Simulation-based education and the effect of multiple simulation sessions - A randomised controlled study

Nurse Educ Today. 2021 Nov:106:105059. doi: 10.1016/j.nedt.2021.105059. Epub 2021 Jul 16.

Abstract

Background: Simulation-based education may improve clinical decision-making skills and supplement clinical placement of nursing students to prepare them for real healthcare settings. Exposing students to several simulation sessions could maximise learning, but longitudinal randomised studies are lacking regarding the effects of simulation-based education.

Objective: In this randomised study, we followed a class of nursing students to assess the effect of multiple simulations on the students' self-reported clinical decision-making skills and self-confidence.

Design: A randomised controlled trial, collecting data four times throughout a 3-year nursing program; at the beginning of the second semester as baseline and at the end of each of the following academic years. Students experienced either a single (control) or a double (intervention) set of simulation scenarios in four simulation days, including several simulation scenarios for each session.

Setting: A university in Norway, 2018-2020.

Participants: The study included 146 baccalaureate nursing students who volunteered to participate.

Methods: The participants completed two validated instruments, the 24-item Nurse Decision-Making Instrument and the Self-Confidence Scale, and demographic data were collected. Analysis of covariance and linear mixed-effect models were applied to analyse the effect of the double compared to the single scenario simulations.

Results: Complete data were obtained for 71 participants. The results showed no significant differences between double vs single scenario sessions on clinical decision-making scores (B = -0.2; 95% confidence interval, -2.1 to 1.7; p = 0.806) or self-confidence score (B = -0.1; 95% confidence interval, -0.4 to 0.2; p = 0.467). However, the overall self-confidence scores increased significantly over time.

Conclusion: In this randomised study, we found no effects of double vs single scenario simulations on clinical decision-making or self-confidence scores among nursing students during their 3-year program.

Keywords: Clinical decision-making; Longitudinal; Multiple simulation; Nurse education; RCT; Self-confidence; Simulation-based education.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Clinical Competence
  • Education, Nursing, Baccalaureate*
  • Humans
  • Learning
  • Patient Simulation
  • Students, Nursing*