Undergraduate nursing educators encounter significant challenges in securing high-quality clinical experiences for students (Miller, 2005; Pijl-Zieber, Em M.; Kalischuk, R.G., 2011). To address growing concern about the lack of traditional clinical sites, the National Council for State Boards of Nursing (NCSBN) investigated student outcomes with varied proportions of simulation and traditional clinical experiences. The multi-site study included 666 undergraduate nursing students, and supported the effectiveness of replacing up to 50% of traditional clinical experiences with simulation learning time in content areas such as reproductive health (Hayden, Smiley, Alexander, Kardong-Edgren, & Jeffries, 2014; Alexander et al. 2015).
Given the preliminary evidence for greater use of clinical simulation in undergraduate nursing education, a large public BSN-granting school of nursing developed a program which will increase the current 8% of clinical learning time spent in reproductive health simulation to 25% beginning Summer 2016. The proposed study will use existing performance indicators, data and assignments already being tracked by the SFSU School of Nursing Simulation Program to evaluate the effectiveness of the increase in simulation training time for reproductive health undergraduate nursing students, and provide comparative data for dissemination and publication regarding the effects of this curriculum innovation on student learning and the potential for employing a greater percentage of simulation learning in other content areas and nursing curriculae.
The goal of this mixed-methods study will be to determine if increasing the proportion of clinical learning being conducted in a clinical simulation training laboratory (as opposed to in a real-life clinical setting such as a hospital) affects undergraduate nursing students’ learning in a reproductive health course.
Methods:
Design and Instruments. This mixed-methods research study compares data from 100 students in three semesters of undergraduate nursing students training under different reproductive health simulation learning curriculae (one 8%/standard and one 25%/expanded).These semesters will be comparable in student composition, previous curriculum, semester length and class size. The data consists of four components: DASH-Student Version; assessment of simulation training video recordings with the C-SEI; Kaplan OB Integrated Exam scores; and student simulation learning journal assignments. The quantitative arm of the study is a cohort-comparison observational study of instrument and exam data. The qualitative component of the study is a narrative analysis of student simulation learning journals.
Data Collection. IRB approval was secured. During standard simulation sessions, students and clinical instructors are already routinely recorded on video as part of the simulation learning process. These existing video recordings of simulation training sessions were evaluated by two researchers, the PI and Co-PI, for clinical competence using the C-SEI. Students are also already given the opportunity to complete the DASH-Student Version in hard copy form at the end of each simulation training day.
As a part of standard practices at the School of Nursing, students in the undergraduate nursing reproductive health course take a standardized assessment test every semester, the Kaplan OB Integrated Exam. The exam scores, available in deidentified and aggregated form from the Kaplan test administrators, were compiled and compared for the two semesters on a number of different indicators including theoretical knowledge and professional judgment, as explicitly measured by different exam questions. Students also complete a brief reflective journal at the end of their simulation training experience as part of the normal clinical training curriculum.
Participants/Recruitment. All data and assignments are already collected per normal educational procedures.
Data analysis. Quantitative data is being analyzed through descriptive statistics and independent samples t-tests to compare the 8%/standard simulation group and the 25%/expanded simulation group. Kaplan exam results are available in a multitude of forms to breakdown and compare different areas of student theoretical knowledge and test performance; C-SEI data is being used to compare observed student competency between the semesters; and DASH-SV survey results is being used to compare student perceptions of the simulation learning experience.
Qualitative data in the form of student simulation learning journals is being evaluated using narrative analysis and the qualitative data analysis software NVivo, which is particularly well-suited to investigations of individual perspectives on discrete experiences and often utilized in healthcare and education research (Chase, 2005).
Results:
Results are currently being finalized.
Conclusion:
Results and conclusions are forthcoming.