Application of a Situation-Based Simulation e-Learning Program on Nursing Education: Using the Elderly with Delirium as an Example

Wednesday, 1 August 2012: 11:10 AM

Jeng Wang, PhD, RN
Department of Gerontological Care and Management, Chang Gung University of Science and Technology, Tao-Yau, Taiwan
Jun-Jie Lin, PhD
Department of Computer Science and Information Engineering, Chang Gung University, TaoYaun, Taiwan

Learning Objective 1: The learner will be able to understand the importance and issue of the elderly with delirium

Learning Objective 2: The learner will be able to realize the effect of applying the situated learning theory in nursing education

Purpose:  High prevalence rates of delirium have been reported in studies (22-83%). Early detection may optimize the outcomes of the delirious elderly patients. However, misdiagnosis or overlooked rates of delirium ranged form 22% to 83%.  Knowledge about delirium has not been fully highlighted in most curriculum of nursing education. The concept of delirium is abstract, so the traditional one-way teaching method may not encounter the learning needs of nursing students (NS). Therefore, the purpose of this study is to improve the ability of NS to identify those patients with delirium; a “situation-based simulation e- learning program ” was created and implemented.  

Methods:  This is a quasi-experimental study. Totally, 95 NS were involved in this study. There were 48 NS in the experimental group (gr1), and 47 in the control group (gr2). The e-learning program was given to the experimental group, but the control group attained the traditional teaching method. Pre- and post-tests were given before and after the program. The situated theory was applied in the study. Each scenario was generated based on a true clinical situation, so NS would have chance to ‘experience” the delirious patients.

Results:  There is no difference between 2 groups, in demographic data. Those in gr1 spent less time in decision making (P<0.05), and gained higher scores in identifying patients with delirium (P<0.01).The gr1 was able to distinguish patients with hypoactive subtype of delirium (p<0.001).

Conclusion:  The “situation-based simulation e- learning program” seemed to effectively improve the clinical judgment ability of NS on delirious patients. Both groups did poorly on hypoactive subtype of delirium initially, but NS in gr1 were able to more accurately identify hypoactive patients after receiving the program. Teaching abstract concept (e.g. delirium), the traditional on-way teaching did not work well. This innovated model could be a reference for similar studies or programs in the future.