SIMULATION USE IN CLINICAL TEACHING
Abstract
Study Title: Evaluating and Enhancing the application of Simulation in Clinical Teaching of Saudi Arabian Undergraduate Nursing Students: A Mixed- Method Study.
Medication errors are common in healthcare settings, especially when nurses are administering medications to patients. Therefore, it is essential for nurses to learn how to prevent errors and support safe and quality of care. The proposed study will evaluate the application and effectiveness of simulations in training nurses on the approaches to prevent medication errors and successfully reduce the prevalence of the underlying issues in healthcare settings. The study will test the effect of a program to develop medical administration competency among undergraduate nursing students in Saudi Arabia.
The proposed study will answer the research question: “What is the effect of using simulation in nursing education on medication administration competence?” Hence, to answer this research question, the study will apply a mixed-method approach to collect both qualitative and quantitative data from 50 undergraduate nursing students, enrolled in a university in Saudi Arabia, and five faculty members. The intervention will be based on a program that will educate the students using simulation.
The study will use an experimental two-group pre-post-test design to assess the level of competence with the standards of preventing medical errors in Saudi Arabian hospitals. The research will use the MASAT approach, developed by Goodstone and Goodstone (2013), to evaluate medication administration competence. In addition, a questionnaire will be used to collect data from the subjects. The researcher will also use an open-ended survey for the respondents, which will include questions to check or respond in their words as well as paint a picture of simulation in nursing education. Given that the data is both qualitative and quantitative, thematic content analysis and statistical tests will be used for the analysis.
Keywords: Simulation, Medication errors, Clinical Testing, Medical Administration Standards Compliance
Introduction
Medication errors are a common problem in health care delivery. Although such errors are common, they can be prevented by improving medication administration education as well as the competence of nurses who are a critical part of the continuum of care (Raban & Westbrook 2014; Hayes, Jackson, Davidson, & Power 2015). Medical errors occur during administration and can be prevented using medical administration competency because nurses will understand the medication and other related aspects, such as dosage and side effects. Therefore, educating nurses to develop medical administration competency through the use of simulation is an area that requires further investigation.
Background
Simulations are important tools in nursing training because they mimic actual settings. They are situations that model real-life practice and provide students with the opportunity to develop practical skills and experience. Simulations are useful in developing clinical skills that stimulate exhaustive learning and allows students to use theoretical knowledge in clinical practice. Various previous studies have revealed the effectiveness of simulations as nursing training tools and in supporting clinical decision-making and patient care (Shin, Park, & Kim 2015; Jarvill, Jenkins, Akman, Astroth, Pohl, & Jacobs 2018). Simulations prepare students as they begin their practice to provide safe and quality care (Hewitt, Tower, & Latimer 2015). As a result, they have attracted significant research evidence to show how they can be implemented effectively in nursing training settings across the world. The current study will assess the application of simulations in training nurses on how to prevent medication errors and successfully reduce the prevalence of such problems in healthcare settings.
The Aim of the Study
From the perspective of the faculty members and the students, the aim of the study is:
- To evaluate critically the needs of the education system of Saudi Arabia Nursing Colleges based on the application of simulation in both training and practice.
- To examine the practice and knowledge of learners and other participants in the nursing field in using simulation in education
- To explore the outcome of applying simulated patients, through two-group pre-post-test study, as an instructional method on the learners’ performance and competence in medication administration.
Research Question
“What is the effect of using simulation in nursing education on a nursing student medication administration competence?”
Proposed Methods
Design
The design of the proposed study is a mixed-method approach, which indicates that both qualitative and quantitative data will be collected to answer the research question from the perspectives of educators and students. Thus, to collect the quantitative data, the researcher will use a quasi-experimental. Pre-post questionnaires will be designed to collect data from undergraduate nursing students in Saudi Arabia.
Population of Interest
The population of interest in the study is undergraduate students from a university in Saudi Arabia. The second population for the survey will be faculty members from the same institution.
Sample and Sampling Approach
The study will use a convenience sample (n = 50) of undergraduate nursing students enrolled in a university in Saudi Arabia. The nursing students will be selected for the study because they are learning how to safely administer medicine to their patients (Stanley, Philips, & Galatzan 2014). The study will include (n =5) faculty members, conveniently selected.
Intervention
The study will test the effect of a simulated medical administration competency designed to teach compliance with medication standards and practice to prevent medical errors. The study will apply an experimental two-group pre-post-test design to examine the level of competence in the two groups, one that undergoes the simulated program and the second that learns compliance without simulation (Jarville et al. 2018). The researcher will test the level of compliance before and after implementation to investigate the effect. The research will use the MASAT, developed by Goodstone and Goodstone (2013) to assess medication administration competence.
Data Collection Approach
The questionnaire will be used to collect data from the participants to test the effect of student’s skill performance on the improvement of the student’s level about the simulated educational intervention for IV medication injection. The data will be collected before and after implementing a simulation scenario in a simulation centre with a manikin (Shin, Ma, Park, Ji, & Kim 2015). Data from faculty members will be collected using a web-based survey. The open-ended survey will include questions to check or respond to paint a picture of simulation in nursing education. The questions will consist of the current nursing educational standards at the school, the use of IV administration, how it is done to establish the current standards, and the need for improvement. The survey will include the engagement of different learner groups and the degree of use and integration of simulation into their curricula, the frequency of use of different types of simulators, the research, and academic activities of simulation centres, and the adequacy of infrastructure and financial support for simulation centres. Besides, a description of perceptions of barriers and strengths for individual simulation centres and opportunities for the future growth of simulation in health care education will be offered. A pilot study will be conducted to test both the reliability and validity of the instrument.
Data Management and Analyses
Given that the data is both qualitative and quantitative, thematic content analysis and statistical tests will be used for the analysis.
Ethical Considerations
Participants will sign an informed consent to participate in the study. They will also be required to approve the use of their data for the study. The study should be approved by the university institutional review board (Connelly 2014). The authors of the Medication Administration Safety Assessment Tool (MASAT) should allow its use in the research. The researcher will also seek approval from the Faculty of the course.
Timeline
Research Activity | Month | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 |
Proposal development | X | ||||||||||||
Proposal submission | X | ||||||||||||
HREC | |||||||||||||
Governance | |||||||||||||
Site preparation | X | ||||||||||||
Participant recruitment | X | ||||||||||||
Data collection | X | X | |||||||||||
Data management/analyses | X | ||||||||||||
Report writing | X | ||||||||||||
Report for HREC / governance | X |
Explanatory Notes on Timeline
The timeline is extensive to ensure proper planning, data collection, and analysis. It will allow enough time to implement the simulation program and collect relevant data from participants.
Reflection
I have proposed a practical study that will support nursing training to reduce the rate of medical errors in health care facilities in Saudi Arabia. Although theoretical teaching is essential in teaching compliance, research shows that simulation is more effective. Therefore, I have proposed the method to achieve a high level of efficacy in medical administration standards compliance.