Abstract
BackgroundAs simulation science continues to advance, the focus previously put on scenario creation and debriefing must now be applied to other components of the learning experience. There is a need to examine the effectiveness of pre-simulation activities and how they relate to the overall simulation experience and learning outcomes. However, few randomized controlled trials have been conducted comparing different approaches in the pre-simulation preparatory phase and the impact on learning outcomes.MethodsA randomized controlled trial was conducted with undergraduate nursing students (n=83) who were randomized to a traditional paper case study (control group) or an interactive pre-simulation activity (intervention group). The use of the two-challenge rule and Satisfaction and Self Confidence in Learning (SSL) was evaluated.ResultsThe proportion of students who utilized the two-challenge rule in the intervention group was significantly higher than the control group. Results from the two independent-samples Wilcoxon-Mann-Whitney test showed a significant difference in the median of the total score of the SSL W=2.5, p <0.001, satisfaction W=6.0, p <0.001, and self-confidence W=68.0, p <0.001 in learning between third-year nursing students in the control and intervention groups.ConclusionOur results showed significant differences in the use of the two-challenge rule by students who completed an interactive pre-simulation activity (intervention group) compared to those who completed the paper case study (control group). Additionally, students in the intervention group were more self-confident and satisfied with the entire simulation intervention than the control group. From a pedagogical perspective, this study also emphasizes the need to ground simulations in theory. Moreover, there is value in using progressive frameworks, i.e., revised Medical Research Council (2014) in simulation design and research to ensure high quality. More studies are required to examine the right dosage and type of pre-simulation activity and impact on learning outcomes.
Highlights
Conflict is a clash or struggle occurring when a real or perceived threat or difference exists in the desires, thoughts, attitudes, feelings, or behaviours of two or more individuals [1]
A randomized controlled trial was conducted with undergraduate nursing students (n=83) who were randomized to a traditional paper case study or an interactive pre-simulation activity
In light of this study’s findings and the broader implications, we conclude by emphasizing the importance of designing and refining simulation interventions before conducting experimental studies, and the importance of teaching undergraduate nursing students conflict management skills, i.e., the two-challenge rule
Summary
Conflict is a clash or struggle occurring when a real or perceived threat or difference exists in the desires, thoughts, attitudes, feelings, or behaviours of two or more individuals [1]. Nursing students begin to experience interpersonal conflict when they enter clinical placements with preceptors and other nurses that, if unchecked, can lead to unsafe care, including medication errors [4,6,7,8]. One method of preparing nursing students for clinical placements is utilizing high-fidelity simulations representing specific aspects of nursing care realistically. More experimental studies are required to evaluate the pre-simulation preparation component of. There is a need to examine the effectiveness of pre-simulation activities and how they relate to the overall simulation experience and learning outcomes. Few randomized controlled trials have been conducted comparing different approaches in the pre-simulation preparatory phase and the impact on learning outcomes
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