The Application Of High-fidelity Simulation Teaching In Training For Undergraduate Nursing Students Before Clinical Practice

ObjectiveThe purpose of this study was:(1)To develope a teaching program ofhigh-fidelity simulation for the training of nursing students before clinical practice;(2)Implementing the high-fidelity simulation teaching program,and comparing withthe traditional teaching method,aiming to explore the effects of high-fidelitysimulation education,;(3) At last,sum up the experiences and provide a basis for thefuture conducting high-fidelity simulation teaching。Method60 volunteer participants from 2007 undergraduate session who will start theclinical practice were investigated. They were divided randomly into two groups.Experimental group was trained by 20 hours of high-fidelity simulation training andthe control group received 20 hours of traditional teaching with the same teachingcontents. Before and after the training, the Objective Structured Clinical Examinationwas used to assess the ability of the 60 nursing students respectively. In addition, afterthe training,the feedback questionnaires was used to survey the comments andsuggestions of 30 students who participated in high-fidelity simulation teachinggroup.The SPSS12.0 statistical software was adopted to analysis the data with themethods including statistical description, t-test and so on。Results1,the results of OSCE examination(1)The OSCE results of the two groups before training:There were no significantdifferences between the two groups(p>0.05).(2)The comparison on the OSCE results of high-fidelity simulation teachinggroup before and after training There were significant differences(p<0.05). Aftertraining, the OSCE results including the overall group ability,nursing inquiry,nursingbody examination,case documentation,nursing diagnosis,nursing plan,writtenhealth education,oral health education,critical thinking,professional attitude of high-fidelity simulation teaching group imprived.(3)The comparison on the OSCE results of traditional group before and aftertraining There were significant differences(p<0.05) ;After training,the OSCE resultsof traditional group including case documentation,nursing diagnosis,nursing plan,written health education,critical thinking improved.(4)The comparison on the OSCE results of high-fidelity simulation teachinggroup and traditional teaching group after training There were significantdifferences(p<0.05):The ability of high-fidelity simulation teaching group were higherthan traditional group in the group comprehensive capacity,nursing inquiry,nursingbody examination,oral health education,professional attitude; But in critical thinkingassessment , there were no significant difference.(p>0.05).2. The results of feedback survey(1)The evaluations and recommendations of students to teachers: More than 90%students had a positive attitude towards teachers. But they hoped that teachers couldcontinue enriching their clinical experience, implementing more clinical experience inthe course. They advised that teachers can participate in the patient care in order toenhancing the interaction between each other.(2) self evaluation and recommendations:More than 50% students realized thatthey did not make enough preview before class. They hoped that teachers could takesome measures to urge the students to preview.(3)The evaluations and recommendations of students to simulation case design:30% students considered that the simulation case was difficult. Many studentssuggested that teachers can adjust the difficulty range according to the understandingof students about the contents. 33.3% of students thought that the simulation wassimulated highly, and teachers should design the simulation more realistically. Besides,the teaching hours was reasonable and they proposed that teachers should adjusted theteaching hours according to the teaching contents, ensuring adequate discussion andpractice time.(4)The evaluations and recommendations of students to simulation teachingmethod implementation: 66.7% students thought the best time to carry out simulationteaching is in combination with the teaching program and courses could be carried inthe following order:classroom teaching, clinical practice, simulation teaching.(5)The evaluations and recommendations of students to the effects of simulationteaching:After attending the simulation teaching, more than 90% students found their lackage of knowledge and skills. It promoted them to integrate knowledge andpractice, and has a great effect on their communication skills, clinical thinking,teamwork and emergency aid abilities.Conclusion:This training had a good result. The OSCE indicated that the high-fidelitysimulation teaching has more advantage than traditional teaching. It is helpful toimprove the comprehensive ability of nursing students. But we should sum upexperiences in the authenticity of the simulation teaching,the difficulty of carryingout the simulation teaching,the suitable time to carried out simulation teaching, andexchange with other institutions.Suggestions:(1)Teachers should enrich their clinical experience further, and make moreinteraction with students;(2)For the lack of simulation teaching authenticity, teachersshould make more efforts to know the effects and function of the simulator, and theteacher-standardized-patients also play an important role in teaching;(3) Thesimulation teaching should be carry out adapted to theoretical courses;(4)Teachersshould have an overall understand of the students condition, and change the difficultyof the simulation in time;(5)Simplify the information provided in the student teachingcase;(6)Exchange with other institutions as more as possible.