Department of Nursing, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo 663-8558, Japan; Department of Mathematical Health Science, Graduate School of Medicine, Osaka University, 1-7 Yamadaoka, Suita, Osaka 565-0871, Japan.
Department of Practical Nursing, Graduate school of medicine, Mie university, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
Nurse Educ Today. 2019 May;76:1-7. doi: 10.1016/j.nedt.2019.01.005. Epub 2019 Jan 27.
Nursing students have limited opportunities to experience end-of-life care, so it is difficult for them to learn how to deliver it empirically. The use of simulations with standardized patients may be a way to provide realistic experience of end-of-life care for nursing students.
The aim of this study was to evaluate the effectiveness of end-of-life care simulations with standardized patients in improving the knowledge, skill performance and self-confidence of undergraduate nursing students.
Randomized controlled study.
Japanese university nursing school.
Thirty-eight students in the third year of the Bachelor's degree in nursing (simulation group = 20, control group = 18).
After randomization to a simulation or control group, participants in the simulation group participated in an end-of-life care simulation with standardized patients. The primary outcome of a change in the knowledge score was assessed using a knowledge questionnaire, skill performance by completing Objective Structured Clinical Evaluations, and self-confidence related to end-of-life care by self-reported questionnaires.
The simulation group improved significantly in knowledge, skill performance in physical assessment and psychological care, and self-confidence related to end-of-life care. The results of the two-way analysis of variance showed a significant interaction between groups and time (p = 0.000). Analysis of the simple main effect showed a significant difference (p = 0.000) between groups after the end-of-life care simulation and a significant difference (p = 0.000) over time in the simulation group. There were large effects on knowledge improvement (η = 0.372), physical assessment (η = 0.619), psychological care skill performance (η = 0.588), and self-confidence in both physical assessment (η = 0.410) and psychological care (η = 0.722).
End-of-life care simulation with standardized patients would be an effective strategy to train nursing students, who have limited opportunities to experience end-of-life care.
护理专业的学生很少有机会体验临终关怀，因此他们很难通过实践学习如何提供临终关怀。使用标准化患者进行模拟可能是为护理专业学生提供真实临终关怀体验的一种方式。
本研究旨在评估使用标准化患者进行临终关怀模拟对提高护理专业本科生知识、技能表现和自信心的效果。
随机对照研究。
日本某大学护理学校。
护理专业三年级学生 38 名（模拟组 20 名，对照组 18 名）。
随机分为模拟组或对照组后，模拟组学生参与了与标准化患者的临终关怀模拟。通过知识问卷评估知识评分的变化，使用客观结构化临床评估完成技能表现评估，通过自我报告问卷评估与临终关怀相关的自信心。
模拟组在知识、身体评估和心理关怀技能表现以及与临终关怀相关的自信心方面均有显著提高。双向方差分析结果显示，组间和时间存在显著交互作用（p=0.000）。简单主要效应分析显示，临终关怀模拟后组间存在显著差异（p=0.000），模拟组的时间差异也具有统计学意义（p=0.000）。在知识提高方面具有较大效应（η=0.372），身体评估（η=0.619），心理关怀技能表现（η=0.588），以及身体评估（η=0.410）和心理关怀（η=0.722）自信心方面均具有较大效应。
使用标准化患者进行临终关怀模拟对于培训护理专业学生是一种有效的策略，因为他们很少有机会体验临终关怀。
