Effects of high fidelity patient simulators as teaching learning strategies on learning outcomes among nursing diploma students in Malaysia / Fong Ka Ling
Simulation education with High Fidelity Patient Simulators (HFPSs) is a teaching and learning tool that serves as a bridge between classroom learning and real-life clinical experience for novice learners. Optimization desired learning outcomes of nursing students is challenged by lack of experien...
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| Format: | Thesis |
| Published: |
2018
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| Online Access: | http://studentsrepo.um.edu.my/11584/4/ka_ling.pdf http://studentsrepo.um.edu.my/11584/ |
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| Summary: | Simulation education with High Fidelity Patient Simulators (HFPSs) is a teaching and
learning tool that serves as a bridge between classroom learning and real-life clinical
experience for novice learners. Optimization desired learning outcomes of nursing
students is challenged by lack of experiential learning in multiple disciplinary settings
and failures in communication between health care providers exposing patients to
adverse events that threaten patient safety. What makes HFPS so useful is its ability to
simulate realistic clinical situations and settings with no risk to the safety of patients.
This study aimed to examine the effectiveness in the learning outcomes (knowledge,
skills performance, critical thinking, learners' satisfaction and self-confidence) using an
adult code blue simulated programme on a High Fidelity Patient Simulator (HFPS) and
low fidelity patient manikin (LFPM) for nursing students in Malaysia. This is a quasiexperimental pre and post-test study. The universal sampling included all year-3
diploma-nursing students (N=389) from three participating nursing schools in Malaysia.
Instruments used were 30-single best questions for knowledge, 40-items skills
performance observational checklist, 75-items of California Critical Thinking
Disposition Inventory (CCTDI) for critical thinking and 36-items likert scale for
satisfaction and self-confidence. All instruments went through back translation from
English to Bahasa Malaysia. All instruments were distributed and pre-tested by all
students prior a lecture delivered on managing deteriorating patient. Students and
assessors were double blinded in the selection of control and intervention groups
whether using HFPS or LFPM. Briefing was given to both students and assessors for
control and intervention groups for the roles and responsibilities held in skills
performance learning outcome using HFPS or LFPM. The same instruments were
distributed and post-tested immediately after students' exposed to HFPS or LFPM but
the 30-single best questions were given to all students 2 months later. The demographic
characteristics of students were 20-year-old 259 (66%), predominantly female, n=359
(92%) and n=30 (8%) male students. Majority of students (n=384, 98%) possess SPM
equivalent qualification. Students were majority from average academic performance,
CGPA of 3 to 3.5, has n=110 (61.1%) in control and n=112 (53.6%) from the
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intervention groups. Students with previous simulation training was n=155 (40%) while
those never been exposed was n=234 (60%). A repeated-measures analysis of variance
revealed a statistically significant effect of intervention groups with HFPS as teaching
learning strategy after controlling for demographic characteristics: knowledge (p<0.05,
η2=0.1460), skill performance (p<0.05, η2=0.744), critical thinking (p<0.05, η2=0.119)
and satisfaction and self-confidence (p<0.05, η2=0.636). The critical thinking overall
means score was found decreased for both post-test intervention and control groups.
However, truth-seeking scores shown increment post-test (intervention, 0.86±SD6.71;
control, 0.45±SD6.61) adversely decrements in CCTDI subscales. All demographic
characteristics have no association with the learning outcomes and non-significant
correlation between the each type of learning outcomes in this study. The utmost value
of this study is to create awareness and management of change in the current nursing
education system to enhance learning, instill the importance of patient safety practices
and achieving the learners' satisfaction and confidence in learning process. However,
there are pitfalls in supporting the use of simulation education in practice and the
learners' ability to transfer learned outcomes to clinical practice in long-term retention.
In conclusion, the intervention groups using HFPS had positive effects in learning
outcomes and simulation education promotes new innovative experiential learning that
enhancing the quality of nursing profession of this country. |
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