Target Audience The target audience is nurse educators, administrators, and students.
Abstract
Purpose: The nursing shortage has resulted in an increased number of students enrolled in nursing programs throughout the United States. The increased number of students entering baccalaureate nursing education programs has led to various problems associated with this growth, including the limitation of clinical learning sites and overcrowding in simulation center learning. In addition, due to the acuity level of hospitalized patients, student require a safe environment in which to learn, one in which they can make mistakes without causing harm to real patients. One creative alternative for this problem involves the use of virtual clinical simulation. Clinical simulation is considered to be an active learning strategy. Active learning strategies engage adult learners in the learning process (Benner, et al., 2010). In addition, participation in virtual clinical simulation has been studied and is considered to have demonstrated effectiveness on the development of self-confidence and self-efficacy in nursing students (Heinrich, et al., 2012; Kilmon, et al., 2010; Shin, et al., 2014). However, few studies have looked at the impact of participation in this type of learning strategy upon course content mastery (Bourke & Ihrke, 2012). This project looked to compare content mastery exam scores of students participating in a virtual clinical simulation with those of students who had not participated in order to assess the impact of the learning strategy.
Methods: Institutional Review Board (IRB) approval was sought and obtained prior to collection of study data. In order to protect student privacy a research proxy was utilized to de-identify student exam scores. Utilizing a retrospective, quantitative, nonexperimental approach to analyze data consisting of Assessment Technologies Institute (ATI) Content Mastery Series (CMS) Maternal Child exam scores of nonequivalent and non-concurrent cohorts, this project compared a total of (N=235) scores to determine if a difference existed between subjects who participated in a virtual clinical simulation learning program with those who participated in a different type of active learning strategy.
Results: The data sample used for this project was that of one of convenience. This consisted of all students who were enrolled in a maternal child nursing course, but who were not repeating the course, in either the fall, 2015 academic semester, or the summer, 2016 academic semester. The study was conducted in a traditional nursing education program located within a university which is a part of a large academic health center in the southwest region of the United States. A total of 236 students were enrolled between the two semesters, and 235 student exam scores were analyzed as one student was repeating the course in the fall, 2015 semester. Students from the summer, 2016 cohort (N= 129) slightly outnumbered those from the fall, 2015 semester (N= 106). The highest number of students (N= 198), were in the 17-25-year age group, with the lowest number (N= 3) in the 36-40-year age group. For ethnicity, the highest number of students (N= 124), were white, while the lowest number of students (N= 12) were Black/African American. Data analysis using the Mann-Whitney U test found that while there was a positive significant difference between student cohort ATI™ CMS scores, it was in favor of the cohort that did not participate in the virtual simulation learning experience; therefore no cognitive gain was demonstrated relating to participation in the virtual learning strategy.
Conclusion: Based on the results of this project, participation in virtual learning assignments by maternal child nursing students enrolled in a traditional baccalaureate nursing program at a large state university, did not impact ATI™ content mastery exam scores in a positive manner. The implications of the results from this project are important for nursing educators. The findings of this project demonstrated that student group participation in the virtual clinical simulation did not produce an increase in course content mastery as evidenced on the ATI CMS exam scores, therefore the implication is that virtual learning environments may not be the best learning strategy to promote content mastery as compared with the use of case studies. However, much of the literature found in review for this project related to student satisfaction with participation in virtual learning scenarios, and the development of confidence from participation in this type of learning activity. It is important for nursing educators to consider these implications when trying to decide on simulation methods to use when educating students based on the need to establish content mastery, or to promote confidence and self-efficacy. Dissemination of this information from this project can add to the body of knowledge pertaining to effective learning methods to promote concept mastery, and those, which may not be as effective.
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