Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
The Effect of Simulation Training on First-year Nursing Students' Ability on Planning Nursing Process and Their Clinical Stress Levels
Simülasyon Eğitiminin Hemşirelik Birinci Sınıf Öğrencilerinin Hemşirelik Sürecini Planlama Becerilerine ve Klinik Stres Düzeylerine Etkisi
Gülten KARAHAN OKUROĞLUa, Nuray ŞAHİN ORAKa, Şükrüye ŞAHİNb, Şule ECEVİT ALPARa
aDepartment of Nursing, Marmara University Faculty of Health Sciences, İstanbul, TURKEY
bDepartment of Nursing, Kocaeli University Faculty of Health Sciences, Kocaeli, TURKEY
Turkiye Klinikleri J Nurs Sci. 2021;13(3):581-9
doi: 10.5336/nurses.2020-78920
Article Language: EN
Full Text
ABSTRACT
Objective: This study aimed to determine the effect of simulation training on first-grade nursing students' ability to plan nursing process and clinical stress levels. Material and Methods: Pre-test and post-test quasi-experimental design with control group was used. It was conducted with first-year nursing students of a Marmara University Faculty of Health Sciences Nursing Department in Istanbul between January-June 2017. The results of the study could be affected by physical conditions and institutional differences in hospitals. Therefore, the sample included 98 nursing students who would involve in clinical applications of the same hospital. The experimental and control groups were separated by simple randomization and created by 49 students. The experimental group was trained with scenario-based high-fidelity simulation after both groups completed theoretical and laboratory training. The data were obtained through the Nursing Process Evaluation Form and Clinical Stress Questionnaire. Results: A statistically significant difference was found between the experimental group's pre-test (first day of clinical training) and post-test (last day of clinical training) Clinical Stress Questionnaire total mean scores. A statistically significant difference was found between the experimental and control groups' pre-test Clinical Stress Questionnaire scores. There was a statistically significant difference between the groups' mean scores on the Nursing Process Evaluation Form sections of assessment and nursing diagnosis. Conclusion: Simulation training has effectively reduced the nursing students' feelings such as sadness, anxiety, fear, and anger in clinical education. Also, it enabled students to be more successful in data collection and nursing diagnosis.

Keywords: High fidelity simulation training; nursing process; stress; nursing student
ÖZET
Amaç: Bu çalışmanın amacı, simülasyon eğitiminin hemşirelik 1. sınıf öğrencilerinin hemşirelik sürecini planlama becerileri ve klinik stres düzeyleri üzerindeki etkisini belirlemektir. Gereç ve Yöntemler: Araştırmanın tasarımı, ön-test son-test randomize kontrollü deneyseldir. Çalışma, Ocak 2017 ve Haziran 2017 tarihleri arasında İstanbul'da Marmara Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Bölümü 1. sınıf hemşirelik öğrencileriyle gerçekleştirildi. Çalışmanın sonuçları hastaneler arasındaki fiziksel durumlar ve kurumsal farklılıklardan etkilenmiş olabilir. Çalışma ve kontrol grupları, basit rastgele randomizasyon ile ayrıldı ve 49 öğrenciden oluşturuldu. Deney grubu, her 2 grup teorik ve laboratuvar eğitimini tamamladıktan sonra senaryo tabanlı yüksek sadakat simülasyonu ile eğitildi. Veriler, Hemşirelik Süreci Değerlendirme Formu ve Klinik Stres Anketi aracılığıyla elde edildi. Bulgular: Çalışma grubunun ön-test (klinik uygulamanın ilk günü) ve son-test (klinik uygulamanın son günü) Klinik Stres Anketi ortalama puanları arasında istatistiksel olarak anlamlı bir fark bulundu. Çalışma ve kontrol gruplarının, ön-test Klinik Stres Anketi puanları arasında istatistiksel olarak anlamlı bir fark bulundu. Grupların, Hemşirelik Süreci Değerlendirme Formu'nun veri toplama ve hemşirelik tanısı bölümlerindeki ortalama puanları arasında istatistiksel olarak anlamlı bir fark saptandı. Sonuç: Simülasyon eğitimi, hemşirelik öğrencilerinin klinik eğitimde üzüntü, kaygı, korku ve öfke gibi duygularını azaltmada etkili olmuştur. Ayrıca öğrencilerin, veri toplama ve hemşirelik tanısını koyma aşamalarında daha başarılı olmalarını sağlamıştır.

Anahtar Kelimeler: Yüksek gerçekli simülasyon eğitimi; hemşirelik süreci; stres; hemşirelik öğrencisi
REFERENCES:
  1. Blomberg K, Bisholt B, Kullén Engström A, Ohlsson U, Sundler Johansson A, Gustafsson M. Swedish nursing students' experience of stress during clinical practice in relation to clinical setting characteristics and the organisation of the clinical education. J Clin Nurs. 2014;23(15-16):2264-71. [Crossref]  [PubMed] 
  2. Zupiria Gorostidi X, Huitzi Egilegor X, Jose Alberdi Erice M, Jose Uranga Iturriotz M, Eizmendi Garate I, Barandiaran Lasa M, et al. Stress sources in nursing practice. Evolution during nursing training. Nurse Educ Today. 2007;27(7):777-87. [Crossref]  [PubMed] 
  3. Karabacak U, Unver V, Ugur E, Kocatepe V, Ocaktan N, Ates E, et al. Examining the effect of simulation based learning on self-efficacy and performance of first-year nursing students. Nurse Educ Pract. 2019;36:139-43. [Crossref]  [PubMed] 
  4. Sharif F, Masoumi S. A qualitative study of nursing student experiences of clinical practice. BMC Nurs. 2005;4:6. [Crossref]  [PubMed]  [PMC] 
  5. Sendir M, Acaroglu R. Reliability and validity of Turkish version of clinical stress questionnaire. Nurse Educ Today. 2008;28(6):737-43. [Crossref]  [PubMed] 
  6. Chan CK, So WK, Fong DY. Hong Kong baccalaureate nursing students' stress and their coping strategies in clinical practice. J Prof Nurs. 2009;25(5):307-13. [Crossref]  [PubMed] 
  7. Watson R, Gardiner E, Hogston R, Gibson H, Stimpson A, Wrate R, et al. A longitudinal study of stress and psychological distress in nurses and nursing students. J Clin Nurs. 2009;18(2):270-8. [Crossref]  [PubMed] 
  8. Lee J, Graham AV. Students' perception of medical school stress and their evaluation of a wellness elective. Med Educ. 2001;35(7):652-9. [Crossref]  [PubMed] 
  9. Chesser-Smyth PA. The lived experiences of general student nurses on their first clinical placement: A phenomenological study. Nurse Educ Pract. 2005;5(6):320-7. [Crossref]  [PubMed] 
  10. Baysan Arabacı L, Akın Korhan E, Tokem Y, Torun R. Hemşirelik birinci sınıf öğrencilerinin ilk klinik deneyim öncesi-sırası ve sonrası anksiyete ve stres düzeyleri ve etkileyen faktörler [Nursing students' anxiety and stress levels and contributed factors before-during and after first clinical placement]. Journal of Hacettepe University Faculty of Nursing. 2015;2(1):1-16. [Link] 
  11. Defenbaugh N, Chikotas NE. The outcome of interprofessional education: Integrating communication studies into a standardized patient experience for advanced practice nursing students. Nurse Educ Pract. 2016;16(1):176-81. [Crossref]  [PubMed] 
  12. Alinier G. A typology of educationally focused medical simulation tools. Med Teach. 2007;29(8):e243-50. [Crossref]  [PubMed] 
  13. Cioffi J. Clinical simulations: development and validation. Nurse Educ Today. 2001;21(6):477-86. [Crossref]  [PubMed] 
  14. Henneman EA, Cunningham H. Using clinical simulation to teach patient safety in an acute/critical care nursing course. Nurse Educ. 2005;30(4):172-7. [Crossref]  [PubMed] 
  15. Bambini D, Washburn J, Perkins R. Outcomes of clinical simulation for novice nursing students: communication, confidence, clinical judgment. Nurs Educ Perspect. 2009;30(2):79-82. [PubMed] 
  16. Kameg K, Howard VM, Clochesy J, Mitchell AM, Suresky JM. The impact of high fidelity human simulation on self-efficacy of communication skills. Issues Ment Health Nurs. 2010;31(5):315-23. [Crossref]  [PubMed] 
  17. Ay F. Kuram nedir? Hemşirelik ile ilgili kuramlar ve hemşire. Ay F, Ertem Ü, Ören B, Özcan N, Işık R, Sarvan S, ed. Temel Hemşirelik Kavramlar, İlkeler, Uygulamalar. 2. baskı. İstanbul: İstanbul Medikal Yayıncılık; 2008. p.19-30.
  18. Bulut H, Demir SG. Yaşam Aktivitelerine Dayalı Hemşirelik Modeli. Karadağ A, Çalışkan N, Göçmen Baykara Z, editörler. Hemşirelik Teorileri ve Modelleri. 1. baskı. İstanbul: Akademi Yayınları; 2017. p.532-73.
  19. Roper N, Logan W, Tierney AJ. The Roper-Logan-Tierney Model of Nursing: Based on Activities of Living. 1st ed. Harlow: Churchill Livingstone; 2000.
  20. Pagana KD. Stresses and threats reported by baccalaureate students in relation to an initial clinical experience. J Nurs Educ. 1988;27(9):418-24. [Crossref]  [PubMed] 
  21. Medley CF, Horne C. Using simulation technology for undergraduate nursing education. J Nurs Educ. 2005;44(1):31-4. [Crossref]  [PubMed] 
  22. Campbell SH, Daley KM. Simulation Scenarios for Nursing Educators: Making It Real. 3rd ed. New York: Springer Publishing Company; 2018. [Crossref] 
  23. Erbil N, Kahraman AN, Bostan Ö. Hemşirelik öğrencilerinin ilk klinik deneyim öncesi anksiyete düzeylerinin belirlenmesi [Determination of the level of anxiety of students of nursing before the first experience in clinic]. Atatürk University School of Nursing Journal. 2006;9(1):10-6. [Link] 
  24. Taşdelen S, Zaybak A. Hemşirelik öğrencilerinin ilk klinik deneyim sırasındaki stres düzeylerinin incelenmesi [The determination the level of stress of nursing students during their first clinical experience]. FN Hem Derg. 2013;21(2):101-6. [Link] 
  25. Bremner MN, Aduddell K, Bennett DN, VanGeest JB. The use of human patient simulators: best practices with novice nursing students. Nurse Educ. 2006;31(4):170-4. [Crossref]  [PubMed] 
  26. Rhodes ML, Curran C. Use of the human patient simulator to teach clinical judgment skills in a baccalaureate nursing program. Comput Inform Nurs. 2005;23(5):256-62; quiz 263-4. [Crossref]  [PubMed] 
  27. Cant RP, Cooper SJ. Use of simulation-based learning in undergraduate nurse education: An umbrella systematic review. Nurse Educ Today. 2017;49:63-71. [Crossref]  [PubMed] 
  28. 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] 
  29. Park HR, Park JW, Kim CJ, Song JU. Development and validation of simulation teaching strategies in an integrated nursing practicum. Collegian. 2017;24(5):279-86. [Crossref] 
  30. Karabacak Ü, Serbest Ş, Kan Öntürk Z, Eti Aslan F, Olgun N. Relationship between student nurses' self-efficacy and psychomotor skills competence. Int J Nurs Pract. 2013;19(2):124-30. [Crossref]  [PubMed] 
  31. Garrett BM, MacPhee M, Jackson C. Implementing high-fidelity simulation in Canada: reflections on 3 years of practice. Nurse Educ Today. 2011;31(7):671-6. [Crossref]  [PubMed] 
  32. Karadag M, Calıskan N, Iseri O. Effects of case studies and simulated patients on students' nursing care plan. Int J Nurs Knowl. 2016;27(2):87-94. [Crossref]  [PubMed] 
  33. Yoo MS, Yoo IY. The effectiveness of standardized patients as a teaching method for nursing fundamentals. J Nurs Educ. 2003;42(10):444-8. [Crossref]  [PubMed] 

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