Evaluation of the design of highfidelity simulation by the third year nursing students in the school of nursing
For many years, simulation has been used as a learning strategy. Student nurses can learn to integrate clinical skills, apply content knowledge, practice teamwork, develop inter-professional communication skills, perform physical assessments, apply nursing care principles, develop critical thinking skills, and much more. High-fidelity simulation design needs to be planned and integrated into the undergraduate nursing curriculum carefully to ensure optimal learning and enabling students to deliver optimal care within the clinical environment. In order to reach these competencies through the use of simulation, the School of Nursing at the University of the Free State has been using simulation as a teaching and learning strategy in the undergraduate and postgraduate programs since 2010. Initially it has been a growing experience through continuous efforts to address shortfalls and improving each simulation scenario. However, the question arose whether the simulations we do, comply with the standards set out for quality simulation experiences on an international level. In 2005, Pamela Jeffries published “A Framework for Designing, Implementing, and Evaluating Simulations Used as Teaching Strategies in Nursing.” which conceptualized practices concerning the planning and running of simulations as a teaching tool. The framework described five major constructs, namely: educational practices, teacher (facilitator), students, simulation design characteristics and outcomes. The aim of the study is to describe the instructional design of high-fidelity simulation from third year nursing students’ perspective in the School of Nursing regarding design characteristics and criteria of the Jeffries simulation model. A quantitative, non-experimental, cross-sectional descriptive design was used for this study. Most of the third year undergraduate nursing students (30 students) evaluated the five design characteristics of Jeffries’ simulation model by means of completing the 20 item Simulation Design Scale (SDS) instrument immediately after participating in a high-fidelity simulation scenario about a patient with burn wounds. The self-report instrument was designed by the National League for Nursing and aims to evaluate the five design characteristics, using a 5-point Likert scale. When designing high-fidelity simulation scenarios, meticulous planning needs to incorporate all the important aspects, including authenticity, scaffolding, alignment and constructivism. By including these aspects, the students have a greater chance of achieving the learning outcomes. Within this study, the researcher aims to describe the aspects involved in the planning and designing of a high-fidelity simulation scenario. Results indicate not only the evaluation of the five design characteristics for a specific simulation scenario, but also the relationship between the adherence to and importance of these characteristics, as seen through the eyes of third year undergraduate nursing students. The importance of debriefing was rated highest of the five categories, with fidelity second, closely followed by support. When the students evaluated the design characteristics, they rated problem solving and support at an equal highest score, with debriefing in second place. Within this research study, the students indicated that they recognized each design characteristic, rating the presence of each at a very high level, indicating overwhelmingly positive feedback scores. Where the students assessed the simulation scenario, they rated support and problem solving at the highest scores, closely followed by debriefing. This evaluation provides a very positive perspective from the third year undergraduate student’s view of the design of high-fidelity simulation scenarios within the third year undergraduate program at the School of Nursing, University of the Free State in South Africa.