Paper
Saturday, July 14, 2007
The Effectiveness of Simulation on Self Efficacy and Medication Administration Safety for Undergraduate Nursing Students
Sandra J. Goldsworthy, MSc, RN, CNCC1, Kimberley Sears, MN, RN1, and William Goodman, PhD2. (1) Nursing, Durham College, Oshawa, ON, Canada, (2) Faculty of Business and Information Technology, University of Ontario Institute of Technology, Oshawa, ON, Canada
| Learning Objective #1: Describe the benefits of simulation education in improving medication safety competency in undergraduate nursing students. |
| Learning Objective #2: Discuss the importance of simulation education in increasing self efficacy in undergraduate nursing students. |
To manage the serious hazard of medication errors in hospitals, nurses play a double role: Many medication errors are attributed to nursing administration. On the other hand, nurses can prevent potential errors—initiated elsewhere during prescription or preparation .
This experimental study examined whether the use of clinical simulation in nurse training could help reduce medication error. It also studied whether the self efficacy of student nurses increased, if they had experience with simulations. Focus groups helped clarify understanding of the variables.
Fifty-four student volunteers were randomly assigned to Experimental (treatment) groups (24 students) or Clinical Control groups (30 students). The treatment replaced some early-term clinical placement hours with time in Simulations. The control group had all normally scheduled hours. Treatment occurred prior to opportunities for administering medications.
The experiment controlled for type of placement: Medical/surgical (26 students) or Maternal (28). Simulations included Laerdal and Virtual case scenarios.
All students increased in Self-Efficacy over the term. The simulation-intervention apparently contributed to this improvement—and possibly increased it. Additional evidence is needed to confirm this.
There is compelling evidence that students in Clinical generate fewer Medication Errors if the Simulation-treatment has been administered. Experimental records included data about the Group (Experimental or Control), and Unit Type, for each observed incident. (Incidents are near-misses, since clinical supervisors intervened.) Results were highly significant (p < 0.01). Of 31 reported medical errors, both Chi-square and simulation-based tests confirmed that, for both Med/Surg and Maternal placements, the students receiving the intervention recorded fewer errors (7 errors, overall) than the controls (24 errors, overall).