Dissertation (Ph.D.)--Auburn University,2008. / Abstract. Vita. Includes bibliographic references (p.111-133).

Thesis (MPhil (Curriculum Studies))--Stellenbosch University, 2008. / Background to the study: The Critical Care nursing programme at the Faculty of Health Sciences (Stellenbosch University) is a one-year programme. The practical component consists of practical procedures and case presentations. Students have limited time available in the clinical areas to reach competency in the practical skills. Students tend to use the majority of the clinical teaching time available to reach competency in these practical procedures, rather than discussing the patient and learning the skills to integrate and understand the patient’s condition and treatment, which they can acquire by doing case presentations. The end result of this misuse of clinical contact time is that some of the students, by the end of their programme, still have difficulty to integrate a patient’s diagnosis and treatment regime, although they have managed to complete the expected practical procedures. Summary of the work: A case study design was used. I wanted to investigate whether one could make use of simulation and the Clinical Skills Centre (CSC) to complete the majority of the practical procedures so that more time would be available in the clinical areas for the students to do case presentations. The study focuses on describing how the tutors and students involved experienced the use of simulation, as well as how it impacted on the available teaching time in the clinical areas. Conclusions and recommendations: Some of the most important issues that were highlighted in the study and needs to be mentioned are the following: · The students highly valued supervision by a Critical Care tutor when practising their skills in the CSC. · Students indicated that they valued the opportunity to practise some of the more risky procedures in simulation, because it presents no risk to patients. · Case presentations seem important to be added to the CSC’s practical sessions in order to attempt making the practical simulated scenarios even more realistic. · The teaching at the bedside in the clinical areas used to be done somewhat ad hoc. With the teaching in the CSC now being much more structured, this necessitates the teaching at the bedside to be revisited and to be structured to a certain extent. Summary of the results: The information obtained from the Critical Care tutors and the students indicated that these two groups were largely in agreement that simulation seems to be valuable and can effectively be used in a Critical Care nursing programme.

Clinical simulation is a teaching strategy to assist nursing students to connect classroom knowledge to the clinical setting. Teaching clinical simulation requires special training, but many nursing faculty who teach clinical simulation do not receive clinical simulation training. The purpose of this study was to determine if the effects of formal versus informal simulation training impacted nursing faculty's self-ratings of their competency in facilitating simulation and identify areas for needed educational support. A quantitative descriptive approach was used and grounded in the National League for Nursing and Jefferies (NLN/JSF) theoretical framework. This framework focuses on the relationship between teacher, student, and educational experience. Data on 102 faculty members from prelicensure nursing programs in Maryland completed the Debriefing Assessment for Simulation in Healthcare (DASH-SV) survey. Data analysis using the independent-samples t-test revealed no significant difference in nursing faculty's perceptions regarding how they facilitate clinical simulation between nursing faculty who are formally trained to teach clinical simulation and those who are not. However, there was a significant difference in one element of the DASH-IV which measured the skill of helping students achieve or sustain good performance. The data will contribute to the nursing simulation literature by providing a better understanding of what faculty members perceive as their strengths and weaknesses in teaching clinical simulation. The findings of this study can influence positive social change in nursing by providing nursing administrators with information about faculty perceptions of clinical simulation and influence decisions on training of nursing faculty in using clinical simulation.

Indiana University-Purdue University Indianapolis (IUPUI) / In nursing education, it is common for students to collaborate and make decisions as a group in simulations. One of the vital nursing competencies is students’ ability to make sound clinical judgments and decision-making in simulation. Teamwork among students in simulation significantly affects their critical thinking and clinical reasoning. However, how students collaborate and make decisions in simulation is a complex phenomenon and not well studied and understood. In addition, most existing decision-making frameworks, such as Tanner’s Clinical Judgment Model and the National Council of State Boards of Nursing’s Clinical Judgment Measurement Model, focus solely on individual decision-making. Alternatively, teamwork and collaboration frameworks, such as TeamSTEPPS®, emphasize interprofessional collaboration rather than intraprofessional or peer-to-peer collaboration. Furthermore, peer collaboration and decision-making cannot be accurately measured without a theoretical framework. Because clinical decision-making in nursing practice is a complex process that involves peer collaboration, more research is needed to explore how nursing students collaborate and make decisions in simulation. This qualitative study comprises of a hybrid concept analysis and Charmaz’s constructivist grounded theory to explore prelicensure nursing student’s peer collaborative clinical decision-making (PCCDM). The concept analysis develops a comprehensive definition of PCCDM based on theoretical and empirical data. The grounded theory develops the theoretical framework that captures the process of PCCDM, which consists of the three major domains of group cognition, behavior, and emotion. These domains undergo the peer regulatory process of awareness, communication, and regulation within the individual and collaborative space at various simulation phases. Additionally, a thematic analysis further explores group emotion in PCCDM as the domain is the least studied in nursing simulation. This study provides the framework to support healthcare and nursing simulation involving peer collaboration and decision-making.

Introduction  In contemporary higher education systems, interactive learning tool such as simulation, has been widely adopted in clinical studies as an effective learning tool to help students to gain both near and far transferable learning skills in a controlled setting, where parameters are defined, and an alternate reality generated. There is a dearth of knowledge on how simulation designers can support learners to transfer learning from simulation settings to clinical settings, by focusing on improving the design of simulation sessions.  Aim of the Study The aim of conducting this qualitative metasynthesis was to identify significant elements of simulation design that are necessary to support learning transfer to clinical settings.   Methodology A qualitative metasynthesis was adopted as a rigorous method to examine the findings of the original 15 qualitative studies to offer new interpretations and insights on the concept of learning transfer. Inductive thematic analysis was used to synthesize the data  Results  Six key findings we identified that include authentic setup, immersive learners’ role, learner’s cognitive boost, positive formative feedback, timing, and learner’s confidence. The findings represent elements of simulation design that can be improved by simulation session designers to support learning transfer from simulation to the clinical setting. Conclusion The result suggests that learning transfer from simulation sessions cannot be assumed to occur spontaneously in clinical settings but as a product of various factors. Therefore, the designers of simulation settings need to focus on replicating reality while provoking learners’ deeper thinking skills in the actual clinical setup, lay efforts in all aspects of the design to achieve higher levels of authenticity and transferability, consider incorporating observers actively and  eliminate categorization bias. This with a view to learners to transfer near and far learning from simulation settings to clinical settings.

Thesis (M. (Nursing Science )) -- University of Limpopo, 2017 / The aim of the study was to determine the utilization of simulation by nurse educators and learner nurses at LCN. The objectives of the study were to describe the utilization of simulation by nurse educators and learner nurses at the LCN and to develop strategies that would improve the utilization of simulation by nurse educators and learner nurses at the LCN. A qualitative research method and exploratory, descriptive and contextual research design was used with a purposive sample of fourty two participants from LCNCs. Tesch’s eight steps of qualitative data analysis were followed. The study found and concluded that there was poor utilization of simulation in clinical laboratories by both the nurse educators and learner at LCNCs. The results of the study recommends that LCNCs should have clinical laboratories managers, to be conducive in order to accommodate the number of learner nurses, to have sufficient and useful simulators, and also accessed at any time of the year by learner nurses. To employ well advanced simulators at the college through buying. Simulation sessions should be given enough time and learner nurses to be allowed to do return demonstration, and continuous practice / University of Limpopo

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Introduction and Background High fidelity simulation (HFS) refers to a mannequin that is modeled to represent a human and is programmed to produce physiologic functions such as palpable pulses, voices and abdominal sounds through computer interfaces. Recent introduction of HFS for learning nursing skills like critical thinking and problem solving in the developing world (Lesotho) has generated debate. The debate is centered on the acceptability of HFS, its effectiveness as a learning strategy compared to its high cost, especially in resource limited settings. Its acceptability in the developing world to date is mixed, affecting its ultimate utilization. Therefore contextual differences between developing and developed countries suggest that research findings on the evaluation of acceptability of HFS in the two places could be different. Additionally, health sciences education is a highly complex discipline with huge differences in practices within and across classes, schools, sites and countries, making it difficult to generalize findings from other settings to the setting of Lesotho. Aim The purpose of this study was to explore third year diploma in nursing students’ perceptions and experiences of HFS use in learning nursing skills. Methods A qualitative descriptive design was utilized to investigate HFS use at a school of nursing. Sixteen participants took part in three separate focus group discussions in two groups of five, and one group of six participants. The data was analyzed thematically. Results Students had mixed perceptions, positive and negative, based on the nature of their experiences which were both fulfilling and frustrating. This study revealed five key themes that shaped students experiences, hence perceptions of using HFS in learning. The themes are authentic learning environment, unique learning opportunities, access, contextual factors and transfer of skills. Discussion Student nurses had both positive and negative experiences of using HFS in learning. They believe that HFS is a valuable learning strategy but that it needs to be better utilized. Student nurses perceive HFS as providing an authentic learning environment which allows learning of complex skills like critical thinking and problem solving. On the other hand, they believe that learning can be improved if HFS is more accessible for use by students and if supervisors are adequately trained and students are better oriented on the use of HFS in learning. Conclusions HFS is viewed as an effective learning strategy among nursing students in resource limited settings, although there in need to improve its utilization for better learning experiences and outcomes. / AFRIKAANSE OPSOMMING: Inleiding en Agtergrond Hoëtrou-simulasie (HTS) verwys na ’n pop wat gemodelleer is om ’n mens te verteenwoordig en geprogrammeer is om fisiologiese funksies soos tasbare polse, stemme en abdominale klanke te lewer deur rekenaar-koppelvlakke. Onlangse bekendstelling van HTS in die aanleer van verpleegvaardighede soos kritiese denke en probleemoplossing in die ontwikkelende wêreld (Lesotho) het debat laat ontstaan. Die debat sentreer om die aanvaarbaarheid van HTS en sy effektiwiteit as ’n leerstrategie in vergelyking met sy hoë koste, veral in hulpbronbeperkte omgewings. HTS se aanvaarbaarheid op verskillende plekke in die ontwikkelende wêreld tot op datum is gemeng, wat die uiteindelike gebruik daarvan raak. Daarom dui kontekstuele verskille tussen ontwikkelende en ontwikkelde lande aan dat navorsingsbevindings oor die beoordeling van aanvaarbaarheid van HTS in die twee omgewings kan wissel. Bykomend is opleiding in die gesondheidswetenskappe ’n uiters komplekse dissipline met groot verskille in praktyke binne en oor klasse, skole, omgewings en lande, wat dit moeilik maak om bevindings van ander omgewings tot die omgewing van Lesotho te veralgemeen. Doel Die doel van hierdie studie was om derdejaar-diplomaverpleegstudente se persepsies en ervarings van die gebruik van HTS vir die aanleer van verpleegvaardighede te ondersoek. Metodes ’n Kwalitatiewe gevallestudieontwerp is benut om die verskynsel van HTS by Paray Verpleegkundeskool te ondersoek. Sestien deelnemers het aan die verskillende fokusgroepbesprekings deelgeneem in twee groepe van vyf, en een groep van ses deelnemers. Die data is ontleed met die gebruik van die konstante vergelykingsanalise-model. Resultate Studente het gemengde waarnemings, positief en negatief, ervaar, gebaseer op die aard van hul ondervindings wat sowel vervullend as frustrerend was. Hierdie studie het vyf sleuteltemas geopenbaar wat studente se ondervindings, en sodoende hul waarnemings van die gebruik van HTS in opleiding gevorm het. Die temas is outentieke leeromgewing, unieke leergeleenthede, toegang, kontekstuele faktore en oordrag van vaardighede. Bespreking Studentverpleegsters aanvaar die gebruik van HTS om verpleegvaardighede te leer. Hulle glo dat HTS ’n waardevolle leerstrategie is, wat egter beter benut moet word. Studentverpleegsters beskou HTS as ʼn verskaffer van ʼn outentieke leeromgewing wat die aanleer van komplekse vaardighede soos kritiese denke en probleemoplossing toelaat. Aan die ander kant glo hulle dat opleiding verbeter kan word indien HTS meer toeganklik is vir gebruik deur studente en indien toesighouers voldoende opgelei is en studente beter voorgelig word in die gebruik van HTS as opleidingsmiddel. Gevolgtrekkings HTS is ʼn aanvaarbare leerstrategie onder verpleegstudente in omgewings met beperkte hulpbronne, hoewel daar ʼn behoefte is om die benutting daarvan vir beter leerervarings en uitkomstes te verbeter.

背景: 高擬真情境模擬（HFS）已成為一種流行的護理教育教學法，能讓學生安全及有效地利用高擬真情境模擬人練習護理。許多西方的研究報告指出，HFS對護理學生的自信心培育、解決問題的能力和批判性思維均有正面影響。然而，對本地護理學生所做的研究有限。基於文化差異，以及不同的學習風格，西方國家的證據未必能套用在香港的護理學生身上。 / 目的: 本研究志在探討高級護理文憑課程的學生對研究員研發的高擬真情境模擬訓練課程(HFSTP)的滿意度，及HFSTP對學生的學習自信及批判性思維發展的影響。 / 研究方法: 這項研究採用了混合方法研究設計，分為兩個階段。第一階段為準實驗性研究，利用前測後測設計，以探討HFSTP對護理學生的自信心、滿意度以及批判性思維發展的影響。共90位護理學高級文憑課程二年級學生，按他們就讀課程的要求，參加了第一階段的研究。而HFSTP是参照科爾布的經驗學習週期所研發，當中包括兩個1小時的小組研討和兩個1小時HFS實驗室培訓。第一階段的研究採用了四份問卷，包括學生滿意度和學習中自信量表（SCL），批判性思維調查（CTS），仿真設計量表（SDS）和人口表。而在SCL得分最高及最低各12位學生會被邀請參加第二階段的焦點團體訪談。這階段研究以半結構化面試指南來探索學生們對HFSTP的看法。所得數據以內容分析法作分析。 / 結果: 配對t檢驗結果表明，SCL和CTS的後測平均分均顯著高於前測（P = 0.001）。而對HFSTP的設計評價，學生評定保真度和匯報會為HFSTP學習中最重要的元素。大部份學生在定性訪談中表示滿意這嶄新的學習方法。根據定性數據分析的結果得出四大主題：（1）模擬臨床環境，（2）整體護理經驗，（3）信息和反思的思維，及（4）HFS的用量，研究人員得出結論，參照科爾布的經驗學習週期所研發的高擬真情境模擬訓練課程，是一種有效的教學策略，它能有效地提高學生的學習自信及培養出批判性思維。同時，學生表示滿意這次課程的安排。至於這次研究結果對護理教育，護理實務和高等教育管理的影響將會在這論文的最後部份發表。 / Background: High-fidelity simulation (HFS) has become a popular teaching method in nursing education that allows students to practice their nursing care skills safely and effectively on human patient stimulators. Many studies have reported the positive impacts of nursing students’ learning experience with the use of HFS on their development of self-confidence, problem solving and critical thinking. However, studies done on local nursing students are limited. Acknowledging that there may be cultural differences in the learning styles between Chinese and non-Chinese people, the existing evidence mainly come from western countries, which may have limited generalizability to Hong Kong nursing students. / Aims: This study aims to examine the satisfaction of the higher diploma nursing students on the researcher-developed high-fidelity simulation training program (HFSTP), and the effects of HFSTP on the students’ self-confidence in learning and development in critical thinking. / Methods: A mixed methods study design was used in two phases. In Phase I, a quasi-experimental, one-group pretest-posttest design was employed to investigate the effects of HFSTP on nursing students’ satisfaction, self-confidence, and critical thinking development. A total of 90 year 2 higher diploma nursing students participated in the Phase I study. The Kolb’s experiential learning cycle guided the development of the HFSTP including two 1-hour simulation tutorials and two 1-hour HFS laboratory and debriefing sessions. Four questionnaires including Student Satisfaction and Self-Confidence in Learning (SCL), Critical Thinking Survey (CTS), Simulation Design Scale (SDS), and a Demographic Sheet were employed in the Phase I study. In Phase II, a focus-group interview was conducted to explore students’ perception of HFSTP. A total of 24 students from the highest or lowest scores in the posttest SCL in Phase I were invited for the focus group interview. A self-developed semi-structured interview guide was used to explore the participants’ perception of the HFSTP. Content analysis was used for data analysis. / Results: Results of paired t-test indicated that the mean scores of both SCL and CTS in the posttest were significantly higher than those of the pretest (p = <0.001). With regard to the evaluation of the design of HFSTP, the participants rated the fidelity and debriefing sessions as the most important learning features in the HFSTP. In the qualitative interview, most of the students expressed satisfaction towards the learning of HFSTP. Four main themes (1) A mimic clinical environment, (2) Holistic care experience, (3) Information and reflective thinking, and (4) Dosage of the HFS, emerged from the analysis of the qualitative data based on students’ perceptions of having HFSTP as a new teaching strategy. Researcher concluded that the HFSTP, which is based on Kolb’s experiential learning cycle, is an effective teaching strategy for promoting nursing students’ self-confidence in learning and critical thinking development. Students were satisfied with the program design. Fidelity and debriefing sessions were reported as the two most important learning features of the HFSTP. Implications of the findings for nursing education, nursing practice and higher education administration will be presented at the end of the paper. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Fong, Wan Ching Kathryn. / Thesis (D.Nurs.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 154-161). / Abstracts also in Chinese. / Chapter CHAPTER ONE --- INTRODUCTION --- p.1 / Introduction --- p.1 / Background of the Study --- p.1 / Justification for the Study --- p.5 / Research Questions --- p.6 / Conceptual and Operational Definitions --- p.7 / Significance of the Study --- p.9 / Overview of the Study --- p.10 / Chapter CHAPTER TWO --- LITERATURE REVIEW --- p.12 / Introduction --- p.12 / Search Strategy --- p.13 / Development of Simulation --- p.13 / History of Simulation Learning in Nursing Education --- p.16 / HFS used in Nursing Education --- p.17 / Self-Confidence in Learning --- p.25 / Satisfaction with Learning Experience --- p.37 / Critical Thinking --- p.43 / Theoretical Framework: Kolb’s Experiential Learning Cycle --- p.48 / Conclusion --- p.52 / Chapter CHAPTER THREE --- METHODOLOGY --- p.55 / Introduction --- p.55 / Research Questions --- p.56 / Aims --- p.56 / Research Objectives --- p.56 / Research Design --- p.57 / Setting --- p.61 / Phase I Study --- p.63 / Phase II Study --- p.83 / Ethical Issues --- p.90 / Pilot Study --- p.91 / Summary --- p.91 / Chapter CHAPTER FOUR --- RESULTS --- p.93 / Introduction --- p.93 / Research Hypotheses --- p.94 / Phase I Study --- p.94 / Phase II Study --- p.105 / Summary --- p.126 / Chapter CHAPTER FIVE --- DISCUSSION --- p.128 / Introduction --- p.128 / Participant Recruitment and Response --- p.128 / Issues of Dropouts and Participant Non-attendance --- p.129 / Discussion on Study Findings --- p.129 / The Use of Assessment Tools --- p.142 / Limitations of the Study --- p.143 / Implications for Nursing Education --- p.144 / Implications for Nursing Practice --- p.146 / Implications for Higher Education Administration --- p.148 / Recommendations for Future Studies --- p.150 / Conclusions --- p.151 / REFERENCES --- p.154

Nursing faculty are utilizing high-fidelity patient simulation (HPS) with debriefing to help engage nursing students in making competent clinical decisions. This quasi-experimental study examined the use of HPS with debriefing and students’ ability to make nursing care decisions using standardized exams. The experimental group received debriefing after HPS and the control group did not receive debriefing after HPS. The pre- and post-test assessed participants’ ability to make clinical care decisions. The analysis of the pre-test and post-test HESI scores showed that there was no significant difference between the two groups.

Effective pain management and time to treatment is essential in patient care. Despite scientific evidence supporting the need to treat pain and an emphasis on addressing pain as a priority, pain management continues to be an unresolved issue. As a member of the health care team, nurses are integral to optimal pain management. Currently, nursing schools have limited innovative or alternative methods for teaching pain assessment and management. Simulation in nursing education provides a unique opportunity to expose students to realistic patient situations and allow them to learn and make mistakes without causing harm. However, modern low- and high-fidelity simulation technology is unable to display emotion, pain, or any facial expression. This limits training and education of conditions that may partially rely on the identification of symptoms based on the alteration of facial appearance, such as pain or stroke. This research explored student nurses’ perception of new technology that displayed computer-generated faces, each expressing varying degrees of physical expressions of pain. A total of 15 nursing students participated in the study. Students were asked to interpret the level of pain in four sequential faces using a numeric rating scale of 0-10, with 0 indicating no pain, and 10 the most severe pain possible. After scoring the faces, students were asked to answer four open-ended questions addressing the technology. Results of the study indicate a majority of nursing students believe the technology should be implemented into nursing curriculum and interacting with the projected faces was more beneficial than traditional teaching methods. Eventually, the potential for increased identification of conditions requiring observation of subtle facial changes will be explored.