Development of student simulated patient training and evaluation indicators in a high-fidelity nursing simulation:a Delphi consensus study

Objective:This study is aimed to develop student simulated patient(SSP)training content and evaluation indicators,and further explores their validity and reliabilities.Methods:Delphi consultations with 20 nursing exper ts were conducted.The weights of indicators were calculated through the analytic hierarchy process.SSP training was conducted with a high-fidelity nursing simulation.Results:The expert positive coefficients were 0.952 in the first round consultation and 1.00 in the second round consultation.The expert authority coefficient was reported as 0.87.The training included role and responsibility of simulated patient(SP),script interpretation,plot performance,and training for a rater,with a total of 17 indicators.SSP evaluation consisted of disease knowledge,role portrayal,and performance fidelity and since being a rater,it consists of 20 indicators in total.The coordination coefficients of two rounds of consultation ranged from 0.530 to 0.918.The content validity of SSP evaluation indicators was 0.95.The inter-rater reliability was repor ted as 0.866,and the internal consistency established using Cronbach’sαwas 0.727.Conclusions:Students as SPs should have first-hand knowledge and experience within the simulated scenarios.SSP training content and evaluation indicators were determined through the Delphi consensus combined with analytic hierarchy process.The evaluation indicators were valid and reliable,and provided the objective and quantifiable measurements for SSP training in nursing。

Nursing students’ experiences of caring for dying patients and their families: a systematic review and meta-synthesis

Objective: Nurses play important roles in caring for dying patients and their families. Difficulties students confronted when facing dying patients challenge the quality of nursing education. A better understanding of students' experiences would enhance teachers' ability in helping students. This study aims to describe available evidence about nursing students' experiences when caring for dying patients and their families.Methods: A review of qualitative studies published between 2005 and 2017 was undertaken using the following databases: MEDLINE, CINAHL, ProQuest Central, ScienceDirect, and CNKI. The keywords included were nursing students, experience, care, end-of-life, and dying. Qualitative Assessment and Review Instrument was used to assess the quality of the studies by two independent reviewers. The data from the studies were analyzed by meta-synthesis.Results: Eighteen English and two Chinese studies were selected in this review. Four themes were emerged:(1) Students with dying patients: students did not have enough ability in symptoms control, comfort supply, and therapeutic communication for dying patients.(2) Students with the patients' families: students advocated more caring for patients' families.(3) Students with the surroundings: professional medical staffs, especially the nursing preceptors, were key roles in constructing a supporting system for students.(4) Students with themselves: nursing students underwent various negative feelings and adopted both negative and positive strategies to cope with such feelings;students experienced professional and personal development during the caring for dying patients.Conclusions: Nursing students' abilities in terminal symptom control, comfort supply, and therapeutic communication should be improved by more theoretic learning and simulation practice. The nursing preceptors were key roles in constructing a supporting system for students and helping them to control the negative emotions when facing dying patients.

Evaluation of undergraduate students’nursing assessment and communication skills through an objective structured clinical examination within a high-fidelity simulation using a student-simulated patient

Objective:To evaluate nursing students’assessment and communication skills through an objective structured clinical examination(OSCE)within a high-fidelity simulation using a student-simulated patient(SSP)and analyze the validity,reliability,degree of difficulty,and discriminability of the OSCE.Methods:A descriptive study was conducted at one nursing school in Macao.All scenarios were designed using a high-fidelity simulator combined with SSPs.A convenience sample of 54 baccalaureate nursing students completed the OSCE.The nursing assessment OSCE checklist(NAOC)and the communication evaluation rubric(CER)were used as observational measurements with three-point Likert scales(2=Achieved,1=Partly achieved,0=Not completed/Incorrect).Results:Difficulty coefficients of the exam were 0.63 for nursing assessment skills and 0.56 for communication skills.The discrimination index of the majority items of the NAOC(86.4%)was>0.20,showing a better to good discriminability.The items of the CER had satisfactory indexes of item discrimination(from 0.38 to 0.84).Students received high scores in conducting blood oxygen saturation and cardiac and lung auscultation but low scores in vomiting and diarrhea assessment.Students presented good communication skills in eye contacting and listening,but culture assessment needs to be improved.The students with experiences in simulation or simulated patient(SP)interactions had better assessment and communication skills than students without those experiences.There was a positive relationship between nursing assessment and communication skills(r=0.67,P=0.000).Conclusions:SSPs were involved in enhancing the realism of interactions in simulated scenarios.Nursing students can conduct nursing assessments specific to patient conditions,explain the conditions to the patient,and ensure that the patient remains informed at all times of the precautions to be taken.However,students’cultural awareness and some communication skills need further training.With moderate difficulty and high discrimination index,OSCE showed satisfactory reliability and validity.

澳门护理专业本科生逆境商的调查研究

目的调查澳门特别行政区护理专业本科生的逆境商,并分析其影响因素。方法采用便利抽样方法从澳门某高等院校中选取护理专业本科生158名。调查问卷包括基本人口社会学问卷、逆境商量表、情绪智力量表、简化应对方式问卷及父母教养方式量表。结果本组护理专业本科生的逆境商得分为(116.72±11.39)分。他们的逆境商得分与消极应对方式和母亲管教风格(过度干预、过度保护)呈负相关(r=-0.332,P<0.001;r=-0.167,P=0.036)。多元回归分析结果,仅消极应对方式进入回归方程(F=19.154,P<0.001)。女生的逆境商得分高于男生(31.98±3.26比29.21±3.08,t=-4.442,P<0.001)。结论澳门护理专业本科生平均逆境商得分处于中等水平,女生更有可能将逆境归因于自己,这可能与其社会心理和文化背景有关。澳门护理专业本科生有必要提高自身克服挫折的能力。教育者应恃別注意培养学生积极的应对方式。