Kiegaldie Debra, Nestel Debra, Pryor Elizabeth, Williams Cylie, Bowles Kelly-Ann, Maloney Stephen, Haines Terry
Faculty of Health Science, Youth & Community Studies Holmesglen Institute Holmesglen Victoria Australia.
Healthscope Hospitals Australia Melbourne Victoria Australia.
Nurs Open. 2019 Jul 23;6(3):1150-1162. doi: 10.1002/nop2.318. eCollection 2019 Jul.
To describe the design, delivery and evaluation outcomes of a simulation-based educational workshop to teach a patient-centred falls prevention strategy to health professional students tasked with implementing the strategy during clinical placement.
Falls are among the most common and costly threat to patient safety. The Safe Recovery Programme (SRP) is an evidence-based, one-to-one communication approach with demonstrated efficacy at preventing falls in the postgraduate context. Simulation-based education (SBE) is commonly used to address issues of patient safety but has not been widely incorporated into falls prevention.
This study was a Pre-Post-test intervention design. Health professional students were taught how to deliver the SRP in an SBE workshop. The workshop incorporated content delivery, role-play simulations and interactions with a simulated patient. Students completed surveys immediately before and after the workshop and after clinical placement. Linear and logistic regression analysis was undertaken to identify differences within each pairwise comparison at the three time points. Qualitative free text responses underwent content analysis.
There were 178 students trained. The educational design of the programme described in this paper was highly valued by students. Following the workshop, students' falls knowledge increased and they correctly identified evidence-based strategies except bedrail use and patient sitters. Following clinical placement, fewer SBE students correctly identified evidence surrounding bed alarm use. Students became more confident about falls communication post-SBE; however, this confidence decreased postclinical placement. Motivation to implement the SRP decreased between postworkshop and postclinical placement time points.
Falls research often includes educational components but previous studies have failed to adequately describe educational methods. Students learnt about best evidence falls prevention strategies using interactive educational methodologies with a workshop viewed by students as being well-designed and assisting their learning from theory to practice.While students valued the delivery of the SRP using SBE, confidence and motivation to implement falls strategies were not sustained following clinical placement. A programme of education including SBE can be used to support the delivery of falls-based education, but further research is needed to identify what factors may influence student's motivation and confidence to implement falls prevention strategies during clinical placement.
描述一个基于模拟的教育工作坊的设计、实施及评估结果，该工作坊旨在向负责在临床实习期间实施以患者为中心的跌倒预防策略的健康专业学生传授相关策略。
跌倒是对患者安全最常见且代价高昂的威胁之一。安全康复计划（SRP）是一种基于证据的一对一沟通方法，在预防研究生阶段的跌倒方面已证明有效。基于模拟的教育（SBE）常用于解决患者安全问题，但尚未广泛应用于跌倒预防。
本研究采用前后测干预设计。健康专业学生在一个基于模拟的教育工作坊中学习如何实施安全康复计划。该工作坊包括内容讲授、角色扮演模拟以及与模拟患者的互动。学生在工作坊前后以及临床实习后立即完成调查问卷。进行线性和逻辑回归分析以确定三个时间点各两两比较之间的差异。对定性的自由文本回复进行内容分析。
共培训了178名学生。本文所述项目的教学设计受到学生高度评价。工作坊结束后，学生的跌倒知识有所增加，他们正确识别了基于证据的策略，但床栏使用和患者陪护方面除外。临床实习后，较少有参加基于模拟教育的学生能正确识别与使用床边警报相关的证据。参加基于模拟教育后，学生在跌倒沟通方面变得更有信心；然而，这种信心在临床实习后有所下降。在工作坊后到临床实习后的时间点之间，实施安全康复计划的积极性有所降低。
跌倒研究通常包括教育部分，但以往研究未能充分描述教育方法。学生通过互动式教育方法学习了最佳的基于证据的跌倒预防策略，一个被学生视为设计良好且有助于他们从理论学习到实践应用的工作坊。虽然学生重视使用基于模拟的教育来实施安全康复计划，但临床实习后实施跌倒预防策略的信心和积极性未能持续。包括基于模拟教育的教育项目可用于支持基于跌倒的教育，但需要进一步研究以确定哪些因素可能影响学生在临床实习期间实施跌倒预防策略的积极性和信心。
