High-fidelity Patient Simulation Research Articles

A simulation-based randomized trial of ABCDE style cognitive aid for emergency medical services CHecklist In Prehospital Settings: the CHIPS-study

BackgroundChecklists are a powerful tool for reduction of mortality and morbidity. Checklists structure complex processes in a reproducible manner, optimize team interaction, and prevent errors related to human factors. Despite wide dissemination of the checklist, effects of checklist use in the prehospital emergency medicine are currently unclear. The aim of the study was to demonstrate that participants achieve higher adherence to guideline-recommended actions, manage the scenario more time-efficient, and thirdly demonstrate better adherence to the ABCDE-compliant workflow in a simulated ROSC situation.MethodsCHIPS was a prospective randomized case–control study. Professional emergency medical service teams were asked to perform cardiopulmonary resuscitation on an adult high-fidelity patient simulator achieving ROSC. The intervention group used a checklist which transferred the ERC guideline statements of ROSC into the structure of the ‘ABCDE’ mnemonic. Guideline adherence (performance score, PS), utilization of process time (items/minute) and workflow were measured by analyzing continuous A/V recordings of the simulation. Pre- and post-questionnaires addressing demographics and relevance of the checklist were recorded. Effect sizes were determined by calculating Cohen’s d. The level of significance was defined at p < 0.05.ResultsTwenty scenarios in the intervention group (INT) and twenty-one in the control group (CON) were evaluated. The average time of use of the checklist (CU) in the INT was 6.32 min (2.39–9.18 min; SD = 2.08 min). Mean PS of INT was significantly higher than CON, with a strong effect size (p = 0.001, d = 0.935). In the INT, significantly more items were completed per minute of scenario duration (INT, 1.48 items/min; CON, 1.15 items/min, difference: 0.33/min (25%), p = 0.001), showing a large effect size (d = 1.11). The workflow did not significantly differ between the groups (p = 0.079), although a medium effect size was shown (d = 0.563) with the tendency of the CON group deviating stronger from the ABCDE than the INT.ConclusionChecklists can have positive effects on outcome in the prehospital setting by significantly facilitates adherence to guidelines. Checklist use may be time-effective in the prehospital setting. Checklists based on the ‘ABCDE’ mnemonic can be used according to the ‘do verify’ approach. Team Time Outs are recommended to start and finish checklists.

Sepsis and Clinical Simulation: What Is New? (and Old).

Sepsis is a critical and potentially fatal condition affecting millions worldwide, necessitating early intervention for improved patient outcomes. In recent years, clinical simulation has emerged as a valuable tool for healthcare professionals to learn sepsis management skills and enhance them. This review aims to explore the use of clinical simulation in sepsis education and training, as well as its impact on how healthcare professionals acquire knowledge and skills. We conducted a thorough literature review to identify relevant studies, analyzing them to assess the effectiveness of simulation-based training, types of simulation methods employed, and their influence on patient outcomes. Simulation-based training has proven effective in enhancing sepsis knowledge, skills, and confidence. Simulation modalities vary from low-fidelity exercises to high-fidelity patient simulations, conducted in diverse settings, including simulation centers, hospitals, and field environments. Importantly, simulation-based training has shown to improve patient outcomes, reducing mortality rates and hospital stays. In summary, clinical simulation is a powerful tool used for improving sepsis education and training, significantly impacting patient outcomes. This article emphasizes the importance of ongoing research in this field to further enhance patient care. The shift toward simulation-based training in healthcare provides a safe, controlled environment for professionals to acquire critical skills, fostering confidence and proficiency when caring for real sepsis patients.

Can High-Fidelity Patient Simulation Be Used for Skill Development in Junior Undergraduate Students: A Quasi-Experimental Study.

High-fidelity patient simulation (HFPS) is widely used in professional training to enhance students' competence in clinical management. A guideline for HFPS provides a systematic approach to direct students to learning during the simulation process. Problem-solving (PS) and clinical reasoning (CR) skills are essential to developing students' professional competence in safe and effective care. These two skills should be initiated in the early training. A structured guideline was developed for HFPS. This study aimed to investigate the effects of the structured HFPS guideline on the development of PS and CR skills in junior nursing students. The students were required to go through four sessions, pre-briefing, simulation design, facilitation, and debriefing, for the HFPS; the study utilized the Problem-Solving Inventory (PSI) and the Nurses' Clinical Reasoning Scale (NCRS) to measure PS and CR abilities before and after HFPS. Bivariate analysis, a one-sample t-test, and an independent t-test were performed to evaluate the performance of the PS and CR skills during the two study periods. A total of 189 students were recruited, with 92 in the intervention group and 97 in the control group. The research assistant was responsible for student recruitment through email invitations and allocating the students into the control group or the intervention group. A Wilcoxon analysis was performed and revealed significant differences in PS and CR between the two groups (p < 0.001). The analytic results showed that the PSI, particularly in domains of Problem-Solving Confidence (PSC) (p < 0.001) and overall PS (p < 0.001), and the CR (p < 0.001) had significant improvement after HFPS, particularly in the intervention group. The study concluded that the structured HFPS guideline significantly improved the students' problem-solving and clinical reasoning abilities. Nurse educators play an important role in providing explicit learning instructions in a simulation guideline that directs and guides students to learn at each stage of HFPS. The students can be directed to be engaged in their learning through HFPS to enhance their competence in knowledge and skill development (PS and CR) for their personal and professional development.

A Modified Guideline for High-Fidelity Patient Simulation to Improve Student Satisfaction and Self-Confidence in Learning: A Mixed Study.

The coronaviral pandemic has led to a shift in traditional teaching methods to more innovative approaches, such as high-fidelity patient simulation (HFPS), which can improve students' clinical judgment and decision making for quality patient care. A modified guideline was introduced to enhance students' satisfaction and self-confidence in learning through HFPS. The study involved 189 baccalaureate nursing students, with 92 in the intervention group and 97 in the control group. The intervention group received the modified HFPS guideline, while the control group received standard treatment with basic instruction. After the HFPS debriefing session, students provided narrative feedback on their learning experiences. The quantitative results showed that students in the intervention group reported a significant improvement in satisfaction and self-confidence in learning compared to the control group. The modified HFPS guideline provided clear guidance for students to learn and apply knowledge and skills more effectively, leading to increased engagement during interactive simulation sessions. The results suggest that the HFPS guideline should be added to the curriculum to enhance students' satisfaction and self-confidence in learning, even for junior students. After the pandemic, innovative teaching methods, such as HFPS, can be necessary and beneficial for healthcare professional training.

High-Fidelity Patient Simulation Activities to Facilitate Self-Regulation in First-Year Medical Students.

The purpose of this innovation was to utilize high-fidelity patient simulation (HFPS) activities for students to self-reflect on their study strategies and performance to provide metacognitive awareness. Students wrote self-reflections after HFPS activities comparing their individual responses to faculty answers focusing on study approach and future planning.

A metacognitive confidence calibration (MCC) tool to help medical students scaffold diagnostic reasoning in decision-making during high-fidelity patient simulations.

The purpose of this study was to 1) help novice students scaffold problem-solving and engage safely in the deliberate practice of diagnostic reasoning and medical decision-making in real time; 2) assess how accurately students gather and apply data in medical reasoning and treatment during high-fidelity patient simulations (HFPSs); 3) identify students' scientific misconceptions related to the case; 4) promote student metacognitive processing, self-assessment, and self-efficacy; and 5) facilitate the explicit calibration of student confidence in deliberate reasoning with patient outcomes. In a mixed-method design, a metacognitive calibration self-assessing (MCC) survey tool was applied to HFPS (n = 80, 20 teams of 6 medical students) and semistructured interviews were conducted with faculty (n = 5). When scored by faculty with a rubric, the mean student accuracy ranged from 23% to 74%, whereas their self-assessment of confidence ranged from 71% to 86%. This result revealed overconfidence bias in novice students regarding the correctness of their wrong responses. The most common misconception identified was inverting cause and effect: metabolic acidosis was pointed to as the cause of the patient's problems rather than a consequence of untreated diabetes mellitus. The most common treatment error was overtreatment, with unnecessary added medication. Interviews with faculty suggested that the MCC tool improved the team process by slowing students down, requiring them to think through their answers, and that overall the tool improved their critical thinking. This study demonstrated the feasibility of using a metacognitive confidence calibration tool to assist novice students in learning safely to make deliberate diagnostic reasoning and decisions on patient care in real time during complex simulations while observing objectively their levels of psychological confidence against patient outcomes.NEW & NOTEWORTHY This study demonstrates the feasibility of a metacognitive confidence calibration tool (MCC) to assess and promote novices in the learning of diagnostic reasoning and treatment decisions on patient care in real time during high-fidelity patient simulations while comparing confidence and accuracy data and identifying students' scientific misconceptions. Results revealed the presence of overconfidence bias, overtreatment, and the misconception of metabolic acidosis as the cause of the patient's problems rather than a consequence of untreated diabetes mellitus.

Using High‐fidelity Human Patient Simulation to Teach Functional Aerodigestive Tract Anatomy And Bridge Clinical Skills: Student Perceptions of Clinical Preparedness

Introduction &amp; ObjectiveHigh‐fidelity human patient simulation (HPS) improves emerging clinical competencies in medical training programs. HPS simulates complex learning environments while minimizing risks. Limited evidence is available regarding HPS use in aerodigestive tract (AT) disorders. Our objective was to explore clinical graduate students’ perceptions regarding their knowledge, skills, and confidence in functional AT anatomy across three different learning environments: didactic, standardized patient (i.e., role play), and HPS.Materials &amp; MethodsUsing a cross‐over design, and following completion of didactic head and neck anatomy lectures, graduate students in a speech‐language pathology clinical program were randomly assigned to one of two case‐based scenarios: standardized patient (STP) or HPS. Following the completion of their assigned scenario, students then completed the alternate. A self‐administered survey using a 10‐pt Likert scale (1 = none/no, 10 = extreme/strongly agree) rated student perceptions across domains of knowledge (K), skills (S) and confidence (C) at four time points (baseline, after didactic, STP, and HPS). Between and within subject comparisons were conducted using the repeated measures. For each domain (K, S, and C), separate and aggregate group mean differences were calculated comparing the domains using t‐test with Welch modification (assuming unequal variance). Within subject changes following each learning environment were calculated using Pearson product moment. Statistical significance was p&lt; .05.ResultsA total of 66 (N) students participated with 227 surveys completed (50% response rate). Across participants, mean (SD) baseline knowledge (4.6 [2.3]), skills (3.6 [2.3]) and confidence (3.2 [2.0]) significantly improved to 7.7 (1.2), 7.1 (1.5) and 6.7 (1.7) respectively following all learning environments. Significant overall increase across K, S and C (aggregate) was 1.5 and strongly correlated to didactic lecture r(35) = .76 (p&lt;.001) and the completion of one scenario r(27) = .84 (p&lt;.001). When comparing STP and HPS, significant improvements were reported in the areas of knowledge (+0.4, p&lt;.05) and confidence (+0.3, p&lt;.05) only with strong correlation to HPS (K=r(23) = .80, p&lt;.001; C = r(23) = .90, p&lt;.001). The majority strongly agreed that both STP and HPS are extremely useful (9.3 [1.2]). Overall, mean (SD) perceived clinical reasoning increased from 3.7 (2.2) to 6.7 (1.1) with significant improvements following didactic (p&lt;.01) at least one case scenario (p&lt;.001), however no significant differences were observed when comparing STP to HPS. Students rated the value of both STP and HPS highly (9.4 [1.2] vs. 9.3 [1.1]).Conclusion &amp; SignificanceStudents perceived that multiple learning environments enhance their knowledge, skills and confidence in AT disorders. While they determined that STP and HPS are equally valuable, their knowledge and confidence improved significantly following HPS. Clinical skills did not change between STP and HPS. This study was the first to develop HPS modules while incorporating functional AT anatomy with clinical skills training across didactic and STP environments. Student learning and confidence is maximized through these environments and using HPS is feasible and effective in our clinical training program.

Development and psychometric testing of learning immersion scale in clinical simulation: A methodological study

BackgroundImmersion during clinical simulation has been suggested to be important for learning effects. However, no valid and reliable instruments have been available for measuring the learner's immersion during simulation experience. ObjectivesTo develop a Learning Immersion Scale in Simulation (LISS) and evaluate its psychometric properties. DesignA methodological study design was employed to develop and validate the instrument. SettingsTwo universities in South Korea. ParticipantsA convenience sample of 204 nursing students. MethodsA literature review and a focus group interview were conducted to determine the properties of learning immersion during simulation experience. Content validity was assessed by a panel of 10 experts. Nursing students who participated in high-fidelity patient simulation (n = 204) were asked to complete the preliminary LISS, after which Students Satisfaction and Self-Confidence in Learning Scale and Learning Flow Scale for Adults were administered for assessing the convergent and criterion validity. Data were analyzed using exploratory factor analyses, Pearson's correlation, and Cronbach's alpha. ResultsExploratory factor analyses extracted a four-factor solution, explaining 65.2% of the total variance. The convergent and criterion validity and internal consistency and half reliability were satisfied. ConclusionsThe LISS is a short multi-dimensional instrument with good psychometric validity and reliability that has potential utility for clinical simulation education and research.

Engaging Older Adults in a Depression Simulation Experience.

Clinical simulation has become integral to curriculum development in nursing programs. This innovative intervention was designed to explore the efficacy of high-fidelity standardized patient (SP) simulation to increase students' ability to recognize signs of depression and to improve therapeutic communication. During a 12-month period, prelicensure nursing students (n = 136) in a midwestern nursing program participated in this simulation experience. Volunteer retirees residing in the college-affiliated retirement village played the roles of depressed patients. Students' self-evaluations indicated this experience was a positive learning experience. All of the students indicated the experience improved their knowledge about depression; 91% stated their confidence in interviewing improved, and 89.7% indicated improvement in their communication skills. Use of SP simulation in mental health nursing is an effective strategy to bolster confidence, improve depression screening skills, and enhance therapeutic communication skills. [J Nurs Educ. 2022;61(4):209-212.].

The Use of Simulation Based Learning: With Bachelor of Science Pharmaceutical Science and PharmD Students

Background and purpose Interprofessional education between bachelor of science pharmaceutical science (BSPS) students and Doctor of Pharmacy (PharmD) students is rare. According to the Association of American Medical Colleges, more than 80% of medical schools incorporate simulation based teaching within all four years of the curriculum. Educational activity and setting: The University of Rhode Island College of Pharmacy healthcare simulation lab has developed integrated educational opportunities for both groups of students by offering independent study opportunities that allow BSPS students to collaborate with PharmD students. A recent example of this model includes BSPS student development of patient cases which are integrated into high-fidelity human patient simulators with faculty assistance. A senior BSPS student researched and designed four clinical patient cases which were presented to P3 pharmacy students. Findings: In all four cases, there was an increase in knowledge and attitudes following the simulation. Qualitative comments from students noted the importance of patient education and an enhanced ability to manage disease and side effects. Summary: The nature of the simulation lab at the University of Rhode Island is a platform that can be modeled by other institutions with both PharmD and BSPS programs.

Increasing Student Confidence With Medically Complex Infants Through Simulation: A Mixed Methods Investigation.

The purpose of this study was to compare student knowledge and confidence, related to the assessment and management of oral feeding readiness in medically complex infants, following a written case study versus a high-fidelity human patient simulation (HPS). A sequential, two-phase, embedded mixed methods design was conducted. Participants were two sequential cohorts of second-year speech-language pathology graduate students enrolled in a didactic Pediatric Dysphagia course. At the end of the course, students completed the same case scenario presented as a written case study (control group; N = 28) or as an HPS (experimental group; N = 24). Pre- and post-knowledge assessment results and self-assessments of confidence conducted at three time points were compared. All students made gains in knowledge, regardless of intervention (written case study or HPS). Despite different baselines, the percent change in knowledge was significant with the control group improving 33% and the experimental group improving 76% from baseline. Students in the experimental group demonstrated significantly greater gains in confidence with skills enhanced by the hands-on, immersive experience of HPS. Qualitative analysis further identified factors contributing to increased confidence with all students reporting that experience significantly contributes to their confidence in their ability to treat patients. While knowledge outcomes were similar between the groups, the confidence that the experimental group gained through the hands-on experiences of HPS fosters student development as confident professionals in assessing feeding readiness and managing medically complex infants. Results support integration of simulation into the graduate curriculum to support student learning. https://doi.org/10.23641/asha.19233504.

High-Fidelity Patient Simulation Incorporated Into a Flipped Classroom Improves Students' Long-Term Knowledge Retention of Acute Organophosphorus Pesticide Poisoning.

The flipped classroom (FC) approach and high-fidelity patient simulation (HFPS) training have shown promising effects in short-term acquisition or long-term retention of knowledge in medical education. In this study, we aimed to explore the incorporation of HFPS into the FC and the impact on the long-term (3 months after classes) knowledge retention of medical undergraduate students learning about acute organophosphorus pesticide poisoning (AOPP). Eighty-two fifth-year medical students were randomly divided into an HFPS group (HG, n = 40) and an FC group (FG, n = 42). A postclass quiz and preinternship quiz were performed to assess the short-term knowledge acquisition and long-term (3 months after classes) knowledge retention of both groups of students. Feedback questionnaires were administered immediately after the class and before the internship to assess the students' self-perceived competency. In the postclass quiz, the scores achieved by the students from the HG and FG were 15.58 ± 2.69 and 14.62 ± 2.19, respectively. No significant difference was found between the 2 groups (P = 0.19). In the preinternship quiz, the scores achieved by the students from the HG (14.50 ± 2.16) were significantly higher than those achieved by the students from the FG (11.40 ± 2.07, P < 0.001). There was no significant difference between the postclass quiz and preinternship quiz scores achieved by the HG students (P = 0.05). However, scores in the preinternship quiz showed a significant decline compared with the postclass quiz for the FG students (P < 0.001). Students in the HG gave significantly higher scores for self-perceived confidence in dealing with AOPP patients in the forthcoming internship on the postclass and preinternship questionnaires. The incorporation of HFPS into the FC approach could improve students' long-term knowledge retention of AOPP and enhance their confidence in caring for these patients in their internship.

Self-efficacy of senior prelicensure nursing students during student-led high-fidelity patient simulation

Simulation has been shown to offer nursing students supplemental learning experiences outside of regular clinical settings. However, these learning experiences are primarily conducted with faculty serving as the patient voice, leading the scenario and prompting nursing actions. As students function within the scenario, psychomotor, cognitive, and affective learning occur within the context of the nurse's role. Little is known about whether student participation as the patient increases the self-efficacy of students' abilities to enhance their understanding of the patient's experience during a deteriorating patient simulation scenario. The purpose of the study is to examine students' self-reported evaluations of simulation sessions. Secondary data from a simulation evaluation tool will be examined with a mixed-method, descriptive, and comparative design to determine if students reported increased self-efficacy following student-led, compared to faculty-led, high-fidelity patient simulation sessions. Findings from this study will help determine the need for more innovative pedagogy to support learning outcomes.

78 Simulation Integrating Deliberate Practice Method for Developing Assesors of Competence

In response to COVID-19, our organization expanded the critical care beds capacity; however, the number of critical care nurses was insufficient to meet expansion demands. Therefore, non-critical care nurses were deployed to COVID-19 critical care units. The deployed nurses lacked experience and training in critical care. To ensure patient safety, the nurses were assigned to assessors who evaluated their fitness to practice after receiving upskilling training through simulation-based education (SBE). However, due to the massive expansion and rapid deployment process, there was a shortage of competency assessors, highlighting an urgent need to use SBE to develop more assessors. We developed additional competency assessors through simulation embedding deliberate practice and rigorous assessment. Deliberate practice in simulation is described as progressive learning, which includes repetitive performance and rigorous assessment The aim of the study was to explore the effectiveness of simulation embedding deliberate practice in developing nurse competency assessors.Eleven assessor candidates were asked to perform competency assessments under simulated conditions. During the simulation, simulated participant (SP) roles were assigned as a bedside nurse and patient relative; the patient was a high-fidelity patient simulator. The assessor candidates were asked to perform a competency assessment of the bedside nurse who should perform the required critical care skills on the patient in the presence of the patient’s relative. The candidates used a valid observation rubric to complete the assessment. Using deliberate practice strategies, after each competency assessment, a debriefing session was conducted in which the SPs provided constructive feedback on the assessor’s performance. The assessor repeated the competency assessment under the same simulation conditions and attended debriefing sessions until they mastered the competency assessment process. Post simulation evaluation collected data to evaluate the candidates’ perception of the training.Eleven nurses completed the simulation developmental programme and were assessed as competent to become assessors. The questionnaire findings revealed that all nurses perceived themselves as competent assessors; however, 90% reported the need for frequent exposure to the competency assessment process over time, in the clinical setting, to enhance their competence and confidence levels.The hybrid simulation modality of SP and patient simulator embedding deliberate practice method was deemed to be an effective fast track method to develop competency assessors. However, practice of competency assessment in real clinical settings is essential to confirm competence.

Athletic Training Educators' ConferenceApril 29–May 1, 2021

Athletic Training Educators' ConferenceApril 29–May 1, 2021

Experience of simulation practice using a high-fidelity patient simulator and standardized patients of nursing students

본 연구의 목적은 고충실도 환자 모형과 표준화 환자를 활용한 시뮬레이션 실습을 수행하는 과정에서 간호학생들이 어떤 경험을 하는지 탐색하는 것이다. 이를 위해 D 대학교 4학년 간호학생 중 19명을 대상으로 포커스 그룹 인터뷰를 적용한 질적 내용분석을 수행하였다. 분석 방법은 Elo and Kyngas(2008)에 기반하여 수행하였다. 연구결과로 고충실도 환자 모형과 표준화 환자를 활용한 시뮬레이션 실습에서 공통적으로 경험한 주제는 ‘집중하기 어려움’, ‘실습 환경에 몰입’, ‘부정적인 심리변화’, ‘긍정적인 심리변화’, ‘간호역량의 향상’ 이었다. 고충실도 환자 모형을 활용한 시뮬레이션 실습에서만 경험했던 주제로는 ‘임상수행능력의 향상’, ‘실습환경의 생동감이 떨어짐’ 이었으며, 표준화 환자를 활용한 시뮬레이션 실습에서만 경험했던 주제로는 ‘의사소통의 생생함’, ‘제한된 직접 간호 술기’, ‘SP 역할 숙련도’ 이었다. 간호학생들은 시뮬레이션 실습을 예비 간호사의 역량을 함양시키는 과정으로 인식했지만, 몰입감, 부담감과 한계 및 몇 가지 제약의 어려움을 겪었다. 따라서 효율적인 시뮬레이션 실습 교육을 위해서는 다양한 시나리오의 개발, 효율적인 커리큘럼 운영을 위한 논의, 학습 효과 극대화를 위한 환경 조성이 필요하다.

Adaptation of the TEAM Mental Healthcare Delivery Model: A Mixed-Methods Evaluation

ABSTRACT We report on the adaptation and evaluation of an existing approach to multicultural education into an eight-session online, modular curriculum for psychiatric mental health nurse practitioner students (n = 6) and psychology interns (n = 10). Training participants were invited to complete verbal feedback, self-report questionnaires, and a high-fidelity patient simulation before and after the training. Self-report questionnaire results revealed no changes in knowledge or attitudes, but qualitative analysis of verbal feedback reflected improvements in attitudes and behaviors relevant to cultural competence. Results from the simulation also demonstrated an increase in measurable cultural competence behavioral indicators.

Application of technology to educational needs in surgery.

Innovations in surgical education follow advancing clinical technology. New surgical methods have prompted demand for systematic methods to leverage computing power and internet tools to achieve proficiency-based training goals. Virtual reality, high-fidelity patient simulation, web-based resources to facilitate performance assessment, and telementoring have become mainstream practices, although patient outcomes benefits are not well studied. Remote virtual meeting and mentoring have had transformative effects on resident experiences, the full effects of which remain to be seen.

Using Simulation to Teach Transitions of Care for Hospitalized Patients.

Understanding and facilitating the seamless and safe transitions of patients across high-acuity hospital settings are important for students to grasp in order to meet patient and family care needs. Clinical placements do not always give students the opportunity to care for patients in various hospital settings or apply complex knowledge and skills learned in their didactic courses. Furthermore, the global pandemic has limited student clinical experiences in health care settings, underscoring the need for simulated clinical learning opportunities. A multiscenario simulation using a high-fidelity human patient simulation manikin was incorporated into a senior-level capstone course. Simulated hospital settings included the (1) emergency department, (2) critical care unit, and (3) progressive care unit. Student evaluations revealed positive perceptions of learning, enhanced proficiency of clinical skills, and increased confidence regarding transitions of care. Faculty held agreeable opinions of the simulation's ease of facilitation and effectiveness as a teaching tool. Application of complex knowledge and skills, understanding the use of bundles of care, and an appreciation for transitions of care hospitalized patients were successfully achieved.

간호사의 투약 안전역량 강화를 위한 고위험 약물 중심의 시뮬레이션 훈련 적용

Purpose: This study attempted to enhance the nurses’ safety competence in administering medications by using simulation training focused on high-alert medication. Method: A total of 30 nurses from 14 teams participated in the simulation training using a high-fidelity patient simulator. Medication administration performance and built-in error recovery was observed using a medication administration safety assessment checklist. Medication safety knowledge and confidence were measured before and after simulation training. Data were analyzed using descriptive statistics and a paired t-test. Results: There were numerous variations in safe medication administration. The safety behavior by oral prescription was insufficient compared to that by routine medication prescription. Following simulation training, knowledge of medication safety increased significantly, but confidence did not. Conclusion: Nurse educators may consider simulation to be an effective strategy for enhancing nurses’ medication safety competence.