Development of High-Fidelity Simulation Case Scenarios for an Undergraduate Medical-Surgical Nursing Course

Monday, July 11, 2011

Shiah-Lian Chen, PhD
Department of Nursing, Hungkuang University, Taichung, Taiwan

Learning Objective 1: The learner will be able to understand the process of developing case scenarios involving use of high-fidelity patient simulator

Learning Objective 2: The learner will be able to recognize the learning needs and learning/teaching process from students' perspectives

Purpose: The purpose of this study is to develop clinical scenarios involving use of high-fidelity patient simulation as part of the Medical Surgical Nursing course content; and to evaluate effectiveness of scenario design and learning satisfaction through action research.

Methods: The method is a technical problem-solving action research. A purposive sample was drawn from a 2-year baccalaureate nursing program in central Taiwan. The researcher develops case scenarios through action intervention, including identifying problems, planning design, carrying out plans, evaluating and reflecting on teaching and learning process, and revising the scenarios accordingly. The data was collected through various methods: literature review, focus/peer group discussions, classroom observations, interviews, assignment collection. The feasibility and effectiveness of scenarios on learning were evaluated using modified direct observation of procedural skills (DOPS) and a self-developed questionnaire of Simulation Design Inventory.  

Results: The study process was guided by the framework of designing, implementing, and evaluating simulations. Template for each scenario was developed to describe objectives, theoretical preparation, scenarios description, settings, scenario implementation procedures, evaluation and debriefing guidelines. Interrator reliabilities of the modified DOPS were above 0.92. Feasibility of implementation and learning effectiveness were all above 82%. The scenarios built on students' previous learning are comprised in a sequence from simple to complex, easy to difficult, and concrete to abstract context allowing faculty to guide students to learn from novice to proficiency. Simulation teaching will be more fruitful if scenarios are design to training competency rather than behavior.

Conclusion: The results of the study suggest simulation is a creative and useful teaching strategy to promote students' learning by doing. The learning effect of single scenario is limited. In order to achieve the best learning outcomes, topics of simulation scenarios should be delivered as an individual course rather than just integrated into, or infused into a particular course.