Nursing student perceptions of a community-based home visit experienced by a role-play simulation.

Abstract

doi: 10.5480/12-932.1Faculty teaching community health nursing are challenged by increas- ing student enrollments, faculty shortages, and diminishing availabil- ity of clinical sites, as well as student safety and security while in the community. These challenges are fueling the exploration of simulation as a viable option for providing community-based education within a safe environment.The study purpose was to describe perceptions of pre-licensure nursing students about the design and effectiveness of a communi- ty-based home visit simulation. The aims of the study were twofold: 1) to evaluate the design and effectiveness of a role-play simulation of a home visit experience as a teaching tool, and 2) to examine how nurs- ing students perceive the learning opportunities from a community home visit simulation.LIterAture revIeWThe nursing literature reflects persistent difficulties faced by faculty in their efforts to establish community health clinical placements and clinical supervision. In a survey of nurse faculty whose expertise was community-based education, Frank, Adams, Edelstein, Speakman, and Shelton (2005) found that with educational experiences taking place in a multitude of different community settings, it was difficult for faculty to provide consistency in the types of clinical experiences. Lack of quality clinical sites also contributes to the challenge of facili- tating these learning experiences (McNelis & Ironside, 2009). The use of role-play simulation provides an option to address these issues.Since nursing first introduced the use of simulation in education, studies have focused on using simulations for learning high-technical skills, acute care interventions, and critical decision-making. It is only recently that studies examining the use of simulation for community health nursing (CHN) education have appeared in the literature. Role- play, standardized clients, interactive gaming, and the use of high-fi- delity patient simulators are all documented as effective teaching strategies for nursing students in CHN (Hogan, Kapralos, Cristancho, Finney, & Dubrowski, 2011; Unsworth, Tuffnell, & Platt, 2011; Yeager & Gotwals, 2010).methodThis descriptive mixed-method study used both quantitative and qual- itative methods for data collection. A convenience sample (N = 144) of traditional baccalaureate nursing students enrolled in two schools of nursing in the Midwest participated in the study. The Jeffries Simulation Model (Jeffries, 2005) provided the foundational frame- work for this study.Procedure and Description of SimulationClinical groups of 8 to 10 students participated in a standard home visit simulation. The simulation was developed by CHN faculty from multiple schools of nursing in collaboration with three community health nurse experts. Learning objectives included application of the nursing process to initiate care of the family in the home setting, and demonstration of therapeutic communication in the care of the client and family.The scenario was set in a living room and kitchen of a family with limited English language proficiency. Various props, such as portable electric heaters, cigarettes, unlabeled medication bottles, and assorted vermin artifacts, were purposefully used to establish unsafe living con- ditions. Students assumed roles (actors) of family members or nurses or served as observers. Actors were given a script with detailed required behaviors and cues to exhibit.A semistructured debriefing protocol, which included a set of 11 standard questions based on Jeffries' model (2005) and concepts from Billings and Halstead (2009), allowed for further probing. Data were collected by the primary researcher immediately following debriefing. Only students who volunteered and signed an informed consent par- ticipated in the study, and confidentiality of participants was main- tained. Approval for the study was obtained from each university insti- tutional review board involved in the study. …