School of Nursing, Indiana State University, United States of America.
Department of Biostatistics and Health Data Science, Indiana University, United States of America.
Nurse Educ Today. 2023 Dec;131:105960. doi: 10.1016/j.nedt.2023.105960. Epub 2023 Sep 4.
Adverse drug events, which occur at various stages of the medication preparation and administration process, cause over half a million injuries or deaths yearly. Upon graduation, prelicensure nursing students lack the skill and competency required for safe medication administration. Therefore, it is essential to ascertain their medication administration proficiency throughout their curriculum prior to participation in clinical experiences. Historically, this has been a deeply embedded process of high-stakes testing. Aligned is cognitive test anxiety which can severely limit a student's performance. Thus, nursing student competency and control appraisal in medication administration can be linked to the Control Value Theory framework.
The purpose of the research was to determine whether an e-simulated high-stakes medication administration test was associated with less anxiety than a standard high-stakes medication math assessment within and between two nursing tracks over three semesters to capture sequencing of medical-surgical clinical courses.
The prospective, quantitative, longitudinal study received Institutional Review Board approval.
PARTICIPANTS/SETTING: Students were recruited from a traditional BSN track and an online LPN-to-BSN track per course level over three semesters.
Participants completed the State-Trait Anxiety Inventory prior to their course level high-stakes assessment modality.
For both tracks, testing anxiety remained a factor with no significant difference in the anxiety level between assessment modalities. There was a trend for anxiety scores to slightly decrease over time with each testing modality, but results were non-significant. There was a trend for traditional BSN students (n = 435) to have slightly lower anxiety scores than the LPN-to-BSN (n = 246) students.
Researchers must continue investigating teaching, learning, and testing modalities in medication calculation/administration that maintain rigor, enhance student self-efficacy, and provide accurate assessment. These can be aligned with research regarding study skills training and cognitive-behavioral interventions to help mitigate the challenge of cognitive test anxiety.
药物准备和给药过程的各个阶段都会发生药物不良事件，每年导致超过 50 万人受伤或死亡。毕业后，获得执照前的护理学生缺乏安全给药所需的技能和能力。因此，在参与临床经验之前，必须在整个课程中确定他们的给药能力。从历史上看，这是一个根深蒂固的高风险测试过程。与之相关的是认知测试焦虑，它会严重限制学生的表现。因此，护理学生在给药方面的能力和控制评估可以与控制价值理论框架联系起来。
本研究的目的是确定电子模拟高风险给药测试是否比标准高风险给药数学评估在两个护理轨道内和之间在三个学期内更能减轻焦虑，以捕捉医疗外科临床课程的顺序。
这项前瞻性、定量、纵向研究获得了机构审查委员会的批准。
参与者/设置：学生从传统的 BSN 轨道和在线 LPN 到 BSN 轨道按课程级别在三个学期内招募。
参与者在完成课程水平高风险评估模式之前完成了状态-特质焦虑量表。
对于两个轨道，测试焦虑仍然是一个因素，两种评估模式之间的焦虑水平没有显著差异。随着每种测试模式的时间推移，焦虑评分略有下降的趋势，但结果不显著。传统 BSN 学生（n=435）的焦虑评分略低于 LPN 到 BSN 学生（n=246）。
研究人员必须继续研究药物计算/管理的教学、学习和测试模式，这些模式保持严谨性，增强学生的自我效能感，并提供准确的评估。这些模式可以与研究学习技能培训和认知行为干预相结合，以帮助减轻认知测试焦虑的挑战。
