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Korean J Adult Nurs : Korean Journal of Adult Nursing

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Original Article

Effects of a Colonoscopy based Simulation Education Program on Knowledge and Clinical Performance in Nursing Students

Hyo-Youn Kim1, Hae-Ran Kim2
Korean Journal of Adult Nursing 2015;27(2):135-145.
Published online: April 30, 2015

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Corresponding author: Kim, Hae-Ran Department of Nursing, Honam University, 417 Eodeung-daero, Gwangsan-gu, Gwangju 506-714, Korea. Tel: +82-62-940-5553, Fax: +82-62-940-5068, E-mail: rahn00@hanmail.net
• Received: February 3, 2015   • Accepted: March 18, 2015

Copyright © 2015 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purposeof thisstudywas toevaluatetheeffectsof acolonoscopysimulationprogramonknowledge and clinical performance amongnursingstudents. Methods: The program consistedof ascenariowith threeob-jectives: health assessment, nursing before/after colonoscopy and emergency care for bleeding following the colonoscopy. Anonequivalent control grouppretest-posttest designwas used. The samplewas 149nursingstu-dents recruited from H University in G city from August, 2013 to December, 2014. The treatment group (n=71) receivedthesimulationandthecomparisongroup(n=78)receivedtheusual lectureprogram. Datawere analyzed using descriptive statistics, x2 test, t-test and repeated measure ANOVA using the SPSS/WIN 20.0 program. Result: Participants in the treatment group had significantly increased reported scores on both knowledge and clinical performance. Conclusion: Results indicate that the simulated program is a useful strategy for improving knowledge and clinical performanceamongnursingstudents. The development of simulationpractice programs in a variety of fields are needed in order to promote the practical competence of nursing students.
  • Key Words: Colonoscopy; Simulation; Nursing
Figure 1.
Research design of this study.
kjan-27-135f1.jpg
Figure 2.
Flow of this study.
kjan-27-135f2.jpg
Table 1.
Learning Subjects, Objectives, Core Nursing Intervention Of the Scenario
Scenario Learning subjects Learning objectives Core nursing intervention
Scenario I Indication Knowledge ․ Be able to know the definition and purpose of colonoscopy.
․ Be able to find the related information by analyzing and integrating various materials for the assessment of an examine 		․ Implement physical examinations.
․ Implement pain assessments.
․ Interview.
․ (history, family history, medication history, present illness)
․ Explain about the purpose of diagnostic checks and physical examinations.
Skill ․ Be able to assess the physical status and health of the examinee.
Attitude ․ Be able to show the appearance of doing our best to the examinee.
Scenario II Nursing before & after colonoscopy Knowledge ․ Analyze and integrate various patient materials necessary for nursing before and after the colonoscopy.
․ Be able to understand how to take cleaning medicines and precautions related to them. 		․ Implement pre-examinations educations.
․ Identify examination consent forms.
․ Explain about the intestine cleaning medicines. (directions, notices, side effects)
․ Explain about the activities after taking the intestine cleaning medicines.
․ Implement the infusion of aqueous solution into veins.
․ Explain about the examination processes.
․ Implement the post-examination educations
Skill ․ Be able to implement nursing educations before and after the colonoscopy.
․ Be able to explain and educate about the prescribed intestine cleaning medicines.
․ Be able to administer the prescribed medicines.
Attitude ․ Apply therapeutic communication skills before and after the colonoscopy.
․ Be able to explain about related matters so that the examinee can understand them.
Scenario III Emergency care for bleeding after colonoscopy Knowledge ․ Analyze and integrate various patient materials necessary in emergency related to the colonoscopy.
․ Be able to find the signs of bleeding and analyze various information.
․ Be able to explain and find the side effects of blood transfusion. 		․ Implement the blood transfusion-related educations.
․ Start the blood transfusion and identify patient's side effects.
․ Stop the blood transfusion and connect normal saline.
․ Report to doctors.
․ Explain to the examinee and do emotional supports.
Skill ․ Be able to implement the nursing for blood transfusion.
․ Be able to identify the side effects of blood transfusion and apply core nursing skills.
Attitude ․ Be able to apply therapeutic communication skills to the examinee in emergency.
․ Be able to do emotional supports.
Table 2.
Homogeneity Test on Demographic and Clinical Characteristics of Subjects (N=149)
Characteristics Categories Exp. (n=71) Cont. (n=78) x2 or t p
n (%) or M±SD n (%) or M±SD
Age (year)   22.48±0.88 22.56±0.78 -0.63 .532
Gender Male 10 (14.1) 12 (15.4) 2.82 .204
Female 61 (85.9) 66 (84.6)
The motivation for admission to nursing To get a job 41 (57.7) 33 (42.3) 3.55 .169
Other choice 15 (21.1) 23 (29.5)
Self choice 15 (21.1) 22 (28.2)
Satisfaction with major High 10 (14.1) 5 (6.4) 2.43 .297
Medium 27 (38.0) 33 (42.3)
Low 34 (47.9) 40 (51.3)
Satisfaction with school life High 20 (28.2) 23 (29.5) 1.62 .654
Medium 44 (62.0) 43 (55.1)
Low 7 (9.9) 12 (15.4)
Satisfaction with clinical practice High 5 (7.0) 6 (7.7) 0.74 .692
Medium 22 (31.0) 29 (37.2)
Low 44 (62.0) 43 (55.1)
Accumulated last semester grade 4.00~4.50 7 (9.9) 11 (14.1) 3.70 .296
3.51~3.99 29 (40.8) 36 (46.2)
3.00~3.50 30 (42.3) 22 (28.2)
≤ 2.51 5 (7.0) 9 (11.5)

Exp.=experimental group; Cont.=control group.

Table 3.
Comparison of Nursing Performance between the Groups (N=149)
Variables Groups Exp. (n=71) Cont. (n=78) t† p Source F‡ p
M±SD M±SD
Knowledge Post 7 days 8.18±1.13 6.52±1.61 11.94 ＜ .001      
Clinical Pretest 54.07±5.96 53.05±4.99 1.14 .258 Group 194.58 ＜ .001
Performance Post 7 days 61.92±7.90 55.87±5.47 8.94 ＜ .001 Time 176.55 ＜ .001
  Post 8 weeks 72.07±3.77 68.41±4.82 23.35 ＜ .001 Group×Time 101.01 ＜ .001

Exp.=experimental group; Cont.=control group;

†t-test;

‡Repeated Measure ANOVA.

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    Effects of a Colonoscopy based Simulation Education Program on Knowledge and Clinical Performance in Nursing Students
    Korean J Adult Nurs. 2015;27(2):135-145.   Published online April 30, 2015
    DOI: https://doi.org/10.7475/kjan.2015.27.2.135
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    Effects of a Colonoscopy based Simulation Education Program on Knowledge and Clinical Performance in Nursing Students
    Korean J Adult Nurs. 2015;27(2):135-145.   Published online April 30, 2015
    DOI: https://doi.org/10.7475/kjan.2015.27.2.135
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    Effects of a Colonoscopy based Simulation Education Program on Knowledge and Clinical Performance in Nursing Students
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    Figure 1. Research design of this study.
    Figure 2. Flow of this study.

    Figure 1.

    Figure 2.

    Effects of a Colonoscopy based Simulation Education Program on Knowledge and Clinical Performance in Nursing Students

    Learning Subjects, Objectives, Core Nursing Intervention Of the Scenario

    Scenario Learning subjects Learning objectives Core nursing intervention
    Scenario I Indication Knowledge ․ Be able to know the definition and purpose of colonoscopy.
    ․ Be able to find the related information by analyzing and integrating various materials for the assessment of an examine     		․ Implement physical examinations.
    ․ Implement pain assessments.
    ․ Interview.
    ․ (history, family history, medication history, present illness)
    ․ Explain about the purpose of diagnostic checks and physical examinations.
    Skill ․ Be able to assess the physical status and health of the examinee.
    Attitude ․ Be able to show the appearance of doing our best to the examinee.
    Scenario II Nursing before & after colonoscopy Knowledge ․ Analyze and integrate various patient materials necessary for nursing before and after the colonoscopy.
    ․ Be able to understand how to take cleaning medicines and precautions related to them.     		․ Implement pre-examinations educations.
    ․ Identify examination consent forms.
    ․ Explain about the intestine cleaning medicines. (directions, notices, side effects)
    ․ Explain about the activities after taking the intestine cleaning medicines.
    ․ Implement the infusion of aqueous solution into veins.
    ․ Explain about the examination processes.
    ․ Implement the post-examination educations
    Skill ․ Be able to implement nursing educations before and after the colonoscopy.
    ․ Be able to explain and educate about the prescribed intestine cleaning medicines.
    ․ Be able to administer the prescribed medicines.
    Attitude ․ Apply therapeutic communication skills before and after the colonoscopy.
    ․ Be able to explain about related matters so that the examinee can understand them.
    Scenario III Emergency care for bleeding after colonoscopy Knowledge ․ Analyze and integrate various patient materials necessary in emergency related to the colonoscopy.
    ․ Be able to find the signs of bleeding and analyze various information.
    ․ Be able to explain and find the side effects of blood transfusion.     		․ Implement the blood transfusion-related educations.
    ․ Start the blood transfusion and identify patient's side effects.
    ․ Stop the blood transfusion and connect normal saline.
    ․ Report to doctors.
    ․ Explain to the examinee and do emotional supports.
    Skill ․ Be able to implement the nursing for blood transfusion.
    ․ Be able to identify the side effects of blood transfusion and apply core nursing skills.
    Attitude ․ Be able to apply therapeutic communication skills to the examinee in emergency.
    ․ Be able to do emotional supports.

    Homogeneity Test on Demographic and Clinical Characteristics of Subjects (N=149)

    Characteristics Categories Exp. (n=71) Cont. (n=78) x2 or t p
    n (%) or M±SD n (%) or M±SD
    Age (year)   22.48±0.88 22.56±0.78 -0.63 .532
    Gender Male 10 (14.1) 12 (15.4) 2.82 .204
    Female 61 (85.9) 66 (84.6)
    The motivation for admission to nursing To get a job 41 (57.7) 33 (42.3) 3.55 .169
    Other choice 15 (21.1) 23 (29.5)
    Self choice 15 (21.1) 22 (28.2)
    Satisfaction with major High 10 (14.1) 5 (6.4) 2.43 .297
    Medium 27 (38.0) 33 (42.3)
    Low 34 (47.9) 40 (51.3)
    Satisfaction with school life High 20 (28.2) 23 (29.5) 1.62 .654
    Medium 44 (62.0) 43 (55.1)
    Low 7 (9.9) 12 (15.4)
    Satisfaction with clinical practice High 5 (7.0) 6 (7.7) 0.74 .692
    Medium 22 (31.0) 29 (37.2)
    Low 44 (62.0) 43 (55.1)
    Accumulated last semester grade 4.00~4.50 7 (9.9) 11 (14.1) 3.70 .296
    3.51~3.99 29 (40.8) 36 (46.2)
    3.00~3.50 30 (42.3) 22 (28.2)
    ≤ 2.51 5 (7.0) 9 (11.5)

    Exp.=experimental group; Cont.=control group.

    Comparison of Nursing Performance between the Groups (N=149)

    Variables Groups Exp. (n=71) Cont. (n=78) t† p Source F‡ p
    M±SD M±SD
    Knowledge Post 7 days 8.18±1.13 6.52±1.61 11.94 ＜ .001      
    Clinical Pretest 54.07±5.96 53.05±4.99 1.14 .258 Group 194.58 ＜ .001
    Performance Post 7 days 61.92±7.90 55.87±5.47 8.94 ＜ .001 Time 176.55 ＜ .001
      Post 8 weeks 72.07±3.77 68.41±4.82 23.35 ＜ .001 Group×Time 101.01 ＜ .001

    Exp.=experimental group; Cont.=control group;

    †t-test;

    ‡Repeated Measure ANOVA.
    Table 1. Learning Subjects, Objectives, Core Nursing Intervention Of the Scenario

    Table 2. Homogeneity Test on Demographic and Clinical Characteristics of Subjects (N=149)

    Exp.=experimental group; Cont.=control group.

    Table 3. Comparison of Nursing Performance between the Groups (N=149)

    Exp.=experimental group; Cont.=control group;

    t-test;

    Repeated Measure ANOVA.

    Table 1.

    Table 2.

    Table 3.

    Korean J Adult Nurs : Korean Journal of Adult Nursing

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