Cardiovascular disease remains the leading cause of mortality in the United States, and a primary educational objective is to develop professional competency among nurses to ensure the provision of safe and effective care to the cardiac patient. Benner's theory of novice-to-expert led to the development of an evidence-based scenario for the care of the patient with chest pain using risk-free high-fidelity simulation environments that focused on assessment, history taking, and communication, while evaluating improvements in the competency of nurses providing care to chest pain patients. Thirty-six nurses volunteered in the study. Feedback from nurse educators, which led to modifications to the scenario, preceptor evaluation of participants during simulation, and post simulation feedback of participants, were analyzed using an inductive and exploratory theme analysis. Participants reported they learned meaningful information but felt somewhat confused regarding the correct course of action when multiple events occurred simultaneously. Preceptors' feedback identified participant failure to meet stated scenario expectations. Quantitative analysis of data, using one sample t test, compared the pre- and post-test scores measuring participant knowledge on assessment, history taking, and communication. Although knowledge scores increased, the difference was not clinically significant based on the negative feedback from both preceptor and participants. Accurate appraisal of nurses' competency in assessment, history-taking, and communication skills is needed prior to exposure to simulation. Simulation scenarios may be more clinically significant when tailored to an individual participant's competency levels.

No description available.

No description available.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

This study examined differences in the effects of three active-learning teaching strategies (case-based learning, simulation, and simulation with narrative pedagogy) on the outcomes of nursing student performance of intervention activities, performance retention of intervention activities, student satisfaction, self-confidence, and educational practice preferences. Engagement theory of student learning provided the overarching theoretical framework. An experimental posttest-only design incorporating two posttests (first performance and retention performance) was used with a sample of 74 nursing students at the University of Iowa College of Nursing. Students attended a cardiac lecture and completed a cardiac test prior to the teaching strategies. Students were randomly assigned and participated in one of the three active-learning teaching strategies and completed the Demographic Questionnaire, the Satisfaction and Self-Confidence in Learning Instrument, and the Educational Practices Questionnaire. Week 3 of the study, after the teaching strategies students participated in an individual performance demonstration in which they implemented nursing intervention activities in response to a cardiovascular scenario interacting with a high-fidelity mannequin. Week 8 of the study, another individual retention performance demonstration was completed by the students using a different case scenario. Both performance demonstrations were digitally recorded and scored using the Student Performance Demonstration Rubric. Two-way mixed analysis of variance (ANOVA) revealed a significant main effect (within-subjects effect) of time, meaning that students in all three teaching strategy groups experienced improved performance of nursing interventions over time, from first performance to retention performance. No significant interaction effect (within-subjects) for time and teaching strategy groups were found. There was also no significant main effect (between-subjects effect) of teaching strategy groups (F 2, 71 = 2.33, p = .105). An exploratory one-way ANOVA on student's first performance rubric scores revealed results approaching significance for the three groups (F 2, 71 = 2.90, p = .06). The simulation with narrative pedagogy group had the highest first performance mean (72.74), followed by the case-based learning group mean (70.68), and finally the simulation group scored the lowest mean (66.16). One-way ANOVA revealed no significant differences across the groups for students' Satisfaction Total scores, Self-Confidence Total scores, and Presence and Importance of Educational Practices Total scores.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

High-fidelity simulation (HFS) is a teaching innovation that is becoming a key component in nursing education programs. Nursing students are able to practice skills without fear of harm to themselves or to a patient, and nurse faculty can demonstrate techniques and critical scenarios in a way that may not be available to students or faculty in the clinical setting. However, nursing faculty are not utilizing this teaching innovation to its potential suggesting educational administrators could benefit from understanding the challenges that nurse faculty face when integrating HFS into their teaching practice. The purpose of this phenomenological study was to explore the lived experiences of nurse faculty who were required to integrate HFS into their teaching practice. In this study, seventeen female nurse faculty who taught in the second year of the Saskatchewan Collaborative Bachelor of Science in Nursing (SCBScN) at Saskatchewan Polytechnic Saskatoon Campus were interviewed about their experiences integrating HFS into their teaching practice. The transcripts were analyzed using Moustakas’ (1994) modified Van Kaam method. Six themes describing the essences of the participants’ experiences were identified: striving for self-efficacy, struggling to maintain autonomy, being part of a community of practice, adopting HFS as a teaching innovation, being an advocate, and being proud. An emerging theme, being an outsider, was discussed. An interpretation and synthesis of the results resulted in a conceptualization of the experience. This research has implications for integrating a new teaching innovation. The nurse faculty required support and resources, psychological safety while learning the new innovation, ongoing communication about the innovation, acknowledgement of their accomplishments, and a sense of pride in the institution. Recommendations for nurse faculty include becoming prepared, finding a mentor, participating in discussion forums, and advocating for time needed to learn. Recommendations for educational administrators include ensuring ongoing education and support, involving nurse faculty in discussions about the innovation from the beginning, providing a psychologically safe environment for learning, providing time to learn away from other teaching responsibilities, and fostering pride through acknowledgement of accomplishments.

No description available.

Hospitalized patients increasingly present with complex health issues that place them at risk for acute patient deterioration (APD). Novice nurses are ill-equipped with the critical clinical skills to function competently in recognizing APD, placing patients at risk for negative health outcomes. This project addressed the need to educate novice nurses to recognize APD and answered the project focused questions that asked if an educational intervention with high-fidelity simulation (HFS) would improve nurse knowledge and clinical confidence in recognizing APD. Benner's novice-to-expert and the constructivism theory were used to guide the project. Based upon a review of the literature, the HFS was developed to provide scenarios in which participants would view APD evolving case studies and demonstrate knowledge and skill for caring for patients with APD. A convenience sample of 11 novice nurses participated in the pre- and posttest design project to determine if knowledge and clinical competence increased. Data from the HFS program were analyzed; results showed no statistically significant change in knowledge or confidence post intervention (p = 0.441). A larger sample size is recommended for future HFS interventions at the site to determine if the program of education will increase knowledge and clinical confidence with future iterations of HFS. The project has the potential to promote positive social change as novice nurses learn to recognize and respond to APD and as APD events are reduced.

High Fidelity Simulation is a teaching strategy that is becoming well-entrenched in the world of nursing education and is rapidly expanding due to the challenges and demands of the health care environment. The problem addressed in this study is the conflicting research results regarding the effectiveness of HFS for students’ knowledge acquisition after participating in simulation exercises. Specifically this researcher determined the effects of a formatted simulation scenario on knowledge acquisition among nursing students and the students’ satisfaction and selfconfidence with the simulation learning activity. Kolb’s Experiential Learning Theory (1984) provided the framework for this study. This study used a quantitative quasi-experimental design, specifically, the Solomon Four Research Design with 43 first semester senior nursing students enrolled at a baccalaureate nursing program at a state university in the southeastern United States. The results of the study found that there was not a statistically significant difference between the experimental group (E1) who received HFS (z = -1.47, p = 0.143) in cognitive gains when compared to the students who did not receive the intervention of HFS (C1) (z = -1.78, p = 0.75). The students’ overall perception of HFS was very positive and the simulation activity increased their self-reported level of self-confidence. The results of this study imply that simulation should not be used with the exclusive goal to increase knowledge but rather for students to increase their confidence and to demonstrate their ability to care for a patient at the bedside. It is our duty as nurse educators to systematically evaluate new teaching efforts such as simulation to determine the effectiveness of this remarkable but expensive technology to ensure that we are providing the best learning opportunities possible for our nursing students.