Alinier Guillaume, Hunt Barry, Gordon Ray, Harwood Colin
Hertfordshire Intensive Care and Emergency Simulation Centre, University of Hertfordshire, Hatfield, UK.
J Adv Nurs. 2006 May;54(3):359-69. doi: 10.1111/j.1365-2648.2006.03810.x.
The aim of this paper is to present the results of a study designed to determine the effect of scenario-based simulation training on nursing students' clinical skills and competence.
Using full-scale, realistic, medical simulation for training healthcare professionals is becoming more and more common. Access to this technology is easier than ever before with the opening of several simulation centres throughout the world and the availability on the market of more sophisticated and affordable patient simulators. However, there is little scientific evidence proving that such technology is better than more traditional techniques in the education of, for example, undergraduate nursing students.
A pretest/post-test design was employed with volunteer undergraduate students (n = 99) from second year Diploma of Higher Education in Nursing programme in United Kingdom using a 15-station Objective Structured Clinical Examination. Students were randomly allocated to either a control or an experimental group. The experimental group, as well as following their normal curriculum, were exposed to simulation training. Subsequently, all students were re-tested and completed a questionnaire. The data were collected between 2001 and 2003.
The control and experimental groups improved their performance on the second Objective Structured Clinical Examination. Mean test scores, respectively, increased by 7.18 and 14.18 percentage points. The difference between the means was statistically significant (P < 0.001). However, students' perceptions of stress and confidence, measured on a 5-point Likert scale, was very similar between groups at 2.9 (1, not stressful; 5, very stressful) and 3.5 (1, very confident; 5, not confident) for the control group, and 3.0 and 3.4 for the experimental group.
Intermediate-fidelity simulation is a useful training technique. It enables small groups of students to practise in a safe and controlled environment how to react adequately in a critical patient care situation. This type of training is very valuable to equip students with a minimum of technical and non-technical skills before they use them in practice settings.
本文旨在呈现一项研究的结果，该研究旨在确定基于情景模拟训练对护生临床技能和能力的影响。
使用全面、逼真的医学模拟来培训医护专业人员正变得越来越普遍。随着全球多个模拟中心的开放以及市场上更先进且价格合理的患者模拟器的出现，获取这项技术比以往任何时候都更容易。然而，几乎没有科学证据证明在本科护生教育等方面，这种技术比更传统的技术更优。
采用前测/后测设计，对英国高等教育护理专业二年级文凭课程的99名志愿本科生进行研究，使用15站客观结构化临床考试。学生被随机分配到对照组或实验组。实验组除了学习正常课程外，还接受模拟训练。随后，所有学生再次接受测试并完成一份问卷。数据收集于2001年至2003年期间。
对照组和实验组在第二次客观结构化临床考试中的表现均有所提高。平均测试成绩分别提高了7.18和14.18个百分点。两组均值之间的差异具有统计学意义（P < 0.001）。然而，用5点李克特量表衡量，学生对压力和信心的感知在两组之间非常相似，对照组为2.9（1，无压力；5，压力非常大）和3.5（1，非常自信；5，不自信），实验组为3.0和3.4。
中等保真度模拟是一种有用的训练技术。它使一小群学生能够在安全且可控的环境中练习如何在危急的患者护理情况下做出适当反应。这种类型的训练对于让学生在实际应用之前掌握最少的技术和非技术技能非常有价值。
