A thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfilment of the requirements of the degree of Doctor of Philosophy Johannesburg, 2017. / Although simulation has been part of health care education for the last 40 years, there appears to be some resistance to embedding the education methodology in both nursing and medical curricula. Possible reasons for this lack of integration could be the educators’ fear of technology, organizational barriers, such as time for integration, and a lack of support for educators wanting to introduce simulation. In South Africa at present, simulation is only being used in pockets at universities and nursing colleges, with no formal contextually relevant training programme in place, specifically for nursing education, despite evidence that simulation improves student’s outcomes and critical thinking. Nurse educators have expressed anxiety and bewilderment and seem uncertain about the use of simulation. The purpose of this study was to develop a best practice simulation programme for nurse educators wanting to use simulation in their undergraduate nursing curricula. A multi-method design within a pragmatic paradigm was used for this study. The process was divided into four phases. Phase one involved data collection, using the National Council of State Board of Nursing (NCSBN) survey: Use of Simulation in Nursing Education (Hayden, 2010), to describe the prevalence and use of simulation in both university and college undergraduate curricula. Phase two consisted of two parts, conducted consecutively: a scoping literature review to determine simulation best practices in nursing and medical education, followed by a Delphi Study to elicit the perceptions of educators in South Africa regarding simulation and best practice. In the scoping literature review the question asked was: What does the literature identify as simulation best practices in nursing and medical education? Four best practices emerged from the literature, namely the importance of debriefing, identifying learner objectives, the integration of simulation into the curriculum and the inclusion of deliberate practice. A Delphi Study was then conducted to elicit the judgement and perceptions of simulation educators, working in the South African context, of the identified best practices. Phase three was the design of a conceptual framework and the development of a constructivist blended learning programme, using the Assessment, Design, Development, Implementation and Evaluation (ADDIE) instructional design method. The goal of the programme was: Participants will be able to apply simulation knowledge and skills to meet the learning needs of their undergraduate nursing students. The four best practices and the National League of Nurses/Jeffries Simulation Framework guided the programme. The resultant programme was developed in seven Modules building towards the completion of a simulation scenario, including planning for the scenario and post simulation debriefing. Phase four was an expert review of the programme, from an e-learning specialist, nurse educators and a simulation expert. Both an expert review guideline for a written report and interviews were used for evaluation and refinement of the programme, prior to the programme being rolled out to nurse educators. Results: Simulation in South African nurse education institutions is predominantly at a task training level and has been developed into complex patient scenarios using higher fidelity simulations. The programme was well received by the experts as relevant to simulation education in South African undergraduate nursing curricula, either in a university or nursing college educational environment. Limitations: The limitations to the study include the small sample sizes in the data collection phases, due to simulation in South Africa being relatively new in nursing education. Universities were predominantly represented in the data collection findings, despite the researcher reaching out to nursing colleges for their perspectives and inputs. There is a dearth of South African simulation literature and none on best education simulation practices in South African Nursing Education Institutions (NEIs), and therefore the researcher relied on international literature in the scoping review. Conclusion: The blended education simulation programme is based on the needs of nurse educators wanting to include simulation in their education environment, based on their resources, and allows them to work through the programme in their own work space and time. / MT2017

Thesis (Masters Diploma (TPost-School Education))--Cape Technikon, Cape Town,1993 / The growing importance of the concept of learning by experience is highlighted through the credit given by American colleges for prior learning experience. However, it is not always possible to provide learners with the opportunity to gain experience where this involves equipment and tasks which are too costly in terms of time, expense, or risk of life and equipment. The accelelated development in technology has led to rapid changes in conditions and instrumentation in the cockpits of aircraft and on the bridges of ships. In maritime training, the burden of maintaining the contemporary relevance of simulation training has been born by the training institutions, who have had to face increased costs and the selection of suitable synthetic training devices (simulators) from a wide variety of equipment offered which ranges in sophistication from the relatively simple to the fully representational high.fidelity ship simulators. Decisions faced by training establishments revolve around the desirability of high. fidelity simulators, the effectiveness of less expensive part-task trainers, and whether the effectiveness of simulation justifies the financial layout and running costs of simulator equipment. These decisions would be influenced initially by the consideration of whether or not simulation is an effective teaching strategy in adult vocational training, and whether this strategy justifies the cost and effort which the application of simulation demands. It was therefore necessary to examine the potential of simulation in the light of historical success, and also the present status, utilisation and acceptance of simulation in the field of maritime training.

An ever-changing healthcare landscape requires today’s nurses to have a solid foundation in knowledge and clinical judgment to provide safe care to patients. Nurse educators must implement teaching strategies that help develop the knowledge and clinical judgment that nursing students will need upon graduation and entry into healthcare. Simulation-based experiences have been shown to help develop clinical judgment when used as part of a clinical practicum. However, few studies have examined the effectiveness of simulation-based experiences as a classroom teaching strategy. A quasi-experimental study was conducted to examine knowledge acquisition, clinical judgment, and general self-efficacy in undergraduate nursing students who participated in simulation-based case studies as a classroom teaching strategy versus those students who attended a traditional lecture. Students in the intervention group rotated through four simulation-based case study stations. Results indicated that there was not a significant difference in knowledge, clinical judgment, or general self-efficacy found between nursing students participating in simulation-based case studies versus those attending a traditional lecture. Additionally, relationships between demographic characteristics and clinical judgment scores in undergraduate nursing students were explored. There were no statistically significant relationships found between demographic characteristics and clinical judgment in this sample. Further analysis indicated that both teaching strategies are effective in promoting knowledge acquisition, clinical judgment, and general self-efficacy. The findings of this study demonstrate that both participation in simulation-based case studies and attending a traditional lecture are effective classroom teaching strategies in promoting knowledge acquisition, clinical judgment, and general self-efficacy in nursing students. Nurse educators are encouraged to continue to explore simulation-based experiences as a teaching strategy in the classroom.

Scientific expertise requires concerted effort and the ability to overcome obstacles, but little research has addressed how these behaviors are modeled for learners in the context of simulation-based science learning. Thus, this study aimed to design instruction using cognitive modeling to promote active engagement by novice learners to ensure they feel competent to tackle novel learning problems in science. Largely drawing on work on social cognitive theory, the current study suggests the importance of a coping model, having incorrect knowledge and inadequate skills and gradually improving to a level of expertise, as an instructional aid to promote student motivation and learning in a simulation-based science learning environment. Two experimental studies were conducted with high school students in Korea who did not possess prior knowledge. Study 1 compared a Coping Model (CM) condition, where students observed a peer model who makes errors and demonstrates initial difficulties but overcomes them, to a Mastery Model (MM) condition, where students observed a peer model who presents an error-free process of interpreting information while manipulating the simulation. The CM students tended to have higher post-self-efficacy than the MM students. However, it did not change over time, nor did it differ by condition. The CM was as effective as MM for learning gains, and the CM had a more favorable impact on transfer than the MM. The CM’s negative emotions, which was intended to indicate task difficulties, may have given students an impression that the task was difficult, resulting in no increase in self-efficacy over time. Thus, Study 2 added one more condition – a coping model with affective states (CMA) – that expressed the model’s changes in emotions and motivations in addition to what the CM demonstrated, and compared its effects to the CM and MM. The CM’s emotional expressions as in Study 1 were all removed in Study 2. Findings demonstrated that self-efficacy of students increased in the CMA and CM conditions over time while self-efficacy of the MM students did not. Students in all conditions demonstrated equal learning gains, but the CMA was more effective for transfer outcomes than the MM, and the CM tended to be more effective for transfer than the MM. It is promising that a model who demonstrates difficulty in understanding but gradual progress to reach full understanding, which is the initial learning process of any novice, has potential to improve self-efficacy and promote transfer. The study discusses limitations and future study directions and concludes with implications for instructional design.

The use of simulation has increased due to the shortage of clinical sites and nursing faculty. Patient acuity and privacy laws have contributed to the increase. Research science in simulation is established in the areas of scenario execution and with the debriefing phases. However, prebriefing is an understudied phase of the simulation. Prebriefing is the phase of simulation that prepares students for the simulation scenario with an orientation to the room, equipment, and manikin. The objectives for the simulation and patient background information are shared with students. There is a limited amount of literature on interventions in prebriefing related to improved student learning outcomes. An experimental design was used to test the hypothesis that students who viewed two videos of clinical skill demonstrations during the prebrief would demonstrate improved clinical skill performance and increased clinical competency. It was also hypothesized that students would also report decreased anxiety with increased self-confidence related to clinical decision-making during the simulation scenario. Additionally, it was hypothesized students who demonstrated increased clinical competency, reported less anxiety and higher self-confidence related to clinical decision making would achieve higher exam scores on related content. A convenience sample of 129 Junior and Senior baccalaureate nursing students consented to participate in the research. Results of an independent samples t test showed that students in the intervention group demonstrated significantly better clinical skill performance in changing the rate on an intravenous fluid administration (p = < 0.001), and in the administration of medication via intravenous push (p = < 0.001) than students in the control group. Students in the intervention group also demonstrated increased clinical competency (p = < 0.05), assessment (p = < 0.05) and patient safety (p = < 0.05) when compared to the control group. A mixed ANOVA testing for the interaction between group and time of test was used to determine if there were group in the changes from pre to post test in anxiety, self-confidence and clinical decision-making. The results showed no significant differences between groups. A Pearson r was used to evaluate the correlation between anxiety and quiz score; self-confidence and quiz score; CCEI-CJ, and quiz score. There was a negative nonsignificant correlation between anxiety and quiz score, r(105) = -.091, p = .358. There was a positive correlation between self-confidence and quiz score, r(105) = .204, p = .037. There was a positive nonsignificant correlation between the CCEI-CJ and quiz grade r(107) = .082, p = .400. This research study demonstrates that the prebriefing phase of simulation can be enhanced to include elements that will improve student learning outcomes.

No description available.

The purpose of this study was to design a model to evaluate the influence of selected factors on the performance of a telephone delivery system for nutrition information and use the model to evaluate the performance of the Roanoke Dietetic Association Dial-A-Dietitian program. The Dial-A-Dietitian program was established to provide nutrition information to the public by Registered Dietitians. The model entailed a systems approach to evaluate the Roanoke Dietetic Association Dial-A-Dietitian program. The five phases of the model included Enabling Factors (inputs), the Interaction Process, Effort Factors (outputs), Performance (outcome), and Feedback. Feedback entailed the utilization of the results of the evaluation in the decision-making process for future Dial-A-Dietitian programs and their operation. The evaluation instruments, the Encounter Form and the Telephone Survey of clients, included reaction statements and attitude assessment of clients and dietitians. The data were analyzed with frequency distributions. Also the Chi Square Tests of Independence were computed to determine the relationship between the independent variables, Enabling Factors (Phase 1) and Effort Factors (Phase 3), and the dependent variable, Performance (Phase 4). The model was useful in the evaluation of the Dial-A-Dietitian program. The data analysis indicated that the Dial-A-Dietitian program was effective as measured by this model. / Ph. D.

This investigation attempted to answer the following research questions, based upon student participation in "hands on" television production activities: (1) What shifts in the students' perceived acceptance of themselves occurred, (2) what shifts in the students' perceived acceptance of others occurred, and (3) what shifts in the students' perceived acceptance of school occurred? In seeking answers to the above three questions, the investigator located seven volunteers from a high school dropout retrieval program. As it developed, all of them were of Mexican American heritage. This investigation was based upon a theoretical framework drawn from perceptual psychology, education, and television. The framework consisted of television as a perceptual experience tending to effect acceptance of self, others, and school. A small n research design with multiple measures was used during this investigation. Data were collected with a student self-report measure using a modified Likert-type response mode. Qualitative data were collected from student interviews and investigator observations recorded as fieldnotes. The research results indicated no significant patterns in acceptance of self and others as a group. The qualitative data revealed the variety of individual shifts in acceptance of self, others and school. Certain unanticipated results occurred because the participants were Mexican American. These included cultural-related observations. The data indicated that "hands on" television production activities involve "learning in context" processes which might have important implications for dropout retrieval programs. The investigator recommended further "learning in context" TV or video studies with multicultural groups of students.

Educators considering implementing a computer simulation must decide on the optimum placement of the simulation in the unit of instruction to maximize student learning. This study examined student achievement using two different placements for the computer simulation, The Civil War, in a unit of instruction of 8th grade American History students in a suburban middle school.

Research has shown that students interest in academics declines significantly with age, especially in the areas of math and science (Kahle et al., 1993; Wigfield, 1994; Wigfield and Eccles, 1992). One approach to combating this problem is by using new technologies to engage students who otherwise would not be interested in learning. In the AquaMOOSE project, 3D graphical technology is combined with a constructionist learning philosophy to create an environment where students can creatively explore new mathematical concepts. The AquaMOOSE socio-technical system has been developed using an iterative design process. Three formal studies were conducted to assess the effectiveness of the system, as well as several smaller scale evaluations. The first study was conducted during a six-week summer program where students were able to use the AquaMOOSE system during their free time. The second study explored different learning issues in the context of a comparison-class study at a local high school where one section learned about polar coordinates using standard curriculum materials and an equivalent section learned the same material using a curriculum designed specifically around the AquaMOOSE system. The final study of the AquaMOOSE system was in an eight-week after-school program at a local high school where a balance between structure and creative freedom was explored. In this thesis, the iterative design and evaluation of the AquaMOOSE socio-technical system is presented. Evidence from this process is used to suggest implications of using 3D technology and constructionist philosophy for teaching complex mathematical content. The findings presented address issues of using constructionist learning environments for complex content and the tradeoffs of using 3D technology for educational systems.