Simulation in nursing education involves an instructor observing students performing a specific task using an anatomical model, standardized patients, or high-fidelity simulation using a simulator. This education method allows creation of realistic clinical scenarios to allow nurses to perform tasks in a safe learning environment. However, accurate performance in the simulation lab must be replicated in the clinical environment to impact patient outcomes.
Chapter 2 is a systematic literature review resulting in 21 articles addressing dependent variables, conceptual frameworks, study designs and outcomes measured in new nurses. Knowledge, simulation satisfaction, confidence, and clinical performance were common simulation outcomes studied. Only 7 research articles reported using a theoretical framework. Even though most of the studies used self-reported measures to demonstrate improvement in the studied variables after simulation, none of the studies used objective observation in the actual clinical setting after simulation. Assessing performance in the actual clinical environment after simulation is an opportunity to link simulation education to patient outcomes. Researchers should explore if learned skills in simulation are transferred to the real clinical setting resulting in safe and competent care. This gap in the literature was the impetus for the study described in Chapter 3.
Chapter 3 focuses on a quasi-experimental study on new nurses hired at an oncology institution to determine if skills learned in the simulation lab transferred to the clinical setting. The study’s aim addressed if a difference exists in clinical observation scores between the intervention group (involved in simulation) and control group (not involved in simulation) when performing a central line dressing change. Fifty-six participants were consented with 19 nurses completing all data collection points. No significant differences were identified between groups.
Chapter 4 is a narrative account applying the concept of resilience to the doctoral dissertation experience during a pandemic. Using Richardson’s Resiliency Model, the challenges of performing research on staff development during a pandemic are presented. The presence of a stressor (pandemic) and the resulting stages of disruption and reintegration are described resulting in resilient reintegration during the doctoral research process.
Simulation is an educational methodology in academia and staff development. However, outcomes such as confidence, knowledge and simulation satisfaction are over-studied and there is a need for studies to focus on if skills performed during simulation are replicated accurately in the clinical setting. In addition, simulations should be designed to ensure they are addressing the identified construct (e.g. clinical judgement). In addition, the logistics involved in observing practice at the point of care is challenging due to unpredictable factors such as staffing, patient acuity, and operational decisions that may impact study design present unique challenges.
Keywords: Simulation, new nurses, resilience
| Identifer | oai:union.ndltd.org:columbia.edu/oai:academiccommons.columbia.edu:10.7916/72ez-0s31 |
| Date | January 2024 |
| Creators | Quashie, Wayne |
| Source Sets | Columbia University |
| Language | English |
| Detected Language | English |
| Type | Theses |
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