Assessing Health Professional Education Pre-Licensure Nursing Students Simulation Learning Experiences

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1 Assessing Health Professional Education Pre-Licensure Nursing Students Simulation Learning Experiences Barbara Gawron, DNP, RN, CHSE Saint Xavier University School of Nursing

2 Objectives 1. Discuss the integration and evaluation of a clinical simulation experience in pre-licensure student nursing as a method to improve patient safety and quality of care 2. Identify valid and reliable instruments for measuring student learning outcomes in simulation experiences 3. Explain a method for organizing simulation data obtained from student scenarios

student nursing as a method to improve patient safety and quality of care 2.

3 Clinical Experiences 2012 Annual Survey of Schools of Nursing identify the lack of clinical sites and placement opportunities as a major constraint and impediment facing pre-licensure nursing programs. American Association of Colleges of Nursing (AACN) in the 2012 Nursing Shortage Fact Report recognizes the significant educational challenges facing nursing programs due to clinical site shortages

4 Simulation Integration of simulation scenarios within nursing courses provides a safe teaching/learning environment for students to develop clinical judgment skills and critical thinking (Jeffries, 2007). An important learning experience used to ensure students are able to address critical learning outcomes

clinical judgment skills and critical thinking (Jeffries, 2007).

5 Define Intended Learning Objectives 1. Domains of learning. 2. Participant s level of learning. 3. Program outcomes. 4. Appropriate time frame 5. Evidence-based practice. 6. Holistic and cultural Standards of Best Practice: Simulation. Standard VII: Evaluation of expected outcomes. (2011). Clinical Simulation in Nursing, 7(4), S18-s19 Standards of Best Practice: Simulation. Standard VII: Evaluation of expected outcomes. (2011). Clinical Simulation in Nursing, 7(4), S18-s19

Standard VII: Evaluation of expected outcomes. (2011).

6 Measure Selected Learning Outcomes Requires evaluation instruments/tools which are valid and reliable. Assessment accurately represents the domain of content or abilities (Oermann & Gaberson, 2013)

7 An instrument has been chosen. What s next? Contact the authors of the tool and obtain permission to utilize Complete the recommended orientation of the instrument with faculty and staff Complete a dry run first to work out the kinks Establish inter rater reliability Decided on a method for collecting, organizing and storing your data

recommended orientation of the instrument with faculty and staff Complete a dry run

8 Valid and Reliable Instruments Creighton Simulation Evaluation Instrument (Todd, Manz, Hawkins, Parsons & Hercinger, 2008) Sweeny-Clark Clinical Simulation Performance Rubric (Clark, M.,2006) NLN - Student Satisfaction and Self- Confidence in Learning (Jeffries & Rizzolo, 2006)

Sweeny-Clark Clinical Simulation Performance Rubric (Clark, M.

9 Respiratory Distress Simulation Beginning level nursing students Completion of didactic related to respiratory assessment, oxygenation and nursing interventions related to management of respiratory distress Simulation Experience: 10 minutes pre-briefing and review of Patient Chart 5 Minute Simulation Experience 15 Minutes Debriefing

related to management of respiratory distress Simulation Experience: 10 minutes

10 Define Intended Learning Objectives Course Objectives Use critical thinking skills to apply the nursing process as the framework for practice APPLICATION Integrate physical assessment skills with history in planning care SYNTHESIS Demonstrate competency in basic nursing skills. APPLICATION Explain evidence-based practice as the model for incorporating research into practice COMPREHENSION Deliver safe care to patients in a clinical setting ANALYSIS Simulation Objectives Use critical thinking skills to apply the nursing process as the framework for the simulation experience. APPLICATION Perform focused respiratory assessment Identify signs of respiratory distress KNOWLEDGE Review physician orders COMPREHENSION Administer oxygen PRN APPLICATION Implement non-pharmacologic methods to aid breathing APPLICATION Implement safety interventions for your simulated patient in an acute care environment Evaluate effectiveness of interventions ANALYSIS

APPLICATION Explain evidence-based practice as the model for incorporating research into practice COMPREHENSION Deliver safe care to patients in a clinical setting ANALYSIS Simulation Objectives Use

11 SIMULATION 1 Scenario: Respiratory Distress Pt Initials: C. J. Creighton Competency Evaluation Instrument (CCEI) 0= Does not demonstrate competency 1= Demonstrates competency 04/23/2013 Pt Dx: CHF - Direct Admission NA= Not applicable MM / DD / YYYY STUDENT PARTICIPANTS - One Student role of Primary RN ASSESSMENT (Circle Appropriate Score for all Applicable Criteria) Obtains Pertinent Data "are you having difficulty breating" 0 1 NA Performs Follow-Up Assessments as Needed "Is your breathing better" 0 1 NA Assesses the Environment in an Orderly Manner Call light in reach, SR x 2, table in reach 0 1 NA ID: N/A - COMMUNICATION Communicates Effectively with Intra/Interprofessional Team (TeamSTEPPS, SBAR, Written Read Back Order) NA ID: - Communicates Effectively with Patient and Significant Other "Explains Oxygen Device" 0 1 NA Documents Clearly, Concisely, & Accurately Responds to Abnormal Findings Appropriately - Low Pulse ox 0 1 NA Promotes Professionalism- Identifies self and role as student 0 1 NA FACULTY EVALUATOR CLINICAL JUDGMENT ID: N/A F - N/A_ Interprets Vital Signs Respiratory rate 0 1 NA *Do not complete this area Interprets Lab Results Interprets Subjective/Objective Data - Administers NC after assessing O2 Sat 0 1 NA Prioritizes Appropriately - Focuses on Respiratory Distress 0 1 NA Select one of the following Performs Evidence Based Interventions - Elevates HOB 0 1 NA Clinical Provides Evidence Based Rationale for Interventions - assess in debriefing 0 1 NA Evaluates Evidence Based Interventions and Outcomes - assess in debriefing 0 1 NA Simulation- initial Reflects on Clinical Experience - "I learned" assessed in debrief 0 1 NA scenario Delegates Appropriately - PATIENT SAFETY Simulation- repeated Uses Patient Identifiers - Patient name and DOB 0 1 NA scenario Utilizes Standardized Practices and Precautions Hand Washing 0 1 NA Administers Medications Safely - Begins 2L 0 1 NA Manages Technology and Equipment Performs Procedures Correctly - NC over ears and under chin 0 1 NA COMMENTS Permission to use this template must be obtained by the authors. This CCEI has been specifically designed for presentation purposes only Reproduction of this tool is prohibited by Copyright Laws Barbara Gawron has obtained permission by the authors of CCEI to distribute at the Symposium Earned Score =

PARTICIPANTS - One Student role of Primary RN ASSESSMENT (Circle Appropriate Score for all Applicable Criteria) Obtains Pertinent Data "are you having difficulty breating" 0 1 NA Performs Follow-Up

12 Respiratory Distress Simulation Video

13 Simulation Data Elicit evidence of learning Support achievement of student learning outcomes Summative Assessment Identify gaps in learning Consider modification in instructional methods Formative Assessment

Assessment Identify gaps in learning Consider

14 References American Associations of College Boards of Nursing. (2012, March 22). New AACN data show an enrollment surge in Baccalaureate and Graduate Programs amid calls for more highly educated nurses [Press release]. Clark M. Evaluating an obstetric trauma scenario. Clinical Simulation in Nursing. 2006;2(2):e75 e77 Jeffries, P. R., & Rizzolo, M. A. (2006). Designing and implementing models for the innovative use of simulation to teach nursing care of ill adults and children: a national, multi-site, multi-method study. New York: National League for Nursing. Retrieved from LeaerdalReport.pdf. Jeffries, P.R., & Rogers, K. (2007). Theoretical framework for simulation design. Simulations in nursing education: From conceptualization to evaluation. Ed. P. Jeffries. New York: The National League for Nursing, pp

Clinical Simulation in Nursing. 2006;2(2):e75 e77 Jeffries, P. R., & Rizzolo, M. A. (2006).

15 References Cont. Kardong-Edgren, S., Adamson, K., & Fitzgerald, C. (2010). A review of currently published evaluation instruments for human patient simulation. Clinical Simulation in Nursing, 6(1), e doi: /j.ecns Oermann, M.& Gaberson, K. (2009). Evaluating and Testing in Nursing Education (3rd Ed.) Springer Pub.Co. Standards of Best Practice: Simulation. Standard VII: Evaluation of expected outcomes. (2011). Clinical Simulation in Nursing, 7(4), S18-s19. Todd, M., Manz, J., Hawkins, K., Parsons, M., & Hercinger, M. (2008). The development of a quantitative evaluation tool for simulations in nursing education. International Journal of Nursing Education Scholarship, 5(1), 1p.

) Springer Pub.Co. Standards of Best Practice: Simulation. Standard VII: Evaluation of expected outcomes. (2011). Clinical Simulation in Nursing, 7(4), S18-s19. Todd, M.

Learning from Other Fields: Program Accountability in Nursing Education. Christine Pintz PhD, RN, FNP-BC George Washington School of Nursing

Learning from Other Fields: Program Accountability in Nursing Education Christine Pintz PhD, RN, FNP-BC George Washington School of Nursing Objectives: This presentation will provide an overview of current