confidence, and critical thinking between two groups of students with different amounts of clinical simulation. In an associate degree nursing program, 34 nursing students completed a single survey on student perceptions of satisfaction and …

Issues Related To Implementing High-Fidelity Simulation In A Nursing Program, Sherry Rene Ray

Walden Dissertations and Doctoral Studies

Due to the shortage of clinical sites, nursing educators, deans, and directors are compelled to implement alternative clinical solutions such as high-fidelity simulation (HFS). The problem is that nursing educators are often not prepared to implement HFS as a teaching strategy. Faculty readiness is imperative for a successful simulation program and student outcomes. Therefore, the purpose of this study was to investigate the perceptions and practices of faculty, deans, and directors on the implementation of HFS across the nursing curriculum. Kolb's experiential learning theory provided the theoretical support for both the teaching and learning required by faculty for a successful …

Educating Nurses On Workflow Changes From Electronic Health Record Adoption, Rhoda Lynn Atienza San Jose

Walden Dissertations and Doctoral Studies

Workflow issues related to adoption of the electronic health record (EHR) has led to unsafe workarounds, decreased productivity, inefficient clinical documentation and slow rates of EHR adoption. The problem addressed in this quality improvement project was nurses' lack of knowledge about workflow changes due to EHR adoption. The purpose of this project was to identify changes in workflow and to develop an educational module to communicate the changes. This project was guided by both the ADDIE model (analysis, design, development, implementation, and evaluation) and the diffusion of innovations theory. Five stages were involved: process mapping, cognitive walkthrough, eLearning module development, …

Nurse Educators’ Perceptions Of Using High-Fidelity Simulation In Teaching, Marlene Whigham

Theses and Dissertations

Nurse Educators’ Perceptions of Using High-Fidelity Simulation in Teaching. Marline Whigham, 2017: Applied Dissertation, Nova Southeastern University, Abraham S. Fischler College of Education. Keywords: nursing education, learning strategies, simulation, staff development, teaching styles.

High-fidelity simulation in nursing refers to the use of computerized manikins to offer realistic hands-on training to nursing students. The problem addressed by this dissertation was resistance among some faculty to the use of new computerized simulation technology in the nursing curriculum. The research question for this case study investigated how faculty members can incorporate simulation into the curriculum and barriers faced in setting the stage for …

Effect Of Sequence Of Simulated And Clinical Practicum Learning Experiences On Clinical Competency, Jamie Hansen

Dissertations (1934 -)

Delivery of clinical education using the traditional model involving faculty supervision of students in a hospital setting has become increasingly difficult for schools of nursing due to factors such as increased student enrollment and decreased clinical site availability. Simulated learning experiences (SLE) have increasingly been used as a supplement or replacement for a portion of nursing students’ traditional clinical learning experiences (CLE). There has been a call for research to ensure that new models for delivery of clinical education are built on a foundation of research. Although SLE have been increasingly used as a supplement to CLE, it is unknown …

Identifying Learning Acquired During Debriefing, Shelly J. Reed

UNLV Theses, Dissertations, Professional Papers, and Capstones

Debriefing, the reflective activity following an experiential learning exercise, has been identified as the most important part of simulation learning and is also important for learning in other activities utilized in nursing education. There is general agreement that debriefing provides learning and improves performance. However, there is little specific evidence about the phenomenon of learning acquired during debriefing, including how it occurs, how it is defined and identified, and how it is evaluated by debriefing facilitators. In addition, there are no instruments or tools specifically measuring learning acquired during debriefing. Without practical and theoretically grounded tools, simulation activities will continue …

The Effect Of Standardized Patient Encounters On Undergraduate Nursing Student Empathy And Self-Efficacy In Therapeutic Communication, Alana M. Urness

Evidence-Based Practice Project Reports

Therapeutic communication between the nurse and patient is an essential component of optimal nursing care. Current evidence supports the use of standardized patient (SP) encounters to assist students in learning therapeutic communication skills. In addition to offering students an opportunity to practice in an environment free of clinical consequence, SP encounters have been shown to increase clinical knowledge and skill, improve diagnostic reasoning, and improve communication skills and interviewing skills. The purpose of this evidence-based practice project was to assess the effect of SP encounters on undergraduate nursing student empathy and self-efficacy related to therapeutic communication. Secondary outcomes included participant …