Abstract

Purpose: The aging worldwide population challenges educators to train larger numbers of health care leaders skilled in geriatric care (World Health Organization). Although clinical simulation is used internationally to educate future nursing leaders, evidence linking simulation and clinical judgment is lacking. For nurses, clinical judgment development is critical to meeting the WHO challenge. The purpose of this international multi-site study was to determine the effect of expert role modeling on students' clinical judgment in the care of a simulated geriatric patient.

Methods: A three-part unfolding clinical simulation of a geriatric patient with a hip fracture was implemented at four diverse US schools and one UK school (N = 221 US students, N = 54 UK students). Students at each site were assigned to treatment or control groups and randomized to nursing roles within each part of the simulation. Treatment groups viewed a video of an exemplar nurse. A digital toolkit minimized variations between sites.

Results: Using the Lasater Clinical Judgment Rubric, trained observers rated student clinical judgment from video recordings of the simulations. Kruskal-Wallis analysis resulted in significant differences between the treatment and control groups for three of four clinical judgment dimensions for all schools: noticing (p < .001), interpreting (p < .001), and responding (p < .001). Significant differences (p < .001) in student perceived satisfaction with the simulation were found between treatment and control groups only for UK students.

Conclusion: Findings suggest that clinical simulation with exposure to expert role modeling may contribute to improved clinical judgment development in the care of older patients. Differences in perceived satisfaction between UK and US schools may be related to differences in international nursing programs. International partnerships offer the potential for discovering best practices in nursing education and meeting the health care challenges of an aging worldwide population.

Description

41st Biennial Convention - 29 October-2 November 2011. Theme: People and Knowledge: Connecting for Global Health. Held at the Gaylord Texan Resort & Convention Center.

Author Details

Elizabeth Johnson, PhD, RN; Kay Hodson-Carlton EdD, RN, FAAN; Kathie Lasater EdD, RN, ANEF; Linda Siktberg PhD, RN; Nancy L. Dillard DNS, RN; Stephanie Sideras RN, PhD; Ronnie Meechan RNA, RNMH, BSc, MSc

Sigma Membership

Unknown

Type

Presentation

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Clinical Judgment, International Nursing Education, Clinical Simulation

Conference Name

41st Biennial Convention

Conference Host

Sigma Theta Tau International

Conference Location

Grapevine, Texas, USA

Conference Year

2011

Rights Holder

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All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

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International nursing education partnership for care of an aging population: Simulation and clinical judgment development

Grapevine, Texas, USA

Purpose: The aging worldwide population challenges educators to train larger numbers of health care leaders skilled in geriatric care (World Health Organization). Although clinical simulation is used internationally to educate future nursing leaders, evidence linking simulation and clinical judgment is lacking. For nurses, clinical judgment development is critical to meeting the WHO challenge. The purpose of this international multi-site study was to determine the effect of expert role modeling on students' clinical judgment in the care of a simulated geriatric patient.

Methods: A three-part unfolding clinical simulation of a geriatric patient with a hip fracture was implemented at four diverse US schools and one UK school (N = 221 US students, N = 54 UK students). Students at each site were assigned to treatment or control groups and randomized to nursing roles within each part of the simulation. Treatment groups viewed a video of an exemplar nurse. A digital toolkit minimized variations between sites.

Results: Using the Lasater Clinical Judgment Rubric, trained observers rated student clinical judgment from video recordings of the simulations. Kruskal-Wallis analysis resulted in significant differences between the treatment and control groups for three of four clinical judgment dimensions for all schools: noticing (p < .001), interpreting (p < .001), and responding (p < .001). Significant differences (p < .001) in student perceived satisfaction with the simulation were found between treatment and control groups only for UK students.

Conclusion: Findings suggest that clinical simulation with exposure to expert role modeling may contribute to improved clinical judgment development in the care of older patients. Differences in perceived satisfaction between UK and US schools may be related to differences in international nursing programs. International partnerships offer the potential for discovering best practices in nursing education and meeting the health care challenges of an aging worldwide population.