Simulation Design Characteristics Research Articles

Nursing Students’ Satisfaction and Self-Confidence with Simulation-Based Learning and Its Associations with Simulation Design Characteristics and Educational Practices

Nursing Students’ Satisfaction and Self-Confidence with Simulation-Based Learning and Its Associations with Simulation Design Characteristics and Educational Practices

Association and Effect Strength of Simulation Characteristics and Transfer of Learning Attitudes in a Disaster Simulation for Prelicensure Nursing Students.

Nurse educators design simulations with the intent that students transfer previous academic learning. Transfer of learning (TOL) is a complex and abstract concept with critical literature gaps needing measurement research. This study examined the association between simulation characteristics and students' TOL attitudes and the effect strength. This baseline study evidenced simulation design characteristics, as category groupings, were associated with students' TOL attitudes with positive and mostly modest effects. The resulting educational implications include applying instructional design to simulation, teaching students what TOL is, and modeling thinking in the classroom for transfer to simulation.

The influence of heart failure high-fidelity simulation education based on NLN Jeffries simulation framework in the prelicensure nursing program: A quasi-experimental study

ObjectivesTo examine the influence of heart failure high-fidelity simulation education based on the National League for Nursing (NLN) Jeffries Simulation Framework in prelicensure nursing education. MethodsA heart failure high-fidelity simulation (HFHFS) education pilot project was carried out at Carrington College Sacramento. Twenty-three students participated in the study. This study used a quasi-experimental design. Students’ Self-Efficacy, Satisfaction, and Knowledge in Heart Failure Clinical Knowledge were measured pre- and post-HFHFS education. ResultsThe results of the high-fidelity simulation education for heart failure showed that students achieved a mean score of 45.39 (SD = 7.88) in self-efficacy, 18.70 (SD = 3.38) in satisfaction, and 64.09 (SD = 10.86) in knowledge after the intervention. The paired-sample t-test significantly improved between the pre- and post-intervention scores (P < 0.001). The students highly rated self-efficacy, student satisfaction, and knowledge because of the positive impact on the teaching effectiveness of simulation design (i.e., objectives, problem-solving, student support, fidelity, debriefing) activity that included the application of quality safety education for nurses (QSEN) three competencies safety, patient-centered care, and teamwork and collaboration during nursing care for patients with acute heart failure. The teaching effectiveness of the heart failure high-fidelity simulation education is closely correlated with student satisfaction, self-efficacy, and improvement of participant knowledge in clinical nursing skills performance and critical thinking. ConclusionA heart failure high-fidelity simulation education established upon the National League for Nursing (NLN) Jeffries framework enhanced student knowledge, satisfaction, self-efficacy, application of safety, patient-centered care, and teamwork and collaboration. Nurse educators should consider simulation planning to include the five simulation design characteristics, i.e., objectives, problem-solving, student support, fidelity, and debriefing, while integrating safety, patient-centered care, and teamwork and collaboration to bring about education effectiveness.

대학의 시뮬레이션 실습교육이 신규간호사의 임상수행능력에 미치는 영향

Objectives New nurses have experienced clinical practice restrictions due to COVID-19 in the nursing department undergraduate course. Therefore, this study aimed to identify the difference in their clinical performance competency based on the characteristics of the simulation practice education they experienced, determine the effect of simulation practice on their clinical performance competency, and identify the influencing factors. Methods Data were collected from a self-reported questionnaire survey conducted on 197 new nurses from January 10 to February 25, 2023, at 12 general hospitals located in the metropolitan area and Gyeongsang-do. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and hierarchical regression based on the SPSS/WIN 22.0 statistical program. Results Clinical performance competency showed a statistically significant positive correlation with simulation design characteristics (r=.54, p&lt;.001); likewise clinical reasoning competency (r=.69, p&lt;.001) also showed a positive correlation to simulation design characteristics. A statistically significant positive correlation was seen between clinical performance competency and clinical reasoning competency (r=.50, p&lt;.001). Multiple regression analysis revealed that factors significantly affecting clinical performance competency were clinical reasoning competency (β=.57, p&lt;.001) and simulation design characteristics (β=.25, p&lt;.001). The explanatory power was 53.8%. Conclusions To improve new nurses' clinical performance competency, various educational programs that can enhance simulation design characteristics and clinical reasoning competency need to be developed. In the simulation practice class, efforts to enhance the clinical realism of nursing students are required, such as scenario development of cases and methods.

Influence of simulation design on stress, anxiety and self-confidence of nursing students: Systematic review withmeta-analysis.

To evaluate the simulation design characteristics that may influence the stress, anxiety and self-confidence of undergraduate nursing students during learning. Systematic review with meta-analysis. Searchers were conducted in October 2020 and updated in August 2022 in the databases CENTRAL, CINAHL, Embase®, ERIC, LILACS, MEDLINE, PsycINFO®, Scopus and Web of Science, PQDT Open (ProQuest), BDTD, Google Scholar and specific journals on simulation. This review was conducted according to the recommendations of Cochrane Handbook for Systematic Reviews and reported according to the PRISMA Statement. Experimental and quasi-experimental studies that compared the effect of simulation on stress, anxiety and self-confidence of nursing students were included. The selection of studies and data extraction was performed independently by two reviewers. Simulation information was collected as prebriefing, scenario, debriefing, duration, modality, fidelity and simulator. Data summarization was performed by qualitative synthesis and meta-analytical methods. Eighty studies were included in the review, and most reported in detail the structure of the simulation, contemplating prebriefing, scenario, debriefing and the duration of each step. In subgroup meta-analysis, the presence of prebriefing, duration of more than 60 min and high-fidelity simulations helped reduce anxiety, while the presence of prebriefing and debriefing, duration, immersive clinical simulation modalities and procedure simulation, high-fidelity simulations and use of mannequins, standardised patients and virtual simulators, contributed to greater students' self-confidence. Different modulations of simulation design components imply reduction of anxiety and increased self-confidence in nursing students, especially highlighting the quality of the methodological report of simulation interventions. These findings help to support the need of more rigorous methodology in simulation designs and research methods. Consequently, impact on the education of qualified professionals prepared to work in clinical practice. No Patient or Public Contribution.

Association between Clinical Simulation Design Features and Novice Healthcare Professionals’ Cognitive Load: A Systematic Review and Meta-Analysis

Background Clinical simulations are complex educational interventions characterized by several design features, which have the potential to influence cognitive load, that is, the mental effort required to assimilate new information and learn. This systematic review and meta-analysis explored the associations between simulation design features and cognitive load in novice healthcare professionals. Methods Based on the Joanna Briggs Institute methodology, a search was performed in five databases for quantitative studies in which the cognitive load of novice healthcare professionals was measured during or after a simulation activity. Each clinical simulation was coded to describe its design features. Univariate and multivariate mixed model analyses were performed to explore the associations between simulation design features and cognitive load. Results From 962 unique records, 45 studies were included and 27 provided enough data on subjective cognitive load (i.e., Paas Scale and NASA-Task Load Index scores) to be meta-analyzed. In the multivariate analysis for the NASA-Task Load Index scores, each repetition of a simulation using the same scenario resulted in a linear decrease in cognitive load. In contrast, technology-based instruction before or during a simulation activity was associated with higher cognitive load. In the univariate analyses, other features such as feedback and instructor presence were also statistically associated with cognitive load. Regarding the univariate analyses of the Paas Scale scores, simulator type, briefing, debriefing, and repetitive practice were statistically associated with cognitive load. Conclusion This is the first meta-analysis exploring the relationship between clinical simulation design features and novice healthcare professionals’ cognitive load. Although the findings show that several design features can potentially increase or decrease cognitive load, several gaps and inconsistencies in the current literature make it difficult to appreciate how such reciprocity influences novice healthcare professionals’ learning. These limitations are discussed and avenues for educators and further research are suggested.

NLN Jeffries Simulation 이론에 근거한 간호대학생의 시뮬레이션기반 실습교육 구조모형

Purpose: This study aimed to construct and test a hypothetical model to explain predictive factors affecting nursing students' satisfaction and self-confidence in simulation-based education based on the National League for Nursing Jeffries Simulation Theory. Methods: A cross-sectional study was conducted on 305 fourth-year nursing students with experience in simulation-based education enrolled at universities in Gangwon-do, Gyeongsangbuk-do, and Gyeonggi-do. Data were analyzed using SPSS 25.0 and AMOS 25.0. Results: The hypothetical model showed good fit with the empirical data: χ2/df 2.17, RMSEA=.01, RMR=.01, GFI=.95, AGFI=.91, NFI=.94, TLI=.95, CFI=.97, and PNFI=.68. Simulation design characteristics, teaching efficiency, and flow were found to affect satisfaction and self-confidence directly. A bootstrap test indicated that teaching efficiency and flow mediated the relationship between simulation design characteristics and satisfaction and self-confidence. Conclusion: Simulation educators should apply best practice that enhance teaching efficiency and flow through well-organized simulation designs, nursing students can attain satisfaction and self-confidence through simulation-based education.

Nursing Students' Satisfaction and Self-Confidence Levels After Their Simulation Experience.

Nursing students should be well prepared before going to clinical setting as they provide direct care to patient. Simulation gives the learners the opportunity to be active learners who practice, train, and give a reflection on a specific experience. To obtain an understanding of the human patient simulation experience and nursing students' perceptions of satisfaction and self-confidence. Cross-sectional, descriptive design was undertaken. Using purposive sampling, 273 nursing students were enrolled in basic adult nursing courses at levels four and five at female nursing college at King Saud University, Riyadh, Saudi Arabia. A questionnaire was used to measure the demographic characteristics, simulation design characteristics, and simulation educational practice context. Student Satisfaction and Self-confidence in Learning Scale was used to measure students' satisfaction and self-confidence. Bivariate analyses were utilized where needed and multiple linear regression analysis was performed to find the relationship between variables. The current study revealed overall, nursing students were satisfied and self-confident after their human patient simulation experience. A relationship was observed between demographic characteristics, simulation design characteristics, and simulation educational practice context with students' satisfaction and self-confidence. Simulation is an effective teaching strategy that prepares nursing students for real clinical practice. Findings provided policymakers with information on nursing students' current levels of satisfaction and self-confidence that can lead to developing future policies.

Relationship between Simulation Design Characteristics and Clinical Reasoning Competence: Multiple Additive Moderating Effects of Teaching Effectiveness and Students' Anxiety on Nursing Students

Relationship between Simulation Design Characteristics and Clinical Reasoning Competence: Multiple Additive Moderating Effects of Teaching Effectiveness and Students' Anxiety on Nursing Students

Nursing students’ perceptions of simulation design features and learning outcomes: The mediating effect of psychological safety

Background The mediating effect of psychological safety on the relationship between students’ perceptions of simulation design features and learning outcomes has not been addressed in simulation-based nursing education. Aim This study aimed to determine whether psychological safety mediates the relationship between students’ perceptions of simulation design features and learning outcomes. Methods This study employed a cross-sectional descriptive survey design with a convenience sample of 194 nursing students. Nursing students completed a structured self-administered questionnaire including the Simulation Design Scale, Academic Safety Measurement Tool, and Student Satisfaction and Self-Confidence in Learning Scale. Data were analysed using multiple regression analysis. Findings Students’ perceptions of simulation design features and psychological safety were significant predictors of their learning outcomes. Psychological safety mediated the relationship between students’ perceptions of simulation design features and learning outcomes. Discussion Simulation educators need to consider optimal educational design features to ensure the psychological safety of learners to achieve target learning outcomes. Conclusion Psychological safety plays an essential role in achieving learning outcomes of simulation-based nursing education.

Effectiveness of Interprofessional Manikin-Based Simulation Training on Teamwork Among Real Teams During Trauma Resuscitation in Adult Emergency Departments: A Systematic Review.

This systematic review synthesizes the relevant evidence about the effectiveness of interprofessional manikin-based simulation training on teamwork among real teams during trauma resuscitation in adult civilian emergency departments. A systematic literature search was conducted in MEDLINE, CINAHL, EMBASE, EBM reviews, PsycINFO, and Web of Science with no time limit. Only experimental and quasi-experimental studies were included. Effects of the simulation intervention on teamwork were categorized according to a modified version of the Kirkpatrick's model. From the 1120 studies found, 11 studies were included for synthesis. All studies showed immediate improvement in teamwork after training, but divergent results were found regarding skills retention. Although this review focused on interprofessional manikin-based simulations in real trauma teams, the results are similar to previous systematic reviews including different types of simulation. This raises significant questions regarding the importance of simulation design characteristics to improve teamwork in trauma care.

Piloting Simulations: A Systematic Refinement Strategy.

IntroductionFew approaches articulate a systematic way to address confusing, missing, or underdeveloped simulation design features prior to implementing into coursework. To address this gap, we tested a novel, systematic refinement strategy to improve the design elements of two simulations.MethodsForty eligible participants (Year 3 undergraduate nursing students) evaluated two simulation scenarios (each followed by a debriefing session) through a novel and systematic refinement strategy across five iterations. Each simulation was evaluated using the validated Simulation Design Survey (SDS). Ratings were analyzed using descriptive data. Students also responded to an open-ended question in order to provide qualitative feedback regarding how to improve its features, i.e., scenario design and debriefing components. Written comments by students were analyzed using the principles of qualitative content analysis. ResultsDescriptive statistics revealed a gradual increase in the mean scores of the SDS over each of the simulation refinement periods. For the first simulation, the SDS mean score reached a high on Day 5 of 4.86 (standard deviation (SD) = 0.14) in contrast to a score of 3.45 (SD = 0.17) on Day 1. For the second simulation, the SDS mean score was 4.75 (SD = 0.16) on Day 5, which represented a mean score increase of 1.01 from the score on Day 1. ConclusionsThis novel refinement strategy improved the overall design elements of each of the simulations. The potential use of the SDS and open-ended feedback, guided by a refinement approach, merits further investigation.

Using Simulation Design Characteristics in a Non-Manikin Learning Activity to Teach Prioritization Skills to Undergraduate Nursing Students

Teaching prioritization skills to nursing students is an important yet complex process. Nurse educators often expect these skills to be developed in the clinical setting; however, there are competing demands for the students' time. In simulation, there is an opportunity to assist students to develop prioritization skills. A limitation in using simulation is often the number of high-fidelity simulators available and the number of students who are assigned to the simulation-based experience. This article discusses the application of simulation design characteristics to a non–manikin-based simulation with a focus on developing prioritization skills.

Based on Delphi method and Analytic Hierarchy Process to construct the Evaluation Index system of nursing simulation teaching quality

BackgroundSimulation has been widely adopted in nursing education, as is known to all, the quality of simulation could be affected by many factors. Since there is not a comprehensive and scientific evaluation Index system, it is important to construct an evaluation Index system to guide high-quality simulation. ObjectivesTo construct the Evaluation Index system of Nursing Simulation teaching Quality and determine the weight of each indicator. DesignIt is a phenomenological research study. SettingsThe study was mainly conducted in one universities in China. Participants27 nursing education experts from China participated in this study. MethodsThis study combines the Delphi method and Analytic Hierarchy Process method. ResultsEvaluation Index system of Nursing Simulation teaching Quality is built using Delphi method, including five first level index (Teacher, Student, Simulation design characteristics, Educational practices and Outcomes), 14 secondary index and 62 tertiary index. It's determined through a two-rounded experts consultation involving 27 experts. The recovery rates of two rounds consultation questionnaire were respectively 96.43% and 100%, and coefficient authority was 0.89. The Kendall's W of second and third level index were respectively 0.515 and 0.589 (P < 0.001). And the weighted value of quality index are established at all levels with the consistency ratio (C.R.) <0.1, demonstrating that Teacher (0.4109) came first among the five first-level index followed by Student (0.2593), the Educational practices (0.1812), Simulation design characteristics (0.096) and Outcomes (0.0527). ConclusionsThe quality index of nursing simulation education is scientific and reliable, so as its weight assignment. It can be a guidance for high-quality simulation teaching, and it is a valid tool to evaluate the quality of simulation teaching in nursing.

A Structural Model on the Nursing Competencies of Nursing Simulation Learners

The purpose of this study was to test a model of nursing competencies of nursing simulation learners. The conceptual model was based on the theory of Jeffries's simulaton theory. Data collection was conducted in October 2017 for 310 students from two nursing universities in Kyungbuk area for 20 days. Data analysis methods were covariance structure analysis using SPSS 21.0 and AMOS 22.0 statistical programs. The hypothetical model was a good fit for the data. The model fit indices were comparative fit index=.97, normed fit index=.94, Tucker-Lewis Index=.97, root mean square error of approximation=.44, and standardized root mean square residual=.04. Teacher factors were directly related to simulation design characteristics, and it was confirmed that the curriculum, classroom operation and teaching method of the instructors were important factors. Learner factors were found to have a direct effect on nursing competence, self-confidence, and clinical performance that belong to nursing capacity. In particular, the results of this study indicate that the simulation design characteristics have a partial mediating effect on learner factors and clinical performance, and a complete mediating effect on learner factors and clinical judgment ability. In order to improve the learner's clinical performance and clinical judgment ability, it is necessary to conduct practical training through nursing simulation besides preparing the learner and the educator.

학부과정의 시뮬레이션 학습이 신규간호사의 문제해결과정과 임상수행능력에 미친 영향

이 연구는 간호학과 학부 과정에서 경험한 시뮬레이션 학습이 신규간호사의 문제해결과정과 임상수행능력에 미친 영향을 파악하기 위한 서술적 조사연구이다. 연구 대상자는 학부과정에서 시뮬레이션 학습 경험이 1회 이상 있으며 임상 경력 12개월 미만의 신규간호사 202명이다. 연구를 통해 학부에서 경험한 시뮬레이션 학습의 횟수와 신규간호사의 문제해결과정 및 임상수행능력에 미친 영향 간에는 유의미한 상관관계가 없었으며, 시뮬레이션 학습의 설계와 문제해결과정 및 임상수행능력에 미친 영향 간에는 유의미한 양의 상관관계가 있는 것으로 나타났다. 연구 대상자들이 경험한 시뮬레이션 학습의 설계를 군집분석으로 유형화하여 문제해결과정 및 임상수행능력에 미친 영향의 차이를 분석한 결과에서도 유의미한 차이를 나타냈다. 이 연구를 통해 학습의 효과를 향상하기 위해서 시뮬레이션 학습의 설계가 중요하다는 점을 확인하였으며, 효과적인 운영을 위한 기초 자료로 활용할 수 있을 것으로 기대한다. 추후 학부 과정의 시뮬레이션 학습이 간호사의 임상 능력에 미치는 영향에 대하여 보다 면밀한 평가가 이루어질 필요가 있다. This study was a descriptive research investigating the impact of simulation-based learning on the problem solving process and clinical competence of new nurses. The 202 participants were new nurses who have provided nursing care for less than 12 months have experienced simulation-based learning more than once in their undergraduate courses. This study found that the number of times participants have experienced the simulation-based learning had no correlation with their problem solving process and clinical competence, but simulation design features correlated with their problem solving process and clinical competence. The results of clustering analysis that examined differences in the effects on problem solving process and clinical competence by classifying simulation design features by clustering also showed significant differences. This study has confirmed the importance of simulation design to simulation-based learning in nursing education. We hope that the findings of the study will be used for effective operation of simulation-based learning. In the future, objective assessment methods will be required to evaluate the effects of simulation-based learning provided in undergraduate courses on nurses' clinical competence.

The effect of anticipatory emotions on students’ performance in marketing simulations

Purpose – This study aims to analyze the effects of goal-directed feelings on student’s performance in marketing simulations. Calculating path coefficients from data collected at two points in time, the authors tested a model consisting of four constructs personal stakes, anticipatory emotions, volitions and goal-directed behavior. The results suggest that positive and negative anticipatory emotions mediate the relationship between personal stakes and volitions and determine student motivation, behavior and actual performance independently from simulation design, simulation environment and cognitive personality characteristics of the participants. Implications for educators include the need for active pursuit of anticipatory emotion development. Design/methodology/approach – The model consists of the four constructs: personal stakes, anticipatory emotions, volitions and goal-directed behavior. Personal stakes determine involvement and are perceived based on an evaluation of the degree of potential impact of one’s performance on one’s personal well-being. Anticipatory emotions, as explained before, are affected by personal stakes and can be either positive or negative. They influence volitions or wills; these are intentions consisting of both directive components (for example, strategy planning and approach selection) and motivational components (for example, the commitment to a necessary effort). Volitions are the mediators that transform anticipatory emotions into goal-directed behaviors. These goal-directed behaviors comprise the fourth construct, consisting of mental and physical efforts aimed at accomplishing a specific objective. Findings – The hypotheses were tested calculating path coefficients. All hypotheses were supported and statistically significant (p &lt; 0.01; one-tailed significance test). With regard to H1, personal stakes were positively related to both positive and negative anticipatory emotions, with a particularly strong relation to positive emotions. Consistent with H2, anticipatory emotions were strongly related to volitions and, thus, heavily influencing the extent to which students would engage in planning and compare their own effort against that of their fellow students. Fueled by the anticipatory emotions, the volitions, in turn, were strongly related to the actually exhibited behavior, supporting H3. In other words, the students put their intentions into practice and engaged in careful simulation planning as well as in an effort that they perceived to be superior to the one of their peers. It is then no surprise that H4 was also supported. The more the students attempted to be carefully prepared and the harder they tried to outperform their fellow students, the more likely the achievement of the desired objectives became. Finally, H5 was supported, even though only weakly with regard to negative outcome emotions. This indicates that successful performance leads to positive emotions, but a failure in the marketing simulation (measured by a non-achievement of objectives set) does not necessarily make the students feel bad. Originality/value – In conclusion, the study provides the rising number of marketing educators using computerized simulations with an approach to increase student motivation and performance. It has become obvious that personal stakes alone are not sufficient to fully develop commitment on the side of students. Rather, anticipatory emotions serve as the mediator between those stakes and students’ volitions.

간호학생을 위한 시뮬레이션기반 임상추론 교육의 효과 및 설계특성과 교육상황 인식 평가

간호학생을 위한 시뮬레이션기반 임상추론 교육의 효과 및 설계특성과 교육상황 인식 평가

Implementation and outcome evaluation of high-fidelity simulation scenarios to integrate cognitive and psychomotor skills for Korean nursing students

This study is involved in designing high-fidelity simulations reflecting the Korean nursing education environment. In addition, it evaluated the simulations by nursing students' learning outcomes and perceptions of the simulation design features. A quantitative design was used in two separate phases. For the first phase, five nursing experts participated in verifying the appropriateness of two simulation scenarios that reflected the intended learning objectives. For the second phase, 69 nursing students in the third year of a bachelor's degree at a nursing school participated in evaluating the simulations and were randomized according to their previous course grades. The first phase verified the two simulation scenarios using a questionnaire. The second phase evaluated students' perceptions of the simulation design, self-confidence, and critical thinking skills using a quasi-experimental post-test design. ANCOVA was used to compare the experimental and control groups, and correlation coefficient analysis was used to determine the correlation among them. We created 2 simulation scenarios to integrate cognitive and psychomotor skills according to the learning objectives and clinical environment in Korea. The experimental group had significantly higher scores on self-confidence in the first scenario. The positive correlations between perceptions of the simulation design features, self-confidence, and critical thinking skill scores were statistically significant. Students with a more positive perception of the design features of the simulations had better learning outcomes. Based on this result, simulations need to be designed and implemented with more differentiation in order to be perceived more appropriately by students.

Simulation Framework for Modeling Large-Scale Flexible Transit Systems

Despite the prevalent use of simulation methods in a majority of areas in transportation research, transit and paratransit research has not relied heavily on simulation models, not only because traditional transit studies do not necessarily require simulation techniques but also because proper simulation packages are not available for modeling innovative transit systems. This study proposes a new type of simulation framework, targeting large-scale flexible transit systems with various vehicle operation schemes. The intent of this study is to describe the generalized concepts and the detailed architecture of the framework developed for urban transportation networks. A comprehensive process for the framework development, including considerations of simulation data conversion and user interface design, is discussed. Two real-time flexible transit applications are modeled with the proposed simulation framework: high coverage point-to-point transit and real-time shuttle service. Detailed simulation results are provided, and the importance of simulation design and operational features is addressed. The results also show that the framework can model realistic large networks several times faster than real time with standard desktop computers; these results raise the possibility of its use in real-time optimization schemes as well as for synchronous modeling with commercial road traffic simulators.