Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Resuscitation. 2012 Mar;83(3):395-8. doi: 10.1016/j.resuscitation.2011.08.021. Epub 2011 Sep 24.
A simulation program was implemented in a pre-registration nursing curriculum for developing nursing students' performances in assessing, managing and reporting in relation to patients with physiological deterioration.
To explore nursing students' experiences of how a simulation programme has prepared them to transfer their performance to clinical practice, in their encounters with deteriorating patients in ward.
A qualitative study using a critical incident technique was conducted. After they had undertaken a simulation program, fifteen undergraduate nursing students, who had encountered deteriorating patients in their clinical practicum in wards were interviewed using semi-structured questionnaires. Content analysis was used to analyse the data.
Four main themes emerged describing key factors influencing the transfer of simulation learning to clinical practice; memory, involving simulation learning enhanced storage and retrieval of knowledge; mnemonics as transfer tools for performing systematic physical assessment and reporting a patient's deterioration to a doctor; recognizing similar situations, where students used experiences from similar simulation situation to identify problems and initiate nursing interventions for their patients; and finally, emotional responses, that have both negative and positive impacts on transferring their simulation learning. Two other main themes emerged regarding strategies to facilitate transfer; self-directed learning for promoting the retention of simulation learning; and, realism, where simulated patients could be used to provide real-life clinical experiences.
The findings provide an understanding of how a simulation program may impact on the nursing students' performances in clinical practice, which is useful information for future improvement of programmes to optimize learning and transfer effective care to patient care settings.
在注册护士课程中实施了一项模拟计划，以培养护理学生在评估、管理和报告与生理恶化患者相关方面的表现。
探讨护理学生的经验，即模拟计划如何使他们为将其表现转移到临床实践中做好准备，以便在病房中遇到恶化的患者。
采用关键事件技术进行定性研究。在完成模拟计划后，对 15 名在病房临床实习中遇到恶化患者的本科护理学生进行了半结构化问卷访谈。采用内容分析法对数据进行分析。
描述了影响模拟学习向临床实践转移的关键因素的四个主题；记忆，涉及模拟学习增强了知识的存储和检索；助记符作为执行系统身体评估和向医生报告患者恶化的转移工具；识别类似情况，学生使用类似模拟情况的经验来识别问题并为患者启动护理干预；最后，情绪反应，对转移模拟学习既有正面影响，也有负面影响。另外两个主题是关于促进转移的策略；自主学习促进模拟学习的保留；以及现实性，模拟患者可以用于提供真实的临床体验。
研究结果提供了对模拟计划如何影响护理学生在临床实践中的表现的理解，这对于未来改进计划以优化学习和将有效的护理转移到患者护理环境中是有用的信息。
