International Nursing Education Partnership for Care of an Aging Population: Simulation and Clinical Judgment Development

Johnson, Elizabeth

Monday, 31 October 2011: 2:05 PM

Elizabeth Johnson, PhD, RN¹
Kathie Lasater, EdD, RN, ANEF²
Ronnie Meechan, RNA, RNMH, BSc, MSc³
Linda Siktberg, PhD, RN¹
Stephanie Sideras, RN, PhD⁴
Kay Hodson Carlton, EdD, RN, FAAN¹
Nancy L. Dillard, DNS, RN¹
(1)School of Nursing, Ball State University, Muncie, IN
(2)School of Nursing, Oregon Health & Science University, Portland, OR
(3)Institute HSC & P, Nursing/Midwifery/Pre-hospital and Emergency Care, University of Worcester, Worcester, United Kingdom
(4)School of Nursing, Oregon Health Science University, Ashland, OR

Learning Objective 1: The learner will be able to describe how an international nursing education partnership used clinical simulation to educate future nursing leaders about older adult care.

Learning Objective 2: The learner will be able to identify the impact of clinical simulation using expert role modeling on clinical judgment development in international nursing students.

Purpose: The aging worldwide population challenges educators to train larger numbers of health care leaders skilled in geriatric care (World Health Organization). Although clinical simulation is used internationally to educate future nursing leaders, evidence linking simulation and clinical judgment is lacking. For nurses, clinical judgment development is critical to meeting the WHO challenge. The purpose of this international multi-site study was to determine the effect of expert role modeling on students’ clinical judgment in the care of a simulated geriatric patient.

Methods: A three-part unfolding clinical simulation of a geriatric patient with a hip fracture was implemented at four diverse US schools and one UK school (N = 221 US students, N = 54 UK students). Students at each site were assigned to treatment or control groups and randomized to nursing roles within each part of the simulation. Treatment groups viewed a video of an exemplar nurse. A digital toolkit minimized variations between sites.

Results: Using the Lasater Clinical Judgment Rubric, trained observers rated student clinical judgment from video recordings of the simulations. Kruskal-Wallis analysis resulted in significant differences between the treatment and control groups for three of four clinical judgment dimensions for all schools: noticing (p < .001), interpreting (p < .001), and responding (p < .001). Significant differences (p < .001) in student perceived satisfaction with the simulation were found between treatment and control groups only for UK students.

Conclusion: Findings suggest that clinical simulation with exposure to expert role modeling may contribute to improved clinical judgment development in the care of older patients. Differences in perceived satisfaction between UK and US schools may be related to differences in international nursing programs. International partnerships offer the potential for discovering best practices in nursing education and meeting the health care challenges of an aging worldwide population.

See more of: Creating and Utilizing Evidence for the Aging Population
See more of: Oral Paper & Poster: Science Sessions