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

Hyo-Youn Kim; Hae-Ran Kim

doi: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

Hyo-Youn Kim¹, Hae-Ran Kim²

Korean Journal of Adult Nursing 2015;27(2):135-145.
Published online: April 30, 2015

DOI: https://doi.org/10.7475/kjan.2015.27.2.135

¹Mokpo Christian Hospital, Mokpo

²Department of Nursing, HonamUniversity, Gwangju, Korea

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

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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Abstract
REFERENCES

Abstract

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.

Figure 2.

Flow of this study.

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
Characteristics	Categories	n (%) or M±SD	n (%) or M±SD	x² or t	p
Age (year)		22.48±0.88	22.56±0.78	-0.63	.532
Gender	Male	10 (14.1)	12 (15.4)	2.82	.204
Gender	Female	61 (85.9)	66 (84.6)	2.82	.204
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
Variables	Groups	M±SD	M±SD	t^†	p	Source	F^‡	p
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

Figure

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

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

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
Characteristics	Categories	n (%) or M±SD	n (%) or M±SD	x² or t	p
Age (year)		22.48±0.88	22.56±0.78	-0.63	.532
Gender	Male	10 (14.1)	12 (15.4)	2.82	.204
Gender	Female	61 (85.9)	66 (84.6)	2.82	.204
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
Variables	Groups	M±SD	M±SD	t^†	p	Source	F^‡	p
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.

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