• Korean Journal of Adult Nursing
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• v.25 no.5
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• pp.574-584
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• 2013

Purpose: The purpose of this study was to evaluate the effects of a simulation based clinical reasoning practice program on clinical competence in nursing students. The program was based on the theoretical frameworks of simulation models and experiential learning theory. Methods: The program consisted of eight scenarios which includes three main symptoms (abdominal pain, changes in mental status, dyspnea), for improvement of clinical competencies in nursing students. A nonequivalent control group pretest-posttest design was used for evaluation of the effects of the program. Fifty-two junior nursing students in Y University participated in the experimental group (n=25) or control group (n=27). Critical thinking was measured using a self-administered questionnaire. Clinical judgment and clinical performance were measured by a rater using the Rubric. Descriptive analysis, t-test, Mann-Whitney U, Wilcoxon signed rank test was used for data analyses. Results: Clinical judgment and clinical performance increased in the experimental group, but there were no significant differences in critical thinking. Conclusion: Results indicate that the program developed in this study is a useful strategy to enhance clinical judgment and clinical performance in nursing students. However, the program did not significantly enhance critical thinking disposition, and further study is needed to measure integrated clinical competence including critical thinking skills.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.24 no.3
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• pp.189-199
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• 2017

Purpose: This study was conducted to examine the level of agreement between a standardized patient (SP) and a faculty member in the evaluation of nursing students' assessment and communication skills. Methods: Participants were 51 third year nursing students in a simulation practice of 'nursing care for a patient admitted with chest pain'. Using a 30-item checklist and a 16-item communication tool, a SP and faculty member evaluated the students' assessment and communication skills during the simulation. Results: The average values for percent agreement and kappa statistic for nursing assessment between the two evaluators were 85.3% and .48 respectively. Twenty of thirty items evaluating assessment skill had above moderate agreement (${\geq}.41$) by kappa between the evaluators. Seven of sixteen items evaluating communication and interpersonal skills showed above fair agreement (${\geq}.40$) between the two evaluators, which was measured by intraclass correlation coefficient. Conclusion: The findings show that the evaluation of the SP was consistent with those of the faculty member to a moderate degree. Clear guidelines for evaluating criteria and optimal time and effort for SP training are necessary to increase the reliability of standardized patients as evaluators in simulation-based nursing education.

• The Journal of Korean Academic Society of Nursing Education
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• v.22 no.4
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• pp.549-558
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• 2016

Purpose: The purpose of this study was to develop and validate a Nursing Competency Scale in Simulation (NCSS) for nursing students. Methods: A preliminary version of the NCSS of 14 items was derived from the literature. A panel of seven experts reviewed the preliminary version for content validation and developed 15 items scale. A convenient sample of 195 nursing students completed the survey and two evaluators measured the performances of nine teams in a simulation scenario with NCSS. The data were analyzed using exploratory factor analysis, descriptive statistics, independent t-test and Cronbach's alpha. Intraclass correlation coefficient (ICC) was used in order to estimate the degree of inter-rater reliability. Results: An exploratory factor analysis demonstrated that two factor structures of the NCSS explained 51.1% of the total variance. Two factors were named psychosocial skills and cognitive and psychomotor skills. The mean scores of NCSS between third and 4th grade were significantly different providing support for its known-group validity. Cronbach's alpha was .90 and ranged from .79 to .88. The overall ICC for inter-rater agreement was 0.89 (95% CI 0.03 to 0.98). Conclusion: This scale shows preliminary evidence for validity and reliability. It could be a useful instrument for measuring learning outcome in simulation for nursing students' clinical competency.

• Journal of Korean Academy of Nursing
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• v.47 no.6
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• pp.842-853
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• 2017

Purpose: This study was conducted to identify effects of debriefing based on the clinical judgment model for nursing students on their knowledge, skill performance, clinical judgment, self-confidence and learner satisfaction during simulation based end-of-life care (ELC) education. Methods: Simulation based ELC education was developed in six steps as follows: selection of learning subjects and objects, development of learning tools, a trial run of simulation-based education, students' skill training, and evaluators' training. Forty-eight senior nursing students (25 in the experimental group and 23 in the control group) participated in the simulation-based ELC education using a high-fidelity simulator. Debriefing based on the clinical judgment was compared with the usual debriefing. Results: ANCOVA showed that there were differences in knowledge (F=4.81, p=.034), skill performance (F=68.33, p<.001), clinical judgment (F=18.33, p<.001) and self-confidence (F=4.85, p=.033), but no difference in satisfaction (t=-0.38, p=.704) between the experimental and control groups. Conclusion: This study found that debriefing based on the clinical judgement model is effective for supporting nursing students for reflecting on clinical judgment and improving their diverse competencies in complex clinical settings such as ELC.

• The Journal of Korean Academic Society of Nursing Education
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• v.21 no.3
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• pp.393-405
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• 2015

Purpose: This study was conducted to plan and apply simulation-based practice for raising the achievement of program outcomes (POs) in nursing students. Methods: Using convenience sampling, 95 nursing students participated in this descriptive study. A self-reported questionnaire was used to measure the achievement of POs (self-directed learning, problem-solving ability, critical thinking) and usefulness of curriculum in addition to observing tracheal suction skills using a checklist. Results: A scenario with a pneumonia patient was developed to observe tracheal suction skills during simulation-based practices. Self-directed learning, problem-solving ability, and critical thinking were then scored. The mean scores of performance skill, self-directed learning, problem-solving ability, critical thinking were $37.82{\pm}6.03$. $3.61{\pm}0.38$, $3.61{\pm}0.33$, and $3.73{\pm}0.32$, respectively. All students passed the simulation-based practice in terms of performance ability and met the required achievement level for the POs at this university. Students with good suction skills showed significant differences in problem identification (p=.044) and alternative development (p=.019), which are components of problem-solving ability, compared to students with only fair skills. Conclusion: These findings indicate that simulation-based practice related to an adult nursing respiratory course was useful for evaluating the achievement of POs in nursing students. Further study is needed to develop a universal method of outcome measurement.

• Journal of Digital Convergence
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• v.19 no.9
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• pp.401-409
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• 2021

This study was performed to identify the difference in nursing process competency, critical thinking disposition and self-efficacy after applying virtual reality simulation education. The data were collected from 31 nursing college students using URL from February to April 2021 and analyzed SPSS 22.0. The pretest and posttest result of each group showed statistically significant improvements in nursing process competency(t=-3.776, p=.001), critical thinking disposition(t=-3.608, p=.001) and self-efficacy(t=-3.580, p=.001). As a result of this study, it was found that virtual reality simulation education improve nursing process competency, critical thinking disposition and self-efficacy of nursing students. Therefore, virtual reality simulation education will be the basis for preparing effective clinical practice education strategies for nursing students. It is suggested to have follow-up studies on virtual reality simulation education and various scenarios should be developed.

• Journal of Digital Convergence
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• v.19 no.1
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• pp.229-237
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• 2021

The purpose of this study is to verify the effects of Simulation-based Chest Tube Drainage Management Nursing Education on the Nursing Students' Response to Scenario Experiences, Confidence in Learning, and Problem Solving Abilities. This study was performed with a one-group pretest-posttest design, and a total of 133 junior nursing students have participated in the research (31 teams of simulation-based education). According to the results of the study, most of the students have shown a positive response to the scenario experience after the simulation training, while their confidence in learning and problem-solving skills have improved significantly. This proves that simulation-based training using simulators can be very effective in practical nursing training. It is expected that this research could make a meaningful contribution to improving the overall quality of field-oriented practical training and clinical practice.

• Women's Health Nursing
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• v.29 no.3
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• pp.229-238
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• 2023

Purpose: This study analyzed the effects of virtual reality simulation-based problem-based learning on nursing students' critical thinking ability, problem-solving ability, and self-efficacy in the nursing care of women undergoing induction of labor. Methods: A nonequivalent control group pretest and posttest design was employed. The study participants included 52 nursing students (24 in the experimental group and 28 in the control group). The experimental group took a problem-based learning (PBL) class in the first week, and then engaged in self-directed learning using virtual reality simulation. In the second week, lectures about emergency nursing care for induction of labor and drug administration were given. The control group participated in PBL in the first week and lectures in the second week. The study was conducted from April 17 to May 19, 2023. Data were analyzed using the chi-square test, Fisher exact test, analysis of variance, and the independent t-test. Results: Before-and-after differences between the two groups were statistically significant in problem solving ability (t=-5.47, p<.001) and self-efficacy (t=-5.87, p<.001). Critical thinking ability did not show a statistically significant difference between the two groups. The score for satisfaction with the virtual reality simulation program was 3.64±5.88 out of 5 in the experimental group. Conclusion: PBL education using a virtual reality simulation was found to be an effective way of teaching. Although convenience sampling was used, PBL education using virtual reality can be used as an educational strategy to enhance nursing students' problem-solving ability and self-efficacy.

• Journal of Digital Convergence
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• v.13 no.9
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• pp.377-386
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• 2015

The purpose of this study was to evaluate the needs and effects of convergence-based simulation practice for obstetrical nursing. The study participants were 47 junior nursing students of a university in Chungnam province. Data were collected by a self-administered questionnaire from February 13 to 25, 2012. Convergence-based simulation practice for obstetrical nursing was applied 8 hours in a day for 2 days and consisted of four sessions. Self-efficacy in obstetrical nursing (t=-14.74, p<.001) and nursing skills related to obstetrical nursing (t=-17.51, p<.001) showed significant increase in the posttest and practice satisfaction was higher than practice stress. The needs of simulation practice was 7.96 out of 10 point and higher as practice satisfaction was higher. The needs of simulation practice before clinical practice was higher than simulation practice after clinical practice. These results indicate that simulation practice for obstetrical nursing can be used as the alternative for clinical practice. In addition to simulation practice should be done before clinical practice and strategies to increase the nursing student's cognition for the need of simulation practice are also needed.

• The Journal of Korean Academic Society of Nursing Education
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• v.30 no.2
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• pp.113-123
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• 2024

Purpose: This study aimed to examine the mediating effect of learning immersion in clinical simulations on the relationship between nursing student learning motivation and achievement in clinical simulation. Methods: This study was conducted using a cross-sectional survey with 184 nursing students from two universities who participated in clinical simulation between September and December 2022. The participants completed a self-administered questionnaire, and the collected data were analyzed using independent an independent t-test, Mann-Whitney U-test, one-way ANOVA, Pearson's correlation coefficient, and multiple regression analysis to identify the mediating effects of learning immersion on the relationship between nursing student learning motivation and achievement. Results: Among the subvariables of nursing student learning motivation, task value and self-efficacy for learning and performance had a significant effect on learning immersion (respectively, β=.36, p=.001; β=.31, p<.001) and learning achievement (respectively, β=.48, p<.001; β=.38, p<.001). With the input of learning motivation variables, the direct effect of learning immersion on learning achievement was significant (β=.20, p=.003), and the effects of learning motivation and task value and self-efficacy on learning achievement was reduced after controlling for learning immersion, which is a mediating variable (respectively, β=.41, p<.001; β=.32, p<.001). The bootstrapping test to confirm the mediating effect of learning immersion was also significant (task value 95% confidence interval [95% CI], 0.02~0.20; self-efficacy 95% CI, 0.01~0.12). Conclusion: The results of this study suggest that simulation educators should consider learners' motivation and immersion when organizing and operating clinical simulations.