Abstract
Purpose
The aim of this study was to verify the effect of simulation and examine the effect of within-team debriefing for cardiac arrest emergency nursing education.
Methods
A non-equivalent control group quasi-experimental de-sign was used. The participants in this study were 199 senior nursing students from one nursing school in Daegu, Korea. Data were analyzed using x2 test, t-test, Fisher's exact test with SPSS 22.0 program.
Results
Developed simulation protocol in this study increased the learning immersion (t=12.19, p<.001, t=5.07, p<.001), learning confidence (t=-10.36, p<.001, t=-5.99, p<.001) and clinical performance ability (t=-10.88, p<.001, t=-3.84, p=.002) among nursing students. In addition to this, learning immersion (t=2.66, p=.008), learning confidence (t=-2.78, p=.006), simulation satisfaction (t=-3.15, p=.002) and clinical performance (t=-3.02, p=.005) were sig-nificantly higher in the experiment group using within-team debriefing.
REFERENCES
1.Park SK., Cho KM., Jwa YK., Kang DW., Lee YJ. Survey of nurses' activities. Final report. Cheongju: Korea Health Industry De-velopment Institute;2014. December. Report No.: 11-1352000-. p. 001476–01.
2.You EY. Medical simulation. Journal of the Korean Medical Association. 2005. 48(3):267–76. https://doi.org/10.5124/jkma.2005.48.3.267.
3.Ryoo EN., Ha EH., Cho JY. Comparison of learning effects using high-fidelity and multi-mode simulation: an application of emergency care for a patient with cardiac arrest. Journal of Korean Academy of Nursing. 2013. 43(2):185–93. https://doi.org/10.4040/jkan.2013.43.2.185.
4.Stoker M., Burmester M., Allen M. Optimisation of simulated team training through the application of learning theories: a debate for a conceptual framework. BMC Medical Education. 2014. 14:69. https://doi.org/10.1186/1472-6920-14-69.
5.Kim YH., Jang KS. Effect of a simulation-based education on cardiopulmonary emergency care knowledge, clinical performance ability and problem solving process in new nurses. Journal of Korean Academy of Nursing. 2011. 41(2):245–55. https://doi.org/10.4040/jkan.2011.41.2.245.
6.Kim HW., Suh EY. Nursing students' immersion experience in a comprehensive simulation scenario using high fidelity hu-man patient simulator among nursing students: a phenom-enological study. Journal of Military Nursing Research. 2012. 30(1):89–99.
7.Kim JY., Kim EJ. Effects of simulation on nursing students' knowledge, clinical reasoning, and self-confidence: a quasi-ex-perimental study. Korean Journal of Adult Nursing. 2015. 17(5):604–11. https://doi.org/10.7475/kjan.2015.27.5.604.
8.Yoo JH. Factors influencing nursing students' flow experience and clinical competency in simulation-based education-based on Jeffries's simulation model- [master's thesis]. Seoul: Sung-shin University;. 2016. 1–71.
9.Kim HR., Choi EY., Kang HY., Kim SM. The relationship among learning satisfaction, learning attitude, self-efficacy and the nursing students' academic achievement after simulation-based education on emergency nursing care. The Journal of Korean Academic Society of Nursing Education. 2011. 17(1):5–13. https://doi.org/10.5977/JKASNE.2011.17.1.005.
10.Ha EH., Song HS. The effects of structured self-debriefing using on the clinical competency, self efficacy and educational satisfaction in nursing students after simulation. The Journal of Korean Academic Society of Nursing Education. 2015. 21(4):445–54. https://doi.org/10.5977/jkasne.2015.21.4.445.
11.Park SN., Chu MS., Hwang YY., Kim SH., Lee SK. Effects of in-tegrated nursing practice simulation-based training on stress, interest in learning and problem-solving ability of nursing students. The Korean Journal of Fundamentals of Nursing. 2015. 22(4):424–32. https://doi.org/10.7739/jkafn.2015.22.4.424.
12.Kim EJ., Lee KR., Lee MH., Kim J. Nurses' cardiopulmonary resuscitation performance during the first 5 minutes in in-situ simulated cardiac arrest. Journal of Korean Academy of Nursing. 2012. 42(3):361–8. https://doi.org/10.4040/jkan.2012.42.3.361.
13.Kim SS., Kim BJ. Outcomes of in-hospital cardiopulmonary re-suscitation according to the in-hospital Utstein style in a gene-ral hospital. Journal of Korean Clinical Nursing Research. 2006. 11(2):177–92.
14.Hamilton R. Nurses' knowledge and skill retention following cardiopulmonary resuscitation training: a review of the literature. Journal of Advanced Nursing. 2005. 51(3):288–97. https://doi.org/10.1111/j.1365-2648.2005.03491.x.
15.Kolb DA. Experiential learning: experience as the source of learning and development. 2nd ed.New Jersey: Pearson Edu-cation;2014. p. 1–390.
16.Miettinen R. The concept of experiential learning and John Dewey' s theory of reflective thought and action. International Journal of Lifelong Education. 2000. 19(1):54–72. https://doi.org/10.1080/026013700293458.
17.Sawyer T., Eppich W., Brett-Fleegler M., Grant V., Cheng A. More than one way to debrief: a critical review of healthcare simu-lation debriefing methods. Simulation in Healthcare. 2016. 11(3):209–17. https://doi.org/10.1097/SIH.0000000000000148.
18.Kim M. A study on simulation-based nursing education status and debriefing operation [master's thesis]. Seoul: Chung-Ang University;. 2015. 1–88.
19.Kim JH., Park IH., Shin SJ. Systemic review of Korean studies on simulation within nursing education. The Journal of Korean Academic Society of Nursing Education. 2013. 19(3):307–19. https://doi.org/10.5977/jkasne.2013.19.3.307.
20.Cantrell MA. The importance of debriefing in clinical simulations. Clinical Simulation in Nursing. 2008. 4(2):e19–23. https://doi.org/10.1016/j.ecns.2008.06.006.
21.Boet S., Bould MD., Bruppacher H., Desjardins F., Chandra D., Naik V. Looking in the mirror: self-debriefing versus instructor debriefing for simulated crises. Critical Care Medicine. 2011. 39(6):1377–81. https://doi.org/10.1097/CCM.0b013e31820eb8be.
22.Boet S., Bould MD., Sharma B., Revees S., Naik VN., Triby E, et al. Within-team debriefing versus instructor-led debriefing for simulation-based education: a randomized controlled trial. Annals of Surgery. 2013. 258(1):53–8. https://doi.org/10.1097/SLA.0b013e31829659e4.
23.Jeong SJ., Jeong JC. The effects of unemployed vocational train-ee' s psychosocial characteristics, training program characteristics, learning flow, and career planning on employability. Journal of Agricultural Education and Human Resource De-velopment. 2014. 46(4):61–89.
24.Martin AJ., Jackson SA. Brief approaches to assessing task ab-sorption and enhanced subjective experience: examining 'short' and 'core' flow in diverse performance domains. Motivation and Emotion. 2008. 32(3):141–57. https://doi.org/10.1007/s11031-008-9094-0.
25.National League for Nursing. Descriptions of available instru-ments [Internet]. Washington, DC: National League for Nursing;2003. [cited 2017 January 23]. Available from. http://www.nln.org/professional-development-programs/research/tools-and-instruments/descriptions-of-available-instruments.
26.Barrett C., Myrick F. Job satisfaction in preceptorship and its effect on the clinical performance of the preceptee. Journal of Advanced Nursing. 1998. 27(2):364–71. https://doi.org/10.1046/j.1365-2648.1998.00511.x.
27.Korean Association of Cardiopulmonary Resuscitation. Pro-vider manual of Korea advanced life support [KALS]. 2nd ed.Seoul: Koonja;2015. p. 48–9.
28.Phrampus PE., O'Donnell JM. Debriefing using a structured and supported approach. Levine AI, DeMaria S, Schwartz AD, Sim AJ, editors. The Comprehensive textbook of healthcare simulation. 1st ed.New York: Springer Science and Busi-ness Media New York;2013. p. 73–84.
29.Jo HS., Park EY., Choi JS. Effects of self directed learning applying basic nursing practice contents of e-learning on nursing students' knowledge, self confidence and satisfaction. The Journal of the Korean Contents Association. 2013. 13(9):504–14. https://doi.org/10.5392/JKCA.2013.13.09.504.
30.Masters K. Edgar dale's pyramid of learning in medical education: a literature review. Medical Teacher. 2013. 35(11):e1584–93. https://doi.org/10.3109/0142159x.2013.800636.
Table 1.
Characteristics | Categories | Total | Exp. (n=98) | Cont. (n=101) | x2 or t | p |
---|---|---|---|---|---|---|
n (%) or M± SD | n (%) or M± SD | n (%) or M± SD | ||||
Age (year) | 23.60±1.32 | 23.54±1.32 | 23.66±1.32 | 0.66 | .513 | |
Gender | Male | 12 (6.0) | 7 (7.1) | 5 (5.0) | 0.42 | .516 |
Female | 187 (94.0) | 91 (92.9) | 96 (95.0) | |||
Religion | Yes | 136 (68.3) | 70 (71.4) | 66 (65.3) | 0.85 | .356 |
No | 63 (31.7) | 28 (28.6) | 35 (34.7) | |||
Satisfaction about nursing major | High | 73 (36.7) | 30 (30.6) | 43 (42.6) | 3.72 | .180† |
Average | 122 (61.3) | 65 (66.3) | 57 (56.4) | |||
Low | 4 (2.0) | 3 (3.1) | 1 (1.0) | |||
Satisfaction about clinical practice | High | 44 (22.1) | 22 (22.4) | 22 (21.8) | 2.47 | .332† |
Average | 149 (74.9) | 75 (76.5) | 74 (73.3) | |||
Low | 6 (3.0) | 1 (1.0) | 5 (5.0) | |||
Interpersonal relationship | High | 125 (62.8) | 59 (60.2) | 66 (65.3) | 1.11 | .592† |
Average | 71 (35.7) | 38 (38.8) | 33 (32.7) | |||
Low | 3 (1.5) | 1 (1.0) | 2 (2.0) | |||
Coping ability | High | 122 (61.3) | 63 (64.3) | 59 (58.4) | 2.22 | .330 |
Average | 69 (34.7) | 33 (33.7) | 36 (35.6) | |||
Low | 8 (4.0) | 2 (2.0) | 6 (6.0) | |||
Grade point average | 4.0~4.5 | 7 (3.5) | 6 (6.1) | 1 (1.0) | 5.54 | .219† |
3.5~3.9 | 81 (40.7) | 43 (43.9) | 38 (37.6) | |||
3.0~3.4 | 76 (38.2) | 33 (33.7) | 43 (42.6) | |||
2.5~2.9 | 32 (16.1) | 15 (15.3) | 17 (16.8) | |||
<2.5 | 3 (1.5) | 1 (1.0) | 2 (2.0) | |||
Learning immersion | 35.64±4.79 | 36.22±4.97 | 35.07±4.56 | 1.71 | .089 | |
Learning confidence | 29.46±3.69 | 29.94±3.68 | 29.00±3.66 | 1.80 | .073 |