To explore the effect of an alternating Lab and Clinical instructional model on Accelerated BSN pre-licensure nursing students’ self-efficacy, readiness, and confidence in skills performance who are enrolled in the Introduction to Nursing Therapeutics Practicum Course in summer of 2018. This Alternating Lab /clinical instructional model in which students attend lab and learn skills and then attend Clinical the next day has been implemented and utilized for the Accelerated BSN pre-licensure nursing students. This instructional model differs from the traditional BSN pre-licensure nursing students in that the traditional BSN students attend six weeks of lab instruction to learn skills, then must perform a random skill in competency, and then attend eight weeks of clinical
Methods:
This is a mixed methods study in which data collection will be through survey Clinical Skills Self-Efficacy Scale (CSES) and Written Guided Reflection in the Accelerated BSN Summer 2018 session and Post Skills Boot Camp Survey during Fall 2018 semester course, Nursing Care of the Adult 2018. Students will be provided verbal explanation and written format of the Informed Consent and purpose of the study at the end of the first day of Lab in the Introduction to Nursing Therapeutics Practicum course for the Accelerated BSN pre-licensure nursing students. This will occur prior to any data collection. During the last day of lab on campus, Clinical Faculty will provide the students/participants with an envelope containing the CSES Survey and Written Guided Reflection. The participants will be instructed to avoid writing their names or any identifying information on their documents. When they are finished they will be instructed to place the documents back into the envelopes and then collected as a group. Completion of these surveys will take roughly 20 minutes of the participants time. The survey tool will be the CSES examining students’ self-efficacy. The Written Guided Reflection will examine students’ feelings of readiness “Written Guided Reflection for Introduction to Nursing Therapeutics Skills Performance”. This would occur the end of July 2018 and/or beginning of August 2018. Students will then complete another survey relating to the skills they are required to be validated on at the Fall 2018 Nursing Care of the Adult Skills Boot camp “Post Skills Boot Camp Survey”. This would occur during the first week of the Fall 2018 semester at the end of August. The Written Guided Reflection will be a structured documentation tool created by the investigator to examine participants’ confidence in skill performance during the Fall 2018 semester Skills Boot Camp. No names or other identifiers will be collected. Participants will be asked to complete the survey/written guided reflection and place it back into the envelope for collection. All data collected from the surveys, guided reflections and focus groups will be reported as aggregate data.
Results:
The literature suggests that this is a relationship between self-efficacy and practicing skills in the lab setting. The research also suggests that multiple variables play a role in skills acquisition and retention. While there is some supportive literature, this study is unique in a few ways. In analyzing the data, the Post Boot Camp Survey demonstrated that 100% of students of that student felt they were able to perform all required skills for the validation and over 96% felt they could perform any of the skills they learned. Although 68.4% of students remained anxious about being validated with only 40% indicating that they practiced on their own time for boot camp. However, slightly over 90% felt that the lab/Clinical experience prepared them for boot camp. Preliminary data shows a positive attitude towards the lab/clinical instructional model as evidenced by the Written Guided Reflections comments. Self-Efficacy also appears to be higher in this study relating to the skills that where performed. Further data analysis is needed to explore all the variables relating to this study.
Conclusion: In summary, this study demonstrated that confidence is built through practicing of skills through exposure in the lab setting and reinforced in the clinical setting when they are occur immediately after one another. This instructional model seemed to have a positive impact upon the retention and performance of the skills in the junior II level as demonstrated by the Post Boot Camp Survey Results. This study, however, is limited due to the small n=22 and that it was performed on a cohort of Accelerated pre-licensure BSN students. Future studies could pilot this instructional model in a traditional pre-licensure BSN cohort.