在虚拟或实景课堂中应对模拟灾害：BSN 学生的学习有何不同？

Responding to a simulated disaster in the virtual or live classroom: Is there a difference in BSN student learning?

机构信息

C.E. Lynn College of Nursing, Florida Atlantic University, BC84, #333, 777 Glades Road, Boca Raton, FL 33431, USA.

C.E. Lynn College of Nursing, Florida Atlantic University, BC84, 777 Glades Road, Boca Raton, FL 33431, USA.

出版信息

Nurse Educ Pract. 2021 Aug;55:103170. doi: 10.1016/j.nepr.2021.103170. Epub 2021 Aug 3.

DOI:10.1016/j.nepr.2021.103170

PMID:34388615

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8513508/

Abstract

AIM

This study aim was to investigate if prelicensure baccalaureate nursing students gained more knowledge from a live or virtual disaster simulation. The study goal was to inform the use of e-learning or traditional textbooks in undergraduate nursing population health courses.

BACKGROUND

Weather-related disasters have increased in frequency and severity in the past ten years, with 2020 being the most active storm season ever seen (National Oceanographic and Atmospheric Administration, 2021.) Even with advances in early warning systems and mitigation efforts, educating student nurses in disaster response remains a priority. Due to the impact of Covid-19 quarantine policies, many in-person student learning labs and clinical experiences were cancelled. However, virtual simulation offers an alternative to developing nursing student skills and clinical reasoning ability (Aebersold, 2018; Fogg et al., 2020).

DESIGN

A randomized quasi-experimental, repeated measures 2 × 2 crossover design (Kim, 2018) was applied, which allowed students to participate in both the live and virtual simulations.

METHODS

Analysis was conducted using paired samples t-test to evaluate knowledge gains. To measure students' self-assessment of knowledge, Unver et al. (2018) 12-item survey was administered. To explore students' own perceptions about the disaster simulations, semi-structured interview questions were offered through private Wiki postings. The responses were analyzed using Saldaña's in vivo coding (2015) and thematic analysis.

RESULTS

Students retained more empirical knowledge following the virtual assignment as compared to the disaster simulation, except in two items addressing triage. Neither age, years of education, or GPA impacted test results. However, students' own assessment of learning did not differ between live and virtual simulations. In all but three items, students perceived a significant increase (p < .05) in their learning following the simulation, regardless whether it was live or virtual. In narrative responses, students overwhelmingly cited the benefit of an in-person simulation. However, they did not believe that they were prepared adequately for the live simulation. They also expressed that they would be more prepared if the simulation was repeated. Students expressed discomfort, even distress, regarding not being able to care adequately for everyone, even though it was a simulation (See Table 5). This highlighted that live simulations can affect students emotionally, and follow-up debriefing is essential to help in both acknowledging and processing student feelings.

CONCLUSION

These findings, which support the use of virtual disaster training in nursing education, are especially important in the light of Covid-19 and increasing threat of storm disasters.

摘要

目的

本研究旨在探讨在获得执照之前的护理专业学生是否从现场或虚拟灾难模拟中获得更多知识。该研究旨在告知在本科护理人群健康课程中使用电子学习或传统教科书。

背景

在过去十年中，与天气相关的灾害发生的频率和严重程度有所增加，2020 年是有史以来最活跃的风暴季节（国家海洋和大气管理局，2021 年）。尽管在预警系统和缓解工作方面取得了进步，但对学生护士进行灾难应对教育仍然是当务之急。由于 2019 冠状病毒疾病隔离政策的影响，许多现场学生学习实验室和临床经验被取消。然而，虚拟模拟为培养护理学生技能和临床推理能力提供了一种替代方法（Aebersold，2018；Fogg 等人，2020 年）。

设计

采用随机准实验、重复测量 2×2 交叉设计（Kim，2018 年），允许学生参加现场和虚拟模拟。

方法

使用配对样本 t 检验分析知识增益。为了衡量学生对知识的自我评估，采用 Unver 等人（2018 年）的 12 项调查进行评估。为了探讨学生对灾难模拟的自身看法，提供了半结构化访谈问题，通过私人 Wiki 发布。使用 Saldaña 的现场编码（2015 年）和主题分析对回复进行了分析。

结果

与灾难模拟相比，学生在虚拟作业后保留了更多的经验知识，只有在涉及分类的两个项目中除外。年龄、教育年限或 GPA 均未影响测试结果。然而，学生对现场和虚拟模拟的学习评估没有差异。除了三个项目之外，无论模拟是现场还是虚拟，学生都认为他们在模拟后学习有了显著提高（p<0.05）。在叙述性回复中，学生压倒性地表示，现场模拟的好处是可以亲自参与。然而，他们并不认为自己对现场模拟有足够的准备。他们还表示，如果模拟重复进行，他们会有更好的准备。学生们对无法充分照顾每个人表示不适，甚至感到痛苦，尽管这只是模拟（见表 5）。这表明现场模拟会对学生的情绪产生影响，因此事后进行讨论是必不可少的，有助于学生认识和处理自己的感受。