• Health Policy and Management
• /
• v.23 no.2
• /
• pp.103-111
• /
• 2013

Seven diagnosis-related groups (DRGs) prospective payment system is going to expand to all hospitals including university hospitals this year. However there are few studies on the change of practice pattern under prospective payment system in the university hospital setting. So This study was intended to predict the practice pattern change after the introduction of 7 DRGs prospective payment system in a university hospital setting. To predict the change of practice pattern, this study used simulation technique. Five hundred and nineteen patients classified as 5 DRGs in a university hospital were selected for simulation. The change of practice pattern were predicted based on clinicians' opinion. We also predicted payment change by service items. Major findings of this study are as follows. First, the total medical payment was reduced by 14.4%. The drug payment change (8.8%) took most of total payment reduction. The followings are the change of treatment material cost (3.2%), the change of laboratory tests cost (1.8%), the change of room charge (0.5%), and other payment change (0.1%), respectively. Second, most of the reduction in total medical payment resulted from the decreased amount of medical services themselves. The transfer of medical services to outpatient setting took up only 4.9% of the total payment reduction. The change of unit price or composition took up 5.5% of the total payment reduction. In this study we found that it is possible to reduce the inpatient services through practice pattern change in university hospital setting. However, it needs to be careful to adjust DRG payment after the reduction of provided services, because most of reduction was not due to service transfer but to service volume reduction. It is desirable to utilize the saving from practice pattern change as incentive to improve quality of care.

• Journal of the Korea Convergence Society
• /
• v.9 no.7
• /
• pp.355-364
• /
• 2018

The purpose of this study is to investigate the effect of simulation practice combining problem-based learning on nursing knowledge, self-confidence, critical thinking tendency and problem solving ability. The subjects of this study were 45 students who took two courses of nursing situation practice in the fourth grade of S university in S area. Data were collected before and after the simulation exercise using the self-report questionnaire. The problem-based learning and the simulation practice convergence training were conducted for three weeks with two hours per week, and the post- integration nursing knowledge, self-confidence, critical thinking disposition, and problem solving ability scores were improved. Nursing knowledge, self-confidence, and critical thinking tendency were positively correlated with problem solving ability and proved the effectiveness of problem-based learning and simulation training. Therefore, education programs combining problem-based learning and simulation training on various topics should be developed and utilized.

• Journal of Digital Convergence
• /
• v.18 no.8
• /
• pp.271-279
• /
• 2020

Simulation practice training is used in nursing education as an education method to improve the adaptability to the clinical field, but responds to unpredictable situations and negatively affects practice satisfaction. This study applied a team-based learning utilizing a pre-briefing inequality controls ago to investigate the effect of self-efficacy, simulation practice satisfaction and clinical performance of the nursing college in the simulation based nursing education and after quasi-experimental study. Data collection in the fourth grade and P University Nursing 72 peoples, the study period is from November 15 from October 14, 2019. As a result, the experimental group that applied team-based learning using pre-briefing showed higher self-efficacy, simulation practice satisfaction, and clinical performance than the control group. Therefore, applying team-based learning to the pre-briefing process can be an important learning strategy for simulation practice training, and suggests a follow-up study to confirm the effectiveness by standardizing the pre-briefing step later.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.23 no.4
• /
• pp.411-418
• /
• 2016

Purpose: The purposes of this study were to identify nursing students' levels of anxiety in simulation based nursing education and to understand the relationship of anxiety and personal satisfaction of simulation, self-efficacy, and clinical competence during simulation. Methods: This study was a descriptive study with 84 senior nursing students at a private university in South Korea. Level of anxiety was measured with STAI (the State- Trait Anxiety Inventory) prior to the stimulation practice. After the debriefing, satisfaction scores were measured with SSE (Satisfaction with Simulation Experience scale), self-efficacy scores with the modified measurement developed by Roh and Park, and scores for clinical skills with a scale developed by the Korea Association of Cardiopulmonary Resuscitation. Results: Nursing students exhibited moderate to severe anxiety in simulation practice (Mean 49.51, SD 8.60). Self-efficacy was negatively correlated to anxiety (r=-.25, p=.022). Conclusion: Decreasing students' anxiety levels needs to be addressed to increase the self-efficacy of the simulation practice.

• Journal of Industrial Convergence
• /
• v.18 no.6
• /
• pp.119-127
• /
• 2020

This study was conducted to confirm the effectiveness of the simulation-based orientation program for students preparing for clinical practice in child nursing for the first time. A quasi-experimental non-equivalent control group, pre-posttest design was used. The subjects were 70 3rd grade nursing students who started clinical practice. The simulation-based orientation was applied to 35 students in the experimental group, and the existing lecture style orientation was applied to 35 students in the control group. Data collection was conducted on the nursing competence, perceived stress, self-efficacy, and communication skills before and after orientation. The collected data were analyzed using the SPSS WIN 23.0 program. As a result of the study, the simulation-based orientation program before child nursing practice of nursing college students was found to improve nursing competence (t=5.390, p<.001). Perceived stress, self-efficacy, and communication skills all increased after practice, but were not statistically significant. Therefore, it is necessary to fully consider the situation of students when constructing and operating the contents of the simulation-based orientation.

• The Journal of Korean Academic Society of Nursing Education
• /
• v.26 no.2
• /
• pp.198-207
• /
• 2020

Purpose: The purpose of this study was to explore the meaning of nursing students' experiences in virtual simulation practice. Methods: The participants were six nursing students who have experience in a virtual simulation. Data were collected from August to September 2019 through a focus group interview. Giorgi's phenomenological method was used for analysis. Results: The study results revealed 3 constituents and 6 sub-constituents that are essential for nursing student's experiences in a virtual simulation. The three constituents were: "Chaos in the virtual reality", "The process of adjusting to chaos", and "Becoming an independent nurse in a safe virtual reality". Conclusion: Based on the results of this study, the following suggestions are made. Results suggest the development of virtual simulations in Korean, the use of simulations as a group activity first, and the use of simulation between lecture and practice or in the regular curriculum. The results of the study can be used as primary data for providing virtual simulation in nursing education.

• The Mathematical Education
• /
• v.59 no.3
• /
• pp.271-294
• /
• 2020

The purpose of this study was to explore the possibility of digital simulation by which pre-service teachers (PSTs) can approximate the core teaching practice of eliciting student thinking. This study examined PSTs' questions to elicit student thinking, their use of "pause" session and peer feedback, and their reflections on doing a digital simulation. We analyzed a two-hour digital simulation session with 13 PSTs who enrolled in the elementary mathematics methods course. The results showed that PSTs shifted their general questions to more content-specific questions throughout the simulation and made a quick transition to comparing students' strategies. The number of lead PST-initiated "pause" ranged one to four times for various reasons. Their peer-coaches did not voluntarily "pause" the simulation session but actively shared what they noticed from the student work samples and suggested the next teaching moves. Without utilizing the pause session, the dramatic improvement of questioning was not observed. Even though the PSTs felt overwhelmed with interacting with the student-avatars in real-time, they highlighted the benefits of simulations, appreciated the opportunity to learn the core teaching practice, and viewed this digital simulation as "real" and "authentic" experience. The findings of this study provide implications for re-designing a practice-based teacher education program.

• The Journal of Korean Institute for Practical Engineering Education
• /
• v.2 no.1
• /
• pp.77-83
• /
• 2010

Effectiveness of the e-learning hands-on practice in the engineering education depends on the quality of the contents of which simulation is a part and the teaching strategy of the instructor. Instructors who develop and use the simulation-included e-learning content should employ various teaching and learning activities which would make online simulation practice effective. Thus, the strategy for the effective e-learning simulated practice in engineering courses should be known and used effectively. The aim of this paper is to classify the development methods of the simulations and the teaching and learning activities of the development types classified. The comparison of the teaching and learning activities leads to suggestion on teaching and learning strategy for effective use of the online simulation in engineering education.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.16 no.12
• /
• pp.8176-8186
• /
• 2015

This research was conducted for the purpose of developing a high-fidelity simulation education program, applying it to clinical field and analyzing this program's effect on nursing college students in order to solve problems being caused from the gap between the adult nursing theoretical class and practical education. As the analysis method, this study developed a scenario including an algorithm for caring hyperkalemia patients, the evaluation check list, and debriefing according to the adult nursing theoretical class's learning goal and measured the high-fidelity simulation program's effect in using the non-equivalent control group pre-test and post-test design. As the results from the analysis, there secured the simulation education program's general properties and dependent variable's homogeneity in the experimental group and the control group. The nursing simulation practice program for hyperkalemia patients showed slight effect on the experimental group compared to the control group in fields such as nursing practice ability, problem solving ability, critical thinking skills, self-confidence of nursing, and knowledge. (t=-83.313, p<.001, t=-3.169, p=.003, t=-2.473, p=.017, t=-4.036, p<.001, t=-5.044, p<.001). High-Fidelity simulation programs in conjunction with an adult nursing theory classes of nursing students nursing practice ability, problem solving ability, critical thinking skills, self-confidence of nursing, and knowledge. This simulation program may be an effective educational method for nursing practice and also support improved quality of nursing education.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.18 no.4
• /
• pp.93-100
• /
• 2017

The purpose of this study was to develop a simulation-based practice that enhances the core competencies of nursing students and to investigate the effects on critical thinking disposition, communication skill, and clinical performance for nursing students. This study used a one group, pre-post test design. There were 53 nursing students from G city enrolled in this study, and self-reported questionnaires were collected between June 10 and August 19, 2016. The simulation-based practice was applied for 6-8 hours/day for 60 hours, using a 4-practice module. The data were analyzed by frequencies, paired t-test, and Pearson's correlation using SPSS Win 18.0. The results showed that there was a significant difference in the clinical performance, however, there was no significant difference in the critical thinking disposition and communication skill. After the simulation-based practice, clinical performance was found to be positively correlated with critical thinking disposition (r= .628, p<.001) and communication (r=.716, p<.001). Critical thinking disposition and communication (r=.650, p<.001) also showed a positive correlation. In order to improve clinical competence, it is necessary to develop a simulation-based practice that enhances critical thinking disposition and communication skill.