The effects of simulation-based resuscitation training on nurses' self-efficacy and satisfaction
Introduction
Timely and appropriate response to a cardiac arrest patient is very important for nurses who are usually the first responders in clinical emergencies. Resuscitation tasks, such as airway rescue, chest compression, defibrillation, and drug administration, need to be integrated in a coordinated sequence of actions for optimal survival rate of the victim (Travers et al., 2010). However, many health care providers are not delivering high-quality resuscitation skills in actual clinical settings (Chan et al., 2008), and nurses' knowledge and skill retention of resuscitation is reported to be poor (Hamilton, 2005, Oh and Han, 2008, Smith et al., 2008). Therefore, it is essential that effective instructional strategies are implemented to ensure high-quality resuscitation performance.
Resuscitation training remains a vital part of nursing education to supplement real-life experiences, and ensure that nurses feel and act competently when faced with a cardiac arrest victim (Hamilton, 2005). This era of emphasis on patient safety combined with a current health care climate that includes duty hour restrictions and inexperience to high-risk clinical situations, makes simulation-based training of resuscitation an appealing technique to augment clinical experience, maximize learning, and limit the frequency and impact of medical errors (Weinstock et al., 2005). Simulation-based training can be targeted to the needs of the learner, allowing multiple practice attempts. It also provides opportunities for objective feedback on performance allowing learners to evaluate their performance in detail.
Although research has demonstrated the usefulness of simulation-based resuscitation training for other health care providers and students, there is little research examining the efficacy of simulation when used as an instructional strategy for nurses. The purpose of this study was to evaluate the efficacy of simulation-based resuscitation training using two modalities for nurses by measuring self-efficacy and satisfaction. Through this knowledge, we could provide evidence demonstrating the efficacy of simulation modalities for improving nurses' resuscitation skills retention.
Section snippets
Background
There are several different modalities that can be used in simulation training, and depend on the target learner, learning objectives, desired outcomes, and available resources. These include a simple part-task or procedural trainers, part or whole body mannequins, whole body computer driven patient simulators, and computer based or on-line simulators.
Research shows that simulation is an effective tool in resuscitation education to identify deficiencies in skills or to use as an instructional
Design
This was a comparison study with random assignment to two simulation-based training modalities: computer-based simulation with MicroSim® or mannequin-based simulation with SimMan® (Fig. 1). A cardiac arrest simulation module was designed based on the Simulation Model Framework (Jeffries, 2005).
Participants
In order to determine sample size, we calculated that 21 participants would be required in each group for an effect size of 0.85 with 80% power at a significance level of 0.05 for t-test using G*Power 3 (
Educational Interventions
All 38 qualified nurses who enrolled in a nursing course received a one-hr lecture plus one-hr task training before a week of simulation in June 2009. This course consisted of the lecture on the principles and algorithm of ALS of a cardiac arrest patient, and the task training on ALS skills, such as cardiac compression, ventilation, and defibrillation. An instructor who had expertise in emergency nursing and ALS led both lecture and task training. Afterward, we randomly assigned the nurses to
Procedures
Ethical approval was granted by the Ethic Committee of College of Nursing. All participants agreed to participate in the study and signed the informed consent form that was assured of anonymity. All nurses completed the baseline knowledge quiz before the simulation, self-administered self-efficacy and learner satisfaction tool after completing the simulation session. Nurses in mannequin-based simulation also completed a self-efficacy and satisfaction questionnaire on overall team performance.
Data Analysis
We used descriptive and t-test statistics with SPSS version 16.0 program (SPSS Inc, Chicago, IL). The level of significance was set at .05 for all tests.
Results
Baseline characteristics of participants and its comparison between computer-based and mannequin-based simulation group are presented in Table 1. There were no statistically significant differences between the groups in demographics regarding age, work duration, position, and work unit. There were no statistically significant differences between the groups in prior simulation experiences (χ2 = .396, p = .529), and baseline knowledge (7.80 ± 1.11 versus 7.79 ± 1.99, t = .020, p = .984).
The mean scores of
Discussion
The present report adds to our understanding of simulation-based resuscitation training by assessing nurses' self-efficacy and satisfaction. This study is the first among nurses in Korea to evaluate the self-efficacy and satisfaction between two different types of training modalities, computer-based and mannequin-based simulations.
The results of this study indicated that self-efficacy after simulation-based training was not different between the two training modalities. Our results are
Conclusions
Resuscitation training for patient safety is needed for practicing nurses who are often the first responders in clinical emergencies to decrease decay of knowledge, skills, gain proficiency and improve self-efficacy in resuscitation. Simulation-based resuscitation training allows participants to experience an emergent critical situation, take action, and review consequences of choices without jeopardizing patient safety. This study demonstrated that nurses who participated in simulation-based
Acknowledgments
The authors are thankful to Dr. S. Barry Issenberg, Michael S. Gordon Professor of Medicine at the University of Miami, for his support, guidance and amendments to the manuscript.
References (35)
- et al.
The effectiveness of high fidelity simulation on medical-surgical registered nurses' ability to recognise and respond to clinical emergencies
Nurse Educ Today
(2011) - et al.
Improving learning of airway management with case-based computer microsimulations Clinical Simulation in Nursing
(2010) - et al.
Evaluating the efficacy of simulators and multimedia for refreshing ACLS skills in India
Resuscitation
(2010) - et al.
Nurses' behaviour regarding CPR and the theories of reasoned action and planned behavior
Resuscitation
(2002) E-learning in resuscitation training — students say they like it, but is there evidence that it works?
Resuscitation
(2010)- et al.
Resuscitation education: narrowing the gap between evidence-based resuscitation guidelines and performance using best educational practices
Pediatric Clinics of North America
(2008) - et al.
Using e-learning for maintenance of ALS competence
Resuscitation
(2009) - et al.
Learning by computer simulation does not lead to better test performance than textbook study in the diagnosis and treatment of dysrhythmias
Journal of Clinical Anesthesia
(2002) - et al.
Comparison of multi-mode simulation and SimMan® simulation on evaluation of nursing care for patients with dyspnea
The Journal of Korean Academic Society of Nursing Education
(2010) Simulation in resuscitation training
Resuscitation
(2007)
The effect of pre-course e-learning prior to advanced life support training: a randomised controlled trial
Resuscitation
Evaluation of staff's retention of ACLS and BLS skills
Resuscitation
Determinants of the quality of basic life support by hospital nurses
Resuscitation
Effects of Advanced Cardiac Life Support Simulation-based Training on Nurses' Competence in Critical Care Settings. Unpublished Master thesis
Benefits of computer screen-based simulation in learning cardiac arrest procedures
Medical Education
Simulation-based learning in nurse education: systematic review
Journal of Advanced Nursing
Delayed time to defibrillation after in-hospital cardiac arrest
American Heart Association National Registry of Cardiopulmonary Resuscitation Investigators. The New England Journal of Medicine
Cited by (73)
Interprofessional simulation with nursing and occupational therapy students: Comparing a virtual and in-person event
2023, Journal of Interprofessional Education and PracticeIdentifying contributing factors influencing pediatric nurses' and health professionals' self-reported collaborative practice behaviors
2022, Journal of Pediatric NursingSimulations with Standardized Patients for Nursing Students in Preparation for Clinical Placements in Mental Health Care
2021, Clinical Simulation in NursingEffectiveness of simulation-based cardiopulmonary resuscitation training programs on fourth-year nursing students
2021, Australasian Emergency CareCitation Excerpt :Low-fidelity models are static models or task trainers primarily made of rubber body parts and are used for the practice of clinical skills such as urinary catheterization and basic life support [14]. It is noted that simulation-based CPR education improved the self-efficacy and satisfaction of nurses [15]. Furthermore, studies have shown that nursing students were highly satisfied with the use of simulation [7,8,16].