Sunday, 28 July 2019: 9:50 AM
A STEM grant was awarded by the US Department of Education to assist in the recruitment and retention of multicultural and economically disadvantage students. Revenue from this grant was utilized to design, implement, and evaluate an evidenced-based practice nursing simulation project in an undergraduate maternal newborn nursing course. An evidence review confirmed the utility and effectiveness of simulation in nursing education (Adamson, 2015; Berndt et al., 2015; Hafaza & Brysiewicz, 2017; Miller, 2014). A systematic review of one hundred and fifty-three studies validated NLN/Jeffries Simulation Framework Variables as a valuable tool to guide and support simulation (Adamson, 2015). This framework was used to underpin the simulation project design. Simulation facilitated the demonstration of the understanding of nursing knowledge and skills obtained through instruction, critical thinking, clinical judgment, problem-solving, and clinical decision-making in a safe non-threatening environment (Hafaza & Brysiewicz, 2017). Simulation has been reported to increase cognitive knowledge, self-confidence and has the potential to have a positive effect on maternal-infant outcomes (Miller, 2014). Several studies have reported the impact of simulation included positive responses for nursing student satisfaction, self-confidence, and increase in cognitive knowledge (Adamson, 2015; Berndt et al., 2015; Bortolato-Major et al., 2018; Hafaza & Brysiewicz, 2017; Macauley et al., 2017; Miller, 2014). The purpose of this project was to facilitate student centered learning through active engagement in a simulated clinical environment. The twenty-six students enrolled in the course were from multiracial, ethnic, and cultural backgrounds. Four simulation modules and case scenarios were designed and utilized to guide 26 students through the simulations. Jeffries five design characteristics (Miller, 2014) were employed. The simulation modules and scenarios were developed according to course objectives and learning outcomes. The students were assigned pre-simulation work to help them prepare for each simulation. The simulated maternity unit was utilized to make the environment realistic, learning activities ranged from the simple to complex and cues were utilized by the faculty when necessary. Pre-brief and debriefing sessions were utilized for reflective learning. Three project outcomes were identified to determine the effectiveness of the simulation on student satisfaction and learning. The first outcome was that 80% of the students surveyed would report the modules substantially helped with learning and improved maternal newborn clinical skills. The second outcome was that there would be a ten percent increase in the standardized Maternity Specialty Exam Scores when compared to a cohort of thirty seven students who completed the same course with no simulation during the previous spring semester. The third outcome was that the students in the cohort who completed simulation would have a ten percentage increase in “A” course grade when compared to the cohort who did not complete simulation. At the end of the simulations the survey results showed 96.15% of the twenty-six students who participated in simulation reported they experienced substantial knowledge gains and improved clinical skills as a result of completing the modules and participating in the simulation scenarios. Their standardized test scores were eighty-four percent or higher. Fifty percent of them obtained “A” course grades. The cohort of thirty-seven students enrolled in the previous semester without simulation activity scored seventy-eight percent or higher on the standardized test. Forty- three percent of them achieved a course grade of "A.” Although only the first outcome was met, student centered learning through active engagement in a simulated clinical environment was achieved. Nurse educators and nursing schools must continue to utilize simulation as a learning tool to promote active learning and problem solving. The revenue from available grants to fund nursing education and nursing education research deserves consideration.