Human Patient Versus HIgh-Fidelity Simulation: Which Is Better to Help Undergraduate Nursing Students Learn Pediatric Assessment Skills
Wilson, Cecila Elaine
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Background: According to undergraduate nursing students, clinical experiences produce a high degree of stress and anxiety, especially when those experiences involve children. Simulation has been shown to teach assessment and allow active learning that increases student comfort with skills. However, even with the practice of simulation, only a small number of students report feeling comfortable with assessment. Standardized patients have been widely used with adult populations; however, there is very little literature describing the use of children as standardized patients. One study with nursing assessment students found that students reported more self-efficacy with community volunteers than high-fidelity simulators. Purpose: The purpose of this project was to examine the impact of using community volunteer children on physical assessment abilities and comfort levels among undergraduate pediatric nursing students. Methods: Students were administered the Pediatric Student Comfort and Worry Assessment Tool at the beginning of the semester and following an intervention. After a didactic class, students were randomly assigned to two groups. One group practiced assessment on high-fidelity simulators programmed to provide verbal feedback to allow for interaction. The second group practiced an assessment on community volunteer children. Students were self-evaluated and faculty-evaluated completing a pediatric assessment using the Effective Noticing and Responding domains of the Lasater Clinical Judgment Rubric. Results/Conclusions: Overall students had similar worry and comfort scores regardless of group; additionally, assessment performances were similar. However, students in both groups significantly rated their observations higher than faculty members. Student and faculty comments and recent changes to the experience will be discussed.