, pp.80-87 http://dx.doi.org/10.14257/astl.2015. Nursing Competency and Simulation Debriefing Evaluation according to Satisfaction in Major and Clinical Practice Eun Hee Choi 1 1 School of Nursing, Yeungnam University College, 170, Hyunchug-ro, Namgu, Daegu, Korea, eh5472@ync.ac.kr Abstract. Nurse has to the nursing competency including problem solving, critical thinking and clinical competency. Because of shortage on directpatient-care practice in hospital, nursing simulation is more important than before. In this study, purpose was to evaluate nursing competency and simulation debriefing according to satisfaction in major and clinical practice. The results were that critical thinking and clinical practice among nursing competency and simulation debriefing according to satisfaction in major and clinical practice were significantly differences. In addition to this, problem solving were differences according to clinical practice satisfaction. But, there were not differences of real performances from educator and students themselves. This means that satisfaction in major and clinical practice is the important element increasing clinical competencies but it is not promoting situational real performances. In order to develop the program promoting real situational performances as increasing satisfaction of major and clinical competency, extended studies are needed. Keywords: Nursing Competency, Simulation, Satisfaction 1 Introduction Competency is a major topic of interest to educators and administrators of nursing. Competency in education is a narrowing of the gap between education and practice leading to positive-patient-outcomes, clinical judgement and accountability of learners. The role of competency in education has grown dramatically as health care provider and educator has identified the gap between education and practice [1]. In order to promote the nursing competency, simulation in nursing education uses specific patient scenarios to provide students with hands-on learning experiences [2]. For shortage on direct-patient-care practice in hospital, nursing simulation is more important than before. Incorporating simulation in nursing education is known to be effective in enhancing education outcomes [3]. It can be used as a teaching strategy to practice nursing competency such as problem solving, decision making and performance. Debriefing with feedback is regarded as essential learning in simulation experience and it is vital to facilitate the best possible experience during debriefing in order for student to maximize their learning [4]. ISSN: 2287-1233 ASTL Copyright 2015 SERSC
The school can be both a risk and a resource for the development of students competency. The risk is most obvious when students have negative perceptions of school. Those students who dislike school are also those most likely to be failing academically [5]. This means students positive perception is related with academic achievement, it is needed to develop students perception more positively. Although satisfaction is related with academic achievement, there are not many articles especially to increase nursing students satisfaction in major and clinical practice in order to promote nursing competency [1,6]. If we would find out how the nursing students satisfaction affected the nursing competency, it would be the basic fundament of the nursing education. 1.1 Purpose The purpose of this study was to evaluate the differences of nursing competencies and simulation debriefing according to satisfaction in major and clinical practice. 1.2 Definition of terms The nursing competency was the gap between nursing education and nursing practice [1]. In this study, attributes of nursing competencies included problem solving, critical thinking, clinical competency and situational performances. Simulation debriefing is facilitator-led activity following a simulation experience where participants are encouraged to think reflectively [4]. In this study, it means the score of debriefing score developed by Reed et al (2013). 2 Materials and methods This is the descriptive study intended to help improving of nursing competency through find out the degree of problem solving, critical thinking, clinical competency and real performance in simulation situation setting and debriefing according satisfaction in major and clinical practice. All subjects who took part in this study were nursing students as had previously submitted written consent after listening about the purpose of survey and a veto in anytime and anywhere. 2.1 Sample The convenience sample for this study consisted of 186 nursing students attending a baccalaureate undergraduate program at a college in the Republic of Korean. The students were participated in simulation that was prat of their outcome based educational course. They were in the seventh semester of eight semester curriculum and had participated in six or seven simulation or debriefing exercise in their nursing curriculum Copyright 2015 SERSC 81
2.2 Process Instrument is classified with nursing competency and simulation debriefing. The tools used for the nursing competency were problem solving scale, created to evaluate the university students problem solving, critical thinking scale for nursing students and clinical competency for new nurses [7-9]. And situational performance scale by educator and themselves was items consisted with more than content validity index 0.8 [10]. It was developed by researcher and 3 members of coworkers had more than 5yrs career as an educator and nurse. 3 Results 3.1 Characteristics The average of students was 22.62 years, 178 were female (95.7%). The students who have religion were 59(31.7%) and more than 3.5 in the grade were 90(48.4%). 95 were high in satisfaction of major (51.1%) and 64 were high in satisfaction of clinical practice (34.4%). Table1. General characteristics (N=186) Characteristic Classification N(%) or M±SD Age (year) 22.62±3.32 Sex Male 8( 4.3) Female 178(95.7) Religion Yes 59(31.7) No 127(68.3) Grade 3.5 90(48.4) <3.5 96(51.6) Satisfaction in major High 95(51.1) Satisfaction in clinical practice Moderate 89(47.8) Low 2( 1.1) High 64(34.4) Moderate 120(64.5) Low 2( 1.1) 82 Copyright 2015 SERSC
Problem solving s average was 3.66 out of 5. Critical thinking was 2.83 and clinical competency was 3.03 out of 4. Performance s were 21.82 by educator and 19.34 by students themselves out of 22. Debriefing was 4.43 out of 5. Table 2. Nursing Competencies and simulation debriefing Characteristic Classification M±SD Problem solving 3.66±0.38 Critical thinking 2.83±0.28 Nursing Competency Clinical competency 3.03±0.27 Performance by educator 21.82±2.11 Performance by 19.34±2.68 themselves Debriefing 4.43±0.48 3.2. Nursing competency and debriefing according to satisfaction Critical thinking and clinical competency in the nursing competency were significantly different between high and below satisfaction in major (p<.05). Debriefing according to satisfaction in major was different (p<.05). Performances by educator and students themselves were no differences according to satisfaction in major. Table 3. Differences according to satisfaction in major (N=144) Characteris tics Classification Satisfacti on in major M±SD t p High 3.70±0.38 Nursing Competency Problem solving 3.61±0.38 1.39.167 Critical thinking High 2.90±0.30 2.77±0.24 3.37.001 Copyright 2015 SERSC 83
Clinical competency Performance by educator Performance by themselves High 3.08±0.27 2.99±0.27 High 22.09±1.92 21.54±2.27 High 19.46±2.56 19.22±2.81 2.22.028 1.81.072 0.62.538 Debriefing High 4.60±0.41 4.26±0.49 * Low satisfaction added to for sample size is fewer than 2 5.09 <.001 Problem solving, critical thinking and clinical competency in the nursing competency were significantly different between high and below satisfaction in major (p<.05). Debriefing according to satisfaction in clinical practice was different (p<.05). Performances by educator and students themselves were no differences according to satisfaction in clinical practice. Table 4. Differences according to satisfaction in clinical practice (N=144) Characteris tics Classification Satisfacti on in major M±SD t p High 3.75±0.37 Problem solving 3.61±0.37 2.50.013 Nursing Competency Critical thinking High 2.91±0.31 2.80±0.26 2.66.009 High 3.14±0.28 Clinical competency 2.99±0.25 3.70 <.001 84 Copyright 2015 SERSC
Performance by educator Performance by themselves High 21.98±2.13 21.74±2.10 High 19.73±2.32 19.14±2.84 0.76.450 1.44.151 Debriefing High 4.60±0.36 4.30±0.49 5.50 <.001 * Low satisfaction added to for sample size is fewer than 2 4 Discussion Satisfaction is related with self-esteem and career motivation in nursing students [12]. It used as a tool for life scale affects career search behavior in nursing students and effected by nursing competency and performance in clinical situations [6, 12-13]. The result of this study supports that satisfaction in major and clinical practice affected to nursing competency attribute such as the problem solving, critical thinking and clinical competency and debriefing. But there was not different in real performance by educator and students themselves according to satisfaction in major and clinical practice. This meaning is that it is not enough when you consider that competency is focused on the individual s behavior underpinning the competent performance and performance based development system is a competency assessment system [1]. This suggests that satisfaction in major and clinical practice would not affect specific performances in some simulation- situation-settings but general competency attributes including problem solving, critical thinking, and clinical competency should be affected. It is because of differences between emotional competency including problem solving, critical thinking and clinical competency and real performance competency. In addition to this, satisfaction in major and clinical practice affected positively to the debriefing after simulation. Debriefing, the purposeful reflection that follows simulation, is an essential step to maximize learning and enable behavior change. Promotion of satisfaction in major and clinical practice would be promoting the effects of simulation and debriefing [4]. Consider these results, intervention that increasing the satisfaction in major and clinical practice would improve nursing competency and debriefing. So the intervention to increase the satisfaction in major and clinical practice was needed. In order to increase students satisfaction, high fidelity simulator is useful instrument [14]. It means that students satisfaction would be more improve if you used the high fidelity simulator although it is not enough to increase the real performances in the specific simulation situational settings. Copyright 2015 SERSC 85
Problem solving, critical thinking and clinical competency in nursing competency are very essential to the nurse. But the real performance in nursing competency is often more important in the real hospital situation. In this regard intervention that increasing satisfaction in major and clinical practice was not enough to increase performance in situation, there are needed to develop the intervention promoting real performances. 5 Conclusions This study contributes to the evidence to find out the influence of the satisfaction in major and clinical practice. Few evidences were found showing the effect of satisfaction in major and clinical practice on nursing students [12, 14]. Although a few differences were exist, students reported overall that their positive perception about the major and clinical practice would increase nursing competency including problem solving, critical thinking and clinical competency and debriefing. Although the satisfaction in major and clinical practice was the important element to increase the nursing competency and debriefing, it is not enough to improve the real performances in the simulation situational settings. So it is needed to find out the elements that influence the real performances in the clinical settings. 6 Conflict of interest and acknowledgment No potential conflict of interest relevant to this article was reported. References 1. Tilley, D. D.S.: Competency in Nursing: A concept Analysis. J. Contin Educ Nurs. 39(2), 58-64 (2008) doi: 10.3928/00220124-20080201-12 2. Owen, A. M. and Ward-Smith, P.: Collaborative Learning in Nursing Simulation: Near- Peer Teaching Using Standardized Patients, J. Nurs Educ, 53(3), 170-173 (2014) 3. Suh, E. E.: Development of a Conceptual Framework for Nursing Simulation Education Utilizing Human Patient Simulators and Standardized Patients. J. Korean Acad Soc Nurs Edu. 18(2), pp.206-219 (2012) doi: http://dx.doi.org/10.5977/jkasne.2012.18.2.206 4. Reed, S. J. Andrews, C. M. Ravert. P.: Debriefing Simulation: Comparison of Debriefing with Video and Debriefing Alone. Clinical Simulation in Nursing. 9(12), e585-591 (2013) doi: http://dx.doi.org.org/10.1016/j.ecns.2013.05.007 5. Samal, I. O. Nutbeam, D. Wold, B. Kannas, L.: Achieving health and educational goals through school-a study of the importance of the school climate and the students satisfaction with school. Health Educ Res. 13(3), 383-397 (1998) 6. Moon, I. O. and Lee, G. W.: The Effect of Satisfaction in Major and Career Efficacy on Career Search Behavior in Nursing Students. J. Korean Acad Soc Nurs Edu. 16(.1), 83-91 (2010). doi: 10.5977/JKASNE.2010.16.083 86 Copyright 2015 SERSC
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