A trial of e-simulation of sudden patient deterioration (FIRST2ACT WEB™) on student learning. (October 2015)

• Record Type: Journal Article
• Authors: Bogossian, Fiona E.; Cooper, Simon J.; Cant, Robyn; Porter, Joanne; Forbes, Helen; the FIRST2ACT™ Research Team
• Is Part Of: Nurse education today. Volume 35:Number 10(2015:Oct.)
• Page Start: e36
• Page End: e42
• Publication Date: 2015-10
• Subjects: Nursing -- Study and teaching -- Periodicals; Education, Nursing -- Periodicals; Soins infirmiers -- Étude et enseignement -- Périodiques; Nursing -- Study and teaching; Periodicals; 610.7307
• DOI: 10.1016/j.nedt.2015.08.003
• Languages: English
• ISSNs: 0260-6917

Abstract

<abstract abstract-type="author" id="ab0005"> <title id="st0005">Summary</title> <sec> <title id="st0010">Background</title> <p id="sp0005">High-fidelity simulation pedagogy is of increasing importance in health professional education; however, face-to-face simulation programs are resource intensive and impractical to implement across large numbers of students.</p> </sec> <sec> <title id="st0015">Objectives</title> <p id="sp0010">To investigate undergraduate nursing students' theoretical and applied learning in response to the e-simulation program—FIRST2ACT WEBTM, and explore predictors of virtual clinical performance.</p> </sec> <sec> <title id="st0020">Design and setting</title> <p id="sp0015">Multi-center trial of FIRST2ACT WEBTM accessible to students in five Australian universities and colleges, across 8 campuses.</p> </sec> <sec> <title id="st0025">Participants</title> <p id="sp0020">A population of 489 final-year nursing students in programs of study leading to license to practice.</p> </sec> <sec> <title id="st0030">Methods</title> <p id="sp0025">Participants proceeded through three phases: (i) pre-simulation—briefing and assessment of clinical knowledge and experience; (ii) e-simulation—three interactive e-simulation clinical scenarios which included video recordings of patients with deteriorating conditions, interactive clinical tasks, pop up responses to tasks, and timed performance; and (iii) post-simulation feedback and evaluation.</p> <p id="sp0030">Descriptive statistics were followed by bivariate analysis to detect any associations, which were further tested using standard regression analysis.</p> </sec> <sec> <title id="st0035">Results</title> <p id="sp0035">Of 409 students who commenced the program (83% response rate), 367 undergraduate nursing students completed the web-based program in its entirety, yielding a completion rate of 89.7%; 38.1% of students achieved passing clinical performance across three scenarios, and the proportion achieving passing clinical knowledge increased from 78.15% pre-simulation to 91.6% post-simulation.</p> <p id="sp0040">Knowledge was the main independent predictor of clinical performance in responding to a virtual deteriorating patient <italic>R</italic><sup>2</sup> = 0.090, <italic>F</italic>(7, 352) = 4.962, <italic>p</italic> < 0.001.</p> </sec> <sec> <title id="st0040">Discussion</title> <p id="sp0045">The use of web-based technology allows simulation activities to be accessible to a large number of participants and completion rates indicate that 'Net Generation' nursing students were highly engaged with this mode of learning.</p> </sec> <sec> <title id="st0045">Conclusion</title> <p id="sp0050">The web-based e-simulation program FIRST2ACTTM effectively enhanced knowledge, virtual clinical performance, and self-assessed knowledge, skills, confidence, and competence in final-year nursing students.</p> </sec> </abstract>