Simulation based learning in midwifery education: a systematic review
- Authors: Cooper, Simon J. , Cant, Robyn , Porter, Joanne , Bogossian, Fiona , McKenna, Lisa , Brady, Susannah , Fox-Young, Stephanie
- Date: 2012
- Type: Text , Journal article
- Relation: Women and Birth Vol. 25, no. 2 (2012), p. 64-78
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- Description: Abstract Aim To critically examine the evidence for simulation based learning in midwifery education. Background Simulated Learning Programs (SLPs) using low to high fidelity techniques are common in obstetric professionals’ education and focus on the development of team work, labour and obstetric emergencies. Review methods A systematic review incorporating critical appraisal approaches, setting clear objectives and a defined search and analysis strategy. Evidence from obstetrics, neonatology, technical and non-technical skills (teamwork) was included where it informed the development of midwifery curricula. Studies in English from 2000 to 2010 were included searching CINAHL Plus, OVID Medline, Cochrane, SCOPUS and ProQuest and Google Scholar. Results Twenty-four papers were identified that met the inclusion criteria. All were quantitative reports; outcomes and levels of evidence varied with two notable papers indicating that simulation had an impact on clinical practice. Benefits of SLP over didactic formats were apparent, as were the development of non-technical skills confidence and competence. The study outcomes were limited by the range of evidence and context of the reports which focussed on obstetric emergency training using a number of simulation techniques. Conclusion There is evidence that simulated learning of midwifery skills is beneficial. Simulation learning has an educational and clinical impact and advantages over didactic approaches. Where clinical practice is infrequent i.e. obstetric emergencies, simulation is an essential component of curricula. Simulation enhances practice and therefore may reduce the time taken to achieve competence; however there is no evidence from the literature that simulation should replace clinical practice.
Managing patient deterioration: A protocol for enhancing student nurses' competence through web-based simulation and feedback techniques
- Authors: Cooper, Simon J. , Beauchamp, Alison , Bogossian, Fiona , Bucknall, Tracey , Cant, Robyn , Devries, Brett , Endacott, Ruth , Forbes, Helen , Hill, Robyn , Kinsman, Leigh , Kain, Victoria , McKenna, Lisa , Porter, Joanne , Phillips, Nicole , Young, Susan
- Date: 2012
- Type: Text , Journal article
- Relation: BMC Nursing Vol. 11, no. 18 (2012), p.1-7
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- Description: Aims To describe a funded proposal for the development of an on-line evidence based educational program for the management of deteriorating patients. Background There are international concerns regarding the management of deteriorating patients with issues around the ‘failure to rescue’. The primary response to these issues has been the development of medical emergency teams with little focus on the education of primary first responders. Design/Methods A mixed methods triangulated convergent design. In this four phase proposal we plan to 1. examine nursing student team ability to manage deteriorating patients and based upon these findings 2. develop web based educational material, including interactive scenarios. This educational material will be tested and refined in the third Phase 3, prior to evaluation and dissemination in the final phase. Conclusion This project aims to enhance knowledge development for the management of deteriorating patients through rigorous assessment of team performance and to produce a contemporary evidence-based online training program.
Situation awareness in undergraduate nursing students managing simulated patient deterioration
- Authors: McKenna, Lisa , Missen, Karen , Cooper, Simon J. , Bogossian, Fiona , Bucknall, Tracey , Cant, Robyn
- Date: 2014
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 34, no. 6 (June 2014), p. e27-e31
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- Description: Background: Nursing work often occurs in complex and potentially hazardous settings. Awareness of patient and practice environments is an imperative for nurses in practice. Objectives: To explore nursing students' situation awareness while engaging in simulated patient deterioration scenarios. Design: The educational process of FIRST2ACT was the model for the nurse intervention. Situation awareness was measured quantitatively using the Situation Awareness Global Assessment tool. Four domains were measured: physiological perception (patient parameters), global perception (surroundings), comprehension (interpretation of information), and projection (forecasting outcomes). Settings: Clinical laboratories at each of three participating universities. Participants: Ninety-seven nursing students from three Australian universities. Methods: Between March and July 2012, students participated in three video-recorded simulation events, in which a trained actor played patient roles and groups of three students worked as teams. To measure situation awareness, following the simulation each team leader was taken to a separate room and asked to report on a question set regarding the patient's vital signs, bedside setting and medical diagnosis. Results and Conclusions: Overall, situation awareness was low (41%). Of the four domains, physiological perceptions scored the lowest (26%) and projection the highest (59%).Final year nursing students may not have well developed situation awareness skills, especially when dealing with these types of scenarios. Education providers need to consider ways to assist students to fully develop this attribute. Findings suggest that this is an aspect of undergraduate nursing education that requires significant consideration by curriculum developers.
Is simulation a substitute for real life clinical experiences in Midwifery? A qualitative examination of the perceptions of educational leaders
- Authors: McKenna, Lisa , Bogossian, Fiona , Hall, Helen , Bady, S , Fox-Young, Stephanie , Cooper, Simon J.
- Date: 2011
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 31, no. 7 (2011), p. 682-686
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- Description: This paper describes the perceptions of midwifery educational leaders concerning the potential for simulation to provide a realistic experience in midwifery education. A qualitative design was employed using focus groups which were audio-taped and transcribed verbatim. Data were analysed using thematic analysis. Eleven focus groups were conducted with 46 key midwifery academics across Australia. Three main themes emerged relating to realism and simulation in midwifery practice: 'we already use a lot of simulation', 'level of realism of manikins', and 'some things cannot be simulated'. Simulation is currently widely used in midwifery education, but this is limited due to realism of available models and equipment. Despite this, within a woman-centred, holistic approach to care there are many aspects of midwifery practice that cannot be easily simulated. There is a need for research and development of realistic simulation approaches to support the enhanced use of simulation. Furthermore, strategies for developing approaches that reflect midwifery care provision need to be developed.
The perspectives of Australian midwifery academics on barriers and enablers for simulation in midwifery education in Australia: a focus group study
- Authors: Fox-Young, Stephanie , Brady, Susannah , Brealy, W , Cooper, Simon J. , McKenna, Lisa , Hall, Helen , Bogossian, Fiona
- Date: 2012
- Type: Text , Journal article
- Relation: Midwifery Vol. 28, no. 4 (2012), p. 435-441
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- Description: Objective: To describe Australian midwifery academics' perceptions of the current barriers and enablers for simulation in midwifery education in Australia and the potential and resources required for simulation to be increased. Design: A series of 11 focus groups/interviews were held in all states and territories of Australia with 46 participating academics nominated by their heads of discipline from universities across the country. Findings: Three themes were identified relating to barriers to the extension of the use of simulated learning environments (SLEs) ('there are things that you can't simulate'; 'not having the appropriate resources'; and professional accreditation requirements) and three themes were identified to facilitate SLE use ('for the bits that you're not likely to see very often in clinical'; ['for students] to figure something out before [they] get to go out there and do it on the real person'; and good resources and support). Key conclusion: Although barriers exist to the adoption and spread of simulated learning in midwifery, there is a long history of simulation and a great willingness to enhance its use among midwifery academics in Australia. Implications for practice: While some aspects of midwifery practice may be impossible to simulate, more collaboration and sharing in the development and use of simulation scenarios, equipment, space and other physical and personnel resources would make the uptake of simulation in midwifery education more widespread. Students would therefore be exposed to the best available preparation for clinical practice contributing to the safety and quality of midwifery care.
A trial of e-simulation of sudden patient deterioration (FIRST2ACT WEB
- Authors: Bogossian, Fiona , Cooper, Simon J. , Cant, Robyn , Porter, Joanne , Forbes, Helen , McKenna, Lisa , Kinsman, Leigh , Endacott, Ruth , Devries, Brett , Philips, Nicole , Bucknall, Tracey , Young, Susan , Kain, Victoria
- Date: 2015
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 35, no. 10 (2015), p. e36-e42
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- Description: Background: High-fidelity simulation pedagogy is of increasing importance in health professional education; however, face-to-face simulation programs are resource intensive and impractical to implement across large numbers of students. Objectives: To investigate undergraduate nursing students' theoretical and applied learning in response to the e-simulation program-FIRST2ACT WEBTM, and explore predictors of virtual clinical performance. Design and setting: Multi-center trial of FIRST2ACT WEBTM accessible to students in five Australian universities and colleges, across 8 campuses. Participants: A population of 489 final-year nursing students in programs of study leading to license to practice. Methods: Participants proceeded through three phases: (i) pre-simulation-briefing and assessment of clinical knowledge and experience; (ii) e-simulation-three interactive e-simulation clinical scenarios which included video recordings of patients with deteriorating conditions, interactive clinical tasks, pop up responses to tasks, and timed performance; and (iii) post-simulation feedback and evaluation.Descriptive statistics were followed by bivariate analysis to detect any associations, which were further tested using standard regression analysis. Results: Of 409 students who commenced the program (83% response rate), 367 undergraduate nursing students completed the web-based program in its entirety, yielding a completion rate of 89.7%; 38.1% of students achieved passing clinical performance across three scenarios, and the proportion achieving passing clinical knowledge increased from 78.15% pre-simulation to 91.6% post-simulation.Knowledge was the main independent predictor of clinical performance in responding to a virtual deteriorating patient R2=0.090, F(7, 352)=4.962, p<0.001. Discussion: The use of web-based technology allows simulation activities to be accessible to a large number of participants and completion rates indicate that 'Net Generation' nursing students were highly engaged with this mode of learning. Conclusion: The web-based e-simulation program FIRST2ACTTM effectively enhanced knowledge, virtual clinical performance, and self-assessed knowledge, skills, confidence, and competence in final-year nursing students. © 2015 Elsevier Ltd.
Best practice in clinical simulation education − are we there yet? A cross-sectional survey of simulation in Australian and New Zealand pre-registration nursing education
- Authors: Bogossian, Fiona , Cooper, Simon J. , Kelly, Michelle , Levett-Jones, Tracy , McKenna, Lisa , Slark, Julia , Seaton, Philippa
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 3 (2018), p. 327-334
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- Description: Background: Simulation is potentially a means of increasing clinical education capacity. Significant investments have been made in simulation but the extent to which this has improved uptake, quality and diversity of simulation use is unclear. Aim: To describe the current use of simulation in tertiary nursing education programs leading to nurse registration Australia and New Zealand, and determine whether investments in simulation have improved uptake, quality and diversity of simulation experiences. Methods: A cross sectional electronic survey distributed to lead nursing academics in programs leading to nurse registration in Australia and New Zealand. Findings: 51.6% of institutions responded and reported wide variation in allocation of program hours to clinical and simulation learning. Simulation was embedded in curricula and positively valued as an adjunct or substitute for clinical placement. While simulation environments were adequate, staff time, training and resource development were barriers to increasing the quality, amount and range of simulation experiences. Quality assurance and robust evaluation were weak. Discussion: Simulation program hours are inconsistently reported and underutilized in terms of potential contribution to clinical learning. Benefits of capital investment in simulation physical resources have been realised, but barriers persist for increasing high quality simulation in nursing programs. Conclusion: Transitioning components of clinical education from the clinical to tertiary sectors has resource implications. Establishment of sustainable, high quality simulation experiences requires staff training, shared resources, best practice and robust evaluation of simulation experiences in nursing curricula. © 2017 Australian College of Nursing Ltd
A cross-sectional survey of nursing students' patient safety knowledge
- Authors: Levett-Jones, Tracy , Andersen, Patrea , Bogossian, Fiona , Cooper, Simon J. , Guinea, Stephen , Hopmans, Ruben , McKenna, Lisa , Pich, Jacqui , Reid-Searl, Kerry , Seaton, Philippa
- Date: 2020
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 88, no. (2020), p.
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- Description: Background: Knowledge provides a foundation for safe and effective nursing practice. However, most previous studies have focused on exploring nursing students' self-reported perceptions of, or confidence in, their level of patient safety knowledge, rather than examining their actual levels of knowledge. Objective: The overarching objective of this study was to examine final year nursing students' levels of knowledge about key patient safety concepts. Design: A cross-sectional design was used for this study. Data collection was undertaken during 2018 using a web-based patient safety quiz with 45 multiple choice questions informed by the Patient Safety Competency Framework for Nursing Students. A Modified Angoff approach was used to establish a pass mark or ‘cut score’ for the quiz. Setting and participants: Nursing students enrolled in the final year of a pre-registration nursing program in Australia or New Zealand were invited to participate in the study. Results: In total, 2011 final year nursing students from 23 educational institutions completed the quiz. Mean quiz scores were 29.35/45 or 65.23% (SD 5.63). Participants achieved highest scores in the domains of person-centred care and therapeutic communication, and lowest scores for infection prevention and control and medication safety. Based on the pass mark of 67.3% determined by the Modified Angoff procedure, 44.7% of students (n = 899) demonstrated passing performance on the quiz. For eight of the institutions, less than half of their students achieved a passing mark. Conclusions: Given the pivotal role that nurses play in maintaining patient safety, the results from this quiz raise important questions about the preparation of nursing students for safe and effective clinical practice. The institutional results also suggest the need for increased curricula attention to patient safety. © 2020 Elsevier Ltd
Clinical placements in contemporary nursing education: Where is the evidence?
- Authors: McKenna, Lisa , Cant, Robyn , Bogossian, Fiona , Cooper, Simon J. , Levett-Jones, Tracy , Seaton, Philippa
- Date: 2019
- Type: Text , Journal article , Editorial
- Relation: Nurse Education Today Vol. 83, no. (2019), p.
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- Description: Clinical practice is fundamental to the learning of undergraduate and entry-level nursing students. It provides the milieu whereby students apply classroom theory and simulated practice to the real world of nursing and become socialised into the profession. In contemporary nursing education, there is often competition among tertiary education providers to locate quality, appropriate placements; substantial costs may be incurred to access suitable placements.