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Effects of Multi-mode Simulation Learning on Nursing Students' Critical Thinking Disposition, Problem Solving Process, and Clinical Competence
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Korean J Adult Nurs : Korean Journal of Adult Nursing

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Original Research

Effects of Multi-mode Simulation Learning on Nursing Students' Critical Thinking Disposition, Problem Solving Process, and Clinical Competence

Eun Ko1, Hye Young Kim2
Korean Journal of Adult Nursing 2014;26(1):107-116.
Published online: February 18, 2014

1Department of Nursing, Nambu University, Gwangju

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Corresponding author: Kim, Hye Young College of Nursing, Chonbuk National University, 20 GunJi-ro, Deokjin-gu, Jeonju 561-712, Korea. Tel: +82-63-270-4618, Fax: +82-63-270-3127, E-mail: tcellkim@jbnu.ac.kr
• Received: August 24, 2013   • Accepted: February 15, 2014

© 2014 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 purpose of this study was to identify the effects of multi-mode simulation learning on critical thinking disposition, on the problem solving process and on clinical competence of nursing students.
  • Methods
    A nonequivalent control group with pre-posttest was designed. The participants in this study were 65 students who were enrolled in an emergency and critical nursing course at N university. The treatment group consisted of 33 juniors in 2010 and the control group 32 juniors in 2011. Collected data were analyzed using chi-square, independent t-test, and ANCOVA with the SPSS/WIN 18.0 for Window Program.
  • Results
    There were significant increases in problem solving process and clinical competence in the treatment group who participated in the multi-mode simulation learning compared to the control group who did not (t=-2.39, p=.020; F=12.76, p=.001). However, there were no significant differences in critical thinking disposition between the treatment and control group (t=0.40, p=.692).
  • Conclusion
    Multi-mode simulation is an effective teaching and learning method to enhance the problem solving process and clinical competence of nursing students. Further exploration is needed to develop and utilize multi-mode simulation for diverse scenarios, depending on emergency nursing educational goals and environments and to develop a universal method to measure outcomes.
  • Key Words: Patient simulation; Learning; Critical thinking; Problem solving; Clinical competence
Figure 1.
Research process.
kjan-26-107f1.jpg
Table 1.
Homogeneity Test for General Characteristics of Participants (N=65)
Variables Exp. (n=33) Cont. (n=32) x2 or t p
n (%) or M±SD n (%) or M±SD
Age (year) 22.41±1.92 22.53±2.15 -0.20 .838
Gender     0.38 .613
      Male 1 (3.0) 2 (6.2)    
      Female 32 (97.0) 30 (93.8)    
Critical thinking disposition 3.58±0.27 3.47±0.36 1.45 .151
Problem solving process 3.17±0.44 3.21±0.35 -0.43 .669
Clinical competence 3.49±0.43 3.51±0.37 -0.16 .877
      Nursing process 3.43±0.44 3.59±0.43 -1.42 .159
      Nursing intervention 3.23±0.73 3.33±0.37 -0.64 .523
      Psychosocial nursing 3.62±0.78 3.56±0.50 0.33 .744
      Education for patient 3.68±0.56 3.65±0.51 0.23 .818
      Physical examination & patient monitoring 3.24±0.77 3.39±0.66 -0.83 .408
      Basic nursing performance 3.78±0.50 3.53±0.49 2.01 .049

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

Table 2.
Differences of the Outcome Variables between the Experimental and Control Group (N=65)
Variables Groups Pretest Posttest Difference t or F p
M±SD M±SD M±SD
Critical thinking disposition Exp. (n=33) 3.58±0.27 3.69±0.36 -0.11±0.29 0.40 .692
Cont. (n=32) 3.47±0.36 3.61±0.37 -0.14±0.31
Problem solving process Exp. (n=33) 3.17±0.44 3.48±0.49 -0.32±0.44 -2.39 .020
Cont. (n=32) 3.21±0.35 3.24±0.52 -0.03±0.51
Clinical competence Exp. (n=33) 3.49±0.43 3.78±0.42 -0.29±0.43 12.76 .001
Cont. (n=32) 3.51±0.37 3.48±0.44 0.03±0.33
Nursing process Exp. (n=33) 3.43±0.44 3.80±0.50 -0.36±0.50 4.19 .045
Cont. (n=32) 3.59±0.43 3.67±0.51 -0.09±0.40
Nursing intervention Exp. (n=33) 3.23±0.73 3.64±0.62 -0.41±0.80 7.36 .009
Cont. (n=32) 3.33±0.37 3.30±0.58 0.03±0.50
Psychosocial nursing Exp. (n=33) 3.61±0.78 3.79±0.64 -0.17±0.78 3.52 .065
Cont. (n=32) 3.56±0.50 3.51±0.58 0.05±0.52
Education for patient Exp. (n=33) 3.68±0.56 3.90±0.58 -0.22±0.69 7.88 .007
Cont. (n=32) 3.65±0.51 3.51±0.56 0.14±0.60
Physical examination & patient monitoring Exp. (n=33) 3.24±0.77 3.64±0.56 -0.39±0.77 5.12 .027
Cont. (n=32) 3.39±0.66 3.36±0.73 0.03±0.69
Basic nursing performance Exp. (n=33) 3.78±0.50 3.94±0.48 -0.16±0.56 7.86 .007
Cont. (n=32) 3.53±0.49 3.49±0.56 0.04±0.53

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

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    Effects of Multi-mode Simulation Learning on Nursing Students' Critical Thinking Disposition, Problem Solving Process, and Clinical Competence
    Korean J Adult Nurs. 2014;26(1):107-116.   Published online February 28, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.1.107
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    Effects of Multi-mode Simulation Learning on Nursing Students' Critical Thinking Disposition, Problem Solving Process, and Clinical Competence
    Korean J Adult Nurs. 2014;26(1):107-116.   Published online February 28, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.1.107
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    Effects of Multi-mode Simulation Learning on Nursing Students' Critical Thinking Disposition, Problem Solving Process, and Clinical Competence
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    Figure 1. Research process.

    Figure 1.

    Effects of Multi-mode Simulation Learning on Nursing Students' Critical Thinking Disposition, Problem Solving Process, and Clinical Competence

    Homogeneity Test for General Characteristics of Participants (N=65)

    Variables Exp. (n=33) Cont. (n=32) x2 or t p
    n (%) or M±SD n (%) or M±SD
    Age (year) 22.41±1.92 22.53±2.15 -0.20 .838
    Gender     0.38 .613
          Male 1 (3.0) 2 (6.2)    
          Female 32 (97.0) 30 (93.8)    
    Critical thinking disposition 3.58±0.27 3.47±0.36 1.45 .151
    Problem solving process 3.17±0.44 3.21±0.35 -0.43 .669
    Clinical competence 3.49±0.43 3.51±0.37 -0.16 .877
          Nursing process 3.43±0.44 3.59±0.43 -1.42 .159
          Nursing intervention 3.23±0.73 3.33±0.37 -0.64 .523
          Psychosocial nursing 3.62±0.78 3.56±0.50 0.33 .744
          Education for patient 3.68±0.56 3.65±0.51 0.23 .818
          Physical examination & patient monitoring 3.24±0.77 3.39±0.66 -0.83 .408
          Basic nursing performance 3.78±0.50 3.53±0.49 2.01 .049

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

    Differences of the Outcome Variables between the Experimental and Control Group (N=65)

    Variables Groups Pretest Posttest Difference t or F p
    M±SD M±SD M±SD
    Critical thinking disposition Exp. (n=33) 3.58±0.27 3.69±0.36 -0.11±0.29 0.40 .692
    Cont. (n=32) 3.47±0.36 3.61±0.37 -0.14±0.31
    Problem solving process Exp. (n=33) 3.17±0.44 3.48±0.49 -0.32±0.44 -2.39 .020
    Cont. (n=32) 3.21±0.35 3.24±0.52 -0.03±0.51
    Clinical competence Exp. (n=33) 3.49±0.43 3.78±0.42 -0.29±0.43 12.76 .001
    Cont. (n=32) 3.51±0.37 3.48±0.44 0.03±0.33
    Nursing process Exp. (n=33) 3.43±0.44 3.80±0.50 -0.36±0.50 4.19 .045
    Cont. (n=32) 3.59±0.43 3.67±0.51 -0.09±0.40
    Nursing intervention Exp. (n=33) 3.23±0.73 3.64±0.62 -0.41±0.80 7.36 .009
    Cont. (n=32) 3.33±0.37 3.30±0.58 0.03±0.50
    Psychosocial nursing Exp. (n=33) 3.61±0.78 3.79±0.64 -0.17±0.78 3.52 .065
    Cont. (n=32) 3.56±0.50 3.51±0.58 0.05±0.52
    Education for patient Exp. (n=33) 3.68±0.56 3.90±0.58 -0.22±0.69 7.88 .007
    Cont. (n=32) 3.65±0.51 3.51±0.56 0.14±0.60
    Physical examination & patient monitoring Exp. (n=33) 3.24±0.77 3.64±0.56 -0.39±0.77 5.12 .027
    Cont. (n=32) 3.39±0.66 3.36±0.73 0.03±0.69
    Basic nursing performance Exp. (n=33) 3.78±0.50 3.94±0.48 -0.16±0.56 7.86 .007
    Cont. (n=32) 3.53±0.49 3.49±0.56 0.04±0.53

    Exp.=experimental group; Cont.=control group.
    Table 1. Homogeneity Test for General Characteristics of Participants (N=65)

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

    Table 2. Differences of the Outcome Variables between the Experimental and Control Group (N=65)

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

    Table 1.

    Table 2.

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