Evaluation of A Problem Based (PB) Simulation Module on Graduate Nurse Anesthesia Student Learning and Attitudes Toward Human Simulation Education.

Abstract

INTRODUCTION: The purpose of this study was to determine if knowledge acquisition occurred with student participation in problem based simulation module and if their attitudes associated with simulation changed significantly with the experience. METHODS: After receiving IRB approval, 1st year nurse anesthesia students enrolled in Applied Physiology and Pathophysiology (2nd semester) were assigned to a PB simulation session. Twenty-nine (n = 29) students who volunteered as subjects completed a 22-item multiple choice pre and post-quiz and a 16-item pre and post-attitudinal survey consisting of a 5-point Likert rating scale (1-strongly disagree, 2-disagree, 3-neutral, 4-agree, 5-strongly agree). All quiz and survey responses were entered via laptop into the Winter Institute for Simulation, Education and Research database with only de-identified data available for investigator analysis. RESULTS: Paired sample t-tests were performed on the pre/post simulation quiz scores and on each of the pre/post attitudinal survey items. There was a statistically significant increase on the student scores between pre-quiz score (M = 54.08, SD = 12.469) and post quiz score (M = 73.98, SD = 10.009), t28 = -10.746, p <.001. There was a statistically significant increase in ratings between student anticipation that the PB anesthesia scenarios would be similar to actual clinical situations pre-module (M = 4.33, SD = .784) and post-module rating that the PB anesthesia scenarios were similar to actual clinical situations (M = 4.63, SD = .492); t26 = -2.302, p = .03. There was a statistically significant decrease in the anxiety rating associated with peers observing simulation performance between pre-module rating (M = 3.75, SD = 1.175) and post-module rating (M = 2.89, SD = 1.315), t27 = 4.204, p <.001; and decrease in the anxiety rating associated with faculty observing simulation performance between pre-module rating (M = 3.79, SD = 1.067) and post-module rating (M = 2.96, SD = 1.401) t27 = 4.116, p <.001. There was a statistically significant increase in student confidence that performance would be held confidential by peers between pre-module rating (M = 3.88, SD = 1.243) and post module ratting (M = 4.23, SD = 1.069), t25 = -3.143, p = .004; and increase in student confidence that performance would be held confidential by faculty between pre module rating (M = 4.50, SD = .793) and post module rating (M = 4.714, SD = .460); t27 = -2.274, p = .031. On the average the students agreed to strongly agreed that the scenarios would be realistic, (M=4.39, SD = .722) and following the modules on the average the students continued to agree to strongly agree that the scenarios were realistic, (M = 4.39, SD = .522). CONCLUSIONS: Human simulation teaching was found to be an effective adjunct to reinforce lecture content provided during the term. Students significantly improved their post test scores and felt less anxious with simulation teaching by the end of the session. Students agreed that the scenarios were realistic and were similar to actual clinical situations. Use of simulation to reinforce lecture content will be continued.