DOI QR코드

DOI QR Code

Effects of a Nursing Simulation Learning Module on Clinical Reasoning Competence, Clinical Competence, Performance Confidence, and Anxiety in COVID-19 Patient-Care for Nursing Students

코로나19 간호시뮬레이션 학습모듈이 간호대학생의 임상추론역량, 임상수행능력, 간호수행자신감 및 불안에 미치는 효과

  • Received : 2022.10.18
  • Accepted : 2023.02.09
  • Published : 2023.02.28

Abstract

Purpose: This study aimed to develop a nursing simulation learning module for coronavirus disease 2019 (COVID-19) patient-care and examine its effects on clinical reasoning competence, clinical competence, performance confidence, and anxiety in COVID-19 patient care for nursing students. Methods: A non-equivalent control group pre- and post-test design was employed. The study participants included 47 nursing students (23 in the experimental group and 24 in the control group) from G City. A simulation learning module for COVID-19 patient-care was developed based on the Jeffries simulation model. The module consisted of a briefing, simulation practice, and debriefing. The effects of the simulation module were measured using clinical reasoning competence, clinical competence, performance confidence, and anxiety in COVID-19 patient-care. Data were analyzed using χ2-test, Fisher's exact test, t-test, Wilcoxon signed-rank test, and Mann-Whitney U test. Results: The levels of clinical reasoning competence, clinical competence, and performance confidence of the experimental group were significantly higher than that of the control group, and the level of anxiety was significantly low after simulation learning. Conclusion: The nursing simulation learning module for COVID-19 patient-care is more effective than the traditional method in terms of improving students' clinical reasoning competence, clinical competence, and performance confidence, and reducing their anxiety. The module is expected to be useful for educational and clinical environments as an effective teaching and learning strategy to empower nursing competency and contribute to nursing education and clinical changes.

Keywords

Acknowledgement

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. 2020R1F1A1065502).

References

  1. Morens DM, Folkers GK, Fauci AS. The challenge of emerging and re-emerging infectious diseases. Nature. 2004;430(6996):242-249. https://doi.org/10.1038/nature02759 Erratum in: Nature. 2010;463(7277):122. 
  2. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. New England Journal of Medicine. 2020;382(8):727-733. https://doi.org/10.1056/NEJMoa2001017 
  3. Al-Abri SS, Abdel-Hady DM, Al-Abaidani IS. Knowledge, attitudes, and practices regarding travel health among Muscat International Airport travelers in Oman: Identifying the gaps and addressing the challenges. Journal of Epidemiology and Global Health. 2016;6(2):67-75. https://doi.org/10.1016/j.jegh.2016.02.003 
  4. World Health Organization (WHO). WHO coronavirus (COVID-19) dashboard [Internet]. Geneva: WHO; 2022 [cited 2022 Aug 19]. Available from: https://covid19.who.int/ 
  5. World Health Organization (WHO). WHO coronavirus disease (COVID-19) [Internet]. Geneva: WHO; 2020 [cited 2020 Oct 19]. Available from: https://covid19.who.int/ 
  6. Gholami M, Fawad I, Shadan S, Rowaiee R, Ghanem H, Hassan Khamis A, et al. COVID-19 and healthcare workers: A systematic review and meta-analysis. International Journal of Infectious Diseases. 2021;104:335-346. https://doi.org/10.1016/j.ijid.2021.01.013 
  7. Korean Nurses Association (KNA). Guidance for COVID-19 response nurses. Seoul: KNA; 2020. p. 1-211. 
  8. International Council of Nurses (ICN). International Council of Nurses COVID-19 update. Geneva: ICN; 2021. p. 1-4. 
  9. Lam SK, Kwong EW, Hung MS, Pang SM, Chiang VC. Nurses' preparedness for infectious disease outbreaks: A literature review and narrative synthesis of qualitative evidence. Journal of Clinical Nursing. 2018;27(7-8):e1244-e1255. https://doi.org/10.1111/jocn.14210 
  10. Cha JE, Cho JY, Kim YG, Nam GH, Lee SY, Lee SY, et al. Nursing students' safety-climate, perception and performance of standard precautions for healthcare-associated infection control. Journal of the Korea Academia-Industrial Cooperation Society. 2017;18(8):72-83. https://doi.org/10.5762/KAIS.2017.18.8.72 
  11. Kim S. Development and effects of a simulation-based education program for healthcare-associated infection control for nursing students [dissertation]. Daegu: Kyungpook National University; 2016. p. 1-100. 
  12. Kim HJ. A study on disaster preparedness, core competencies and educational needs on disaster nursing of nursing students. Journal of the Korea Academia-Industrial Cooperation Society. 2015;16(11):7447-7455. https://doi.org/10.5762/KAIS.2015.16.11.7447 
  13. Seo JH, Jung EY. Factors influencing nursing students' performance on standard precautions of infection control. Journal of Korean Biological Nursing Science. 2017;19(2):69-75. https://doi.org/10.7586/jkbns.2017.19.2.69 
  14. Lasater K. High-fidelity simulation and the development of clinical judgment: Students' experiences. Journal of Nursing Education. 2007;46(6):269-276. https://doi.org/10.3928/01484834-20070601-06 
  15. Shin S, Park JH, Kim JH. Effectiveness of patient simulation in nursing education: Meta-analysis. Nurse Education Today. 2015;35(1):176-182. https://doi.org/10.1016/j.nedt.2014.09.009 
  16. Alsahafi AJ, Cheng AC. Knowledge, attitudes and behaviours of healthcare workers in the Kingdom of Saudi Arabia to MERS coronavirus and other emerging infectious diseases. International Journal of Environmental Research and Public Health. 2016;13(12):1214. https://doi.org/10.3390/ijerph13121214 
  17. Sun Y, Wang D, Han Z, Gao J, Zhu S, Zhang H. Disease prevention knowledge, anxiety, and professional identity during COVID-19 pandemic in nursing students in Zhengzhou, China. Journal of Korean Academy of Nursing. 2020;50(4):533-540. https://doi.org/10.4040/jkan.20125 
  18. Lee J, Kang SJ. Factors influencing nurses' intention to care for patients with emerging infectious diseases: Application of the theory of planned behavior. Nursing and Health Sciences. 2020;22(1):82-90. https://doi.org/10.1111/nhs.12652 
  19. Abualenain JT, Al-Alawi MM. Simulation-based training in Ebola Personal Protective Equipment for healthcare workers: Experience from King Abdulaziz University Hospital in Saudi Arabia. Journal of Infection and Public Health. 2018;11(6):796-800. https://doi.org/10.1016/j.jiph.2018.05.002 
  20. O'Keeffe DA, Bradley D, Evans L, Bustamante N, Timmel M, Akkineni R, et al. Ebola emergency preparedness: Simulation training for frontline health care professionals. MedEdPORTAL. 2016;12:10433. https://doi.org/10.15766/mep_2374-8265.10433 
  21. Elcin M, Onan A, Odabasi O, Saylam M, Ilhan H, Daylan Kockaya P, et al. Developing a simulation-based training program for the prehospital professionals and students on the management of Middle East respiratory syndrome. Simulation in Healthcare. 2016;11(6):394-403. https://doi.org/10.1097/SIH.0000000000000198 
  22. Yoo E, Jung Y. Training effectiveness of the COVID-19 infection control simulation program on nursing students. The Journal of Humanities and Social Science 21. 2020;11(6):939-953. https://doi.org/10.22143/HSS21.11.6.66 
  23. Kim JK, Song MS. Effects of respiratory infectious disease simulation-based education on nursing student's of clinical competency, self-leadership and critical thinking. Journal of the Korea Academia-Industrial Cooperation Society. 2019;20(8):93-101. https://doi.org/10.5762/KAIS.2019.20.8.93 
  24. Liou SR, Liu HC, Tsai HM, Tsai YH, Lin YC, Chang CH, et al. The development and psychometric testing of a theory-based instrument to evaluate nurses' perception of clinical reasoning competence. Journal of Advanced Nursing. 2016;72(3):707-717. https://doi.org/10.1111/jan.12831 
  25. Joung JW, Han JW. Validity and reliability of a Korean version of nurse clinical reasoning competence scale. Journal of the Korea Academia-Industrial Cooperation Society. 2017;18(4): 304-310. https://doi.org/10.5762/KAIS.2017.18.4.304 
  26. Korea Disease Control and Prevention Agency (KDCA). Coronavirus disease-2019 response guidelines for hospitals. Cheongju: KDCA; 2020. p. 1-92. 
  27. Lee SK. The effect of simulation practice education on the clinical judgment, self-confidence and clinical performance ability in nursing student. The Journal of the Korea Contents Association. 2017;17(11):577-587. https://doi.org/10.5392/JKCA.2017.17.11.577 
  28. Spielberger CD. State-trait anxiety inventory. In: Weiner IB, Craighead WE, editors. The Corsini Encyclopedia of Psychology. 4th ed. Hoboken (NJ): John Wiley & Sons; 2010. p. 1698. 
  29. Kim J, Shin D. A study based on the standardization of the STAI for Korea. New Medical Journal. 1978;21(11):69-75. 
  30. Jeffries PR. A framework for designing, implementing, and evaluating: Simulations used as teaching strategies in nursing. Nursing Education Perspectives. 2005;26(2):96-103. 
  31. Choi YE, Lee ES. A study on knowledge, attitude, infection management intention & educational needs of new respiratory infectious disease among nurses who unexperienced NRID(SARS & MERS). Journal of the Korea Academia-Industrial Cooperation Society. 2019;20(2):721-731. https://doi.org/10.5762/KAIS.2019.20.2.721 
  32. Korea Disease Control and Prevention Agency (KDCA). MERS response guidelines. 6th ed. Cheongju: KDCA; 2020. p.1-300. 
  33. Korea Disease Control and Prevention Agency (KDCA). Ebola response guidelines in 2017. 7th ed. Cheongju: KDCA; 2017. p. 1-158. 
  34. Scherer YK, Bruce SA, Graves BT, Erdley WS. Acute care nurse practitioner education: Enhancing performance through the use of clinical simulation. AACN Clinical Issues. 2003;14(3):331-341.  https://doi.org/10.1097/00044067-200308000-00008
  35. Kim EJ. Nursing students' clinical judgment skills in simulation: Using Tanner's clinical judgment model. Journal of Korean Academic Society of Nursing Education. 2014;20(2):212-222. https://doi.org/10.5977/jkasne.2014.20.2.212 
  36. Dreifuerst KT. Getting started with debriefing for meaningful learning. Clinical Simulation in Nursing. 2015;11(5):268-275. https://doi.org/10.1016/j.ecns.2015.01.005 
  37. Cant RP, Cooper SJ. Simulation-based learning in nurse education: Systematic review. Journal of Advanced Nursing. 2010;66(1):3-15. https://doi.org/10.1111/j.1365-2648.2009.05240.x 
  38. Lee CM, So HS, Kim Y, Kim JE, An M. The effects of high fidelity simulation-based education on clinical competence and confidence in nursing students: A systematic review. The Journal of the Korea Contents Association. 2014;14(10):850-861. https://doi.org/10.5392/JKCA.2014.14.10.850 
  39. Kang H, Kang HY. The effects of simulation-based education on the clinical reasoning competence, clinical competence, and educational satisfaction. Journal of the Korea Academia-Industrial Cooperation Society. 2020;21(8):107-114. https://doi.org/10.5762/KAIS.2020.21.8.107 
  40. Cappelletti A, Engel JK, Prentice D. Systematic review of clinical judgment and reasoning in nursing. Journal of Nursing Education. 2014;53(8):453-458. https://doi.org/10.3928/01484834-20140724-01 
  41. Griffits S, Hines S, Moloney C, Ralph N. Characteristics and processes of clinical reasoning in nurses and factors related to its use: A scoping review protocol. JBI Database of Systematic Reviews and Implementation Reports. 2017;15(12):2832- 2836. https://doi.org/10.11124/JBISRIR-2016-003273 
  42. Wang J, Zhou M, Liu F. Reasons for healthcare workers becoming infected with novel coronavirus disease 2019 (COVID-19) in China. Journal of Hospital Infection. 2020; 105(1):100-101. https://doi.org/10.1016/j.jhin.2020.03.002 
  43. Suwantarat N, Apisarnthanarak A. Risks to healthcare workers with emerging diseases: Lessons from MERS-CoV, Ebola, SARS, and avian flu. Current Opinion in Infectious Diseases. 2015;28(4):349-361. https://doi.org/10.1097/QCO.0000000000000183 
  44. Vural Dogru B, Zengin Aydin L. The effects of training with simulation on knowledge, skill and anxiety levels of the nursing students in terms of cardiac auscultation: A randomized controlled study. Nurse Education Today. 2020;84:104216. https://doi.org/10.1016/j.nedt.2019.104216 
  45. Ahn SH, Kim G, Yang JW. Trait anxiety as a moderator for the accuracy of affective forecasting and recall. Korean Journal of Psychology: General. 2019;38(3):401-417. https://doi.org/10.22257/kjp.2019.09.38.3.401 
  46. Ross JG, Carney H. The effect of formative capstone simulation scenarios on novice nursing students' anxiety and self-confidence related to initial clinical practicum. Clinical Simulation in Nursing. 2017;13(3):116-120. https://doi.org/10.1016/j.ecns.2016.11.001 
  47. Labrague LJ, McEnroe-Petitte DM, Bowling AM, Nwafor CE, Tsaras K. High-fidelity simulation and nursing students' anxiety and self-confidence: A systematic review. Nursing Forum. 2019;54(3):358-368. https://doi.org/10.1111/nuf.12337