Nursing Commons^™

Impetus To Transform: Essential Nursing Leadership Development Through Simulation, Mary J. Mette

Doctor of Nursing Practice (DNP) Projects

Abstract

A nurse manager’s ability to effect positive change and inspire others to higher levels of achievement is related to his or her leadership style in the practice setting, as well as the culture present in the organization as a whole. The aim of this Doctor of Nursing evidence-based change in practice project was to create an educational modality that supported training nurse leaders through innovation and creative problem solving in today’s acute healthcare setting.

A survey was administered to 48 frontline managers in a Northern California healthcare system to access the gaps and voids in their ability to integrate …

Patient-Centered Appointment Scheduling Using Agent-Based Simulation, Tammy Toscos, Ayten Turkcan, Brad Doebbeling

Tammy R Toscos

Enhanced access and continuity are key components of patient-centered care. Existing studies show that several interventions such as providing same day appointments, walk-in services, after-hours care, and group appointments, have been used to redesign the healthcare systems for improved access to primary care. However, an intervention focusing on a single component of care delivery (i.e. improving access to acute care) might have a negative impact other components of the system (i.e. reduced continuity of care for chronic patients). Therefore, primary care clinics should consider implementing multiple interventions tailored for their patient population needs. We collected rapid ethnography and observations to …

Written Debriefing: Evaluating The Impact Of The Addition Of A Written Component When Debriefing Simulations, Shelly Jensen Reed

Faculty Publications

Debriefing, the reflective period following a simulation, is said to be where the bulk of simulation learning takes place. Many expert opinions regarding debriefing exist, but evidence-based best practices have yet to be identified. Written debriefing is one of these practices; experts state learning can be extended through the addition of a written component to the debriefing process, but no evidence exists to support this. This study compares three debriefing types: discussion alone, and discussion followed by journaling or blogging. Undergraduate nursing students participating in a simulation were randomized as a simulation group to one of these three debriefing types. …

Newly Licensed Registered Nurses' Experiences With Clinical Simulation, Carrie Ann Bailey

Doctoral Dissertations

The purpose of this study was to understand how new graduate nurses perceive the value of simulation in making the transition into professional practice. This study will use a descriptive qualitative approach with a sample of first year nurses. Kolb’s Experiential Learning Model serves as this study’s conceptual framework. For the current study, the sample consisted of 10 newly graduated, female nurses with less than one year of experience working in the hospital setting were interviewed. Data analysis included interviews and transcription by the researcher. Finally, participants were asked about themes to increase rigor. Four themes emerged from this research: …

Does Simulation Improve Nursing Student Knowledge, Skills, And Attitudes In Identifying Delirium Superimposed On Dementia?, Sheryl A. Kelly

Theses and Dissertations

This dissertation is comprised of three manuscripts, to be submitted for publication, exploring the use of simulation in geriatric nursing education. The first manuscript is a literature review. Although, a number of articles exist on the use of simulation in nursing education, there is a paucity of research using simulation emphasizing the care of patients with dementia and delirium as a pedagogical strategy or those using a stringent research design.

The second manuscript provides an overview of two conceptual frameworks (National League for Nursing (NLN)/Jeffries Simulation Framework and situated cognition learning framework) and recommends merging them to guide researchers as …

Exploring The Usability Of Game-Based Virtual Reality For Development Of Procedural Skills In Undergraduate Nursing Students, Ann Louise Butt

Boise State University Theses and Dissertations

Providing safe, high quality patient care requires that undergraduate nursing students learn and apply extensive content knowledge as they also begin to develop clinical judgment. Nursing students must learn several procedural skills and be ready to remember and competently perform these skills when the need arises during patient care. Some procedures require strict adherence to aseptic technique in order to protect patients from hospital-acquired infections. Consequently, nurse educators are challenged to find innovative and interactive ways to help students develop and remember these important fundamental skills while ensuring patient safety.

This study used a mixed methods design to explore the …

The Effects Of The Hcahps Learning Module On Undergraduate Nursing Students During The Simulated Hospital Day, Ronnie C. Stout

UNLV Theses, Dissertations, Professional Papers, and Capstones

The introduction of the Affordable Care Act has brought about change in the way the Centers for Medicare and Medicaid Services (CMS) reimburses for hospital care. Hospitals are being rewarded for making the patient experience a positive one as evaluated by the patients. This information is provided through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. These survey results allow consumers to compare hospitals locally and nationally with other hospitals. Patients are able to evaluate the hospitals in their area and make informed decisions about where they want to get their care based on previous patients’ experiences. …

The Effect Of Worked Out Modeling In Nursing Simulation, Jayne Josephsen

Boise State University Theses and Dissertations

This study provides a research framework that incorporates cognitive load theory (CLT) into simulation design and implementation, as well as providing a pilot tool to measure cognitive load specific to nursing simulation. The pedagogy of CLT is based in an understanding of cognitive architecture, which includes working memory, long-term memory, various types of cognitive load, and schema development. A quasi-experimental quantitative design was used with a convenience sample of senior baccalaureate nursing students who participated in simulation as part of their coursework. The treatment group received a worked out modeling intervention, designed upon the CLT instructional intervention of the worked …

Effect Of An Adaptive Thinking Training Methodology On Critical Thinking Disposition Using Human Patient Simulators: A Catalyst For Preparing Advanced Nursing Students, Robert Joseph Fitkin Jr.

Teaching & Learning Theses & Dissertations

Critical thinking decision making is the foundation for effective, safe, nursing practice. Nurses have to assess patient issues rapidly regardless of whether it is emotional, psychological, or physical, and then sort through "rapid fire" questions resulting in invisible sorting, discerning, and drawing of conclusions. Doing this "invisible sorting" well requires practice. Nursing education provides practice through preceptors or scenarios-driven human patient simulators to practice critical thinking. This study examines Adaptive Thinking Training Methodology with simulation exercises as a possible catalyst for growth in critical thinking disposition, and help in addressing the preparation-practice gap for novice nurses.

A class of advanced …

Nursing Students’ Experiences With High-Fidelity Simulation, Rana Halabi Najjar, Bret Lyman, Nick Miehl

Faculty Publications

Research has revealed the effectiveness of simulation for facilitating student development of self-efficacy, knowledge, clinical judgment, and proficiency in technical skills. This grounded theory study was conducted to describe the experience of nursing students in high-fidelity simulation and develop a model which explicates the experience of nursing students in simulation. Focus group interviews were conducted with three cohorts of students enrolled in a baccalaureate nursing program who experienced simulation four to twelve times per academic year. Five prominent themes emerged during analysis Emotional Processing; Anxiety; Making Connections; Fidelity; and Learning. The Simulation Learning Model – Student Experience (SLM-SE) was developed …

National Skills Training Centre In India, Manju Chhugani, Ashin Merlin

Journal of Asian Midwives (JAM)

A key determinant which can ensure the quality of healthcare in public health institutions is the skill set of the individuals providing service delivery. Health professionals possess the skills and the expertise in this respect; however, they fail to utilize these optimally. This is because there is a disconnect between their knowledge and practice, it is now imperative tobridge the gap between basic education and clinical practice. The creation of skill labs is one way in which this gap can be addressed. Though India has seen a decline inboth the Maternal and Infant Mortality Rates, significant changes are yet to …

Shifting The Paradigm Of Classroom Nursing Orientation, Mary Leyk

Nursing Posters

Purpose Statement: The purpose of the Evidence-Based Practice Nursing Orientation Project is to find evidence to support a change in teaching strategy for newly hired RNs (both New Grads as well as experienced nurses), from the current process in order to improve outcomes of clinical competence, independence and nurse confidence, and retention.

Cultural Norms Of Clinical Simulation In Undergraduate Nursing Education, Susan G. Mcniesh

Faculty Publications

Simulated practice of clinical skills has occurred in skills laboratories for generations, and there is strong evidence to support high-fidelity clinical simulation as an effective tool for learning performance-based skills. What are less known are the processes within clinical simulation environments that facilitate the learning of socially bound and integrated components of nursing practice. Our purpose in this study was to ethnographically describe the situated learning within a simulation laboratory for baccalaureate nursing students within the western United States. We gathered and analyzed data from observations of simulation sessions as well as interviews with students and faculty to produce a …

Incorporating Simulation Into Advanced Cardiac Life Support, Lorraine Calwile

Nursing Theses and Capstone Projects

The knowledge and practical skills of the Basic Life Support (BLS) and the Advanced Cardiac Life Support (ACLS) are among the most important determining factors of the cardiopulmonary resuscitation (CPR) success rates. Every year there are millions of healthcare workers that dread coming to ACLS class for fear of failure of the written exam or the mega code. Many of these participants haven’t participated in a code situation since they left class the previous two years. Participants sit in class for two days listening to lectures and going through practice mega codes to prepare them for the final mega code. …

Evaluating Chain-Of-Command Self-Efficacy Through High Fidelity, Student-Directed, Obstetrical Simulation, Michelle Mcewen-Campbell

Nursing Theses and Capstone Projects

The purpose of this quasi-experimental capstone project was to evaluate the impact of high fidelity, student-directed, obstetrical simulation upon chain-of-command self-efficacy of baccalaureate nursing students. The convenience sample, composed of 48 junior nursing students, was randomly divided into four simulation groups, and then further randomly divided into active or observational status. Active participants planned interventions and participated in high fidelity obstetrical simulations related to patient safety and chain-of-command initiation. Active and observational students participated in a combined debriefing session. A pretest posttest design utilizing the General Self-Efficacy Scale (GSES) was utilized to measure chain-of-command self-efficacy in relation to both active …

Improving Attitudes Toward Interdisciplinary Collaboration Between Nursing And Medical Students In Simulation, Kristy H. Williams

Nursing Theses and Capstone Projects

This capstone project assessed whether a curriculum change for senior nursing students could have an impact on improving attitudes toward physician-nurse collaboration. A convenience sample of 60 senior level nursing students and eight residents were enrolled in the study. The nursing students and residents participated in a high-fidelity simulation scenario, and were given a pretest and posttest using the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration. There was strong evidence (t= -1.971, p=.05) that the attitudes of physician-nurse collaboration improved for nursing students through a simulation based scenario with residents. The confidence interval for the difference was (-0.22, 0.002). Although …

The Impact Of Simulation-Based Learning Experience On Student Satisfaction, Perceived Self-Confidence, And Anxiety, Michelle Britt Warren

Nursing Theses and Capstone Projects

Nurse educators are faced with the challenges of facilitating student learning in shorter time frames along with decreasing student opportunities to further their learning experiences in real-world clinical situations (LaFond & Van Hulle Vincent, 2012; Smith & Barry, 2013). There is an identifiable need for safe environments where students can practice and apply the knowledge they have learned in the didactic component of the course to the clinical situations (LaFond & Van Hulle Vincent, 2012; McClure & Gigliotti, 2012). The capstone project, "The impact of simulation based learning experience on student satisfaction, perceived self-confidence and anxiety" examined the implementation of …

Recent Graduates' Perspective On The Efficacy Of Nursing Simulation Laboratory Experiences, Holli Sowerby

Walden Dissertations and Doctoral Studies

It has become progressively difficult to find suitable clinical placement for nursing students. To help meet this need, local schools of nursing are turning to high-fidelity simulation manikins to substitute for clinical experience. There is a lack of research that explores recently graduated nurses' perceptions about the efficacy of simulation experiences. Guided by the constructivist theory, this qualitative case study identified how recent RN graduates viewed simulation experiences and whether associate's-degree RN program graduates and bachelor's-program RN graduates viewed simulation differently. Nine recent graduates participated in individual face-to-face interviews. The data were coded and grouped into 5 major themes in …

A Comparative Evaluation Of The Learner Centered Grading Debriefing Method In Nursing Education, Marisa J. Belote

USF Tampa Graduate Theses and Dissertations

The nursing discipline lacks a consensus on a best practice method for debriefing students following simulation-based training. A recognized, standardized method does not exist and various methods are utilized within the domain. The similarities between aviation and healthcare are well documented. Training members of both disciplines require standardization and methods of best practice. The aviation industry through the Federal Aviation Administration has found Learner Centered Grading (LCG) to be a successful educational format. The utilization of the LCG Debriefing method in simulation-based training is the standardized debriefing format for a technologically dynamic industry.

The aim of this research was to …

The Effectiveness Of Combining Simulation And Role Playing In Nursing Education, Shari Lynn Redden

Walden Dissertations and Doctoral Studies

The profession of nursing is affected by a nursing and nursing faculty shortage that is impacting the ability to produce adequate numbers of nurse graduates to address the healthcare needs of the future. Nursing schools are increasingly using simulation and/or role-playing to supplement the decreased number of nurse faculty and clinical sites in order to be able to continue to enroll nursing school applicants. The purpose of this phenomenological study was to examine the experiences of nursing students with role-playing and simulation and the extent to which role-playing with simulation is perceived by students as beneficial for learning within the …

Effects Of A Mental-Health Clinical Simulation Experience Using Standardized Patients And Two Debriefing Styles On Prelicensure Nursing Students' Knowledge, Anxiety, And Therapeutic Communication And Psychiatric Assessment Skills, Debrayh Gaylle

Doctoral Dissertations

The purpose of this quasi-experimental pretest-posttest study was to compare the effects of two debriefing styles (insimulation and postsimulation) on (a) students’ knowledge of psychiatric assessment and therapeutic communication, (b) students’ performance of a psychiatric assessment using therapeutic communication, (c) students’ perceived anxiety related to a clinical rotation in psychiatric mental-health, and (d) students’ perceptions of the efficacy of the insimulation debriefing. The participants (n = 67) were senior, prelicensure nursing students enrolled in a baccalaureate degree program. Students were assigned randomly to either the treatment or the compression group and participated in a series of simulated interviews using student …

Cultural Norms Of Clinical Simulation In Undergraduate Nursing Education, Susan G. Mcniesh

Susan McNiesh

Simulated practice of clinical skills has occurred in skills laboratories for generations, and there is strong evidence to support high-fidelity clinical simulation as an effective tool for learning performance-based skills. What are less known are the processes within clinical simulation environments that facilitate the learning of socially bound and integrated components of nursing practice. Our purpose in this study was to ethnographically describe the situated learning within a simulation laboratory for baccalaureate nursing students within the western United States. We gathered and analyzed data from observations of simulation sessions as well as interviews with students and faculty to produce a …