Villanova University, M. Louise Fitzpatrick College of Nursing, Creighton University, College of Nursing, 222 Criss II Bldg., 2500 California Plaza, Omaha, NE 68178, United States.
Villanova University, M. Louise Fitzpatrick College of Nursing, 322 Driscoll Hall, 800 Lancaster Ave, Villanova, PA 19085, United States.
Nurse Educ Today. 2019 Feb;73:23-30. doi: 10.1016/j.nedt.2018.11.003. Epub 2018 Nov 14.
Palliative care education and experience are needed for student competence in delivering high-quality palliative nursing care. Simulation has been linked to acquired clinical competency among pre-licensure students. A known literature gap is measurement of students' performance during end-of-life simulations.
The aim of this study was to determine relationships among previous palliative care nursing experience, knowledge, self-awareness, and performance in nursing students during an end-of-life simulation.
DESIGN/SETTING/PARTICIPANTS: A quasi-experimental pretest/posttest design was used to assess these variables with a convenience sample of 75 senior nursing students during an end-of-life simulation at a Midwest Jesuit university.
Self-awareness was measured with the Frommelt Attitudes Toward Care of the Dying, Form B. The Palliative Care Quiz for Nursing measured participants' knowledge. Participants' performance during the simulation was measured using a modified version of the Creighton Competency Evaluation Instrument®. Palliative care nursing self-awareness and knowledge were assessed before and after the simulation. Previous end-of-life care experience was assessed with a single demographic question at pretest only.
The sample was highly experienced in end-of-life care (93.3% reporting experience pre-simulation). Although pretest self-awareness (M = 124.5; ±1.3) and knowledge (M = 57.1%; ±2.2) were higher in students with two or more types of end-of-life experience (n = 42), there were no significant differences (p > .10) in these outcomes by groups pre- or post-simulation. Self-awareness (M = 130.1; ±1.2), knowledge (M = 80.5%; ±2.6), and performance (M = 94.1%; IQR 87.5 to 100) scores were high for student participants (n = 36) post-simulation, with moderate correlations found between some scores (r < -0.40 or 0.40).
Findings support self-awareness and knowledge as antecedents of high quality palliative nursing care. Students demonstrated increased post-simulation knowledge, self-awareness, and quality performance of palliative nursing care regardless of previous end-of-life experience. End-of-life simulation is supported as an education method for increasing palliative care nursing competence and assessing student performance of palliative care nursing interventions.
学生要提供高质量的姑息护理，就需要接受姑息护理教育并积累经验。模拟教学已被证明与护理专业学生的临床能力习得有关。目前，文献中存在一个空白，即缺乏对临终模拟中学生表现的衡量。
本研究旨在确定姑息护理经验、知识、自我意识与护理学生在临终模拟中的表现之间的关系。
设计/设置/参与者：采用准实验前后测试设计，在中西部耶稣会大学对姑息护理经验进行临终模拟，使用方便样本对 75 名护理专业高年级学生进行评估。
使用 Frommelt 临终关怀态度量表 B 版评估自我意识，使用姑息护理护理知识测试评估参与者的知识。使用修改后的 Creighton 能力评估工具®评估参与者在模拟中的表现。姑息护理护理自我意识和知识在模拟前后进行评估。临终关怀经验仅在预测试时通过单一的人口统计学问题进行评估。
该样本在临终关怀方面经验丰富（93.3%的学生报告在模拟前有相关经验）。尽管具有两种或两种以上临终关怀经验的学生（n=42）的预测试自我意识（M=124.5；±1.3）和知识（M=57.1%；±2.2）较高，但预模拟或后模拟组之间这些结果没有显著差异（p>.10）。后模拟组学生的自我意识（M=130.1；±1.2）、知识（M=80.5%；±2.6）和表现（M=94.1%；IQR 87.5 至 100）得分较高，且某些得分之间存在中度相关性（r < -0.40 或 0.40）。
研究结果支持自我意识和知识是高质量姑息护理的前提。无论学生是否有临终关怀经验，模拟教学都能提高学生的知识、自我意识和姑息护理护理质量。临终模拟教学支持作为增加姑息护理护理能力和评估姑息护理护理干预措施学生表现的教育方法。
