Comparing Human Patient Simulation to Traditional Case Study

Background: High-fidelity patient simulation (HFPS) and case study are two teaching methods used for nursing education. Both teaching methods help the student to think critically, use diagnostic reasoning, and assess patients to improve their clinical competence skills. This study compared the impact HFPS and case study methods had on clinical judgment, knowledge acquisition, and the suspension of disbelief among senior nursing students.

Methods: This study was conducted at a small private university with 40 senior nursing students in four clinical groups. Each group participated in both HFPS and case study experiences. A pretest/post-test quantitative design measured clinical judgment, knowledge acquisition, and suspension of disbelief. Clinical judgment was measured by the Lasater Clinical Judgment Rubric, knowledge acquisition by two topic quizzes, and suspension of disbelief via a custom survey. ANOVA and/or paired t-test statistics were used to determine group differences with a .05 level of significance.

Results: Clinical judgment scores were not significantly different between student groups for either the HFPS or case study methods. No significant differences were found with the knowledge acquisition scores (p=.347), although HFPS had a greater difference between pre-and post-scores (8.13) compared to case study (3.13). Students reported that HFPS provided for a greater suspension of disbelief (72%) than case study (56%). These findings suggested that both HFPS and case study yielded similar gains in clinical judgment and knowledge acquisition, while the students suspended their disbelief more with the HFPS method.

Conclusions: Both HFPS and case study are dynamic teaching methods that equally provide students with the opportunity to enhance their critical thinking, reasoning and assessment skills. Although this study demonstrated no significant difference in knowledge acquisition with either teaching method, more research is needed to determine the best combination of education methodologies that enhance development of clinical competence skills in nursing students.