The purpose of this presentation is to discuss the impact of a hybrid nursing education certificate program on Guyanese nurse tutor self - reported confidence and competence related to the use of simulation in nursing education. In response to a dire nursing shortage the Guyanese government increased the enrollment capacity for the Guyana Schools of Nursing. Guyanese nursing schools are experiencing decreased student retention and successful completion of the national licensure exam in part due to an inadequate number of experienced tutors(educators). In an effort to address these concerns an agreement with Guyana’s Ministry of Health and the Pan American Health Organization (PAHO) Regional Office in Guyana, and the School of Nursing was made to offer a Nursing Education Certificate Program. This initiative supports the objective to educate and develop human resources in nursing. The goal for the nursing education certificate program is to provide nursing tutors with the critical knowledge and skills to provide high quality nursing education. Simulation is an educational strategy utilized extensively in nursing programs in the United States (Aebersold & Tschannen, 2013). A multi-site longitudinal study by the National Council of the State Boards of Nursing (NCSBN) (Alexander et al., 2015) found that up to 50% of clinical time could be substituted with high quality simulation with similar student learning outcomes. There is evidence, promoting the utility of simulation to enhance critical thinking, medication-administration skills, promotion of inter professional communication (Liaw, Sl, Zhou, W., Lau, T., Siau, C., & Chan, S., 2013, Pauly-O’Neill & Prion, 2013, Shin, H.,Ma, H., Park,I., Ji, E., & Kim., D., 2015). The research aim was to evaluate the effects of the Guyana Nursing Education Certificate Program on the participant’s self -reported confidence and competence in simulation knowledge and skills.
Methods:
The program consists of 4 courses that combine distance learning via weekly virtual online classes with face-to-face instruction. Faculty made four trips to Guyana to provide onsite education and support. The program was tailored to meet the specific needs of the tutors with the goal of giving participants tools to customize their own curricula. Topics included teaching and learning theory, teaching methodology, and evaluation methods. Specific simulation topics covered throughout the program comprised of the development of simulation objectives, development and implementation of simulation scenarios, incorporation of critical thinking components into simulation activities, use of standardized patients, the role of the facilitator, and the simulation debriefing process. The NCSBN guidelines for Pre licensure Nursing Programs (2015) and the International Nursing Association for Clinical Simulation and Learning Simulation standards (2013) provided the foundation for the content provided. The participants were required to develop simulation objectives, scenarios and debriefing points as part of the course assignments.
A pre/post mixed method design was utilized. Following institutional review board approval twenty-six participants were asked to complete online surveys prior to and following the certificate program. The participants were nursing tutors from four schools of nursing. The survey consists of demographic data, self -reported confidence and competence in the seven-simulation topic areas described above, and qualitative open - ended questions.
Results:
Scale analysis for the self - reported confidence and competence survey revealed a Cronbach’s alpha value of 0.98 and demonstrated good internal consistency with all item correlations greater than 0.76. Statistically significant pre – post scores were found in the participants self -reported confidence in the areas of the development of simulation objectives ( p = .002), development of simulation scenario( p=.010), implementation of scenario (p = .040), incorporation of critical thinking (p= .006), simulation debriefing(p= <.001), and role of simulation facilitator (p=.008). Pre- post scores for self reported confidence in the area of use of a standardized patient in simulation was not statistically significant (p=.075 ). Statistically significant pre – post scores were found in the participants self -reported competence in the areas of the development of simulation objectives ( p = .013), development of simulation scenario( p=.013), implementation of scenario (p = .029), incorporation of critical thinking (p= .002), simulation debriefing(p= .006), and role of simulation facilitator (p=.036). Pre- post scores for self reported competence in the area of use of a standardized patient in simulation was not statistically significant (p=.10 ).
Conclusion:
Following the completion of the nursing education certificate program for Guyanese nurse tutors, statistically significant pre-post scores were found in the participants’ self- reported confidence and competence scores in the areas of development of simulation objectives, development and implementation of simulation scenarios, incorporation of critical thinking components into the activity, the role of the simulation facilitator and the simulation debriefing process. No significant difference was noted in the post survey in the use of standardized patients in simulation education. These findings offer promise for future plans to repeat the nursing education certificate program for additional Guyanese nurse tutors to improve self reported confidence and competence in the use of simulation as a teaching modality. The increase in confidence and competence may result in an increase in the use of simulation as a teaching modality. Several study limitations exist including a relatively small number of participants and the use of self-reported data. Future offerings of the program will include an increased emphasis on the use of standardized patients for simulation and the use of “virtual” simulation modalities.
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