Nursing Commons^™

High Fidelity Simulation Experience And Development Of Clinical Judgment: Recent Graduate Nurses’ Reflections, Martha Kay Lawrence

Theses and Dissertations

Introduction: Nurse faculty endeavor to educate future nurses who are able to effectively transition to competent practice after graduation. Shrinking clinical resources and shortages of qualified clinical faculty have contributed to the increasing utilization of high fidelity simulation (HFS) as a substitute for and enhancement of clinical practice in nursing education. The growing body of HFS research documents both student and faculty satisfaction and increased student self-confidence and self-efficacy. A significant gap in the literature is the lack of research on the translation of knowledge gained in HFS to practice. The aim of this research was to investigate recently graduated …

The Effect Of Poverty Simulation Participation On Attitudes Toward Children Living In Poverty For Baccalaureate Nursing Students, Amanda Moore, Leah Struhsaker, Kaylee Gutschow

Williams Honors College, Honors Research Projects

Poverty is a major issue in the United States. Because perceived discrimination can impact health and willingness to seek care, it is important for healthcare providers to be educated on and exposed to issues that poverty presents to individuals who are poor. The purpose of this study was to examine the effect of a poverty simulation on attitudes of undergraduate nursing students towards children living poverty. The study was guided by Albert Bandura’s social learning theory and used a longitudinal, quasi-experimental design and convenience sampling of undergraduate nursing students enrolled in a community health nursing course. Attitudes were measured at …

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 …

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 …

Integration Of Learning Activities For Improved Performance On The Nclex-Rn Exam, Erika Wilkinson

Walden Dissertations and Doctoral Studies

An institute of higher education located in the United States was unable to maintain the required first-time pass rate, on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) exam, by nursing graduates, as defined by their State Board of Nursing and accreditation body. Failure to meet these requirements resulted in a corrective action plan and fewer licensed nurses able to enter practice. The purpose of this study was to identify curricular changes to the associate nursing program to improve the first time pass rate by their nursing graduates. Benner's theory of skill acquisition was used as the conceptual framework …

Are Midwifery Students Adequately Prepared For Vaginal Breech Birth In Clinical Practice?, Steffne Nel, Sadie Geraghty

Research outputs 2014 to 2021

While the value of the clinical skills and expertise required to enable safe vaginal breech birth remains high, midwives who possess these skills are becoming scarce. Additionally, for many midwifery students, vaginal breech birth is becoming somewhat of an elusive event, rarely experienced in clinical practice when completing their training. Not so long ago, this was a standard competency taught to and held by obstetricians and midwives alike, but for those in developed nations working within robust healthcare systems, the frequency of planned vaginal breech birth is on a downward trend, and this is reflected in midwifery educational curriculums.

Debriefing With Reflection: Best Practice For Learning In Simulation In Pre-Licensure Nursing Education, Mary Mcdermott

Seton Hall University DNP Final Projects

Purpose: The purpose of this project was intended to transform the outdated method of conducting debrief after simulation by implementing a good judgment model and integrating the concept of “advocacy-inquiry.” This implementation was expected to reduce demoralizing and anxiety producing debrief experiences and improve student reflection and learning in order for students to more deliberately link theory with practice.

Significance: The debrief is often recognized as the component of simulation in which the most effective learning occurs. It is the time when students are provided opportunity to reflect on thoughts, actions and behaviors. Unfortunately, many nursing students often experience undue …

Assessing The Impact Of Simulation Role On Anxiety And Perceived Outcomes In Undergraduate Nursing Students, Teresa A. Bates

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

Background: Due to large class sizes and limited resources, students participating in high-fidelity simulation experiences may be assigned to an observer role as opposed to an active, nursing role. It is important for educators to determine if anxiety levels and student learning outcomes are comparable regardless of role.

Methods: A quasi-experimental correlational study composed of 132 prelicensure baccalaureate students was conducted.

Results: There were no significant differences between simulation roles for anxiety levels and perceived outcomes for satisfaction, self-confidence in learning, clinical ability, problem solving, confidence in clinical practice, and collaboration.

Conclusions: These findings suggest that either role is an …

Simulation Based Post-Partum Hemorrhage Training In Nigeria: A Pilot Project, Nneka Chukwu

Doctor of Nursing Practice (DNP) Projects

Postpartum hemorrhage (PPH) is one of the leading causes of mortality and morbidity among childbearing women globally (Ononge, Mirembe, Wandabwa, & Campbell, 2016). Although this outcome is preventable, it remains a significant cause of death among women, especially in underdeveloped countries. This paper examines an educational project that was aimed to increase the knowledge of student midwives and registered midwives in a rural academic setting in Nigeria.

Methods: A one-day educational pilot training which consisted of a didactic component and a case-based simulation training focused on identifying risk factors, assessment techniques, and management protocols for the PPH patient. There were …

Simulation As A Multidisciplinary Team Approach In Health Care Programs In An Urban University Setting, Geraldine Fike, Dawn Blue, Guillermo Escalante, Phoebe (Yeon) S. Kim, Jose A. Munoz

Health Science and Human Ecology Faculty Publications

The poster provided here showcases results from a simulation study that began in the Spring Quarter of 2017 at CSU San Bernardino. The results presented here are based on four simulations conducted on campus in our nursing lab space. We incorporated the participation of 44 students in our study.

Patients are cared for by a nurse and multidisciplinary teams which may include physical therapists, social workers, and public health workers; however, students in health care programs usually will not experience necessary scenarios developing needed skills. Although needed skills are learned within the walls of the university they remain in a …

Student Registered Nurse Anesthetist Simulation Training With The Use Of Cognitive Aids In Malignant Hyperthermia Recognition And Treatment, Daniel Martin

Doctoral Projects

One of the most stressful times in the life of a student registered nurse anesthetist (SRNA) is during the integration of didactic work with that of clinical anesthesia practice (Chipas et al., 2012). One method that has been proven effective in other avenues of student nursing education is the use of procedural simulation labs. These simulation labs allow SRNAs to experience what it is like to be in the operating room setting, while also showing distinct differences within each case, treatment, and the importance to be familiar with all aspects of anesthesia. The purpose of this project was to examine …

The Impact Of Simulation Sequencing On Perceived Clinical Decision Making, Aimee A. Woda, Jamie Hansen, Mary Paquette, Robert V. Topp

College of Nursing Faculty Research and Publications

An emerging nursing education trend is to utilize simulated learning experiences as a means to optimize competency and decision making skills. The purpose of this study was to examine differences in students' perception of clinical decision making and clinical decision making-related self-confidence and anxiety based on the sequence (order) in which they participated in a block of simulated versus hospital-based learning experiences.

A quasi-experimental crossover design was used. Between and within group differences were found relative to self-confidence with the decision making process. When comparing groups, at baseline the simulation followed by hospital group had significantly higher self-confidence scores, however, …

Video Simulation As An Educational Strategy To Increase Knowledge And Perceived Knowledge In Novice Nurse Anesthesia Trainees, Rachel A. Kozlowski, Jennifer A. Kurdika

College of Science and Health Theses and Dissertations

Background: Video simulation is gaining popularity as an alternative method of teaching and can play an important role in nurse anesthesia education.

Objectives: The purpose of this study is to analyze the effects of an educational video simulation on acquisition of knowledge and perceived knowledge of anesthesia induction in novice nurse anesthesia trainees (NATs).

Method: A single group pre-test post-test design was used to compare knowledge and perceived knowledge on standard and rapid sequencing induction of anesthesia. Pre test scores on knowledge and perceived knowledge were obtained and followed by a viewing of pre-recorded video simulation on standard and rapid …

Cultivating A Culture Of Compassion Among Newly Graduated Registered Nurses: An Evidence-Based Mobile Learning Toolkit, Benson Yeung

Doctor of Nursing Practice (DNP) Projects

Empathy, kindness, and compassion are some of the humanistic values essential to nursing practice particularly in today’s patient and family-centric healthcare environment. A genuinely empathetic and caring relationship between a nurse and a patient not only enhances the quality and safety of care but also contributes to patient satisfaction, compliance to treatment, and overall health outcomes. Debate amongst educators and researchers continues to grow as to whether these uniquely humanistic values are innate or if they can be taught. How do nurses acquire the knowledge, skills, and attitudes towards the delivery of compassionate patient care? What strategies are best suited …

Understanding The Experience Of Interprofessional Team Members After Participating In Comprehensive Obstetric Hemorrhage Training, Frances Kelly

Dissertations and Theses (Open Access)

Purpose: The obstetric hemorrhage rate has risen steadily in the U.S. accounting for 11.4% of maternal deaths between 2011 and 2013, and remains a leading cause of maternal morbidity. Improving the quality and safety of care could prevent much of the morbidity and potential mortality associated with obstetric hemorrhages. An interprofessional obstetric team developed, tested, and implemented obstetric hemorrhage and massive transfusion protocols. Multi-modal team training occurred before service-wide implementation of the protocols, including didactic, skills stations, on-line educational modules, and in situ simulation team training. Early quantitative results were promising.

Methods: To augment understanding of the quantitative results and …

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 …

Pilot Test Of Communication With A ‘Rapid Fire’ Technique, Desiree A. Díaz, Candace Pettigrew, Christine Dileone, Meredith Dodge, Deborah Shelton

Journal for Evidence-based Practice in Correctional Health

Abstract

An innovative communication training technique, ‘Rapid Fire’, was created to enhance communication and was incorporated into the debrief component of a simulation designed for correctional nurses to promote learning and engagement. The term ‘Rapid Fire’ was used to expose the critical time element that appears in the first five minutes of many crisis situations, where a quick relay of information and problem solving is essential; such as in a cardiac arrest or other rapidly deteriorating patient situations. This technique consists of a five-minute session prior to the structured debrief. During the ‘Rapid Fire’ portion of the debrief, all learners …

Curriculum Development Of California Correctional Institution (Cci) Nursing Staff Performance During Simulation Training Related To Cardiac Emergency Response, Dina Wang

Doctoral Projects

The Cycle 4 OIG medical reports published in January 2016 for California Correctional Institution (CCI) noted emergency medical response (EMR) inadequacies. Nursing was specifically called out for EMR care deficits. Chest pain and respiratory distress were amongst the top signs and symptoms identified as having substandard nursing care issues within the report. The cycle 4 OIG medical inspection report gives specific incidences of patient care inadequacies.

As a result of the EMR portion results of the cycle 4 OIG reports, there was a need for improvement planned interventions. The Doctor in Nurse Practice (DNP) project is a quantitative quasi-experimental study …

Conflict-Handling Styles Demonstrated By Nursing Students In Response To Microethical Dilemmas, Lorretta Krautscheid, Carissa M. Luebbering, Beth A. Krautscheid

Faculty Publications - College of Nursing

Undergraduate nursing students have reported feeling ill-prepared to handle the conflict that accompanies the routine exposure to microethical dilemmas. Microethical dilemmas, as first defined by Worthley (1997), are routine questionable practices that have the potential to compromise quality patient care, negatively impact workplace culture, and initiate moral distress. Nurse educators employ a variety of strategies to support students’ ability to effectively manage conflict; however, little is known about how students authentically respond to ethical dilemmas. The purpose of this pilot study was to describe the frequency of conflict-handling styles demonstrated by undergraduate nursing students who encountered microethical dilemmas embedded within …

Improving Cardiopulmonary Resuscitation Skills Using Unit Based Simulation, Lesa R. Smith

Nursing Theses and Capstone Projects

The performance and quick interventions by nurses during a code blue event can have significant impact on patient outcomes. Code blue events can be stressful for nurses practicing in the medical surgical environment where, since the implementation of rapid response teams, the number of code blue events has decreased. The traditional basic life support (BLS) offering in the acute care settings offers nurses the opportunity to practice cardiopulmonary resuscitation (CPR) with manikins and automatic external defibrillators (AED). However, the experience is lacking real working environment teams and equipment in which nurses practice every day. It is also well documented in …

Using High-Fidelity Simulation To Prepare Nursing Students In The Obstetrical Environment, Cynthia Ann Dixon

Nursing Theses and Capstone Projects

Aim: The goal of this study was to evaluate senior nursing students and use of high-fidelity simulation in the development of critical thinking skills. Background: Nursing students are only given limited opportunities in the specialty areas, such as obstetrics, and often lack the skills and confidence necessary to provide safe and effective care as they join the health care industry as new graduates. Methods: The senior nursing students were brought into the simulation lab and given a new scenario on a preeclampsia patient. The students were given ten minutes to ask questions of the patient, complete a focused assessment, call …

Bsn Students’ Satisfaction And Self-Confidence In Simulation-Based Learning, Aubrey Winum

Undergraduate Honors Theses

As nurse educators prepare students to enter the real world, they are challenged to create learning methods that develop confident and competent nurses. While new graduate nurses have much to learn, they are expected to be able to work as a team, think critically, and provide a safe environment for patients. A nursing program at a small, liberal arts college in the Foothills of the Blue Ridge Mountains utilized simulation-based learning experiences to prepare students for the many situations they may face as a future nurse. The purpose of this study was to evaluate the impact these experiences had on …

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 …

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 …

Evaluation Of A Competency-Based Interprofessional Diabetes Management Education Module For Health Professions Students: A Multi-Modular Approach, Bilinda Norman

Doctor of Nursing Practice Projects

The purpose of this study was to evaluate the effectiveness of a competency-based interprofessional diabetes education module, using a multi-modular approach. The results of a needs assessment of health professionals revealed few opportunities for interprofessional diabetes education, other than through “on-the-job” training. A nurse-led, comprehensive diabetes education program was developed to support achievement of interprofessional competencies for health professions students prior to graduation for the improvement of population health for clients with diabetes, following the needs assessment. The program included didactic education and simulation experience encompassing the use of the Alphabet Strategy for diabetes education, addressing the need for interprofessional …

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 …

Violence Against Nurses, Terri Lynne Declerck

Walden Dissertations and Doctoral Studies

Workplace violence against nurses causes stress, job dissatisfaction, injury, and financial burden. The purpose of this project was to examine training for nurses on violence, risk factors and on reporting workplace violence. The practice-focused question was designed to examine the effectiveness of educating nurses regarding violent patients and how to report episodes of violence. Benner's novice to expert theory guided the skill acquisition training of a convenience sample of 25 Midwestern medical nurses. The nurses participated by completing a survey prior to and following a violence simulation. A qualitative design was used with the 25 nurse participants who completed the …

Community Engagement With Older Adults To Evaluate Interprofessional Education In Allied Healthcare Students, Scott Heinerichs, Mary Beth Gilboy, Stacie Metz, Melissa A. Reed, Barbara E. Harrison

Internet Journal of Allied Health Sciences and Practice

Purpose: To examine students’ perceptions of interprofessional education (IPE) as a result of their participation in a community engagement experience with older adults. Methods: Thirty-six students enrolled in the undergraduate majors of athletic training, exercise science, and nutrition participated in an 8-week fall prevention program in two community dwelling senior centers. A one-group pretest-posttest evaluation design was used to assess the IPE experience of the students. Students completed the University of the West England Interprofessional Questionnaire pre and post intervention. Results: Both pretest and posttest student self-assessments of communication and teamwork skills ranged from slightly positive to neutral (means from …

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, …

Simulation-Based Interprofessional Education In A Rural Setting, Ann D. Scott

Theses and Dissertations

The purpose of this project was to examine the feasibility and acceptability of a simulation-based IPE experience for pre-licensure nursing, pharmacy, and medical students on a rurally-located campus. Using a mixed-methods, explanatory sequential approach, this project: 1) examined the feasibility of implementing a simulation-based IPE experience using telehealth tools; and 2) evaluated student perceptions of inter-professional teamwork, roles and responsibilities, and patient outcomes for collaborative practice, both pre- and post-scenario.

Quantitative data were analyzed using SPSS. Results revealed 94% agreed/strongly agreed the IPE experience resembled a real-life situation. 100% of nursing/medical students and 80% of the pharmacy students indicated they …