Research Objectives: The purpose of this project was to examine the impact on self-efficacy pre and post disaster simulation among senior nursing students at a large nursing college.
Methods: The project design was a descriptive study with a quantitative, non-experimental, retrospective, and pre- and posttest design. A retrospective methodology examined the data obtained from a quality improvement project. The target population included nursing students who participated in the disaster simulation. The sample included N = 23 students who participated in the project: senior level students in their senior course, Community Health Nursing. The majority of students were adult learners, different ethnicities, pursuing a second career in nursing, low-to-middle income homes, and ranged from single parents to married. Some students brought prior experiences in healthcare to the program. These experiences included Emergency Medical Technician, Licensed Professional Nurse, and Certified Nurse Assistant. Eligibility for inclusion included first time enrollment in the Community Health Nursing course and no previous experience in healthcare as an Emergency Medical Technician (EMT), Certified Nurse’s Aide (CNA), Patient Care Technician (PCT) or Licensed Practical Nurse (LPN) working in a critical care setting such as the Emergency Department or Intensive Care Unit. Students who were repeating the course and had previous experience in healthcare as an EMT, CNA, PCT, or LPN in a critical care setting were excluded from the project. By surveying this population, this author identified the perception of the students’ self-efficacy in decision- making after participation in the scenario. The goal was for the student to feel more empowered and self-confident in their decision-making skills while caring for their patients. The General Nursing Self- Efficacy Scale consisting of a 5- point Likert Scale was used to survey the students enrolled in the Community Health Nursing course and to collect data to determine the effect participation in this simulation had on their self-efficacy. A proxy, the lab manager, administered the survey via an online link; she did not have any interaction with students or impact on their grades. The pretest was administered two weeks prior to the simulation experience. The posttest was administered two weeks after the simulation. Comparisons between pre- and post-simulation survey scores were made using the Wilcoxon signed-rank test
Results: Nine of the pre-simulation survey responses were “Uncertain” or “Strongly Agree,” which left little room for measurable improvement following the simulation training. Statistical significance noted to Question 12 following training-“In a general patient context, when facing a difficult case, I am certain I can make the right management decisions” (p=0.008). The intervention and study results indicate the significance of utilizing a disaster-based scenario simulation to improve senior nursing students’ self-efficacy in making the correct management decision in difficult situations. The experience which required them to make quick decisions and manage the care of injured patients, led them to feel more empowered and confident in making the right decisions. The repetition of experiences contributes to the mastery of making clinical decisions so when the graduate is presented with a similar case, he or she will be confident that they are making the right decisions for their patients.
Conclusions: The findings show that like traditional clinical experiences, simulation can be used in nursing education to give students adequate experiences needed to foster self-efficacy in clinical decision-making skills. A disaster-based simulation can be used to improve the senior nursing student’s self-efficacy in making the right management decisions in a critical situation.