네 개의 고위험 신생아 간호 시뮬레이션 교육에 참여한 간호학생의 단계별 핵심간호수행능력, 만족도 및 임상적 판단력 수준
Levels of Nursing Students’ Core Skills Performance, Satisfaction, and Clinical Judgment According to Four Types of High-risk Neonatal Nursing Simulation during Three Phases
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Objectives: The purpose of this study was to determine if the level of nursing students’ core skills performance, satisfaction, and clinical judgment differed and increased to according to the types of fidelity and debriefing during three clinical semesters. Methods: A total of 149 students enrolled year three baccalaureate nursing program, at a college in Daegu, South Korea, participated in a non-equivalent control group non-synchronized post-test only design over three semesters. Four study groups consisted of a low-fidelity simulation (LFS) only, high-fidelity simulation (HFS) only, HFS with conventional debriefing, and HFS with reflective debriefing. Tanner’s Clinical Judgment Model and Lasater’s Clinical Judgment Rubric (LCJR) guided the study interventions within three levels of team-based high-risk neonatal care simulations. Outcome measures included self-rated core skills performance, a single Likert question of simulation satisfaction, and the self and expert rated LCJR. Results: The HFS group with reflective debriefing showed the highest score in core skills performance, but those of HFS only in satisfaction in phase 2. Self and expert ratings of clinical judgment revealed the highest score in HFS group with reflective debriefing during phase 1 and 2. Repeated HFS with reflective debriefing made no difference in students’ clinical judgment and core skills performance, but three times HFS with reflective debriefing in satisfaction. One time HFS with reflective debriefing resulted significant differences in core skills performance and the expert rating of individual students’ noticing performance in phase 2. Conclusions: The use of HFS with reflective debriefing repeatedly under longitudinal designs would imply more potential to facilitate students’ competency in neonatal intensive care unit than LFS. Having considered the cost-effectiveness of HFS education, further research needs to explore optimal frequency of HFS and correlates influencing students’ outcomes in other different levels of pediatric nursing scenarios.
Abstract
Objectives: The purpose of this study was to determine if the level of nursing students’ core skills performance, satisfaction, and clinical judgment differed and increased to according to the types of fidelity and debriefing during three clinical semesters. Methods: A total of 149 students enrolled year three baccalaureate nursing program, at a college in Daegu, South Korea, participated in a non-equivalent control group non-synchronized post-test only design over three semesters. Four study groups consisted of a low-fidelity simulation (LFS) only, high-fidelity simulation (HFS) only, HFS with conventional debriefing, and HFS with reflective debriefing. Tanner’s Clinical Judgment Model and Lasater’s Clinical Judgment Rubric (LCJR) guided the study interventions within three levels of team-based high-risk neonatal care simulations. Outcome measures included self-rated core skills performance, a single Likert question of simulation satisfaction, and the self and expert rated LCJR. Results: The HFS group with reflective debriefing showed the highest score in core skills performance, but those of HFS only in satisfaction in phase 2. Self and expert ratings of clinical judgment revealed the highest score in HFS group with reflective debriefing during phase 1 and 2. Repeated HFS with reflective debriefing made no difference in students’ clinical judgment and core skills performance, but three times HFS with reflective debriefing in satisfaction. One time HFS with reflective debriefing resulted significant differences in core skills performance and the expert rating of individual students’ noticing performance in phase 2. Conclusions: The use of HFS with reflective debriefing repeatedly under longitudinal designs would imply more potential to facilitate students’ competency in neonatal intensive care unit than LFS. Having considered the cost-effectiveness of HFS education, further research needs to explore optimal frequency of HFS and correlates influencing students’ outcomes in other different levels of pediatric nursing scenarios.
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