Utilizing Formative and Summative Student Course Evaluations to Improve a Simulation-Based Nursing Course

Sunday, November 1, 2009

Cynthia Blum, PhD, RN, CNE
Candice L. Palmer, MSN, RN
Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL

Learning Objective 1: Use formative assessment as a means to improve course outcomes through specific problem identification

Learning Objective 2: evaluate simulation as a learning modality for beginning nursing students

The purpose of this research study is to determine how a foundational nursing course could be enhanced through student participation and feedback.  The course design incorporated simulation in the classroom for all students as well as for two-thirds of the group in their lab instruction. The other third of the group participated classroom simulation with lab course design using traditional methods of faculty demonstration and practice on task trainers and partial body manikins. Mid-curricular and end of the semester focus groups for all students allowed the researchers/faculty to incorporate student feedback within the remainder of the didactic course instruction and lab. This research was reviewed by the university Institutional Review Board and participant consents were obtained.
            Sixty-one first semester baccalaureate nursing students enrolled in a nursing skills and assessment didactic course participated in this study with 3 smaller groups of 20-22 students in either a control or an experimental group for their lab instruction.  A live, ongoing simulation scenario was broadcast into the didactic course at the beginning of the course period that complimented the daily instructional material. Students saw a demonstration of nursing skills and associated nursing assessment within a context of unanticipated events and changes in health status. This scenario was based on realistic patient experiences which were sometimes complicated by family presence. After the simulation was broadcast, the course faculty engaged all students in discussion of what they had observed.  The weekly simulation scenario from the didactic course became the basis for the weekly lab scenario where students in the experimental group were expected to practice and demonstrate a beginning level of competence. At midterm and in the final week of the course, students voluntarily engaged in focus groups to discuss and evaluate this method of instruction.
             Focus group discussion from students and faculty has been complimentary of simulation-based instruction as preparation for hospital based nursing courses. In response to a frequent expressed student concern that nursing assessment was not demonstrated with consistency between the lab groups, a full nursing assessment based on the weekly content was immediately incorporated into the weekly didactic course simulation. Excessive wait time for lab simulation prompted course faculty to obtain another simulator and run two scenarios simultaneously. This immediate response to student concerns was acknowledged and appreciated by students during the final focus groups encouraging additional feedback at that time. Students also had an opportunity for clarification of questions related to original course design which prompted input into future consideration of changes and possible course enhancements.