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模拟给药学习对护生临床实践表现的影响:一项比较性准实验研究。

The influence of simulated medication administration learning on the clinical performance of nursing students: A comparative quasi-experimental study.

作者信息

Avraham Rinat, Shor Vlada, Kimhi Einat

机构信息

Department of Nursing, Recanati School of Community Health Professions, Faculty of Health sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.

Department of Nursing, Recanati School of Community Health Professions, Faculty of Health sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.

出版信息

Nurse Educ Today. 2021 Aug;103:104947. doi: 10.1016/j.nedt.2021.104947. Epub 2021 May 4.

Abstract

BACKGROUND

Medication administration is a main role of nurses, and by mastering this skill, medication errors can be reduced. Simulation provides a safe environment for learning and improving medication administration. Simulation design may influence the students' learning curve and ability to transfer skills into the clinical setting.

OBJECTIVE

To examine the influence of simulation-based learning of the medication administration process, on satisfaction, self-perception of preparedness, and clinical performance of students who practice simulation either individually or in a group.

DESIGN

A comparative quasi-experimental study.

SETTING

A public university in southern Israel.

PARTICIPANTS

Third-year nursing students in two consecutive academic years (78 in the individual sample and 50 in the group sample).

METHODS

Nursing students participated in a scenario-based simulation for medication administration either individually or in a group. Self-reported questionnaires evaluated participants' satisfaction with the simulation experience, and perception of preparedness before and after the simulation. Faculty members observed and evaluated participants' medication administration during the simulation and in the clinical setting. Paired t-tests were performed to compare preparedness before and after the simulation experience. Linear regression models were formulated to elicit the predictors of preparedness after simulation and evaluations for medication administration in the clinical setting.

RESULTS

The simulation experience increased participants' preparedness both when designed for an individual student and for a group of students. Simulation performance was the main contributor to the participant preparedness among the individual sample (β = 0.51, p < 0.01), whereas previous preparedness was the main contributor among the group sample (β = 0.42, p < 0.01). The association between simulation performance and clinical performance was mediated by preparedness after simulation in the individual sample, but not in the group sample.

CONCLUSIONS

Simulation improves students' preparedness for medication administration. Individual simulation also impacts clinical performance, via preparedness. Further research is needed to identify other factors that facilitate skills transfer into the clinical setting.

摘要

背景

药物管理是护士的主要职责,掌握这项技能可减少用药错误。模拟为学习和改进药物管理提供了一个安全的环境。模拟设计可能会影响学生的学习曲线以及将技能应用于临床环境的能力。

目的

探讨基于模拟的药物管理过程学习对单独或分组进行模拟练习的学生的满意度、自我准备认知及临床操作表现的影响。

设计

一项比较性准实验研究。

地点

以色列南部的一所公立大学。

参与者

连续两个学年的三年级护理专业学生(个体样本78名,小组样本50名)。

方法

护理专业学生单独或分组参与基于场景的药物管理模拟。自我报告问卷评估参与者对模拟体验的满意度以及模拟前后的准备认知。教师在模拟过程及临床环境中观察并评估参与者的药物管理操作。进行配对t检验以比较模拟体验前后的准备情况。构建线性回归模型以找出模拟后准备情况的预测因素以及临床环境中药物管理操作的评估指标。

结果

无论是针对个体学生还是学生小组设计的模拟体验,均提高了参与者的准备程度。在个体样本中,模拟操作表现是参与者准备程度的主要影响因素(β = 0.51,p < 0.01),而在小组样本中,之前的准备情况是主要影响因素(β = 0.42,p < 0.01)。在个体样本中,模拟操作表现与临床操作表现之间的关联是通过模拟后的准备程度介导的,但在小组样本中并非如此。

结论

模拟提高了学生进行药物管理的准备程度。个体模拟还通过准备程度影响临床操作表现。需要进一步研究以确定促进技能向临床环境转化的其他因素。

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