The learning experience of third-year Baccalaureate nursing students on high fidelitity simulation
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Date
2013-06
Authors
Welman, Anna-Marie
Journal Title
Journal ISSN
Volume Title
Publisher
University of the Free State
Abstract
High fidelity simulation is an innovative learning strategy that supports students in developing their critical thinking and clinical judgement abilities. This strategy is used in the School of Nursing at the University of the Free State (UFS) to enhance the acquisition of basic and advanced competencies of students. It was implemented for use in 2009 and is thus regarded as a new practice at the School. It was essential to determine the effectiveness of this strategy. A qualitative, descriptive and exploratory design was used to explore the learning experience of third-year Baccalaureate nursing students on high fidelity simulation (HFS). After the students were exposed to the HFS, they were invited to participate in focus group interviews. Fourteen of the 35 third-year students chose to participate. The inclusion criteria specified that the students should be registered for both their third-year nursing theory and their clinical modules and should have been exposed to the two high fidelity simulation sessions that had been presented. The focus group interviews were audio-recorded and transcribed. For triangulation purposes, data collected by means of the module evaluation questionnaire completed at the end of the semester was also used. Tesch‟s method was used to code the data and NVivo software implemented to simplify the process. The students described their learning experience as positive and highlighted the advantage and value of HFS as a learning strategy. They entered the learning environment anticipating that they would learn new things. Several emotions were experienced during all the phases of the simulation. They experienced fear before commencing the simulation scenario. This emotion developed into astonishment, alertness and anxiety during the simulation, but changed into self-confidence. The complexity of the simulated situation caused anxiety within the students since they were unsure of how to care for the patient. The students felt excited and stimulated after participating in the facilitated reflection session. The high-technological features of the human patient simulator, the convincing nature of the environment and the interaction within the team led the students to experience the simulation as real. Although authentic, the high fidelity simulation posed less risk than real patient care since students were permitted to make mistakes and learn from these. The students felt that they were able to integrate their theoretical knowledge with nursing practice. This integration occurred during the facilitated reflection session. The self- and peer assessment strategies to which they were exposed assisted the students in identifying gaps in their knowledge. An improvement in critical thinking and clinical judgement abilities was the result of the effective theory and practice integration that occurred. This led to an increase in self-confidence and the belief that the skills acquired during the high fidelity simulation session were transferrable to real instances of patient care. It was evident that proper preparation before the simulation is essential to ensure an optimal learning experience. The students also realised that they should have been better prepared on the subject matter, since this would have enabled them to meet the needs of the human patient simulator more effectively. It can be concluded that the HFS experiential learning opportunity that the third-year students were exposed to assisted them in integrating their nursing theory with practice. Repeated exposure to HFS learning experiences, commencing during their first year of study, might enable nursing students to develop their critical thinking and clinical reasoning skills and, together with patient contact instances, develop their clinical judgement abilities. This will prepare them, as registered nurses, to render safe and effective care to their patients.
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Keywords
Dissertation (M.Soc.Sc. (Nursing))--University of the Free State, 2013, Nurses -- Study and teaching (Higher), Nursing students -- Training of., Simulated patients, Critical thinking, Clinical judgement, Facilitated reflection (debriefing), High fidelity simulation, Human patient simulator, Integration of theory and practice