Nakayama Natsuki, Ejiri Harumi, Arakawa Naoko, Makino Tsuneko
Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
Department of Nursing, College of Life and Health Sciences, Chubu University, Kasugai, Japan.
Nurs Open. 2021 Mar;8(2):776-783. doi: 10.1002/nop2.680. Epub 2020 Nov 18.
The use of high-fidelity simulation practice as an educational tool is becoming increasingly prevalent in nursing education. Despite the learning effects of simulation practice, students have been shown to experience high levels of stress and anxiety during simulation. In recent years, peer learning has been defined as an acquisition of knowledge and skills through active support and support among equal or equal peers and has been shown to be an effective educational intervention for clinical health science students.
The purpose of this study was to incorporate peer learning into simulation learning and to clarify the differences between stress and anxiety during personal and peer simulations.
Third-grade undergraduate students in a four-year course at two nursing universities participated in this study. In this study, the simulated patient was a 53-year-old man who had undergone gastrectomy for the treatment of gastric cancer. The scenario was that the patient had completely recovered consciousness in the operating room, and his tracheal tube had been removed one hour before the students examined him. Stress while simulation training was evaluated with heart rate variability. Anxiety was evaluated by the STAI after the simulations were complete.
Personal simulation practice (personal group; n = 50) and peer simulation practice (peer group, n = 59) was conducted. The personal group included 7 male students, and the peer group included 12 male students; the difference in male proportion was not significant. At the first patient assessment phase, stress of heart rate variability components at the peer group significantly increased relative to that of the personal. In addition, the personal had a significantly higher state anxiety score after simulation than the peer.
This study shows that in the face-to-face scene involving vital sign measurements, the presence of peers did not objectively alleviate stress.
高保真模拟实践作为一种教育工具在护理教育中越来越普遍。尽管模拟实践有学习效果，但学生在模拟过程中仍表现出高度的压力和焦虑。近年来，同伴学习被定义为通过平等或同等同伴之间的积极支持和互助来获取知识和技能，并且已被证明是对临床健康科学专业学生有效的教育干预措施。
本研究的目的是将同伴学习纳入模拟学习，并阐明个人模拟和同伴模拟过程中压力和焦虑的差异。
两所护理大学四年制课程的三年级本科生参与了本研究。在本研究中，模拟患者是一名53岁因胃癌接受胃切除术的男性。情景设定为该患者在手术室完全苏醒，在学生检查前一小时已拔除气管导管。模拟训练时通过心率变异性评估压力。模拟结束后通过状态特质焦虑问卷（STAI）评估焦虑程度。
进行了个人模拟实践（个人组；n = 50）和同伴模拟实践（同伴组，n = 59）。个人组有7名男学生，同伴组有12名男学生；男性比例差异不显著。在首次患者评估阶段，同伴组心率变异性成分的压力相对于个人组显著增加。此外模拟后个人组的状态焦虑得分显著高于同伴组。
本研究表明在涉及生命体征测量的面对面场景中，同伴在场并不能客观地减轻压力。
