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The Effects of Simulation-based Education on the Clinical Reasoning Competence, Clinical Competence, and Educational Satisfaction

시뮬레이션 교육이 간호학생의 임상추론역량과 임상수행능력 및 교육만족도에 미치는 효과

  • Kang, Hee (Department of Nursing, Graduate School, Chosun University) ;
  • Kang, Hee-Young (Department of Nursing, Chosun University)
  • 강희 (조선대학교 일반대학원 간호학과) ;
  • 강희영 (조선대학교 간호학과)
  • Received : 2020.05.06
  • Accepted : 2020.08.07
  • Published : 2020.08.31

Abstract

This study was conducted to examine the effects of simulation-based education on the clinical reasoning competence, clinical competence, and satisfaction with simulation experience (SSE). The research design was one group pretest-posttest. Study participants were 89 third-year nursing students from C University in G city, who were engaged the simulation-based education for eight weeks from August to October 2019. Learning scenario titles were blood transfusion reaction patient care with postoperative total hip replacement, hypoglycemia patient care with diabetes mellitus, and hyperkalemia patient care with liver cirrhosis. The data were analyzed by paired t-test using SPSS Win 23.0 program. After applying simulation-based education, nursing students' clinical reasoning competence (t=-17.082, p<.001) and clinical competence(t=-18.40, p<.001) improved significantly. SSE score was 4.65 out of 5 points. The results indicate that the simulation-based education in this study gave the students the experience of providing qualified and secure nursing care under conditions similar to those in the real clinical field. To improve the clinical reasoning competence and clinical competence of nursing students, various cases scenarios are developed and simulation-based education should be applied to more subjects in the nursing curriculum.

본 연구는 시뮬레이션 기반 교육이 간호학생들의 임상추론역량과 임상수행능력 및 시뮬레이션 교육만족도에 미치는 효과를 알아보고자 수행되었다. 본 연구 설계는 단일군 전후 설계이다. 대상자는 G시 C대학교의 89명 3학년 간호학생으로, 8월부터 10월까지 8주간의 시뮬레이션 교육을 참여하였다. 학습한 시나리오 주제는 전 고관절대치술 후 수혈 부작용 환자 간호, 당뇨 환자의 저혈당증 환자 간호, 간경화증 환자의 고칼륨혈증 환자 간호이다. 자료는 SPSS 23.0 프로그램을 이용하였고, 평균과 표준편차, 대응표본 t검정으로 분석하였다. 간호학생들은 시뮬레이션 교육을 적용한 후 임상추론역량(t=-17.082, p<.001)과 임상수행능력(t=-18.40, p<.001)이 통계적으로 유의하게 향상되었고, 시뮬레이션 교육만족도는 5점 만점에 4.65점으로 높은 점수를 나타내었다. 이러한 결과로 볼 때, 본 시뮬레이션 기반 교육은 간호학생에게 임상상황과 유사한 환경에서 질적이고 안전한 간호를 경험할 수 있도록 하였다. 따라서 간호학생들의 임상추론역량과 임상수행능력을 향상시키기 위해서는 임상현장에서 접할 수 있는 다양한 사례의 시나리오 개발 및 간호교육과정에서 시뮬레이션 기반 교과목들의 적용이 더 필요하다.

Keywords

References

  1. M. Y. Kim, S. H. Park, "Effects of Pre-briefing in Simulation-based Learning on Nursing Students' Satisfaction with Simulation", Journal of Korea Society for Simulation in Nursing, vol. 6, no. 2, pp. 27-34, 2018. DOI: http://dx.doi.org/10.17333/JKSSN.2018.6.2.27
  2. J. M. Kim, Y. S. Choi, "Effect of Practice Education using the Simulator, Critical Thinking, Problem Solving Ability and Nursing Process Confidence of Nursing Students", The Society of Digital Policy & Management, vol. 13, no. 4, pp. 263-270, 2015. DOI: http://dx.doi.org/10.14400/JDC.2015.13.4.263
  3. K. C. Lim, "Directions of Simulation-based Learning in Nursing Practice Education: A Systematic Review", The Journal of Korean Academic Society of Nursing Education, vol. 17, no. 2, pp. 246-256, 2011. DOI: http://dx.doi.org/10.5977/JKASNE.2011.17.2.246
  4. Y. H. Kim, K. S. Jang, "Effect of a Simulation-based Education on Cardio-Pulmonary Emergency Care Knowledge, Clinical Performance Ability and Problem Solving Process in New Nurses", Journal of Korean Academy of Nursing, vol. 41, no. 2, pp. 245-255, 2011. DOI: http://dx.doi.org/10.4040/jkan.2011.41.2.245
  5. W. F. Bond, L. Spillane, "The Use of Simulation for Emergency Medicine Resident Assessment", Academic Emergency Medicine, vol. 9, no. 11, pp. 1295-1299, 2002. DOI: http://dx.doi.org/10.1197/aemj.9.11.1295
  6. P. R. Jeffries, Simulation in Nursing Education: from Conceptualization to Evaluation, National League for Nursing, 2012.
  7. Korean Accreditation Board of Nursing, Certification Criteria and Handbook, 2017, Available From : http://www.kabone.or.kr/kabon02/index04.php (accessed Jan., 26, 2017)
  8. B. Simmons, "Clinical Reasoning: Concept Analysis", Journal of Advanced Nursing, vol. 66, no. 5, pp. 1151-1158, 2010. DOI: https://doi.org/10.1111/j.1365-2648.2010.05262.x
  9. R. A. Kuiper, D. J. Pesut, "Promoting Cognitive and Metacognitive Reflective Reasoning Skills in Nursing Practice: Self‐regulated Learning Theory", Journal of Advanced Nursing, vol. 45, no. 4, pp. 381-391, 2004. DOI: https://doi.org/10.1046/j.1365-2648.2003.02921.x
  10. S. Griffits, S. Hines, C. Moloney, N. Ralph, "Characteristics and Processes of Clinical Reasoning in Nurses and Factors related to Its Use: A Scoping Review Protocol", JBI Database of Systematic Reviews and Implementation Reports, vol. 15, no. 12, pp. 2832-2836, 2017. DOI: http://dx.doi.org/10.11124/JBISRIR-2016-003273
  11. C. Barrett, F. Myrick, "Job Satisfaction in Preceptorship and Its Effect on the Clinical Performance of the Preceptee", Journal of Advanced Nursing, vol. 27, no. 2, pp. 364-371, 1998. DOI: https://doi.org/10.1046/j.1365-2648.1998.00511.x
  12. C. B. Evans, D. K. Mixon, "The Evaluation of Undergraduate Nursing Students' Knowledge of Post-op Pain Management after Participation in Simulation", Pain Management Nursing, vol. 16, no. 6, pp. 930-937, 2015. DOI: https://doi.org/10.1016/j.pmn.2015.07.006
  13. H. K. Hur, Y. S. Roh, "Effects of a Simulation based Clinical Reasoning Practice Program on Clinical Competence in Nursing Students", Korean Journal of Adult Nursing, vol. 25, no. 5, pp. 574-584, 2013. DOI: http://dx.doi.org/10.7475/kjan.2013.25.5.574
  14. A. R. Kim, "Effects of Maternity Nursing Simulation using High-fidelity Patient Simulator for Undergraduate Nursing Students", Journal of the Korea Academia-Industrial Cooperation Society, vol. 17, no. 3, pp. 177-189, 2016. DOI: http://dx.doi.org/10.5762/KAIS.2016.17.3.177
  15. E. M. Kwak, "Effects of Simulation-based Integrated Nursing Practice on Nursing Students", Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology, vol. 7, no. 10, pp. 445-455, 2017. DOI: http://dx.doi.org/10.14257/ajmahs.2017.10.77
  16. J. Y. Kim, E. J. Kim, "Effects of Simulation on Nursing Students' Knowledge, Clinical Reasoning, and Self-confidence: A Quasi-experimental Study", Korean Journal of Adult Nursing, vol. 27, no. 5, pp. 604-611, 2015. DOI: http://dx.doi.org/10.7475/kjan.2015.27.5.604
  17. S. R. Liou, H. C. Liu, H. M. Tsai, Y. H. Tasi, Y. C. Lin, et al., "The Development and Psychometric Testing of a Theory‐based Instrument to Evaluate Nurses' Perception of Clinical Reasoning Competence", Journal of Advanced Nursing, vol. 72, no. 3, pp. 707-717, 2016. DOI: https://doi.org/10.1111/jan.12831
  18. J. W. Joung, J. W. Han, "Validity and Reliability of a Korean Version of Nurse Clinical Reasoning Competence Scale", Journal of the Korea Academia-Industrial Cooperation Society, vol. 18, no. 4, pp. 304-310, 2017. DOI: http://dx.doi.org/10.5762/KAIS.2017.18.4.304
  19. T. Levett-Jones, M. McCoy, S. Lapkin, D. Noble, K. Hoffman, et al., "The Development and Psychometric Tsting of the Satisfaction with Simulation Experience Scale", Nurse Education Today, vol. 31, no. 7, pp. 705-710, 2011. DOI: https://doi.org/10.1016/j.nedt.2011.01.004
  20. C. A. Tanner, "Thinking like a Nurse: A Research-based Model of Clinical Judgement in Nursing", Journal of Nursing Education, vol. 45, no. 6, pp. 204-211, 2006. DOI: https://doi.org/10.3928/01484834-20060601-04
  21. M. Banning, "Clinical Reasoning and Its Application to Nursing: Concepts and Research Studies", Nurse Education in Practice, vol. 8, no. 3, pp. 177-183, 2008. DOI: https://doi.org/10.1016/j.nepr.2007.06.004
  22. C. M. Hong, "The Effects of Simulation on Nursing Students' Clinical Competence, Communication Skills, and Team Efficacy", Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology, vol. 8, pp. 397-405, 2018.
  23. J. K. Kim, M. S. Song, "Effects of Respiratory Infectious Disease Simulation-based Education on Nursing Student's of Clinical Competency, Self-leadership and Critical Thinking", Journal of the Korea Academia-Industrial cooperation Society, vol. 20, no. 8, pp. 93-101, 2019. DOI: https://doi.org/10.5762/KAIS.2019.20.8.93
  24. Y. M. Kim, J. Y. You, M. S. Lee, "Effect of Simulation-based Integrated Practice for High-risk Newborn on Problem Solving Process, Resilience and Clinical Performance Abilities in Nursing Students", Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology, vol. 8, no. 12, pp. 343-352, 2018. DOI: http://dx.doi.org/10.21742/AJMAHS.2018.12.78
  25. M. H. Han, "A Clinical Skill Test using OSCE Modules Developed by Nursing Students", Journal of Korean Academy of Nursing Administration, vol. 12, no. 3, pp. 365-372, 2006.