Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, No. 169 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China.
Department of Cardiology, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China.
BMC Med Educ. 2024 Jan 5;24(1):32. doi: 10.1186/s12909-023-04988-6.
Virtual simulation and face-to-face simulation are effective for clinical judgment training. Rare studies have tried to improve clinical judgment ability by applying virtual simulation and face-to-face simulation together. This study aimed to evaluate the effect of an integrated non-immersive virtual simulation and high-fidelity face-to-face simulation program on enhancing nursing students' clinical judgment ability and understanding of nursing students' experiences of the combined simulation.
A sequential exploratory mixed-methods study was conducted in a nursing simulation center of a university in Central China. Third-year nursing students (n = 122) taking clinical training in ICUs were subsequentially assigned to the integrated non-immersive virtual simulation and high-fidelity face-to-face simulation program arm (n = 61) or the face-to-face simulation-only arm (n = 61) according to the order in which they entered in ICU training. Clinical judgment ability was measured by the Lasater Clinical Judgment Rubric (LCJR). Focus group interviews were conducted to gather qualitative data.
Students in both arms demonstrated significant improvement in clinical judgment ability scores after simulation, and students in the integrated arm reported more improvement than students in the face-to-face simulation-only arm. The qualitative quotes provided a context for the quantitative improvement measured by the LJCR in the integrated arm. Most of the quantitative findings were confirmed by qualitative findings, including the domains and items in the LJCR. The findings verified and favored the effect of the combination of non-immersive virtual simulation and high-fidelity face-to-face simulation integrated program on enhancing nursing students' clinical judgment ability.
The integrated virtual simulation and face-to-face simulation program was feasible and enhanced nursing students' self-reported clinical judgment ability. This integrated non-immersive virtual simulation and high-fidelity face-to-face simulation program may benefit nursing students and newly graduated nurses in the ICU more than face-to-face simulation only.
虚拟模拟和面对面模拟对于临床判断培训都是有效的。很少有研究尝试通过同时应用虚拟模拟和面对面模拟来提高临床判断能力。本研究旨在评估非沉浸式虚拟模拟和高保真面对面模拟综合程序对提高护理学生临床判断能力和理解护理学生对联合模拟体验的影响。
在中国中部一所大学的护理模拟中心进行了一项顺序探索性混合方法研究。正在 ICU 接受临床培训的三年级护理学生（n=122）根据进入 ICU 培训的顺序，先后被分配到非沉浸式虚拟模拟和高保真面对面模拟综合程序组（n=61）或仅面对面模拟组（n=61）。临床判断能力通过 Lasater 临床判断量表（LCJR）进行测量。进行焦点小组访谈以收集定性数据。
模拟后，两组学生的临床判断能力评分均显著提高，综合组学生报告的提高幅度大于仅面对面模拟组学生。定性引述为综合组中通过 LCJR 测量的定量提高提供了背景。大多数定量发现得到了定性发现的证实，包括 LCJR 的领域和项目。这些发现验证并支持了非沉浸式虚拟模拟和高保真面对面模拟综合程序对提高护理学生临床判断能力的效果。
综合虚拟模拟和面对面模拟程序是可行的，并提高了护理学生自我报告的临床判断能力。这种综合的非沉浸式虚拟模拟和高保真面对面模拟程序可能比仅面对面模拟更有益于 ICU 的护理学生和新毕业的护士。
