Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
The Effect of High Fidelity Simulation Training Applied to Nursing Students for Improving Endotracheal Suctioning Skills on Clinical Decision Making and Practices: An Experimental Study
Endotrakeal Aspirasyon Becerisini Geliştirmede Hemşirelik Öğrencilerine Uygulanan Yüksek Gerçekli Simülasyon Eğitiminin Klinik Karar Verme ve Klinik Uygulamaya Etkisi: Deneysel Bir Çalışma
Burcu Kübra SÜHAa , Şerife KARAGÖZOĞLUa
aCumhuriyet University Faculty of Health Science, Division of Nursing, Department of Fundamentals of Nursing, Sivas, Türkiye
Turkiye Klinikleri J Nurs Sci. 2024;16(2):479-88
doi: 10.5336/nurses.2023-99808
Article Language: EN
Full Text
ABSTRACT
 Objective: This study aimed to determine the effect of high fidelity simulation (HFS) training applied to nursing students on clinical decision making and clinical practice in improving endotracheal suctioning skills. Material and Methods: This is an experimental study with pre- and post-test design. The study was conducted to determine the effect of HFS applied to senior nursing students for developing endotracheal suctioning skills and diagnosing patients' needs for endotracheal suctioning on clinical decision making and practices. After those in the experimental group were given HFS training, they were involved in clinical practices, while those in the control group performed clinical practices without this simulation training. Results: Although there was no statistically significant difference between the mean scores in our study (p>0.05), the correct clinical decision-making level of the nursing students in the experimental group increased in clinical practice after the simulation training, and although the level of correct clinical decision-making of the nursing students in the control group was higher than the students in the experimental group when they started clinical practice, it was found that it decreased after endotracheal aspiration. In this study, it was found that simulation training had a statistically significant high effect on diagnosing the need for endotracheal aspiration in the patient and performing this skill with the correct steps (p<0.05). Conclusion: In this study, HFS application is considered to prepare nursing students for clinical practices and strengthen their clinical decision-making skills.

Keywords: Students, nursing; high fidelity simulation training; education, nursing; suction; clinical decision-making
ÖZET
 Amaç: Bu çalışmanın amacı, endotrakeal aspirasyon becerisini geliştirmede hemşirelik öğrencilerine uygulanan YGS eğitiminin klinik karar verme ve klinik uygulamaya etkisini incelemektir. Gereç ve Yöntemler: Deneysel tipte ön-test ve son-test desenli ve randomize kontrol gruplu planlanan bu araştırma endotrakeal aspirasyon becerisi geliştirme ve hastanın aspirasyon ihtiyacını tanılamada son sınıf hemşirelik öğrencilerine uygulanan YGS yönteminin klinik karar verme ve klinik uygulama üzerine etkisinin belirlenmesi amacıyla yapılmıştır. Deney grubuna YGS eğitimi verildikten sonra klinik uygulama yaptırılmış, kontrol grubuna ise simülasyon eğitimi verilmeden klinik uygulama yaptırılmıştır. Bulgular: Araştırmamızda puan ortalamaları arasında istatistiksel olarak anlamlı bir fark bulunmamakla birlikte (p>0,05), deney grubundaki hemşirelik öğrencilerinin doğru klinik karar verme düzeyinin simülasyon eğitiminden sonra klinik uygulamada arttığı, kontrol grubundaki hemşirelik öğrencilerinin ise klinik uygulamaya başladığında deney grubundaki öğrencilerden daha yüksek olmasına rağmen hastaya endotrakeal aspirasyon uygulamasından sonra düştüğü saptanmıştır. Bu çalışmada hastada endotrakeal aspirasyon ihtiyacını tanılama ve bu beceriyi doğru adımlarla gerçekleştirmede simülasyon eğitiminin istatistiksel olarak anlamlı düzeyde yüksek etkiye sahip olduğu bulunmuştur (p<0,05). Sonuç: Çalışmamızdan elde edilen tüm bu bulgular doğrultusunda, senaryoya dayalı YGS uygulamasının hemşirelik öğrencilerini klinik uygulamaya hazırladığı ve klinik karar verme becerilerini güçlendirdiği söylenebilir.

Anahtar Kelimeler: Öğrenciler, hemşirelik; yüksek gerçekli simülasyon uygulamaları; eğitim, hemşirelik; emme; klinik karar verme
REFERENCES:
  1. Özden D, Görgülü RS. Development of standard practice guidelines for open and closed system suctioning. J Clin Nurs. 2012;21(9-10):1327-38. [Crossref]  [PubMed] 
  2. Mwakanyanga ET, Masika GM, Tarimo EAM. Intensive care nurses' knowledge and practice on endotracheal suctioning of the intubated patient: A quantitative cross-sectional observational study. PLoS One. 2018;13(8):e0201743. [Crossref]  [PubMed]  [PMC] 
  3. Pinto HJ, D'silva F, Sanil TS. Knowledge and Practices of Endotracheal Suctioning amongst Nursing Professionals: A Systematic Review. Indian J Crit Care Med. 2020;24(1):23-32. [Crossref]  [PubMed]  [PMC] 
  4. Qaiser K, Saggu Y, Javed S, Ghani M, Generic SN, Generic MM. Endotracheal Suctioning: Effectiveness of Structured Training Program in Enhancing Performance Knowledge of Intensive Care Unit Nurses. Saudi Journal of Nursing and Health Care. 2020. [Crossref] 
  5. Arkan B, Ordin Y, Yılmaz D. Undergraduate nursing students' experience related to their clinical learning environment and factors affecting to their clinical learning process. Nurse Educ Pract. 2018;29:127-32. [Crossref]  [PubMed] 
  6. Jamshidi N, Molazem Z, Sharif F, Torabizadeh C, Najafi Kalyani M. The challenges of nursing students in the clinical learning environment: a qualitative study. ScientificWorldJournal. 2016;2016:1846178. [Crossref]  [PubMed]  [PMC] 
  7. Weaver A. The Effect of a model demonstration during debriefing on students' clinical judgment, self confidence and satisfaction during a simulated learning experience. Clinical Simulation in Nursing. 2015;11(1):20-6. [Crossref] 
  8. Keskin M, Ozer Kaya D. COVID-19 sürecinde öğrencilerin web tabanlı uzaktan eğitime yönelik geri bildirimlerinin değerlendirilmesi [Evaluation of students' feedbacks on web-based distance education in the Covid-19 process]. İzmir Katip Celeb Univ Fac Heal Sci J. 2020;5(2):59-67. [Link] 
  9. Morin KH. Nursing education after COVID-19: Same or different? J Clin Nurs. 2020;29(17-18):3117-9. [Crossref]  [PubMed] 
  10. Konrad S, Fitzgerald A, Deckers C. Nursing fundamentals - supporting clinical competency online during the COVID-19 pandemic. Teach Learn Nurs. 2021;16(1):53-56. [Crossref]  [PubMed]  [PMC] 
  11. Ramos-Morcillo AJ, Leal-Costa C, Moral-García JE, Ruzafa-Martínez M. Experiences of nursing students during the abrupt change from face-to-face to e-learning education during the first month of confinement due to COVID-19 in Spain. Int J Environ Res Public Health. 2020;17(15):5519. [Crossref]  [PubMed]  [PMC] 
  12. Przybyl H, Androwich I, Evans J. Using high-fidelity simulation to assess knowledge, skills, and attitudes in nurses performing CRRT. Nephrol Nurs J. 2015;42(2):135-47; quiz 148. [PubMed] 
  13. Adib-Hajbaghery M, Sharifi N. Effect of simulation training on the development of nurses and nursing students' critical thinking: A systematic literature review. Nurse Educ Today. 2017;50:17-24. [Crossref]  [PubMed] 
  14. Luctkar-Flude M, Wilson-Keates B, Larocque M. Evaluating high-fidelity human simulators and standardized patients in an undergraduate nursing health assessment course. Nurse Educ Today. 2012;32(4):448-52. [Crossref]  [PubMed] 
  15. Bridgen D, Dangerfield P. The role of simulation in medical education. The Clinical Teacher. 2008;5(3):167-70. [Crossref] 
  16. Yuan HB, Williams AB, Man YC. Nursing students' clinical judgment in high-fidelity simulation based learning: A quasi-experimental study. Journal of Nursing Education and Practice. 2014;4(5):7-15. [Crossref] 
  17. Carter AG, Creedy DK, Sidebotham M. Evaluation of tools used to measure critical thinking development in nursing and midwifery undergraduate students: a systematic review. Nurse Educ Today. 2015;35(7):864-74. [Crossref]  [PubMed] 
  18. Fawaz MA, Hamdan-Mansour AM. Impact of high-fidelity simulation on the development of clinical judgment and motivation among Lebanese nursing students. Nurse Educ Today. 2016;46:36-42. [Crossref]  [PubMed] 
  19. Bvumbwe T. Enhancing nursing education via academic-clinical partnership: An integrative review. International Journal of Nursing Sciences. 2016;3(3):314-22. [Crossref] 
  20. Baraz S, Memarian R, Vanaki Z. Learning challenges of nursing students in clinical environments: A qualitative study in Iran. J Educ Health Promot. 2015;4:52. [Crossref]  [PubMed]  [PMC] 
  21. Ayed A, Malak MZ, Alamer RM, Batran A, Salameh B, Fashafsheh I. Effect of high fidelity simulation on clinical decision-making among nursing students. Interactive Learning Environments. 2023;31(4):2185-93. [Crossref] 
  22. Kunst EL, Mitchell M, Johnston AN. Using simulation to improve the capability of undergraduate nursing students in mental health care. Nurse Educ Today. 2017;50:29-35. [Crossref]  [PubMed] 
  23. Blakeman TC, Scott JB, Yoder MA, Capellari E, Strickland SL. AARC Clinical Practice Guidelines: Artificial Airway Suctioning. Respir Care. 2022;67(2):258-71. [Crossref]  [PubMed] 
  24. Tuzer H, Dinc L, Elcin M. The effects of using high-fidelity simulators and standardized patients on the thorax, lung, and cardiac examination skills of undergraduate nursing students. Nurse Educ Today. 2016;45:120-5. [Crossref]  [PubMed] 
  25. Chen R, Grierson LE, Norman GR. Evaluating the impact of high- and low-fidelity instruction in the development of auscultation skills. Med Educ. 2015;49(3):276-85. [Crossref]  [PubMed] 
  26. Orhan Ş. Hemşirelik öğrencilerinin düşük ve yüksek gerçeklikli simülatör ile aspirasyon becerisini öğrenmede yaşadığı kaygı, memnuniyet ve kendilerine güven düzeyinin belirlenmesi [Yüksek lisans tezi]. Sivas: Sivas Cumhuriyet Üniversitesi; 2019. Erişim tarihi: 11.05.2024 [Link] 
  27. Lapkin S, Fernandez R, Levett-Jones T, Bellchambers H. The effectiveness of using human patient simulation manikins in the teaching of clinical reasoning skills to undergraduate nursing students: a systematic review. JBI Libr Syst Rev. 2010;8(16):661-94. [Crossref]  [PubMed] 
  28. Craft-Blacksheare M, Frencher Y. Using high fidelity simulation to increase nursing students' clinical postpartum and newborn assessment proficiency: A mixed-methods research study. Nurse Educ Today. 2018;71:198-204. [Crossref]  [PubMed] 
  29. Ann Kirkham L. Exploring the use of high-fidelity simulation training to enhance clinical skills. Nurs Stand. 2018;32(24):44-53. [Crossref]  [PubMed] 
  30. Mompoint WD, Brooks A, Lee L, Watts P, Moss J. Using high-fidelity simulation to prepare advanced practice nursing students. Clinical Simulation in Nursing. 2014;10(1):5-10. [Crossref] 
  31. Letcher DC, Roth SJ, Varenhorst LJ. Simulation-based learning: improving knowledge and clinical judgment within the NICU. Clinical Simul Nurs. 2017;13(6):284-90. [Crossref] 
  32. Durmaz A, Dicle A, Cakan E, Cakir Ş. Effect of screen-based computer simulation on knowledge and skill in nursing students' learning of preoperative and postoperative care management: a randomized controlled study. Comput Inform Nurs. 2012;30(4):196-203. [Crossref]  [PubMed] 
  33. Coşkun G, Karagözoğlu Ş. Yüksek gerçeklikli simülasyon yönteminin hemşirelik öğrencilerinin anjinalı hastanın hemşirelik bakımına yönelik bilgi ve klinik karar verme düzeyine etkisi [The effect of high-fidelity simulation on level of nursing students' knowledge and clinical decision making regarding nursing care of patients with angina]. HUHEMFAD-JOHUFON. 2023;10(2):135-44. [Crossref] 
  34. Walker DM, Cohen SR, Fritz J, Olvera-García M, Zelek ST, Fahey JO, Romero-Martínez M, Montoya-Rodríguez A, Lamadrid-Figueroa H. Impact Evaluation of PRONTO Mexico: A Simulation-Based Program in Obstetric and Neonatal Emergencies and Team Training. Simul Healthc. 2016;11(1):1-9. Erratum in: Simul Healthc. 2017;12(1):65. [Crossref]  [PubMed]  [PMC] 
  35. Karkada S, Radhakrishnan J, Natarajan J, Matua GA, Kaddoura M. Knowledge and Competency of Novice Nursing Students in Nasogastric Tube Feeding: Is Simulation Better than Case Scenario? Oman Med J. 2019;34(6):528-33. [Crossref]  [PubMed]  [PMC] 

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