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Effects of Simulation Fidelity Level...

McCorry, Lesley S.,

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Effects of Simulation Fidelity Level on BSN Students' Medication Administration Outcomes /

Record Type:	Electronic resources : Monograph/item
Title/Author:	Effects of Simulation Fidelity Level on BSN Students' Medication Administration Outcomes // Lesley S McCorry.
Author:	McCorry, Lesley S.,
Description:	1 electronic resource (237 pages)
Notes:	Source: Dissertations Abstracts International, Volume: 86-07, Section: B.
Contained By:	Dissertations Abstracts International86-07B.
Subject:	Nursing. -
Online resource:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=31640826
ISBN:	9798302167521

Effects of Simulation Fidelity Level on BSN Students' Medication Administration Outcomes /
McCorry, Lesley S.,

Effects of Simulation Fidelity Level on BSN Students' Medication Administration Outcomes /Lesley S McCorry. - 1 electronic resource (237 pages)

Source: Dissertations Abstracts International, Volume: 86-07, Section: B.

Research suggests that newly graduated nurses commit most medication errors (Im et al., 2023; Kim et al., 2016). Additionally, research demonstrates that simulation-based education (SBE) improves student learning related to medication administration safety (Craig et al., 2021). Simulation educators must consider how simulation design, which includes fidelity, contributes to participants' cognitive load. Importantly, fidelity can contribute to high cognitive load and poor learning outcomes if misused (Rogers & Franklin, 2021). This study investigated the effects of two types of fidelity, a high-fidelity (HF) manikin compared to a standardized patient (SP), on student learning outcomes and perceived cognitive load during a medication administration SBE. This quasi-experimental quantitative study included 103 pre-licensure Bachelor of Science in Nursing (BSN) students. The Medication Safety Critical Elements Checklist (MSCEC) survey compared participants' medication administration competency results before and after completing a medication administration SBE using either an HF manikin or an SP. Following each simulation, the Simulation Self-Report Cognitive Load Measuring Tool (SSRCLMT) 2.0 measured each student's perceived cognitive load.Univariate data revealed higher pre-simulation MSCEC scores (M = 10.5, SD = 0.78) than post-simulation MSCEC scores (M = 8.76, SD = 1.51). However, both pre-and post-test scores indicated student medication administration competency. The SSRCLMT 2.0 showed that students reported a medium overall cognitive load (M = 6.17, SD = 1.33), a balanced intrinsic load (4.63, SD = 1.04), a low extraneous load (M = 3.12, SD = 1.17), and a high germane load (M = 7.03, SD = 1.47).Regression analysis revealed that students participating in the HF manikin SBE, students with previous healthcare experience, students awarded an A in pharmacology, and students with a high pre-simulation MSCEC score predicted significantly higher post-simulation MSCEC scores. Further, students participating in the HF manikin simulation were three times more likely to prepare their patient's medication properly. Cognitive load results indicated that students enrolled in an Accelerated Second Degree (ASD) BSN curriculum significantly predicted lower intrinsic and extraneous loads. In contrast, students who scored higher on the MSCEC pre-test reported higher extraneous load. Finally, receiving an A versus a C in pharmacology predicted a higher reported germane load. This study provided novel research indicating that using an HF manikin versus an SP in a second-semester pre-licensure BSN medication administration SBE resulted in higher student learning outcomes. Additionally, students with more medication administration knowledge and experience reported lower intrinsic load, lower extraneous load, and higher germane loads. These results align with current research and theoretical frameworks suggesting that individuals learn and remember better when simulation content and fidelity are scaffolded to match the student's needs (Craig et al., 2021; Jeffries et al., 2015; Leppink et al., 2013; Mariani et al., 2017). Finally, this research will inform nurse educators in designing medication administration simulations that better prepare nursing students to safely administer medications upon transitioning into nursing practice.

English

ISBN: 9798302167521Subjects--Topical Terms:

528444
Nursing.
Subjects--Index Terms:

Cognitive load

Effects of Simulation Fidelity Level on BSN Students' Medication Administration Outcomes /
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520 $a Research suggests that newly graduated nurses commit most medication errors (Im et al., 2023; Kim et al., 2016). Additionally, research demonstrates that simulation-based education (SBE) improves student learning related to medication administration safety (Craig et al., 2021). Simulation educators must consider how simulation design, which includes fidelity, contributes to participants' cognitive load. Importantly, fidelity can contribute to high cognitive load and poor learning outcomes if misused (Rogers & Franklin, 2021). This study investigated the effects of two types of fidelity, a high-fidelity (HF) manikin compared to a standardized patient (SP), on student learning outcomes and perceived cognitive load during a medication administration SBE. This quasi-experimental quantitative study included 103 pre-licensure Bachelor of Science in Nursing (BSN) students. The Medication Safety Critical Elements Checklist (MSCEC) survey compared participants' medication administration competency results before and after completing a medication administration SBE using either an HF manikin or an SP. Following each simulation, the Simulation Self-Report Cognitive Load Measuring Tool (SSRCLMT) 2.0 measured each student's perceived cognitive load.Univariate data revealed higher pre-simulation MSCEC scores (M = 10.5, SD = 0.78) than post-simulation MSCEC scores (M = 8.76, SD = 1.51). However, both pre-and post-test scores indicated student medication administration competency. The SSRCLMT 2.0 showed that students reported a medium overall cognitive load (M = 6.17, SD = 1.33), a balanced intrinsic load (4.63, SD = 1.04), a low extraneous load (M = 3.12, SD = 1.17), and a high germane load (M = 7.03, SD = 1.47).Regression analysis revealed that students participating in the HF manikin SBE, students with previous healthcare experience, students awarded an A in pharmacology, and students with a high pre-simulation MSCEC score predicted significantly higher post-simulation MSCEC scores. Further, students participating in the HF manikin simulation were three times more likely to prepare their patient's medication properly. Cognitive load results indicated that students enrolled in an Accelerated Second Degree (ASD) BSN curriculum significantly predicted lower intrinsic and extraneous loads. In contrast, students who scored higher on the MSCEC pre-test reported higher extraneous load. Finally, receiving an A versus a C in pharmacology predicted a higher reported germane load. This study provided novel research indicating that using an HF manikin versus an SP in a second-semester pre-licensure BSN medication administration SBE resulted in higher student learning outcomes. Additionally, students with more medication administration knowledge and experience reported lower intrinsic load, lower extraneous load, and higher germane loads. These results align with current research and theoretical frameworks suggesting that individuals learn and remember better when simulation content and fidelity are scaffolded to match the student's needs (Craig et al., 2021; Jeffries et al., 2015; Leppink et al., 2013; Mariani et al., 2017). Finally, this research will inform nurse educators in designing medication administration simulations that better prepare nursing students to safely administer medications upon transitioning into nursing practice.
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