Woda Aimee, Hansen Jamie, Paquette Mary, Topp Robert
Marquette University College of Nursing, P.O. Box 1881, Milwaukee, WI 53201-1881, USA.
Carroll University, College of Nursing, 100 N. East Avenue, Waukesha, WI 53186, USA.
Nurse Educ Pract. 2017 Sep;26:33-38. doi: 10.1016/j.nepr.2017.06.008. Epub 2017 Jun 20.
An emerging nursing education trend is to utilize simulated learning experiences as a means to optimize competency and decision making skills. The purpose of this study was to examine differences in students' perception of clinical decision making and clinical decision making-related self-confidence and anxiety based on the sequence (order) in which they participated in a block of simulated versus hospital-based learning experiences. A quasi-experimental crossover design was used. Between and within group differences were found relative to self-confidence with the decision making process. When comparing groups, at baseline the simulation followed by hospital group had significantly higher self-confidence scores, however, at 14-weeks both groups were not significantly different. Significant within group differences were found in the simulation followed by hospital group only, demonstrating a significant decrease in clinical decision making related anxiety across the semester. Finally, there were no significant difference in; perceived clinical decision making within or between the groups at the two measurement points. Preliminary findings suggest that simulated learning experiences can be offered with alternating sequences without impacting the process, anxiety or confidence with clinical decision making. This study provides beginning evidence to guide curriculum development and allow flexibility based on student needs and available resources.
一种新兴的护理教育趋势是利用模拟学习体验作为优化能力和决策技能的手段。本研究的目的是根据学生参与一组模拟学习与医院实习学习体验的顺序（次序），考察他们在临床决策认知、与临床决策相关的自信和焦虑方面的差异。采用了准实验交叉设计。在决策过程的自信方面发现了组间和组内差异。比较各组时，在基线时，先模拟后医院实习的组自信得分显著更高，然而，在14周时两组没有显著差异。仅在先模拟后医院实习的组中发现了显著的组内差异，表明整个学期与临床决策相关的焦虑显著降低。最后，在两个测量点上，组内或组间在感知临床决策方面没有显著差异。初步研究结果表明，可以交替提供模拟学习体验的顺序，而不会影响临床决策的过程、焦虑或信心。本研究为指导课程开发提供了初步证据，并允许根据学生需求和可用资源进行灵活调整。
