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The Effects of Simulation Training With Hybrid Model for Nursing Students on Nursing Performance Ability and Self Confidence

Suk Jeong Lee1, Young Mi Park2, Sang Mi Noh1
Korean Journal of Adult Nursing 2013;25(2):170-182.
Published online: April 18, 2013

1Red Cross College of Nursing, Chung-Ang University, Seoul

2Department of Nursing, Ansan University, Ansan, Korea

Corresponding author: Park, Young Mi Department of Nursing, Ansan University, 155 Ansandaehak-ro, Sangnok-gu, Ansan 426-701, Korea. Tel: +82-31-400-7991, Fax: +82-31-400-7107, E-mail: susana21@ansan.ac.kr
• Received: September 7, 2012   • Accepted: April 23, 2013

© 2013 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
    This study investigated the effectiveness of simulation training with a hybrid model of student nurses’ performance ability and reported self confidence.
  • Methods
    A nonequivalent control group with pre-posttest was designed. Data collection was done during the first semester in 2012 at a college of nursing in Seoul. Nursing performance ability and reported self confidence related to taking care of patients with urinary problems were evaluated. The treatment group (n=96) received simulation training of a catheterization procedure with a hybrid model involving standardized patients and a mannequin. Nursing students in the comparison group (n=84) did not receive the simulation training but would receive it prior to their next clinical practicum's.
  • Results
    The treatment group showed a significantly higher performance ability and reported self confidence than that of the comparison group. The perceived helpfulness and contentment of the simulation training in experimental group was high.
  • Conclusion
    The findings of this study demonstrated that simulation with a hybrid model was effective in teaching skills prior to the clinical experience which suggests that skill development is not dependent on the actual clinical situation. Nurse educators should consider simulation training as a tool beyond that of clinical practicum.
  • Key Words: Simulation; Nursing student; Performance; Confidence
Figure 1.
A perception of satisfaction on simulation practice in the experimental group.
kjan-25-170f1.jpg
Table 1.
General and Nursing Practice-related Characteristics (N=180)
Characteristics Categories Exp. (n=96) Cont. (n=84) x2 or t p
n (%) n (%)
Age (year) ≤19 34 (35.4) 26 (31.0) 0.47 .789
20 25 (26.0) 22 (26.2)
≥21 37 (38.6) 36 (42.8)
Gender Female 89 (92.7) 75 (89.3) 0.65 .421
Male 7 (7.3) 9 (10.7)
The anxious things before clinical practicum† Assessment ability for patient 31 (32.3) 31 (36.9) 0.42 .516
Deficiency of knowledge for nursing 69 (71.9) 53 (63.1) 1.58 .209
Communication with medical staffs 40 (41.7) 37 (44.0) 0.10 .747
Human relationship with patients and their families 17 (17.7) 24 (28.6) 3.01 .083
Deficiency of nursing performance ability 55 (57.3) 46 (54.8) 0.12 .733
Stress level of clinical practice (n=82 in Cont) Low 12 (12.5) 10 (12.2) 1.66 .436
Middle 34 (35.4) 22 (26.8)
High 50 (52.1) 50 (61.0)
NA experience in clinical practicum‡ Experience of observation 54 (56.3) 62 (73.8) 6.13 .047
Experience of performance 1 (1.0) 0 (0.0)
No experience 41 (42.7) 22 (26.2)

Exp.=Experimental group; Cont.=Control group; NA=nursing activities (for patients with urinary problem).

†Multiple response;

‡Fisher's exact test.

Table 2.
Differences of Nursing Performance Ability and Self Confidence between the Two Groups according to Experience of Caring Patients with Urinary Problem (N=180)
Variables Categories Experimental group Control group t (p)
Total (n=96) Experience in clinic (n=55) No-experience in clinic (n=41) t (p) Total (n=84) Experience in clinic (n=62) No-experience in clinic (n=22) t (p)
M±SD M±SD M±SD M±SD M±SD M±SD
Pre-nursing performance ability Total 41.2±6.27       40.5±6.54       0.69 (.492)
  41.2±5.18 40.9±7.61 0.33 (.742)   41.2±6.70 38.3±5.66 1.78 (.078)  
Assessment 8.6±1.75       8.5±1.82       0.14 (.889)
  8.5±1.56 8.6±1.99 -0.01 (.990)   8.8±1.73 7.8±1.89 2.11 (.042)  
Intervention 13.2±2.54       13.2±2.54       -0.40 (.689)
  13.3±2.21 13.2±3.00 0.20 (.845)   13.6±2.98 12.9±2.61 0.98 (.332)  
Communication 14.3±2.41       13.8±2.45       1.47 (.143)
  14.5±2.04 14.2±2.89 0.64 (.525)   14.0±2.49 13.4±2.32 0.99 (.323)  
Evaluation 5.0±0.93       4.8±1.01       1.46 (.147)
  5.0±0.96 5.0±0.91 0.06 (.954)   4.9±1.03 4.5±0.93 1.56 (.123)  
Post-nursing performance ability Total 47.1±7.32       41.6±8.13       4.73 (＜.001)
  47.1±7.05 47.0±7.70a 0.08 (.934)   43.5±7.37b 36.4±8.05 3.16 (＜.001) 2.32 (.023)
                a vs b
Assessment 10.2±1.57       8.9±1.88       5.07 (＜.001)
  10.1±1.54 10.4±1.61a -0.98 (.330)   9.2±1.67b 7.9±2.10 3.12 (.003) 3.39 (.001)
                a vs b
Intervention 15.0±2.94       13.2±3.08       4.04 (＜.001)
  14.9±2.73 15.2±3.23a -0.52 (.603)   13.9±2.84b 11.1±2.89 3.88 (＜.001) 2.12 (.037)
                a vs b
Communication 16.3±2.69       14.6±3.06       3.97 (＜.001)
  16.6±2.67 15.9±2.72a 1.24 (.218)   15.2±2.92b 13.0±2.89 3.03 (.002) 1.28 (.208)
                a vs b
Evaluation 5.6±1.12       5.0±1.19       3.57 (＜.001)
  5.6±1.18 5.5±1.04a 0.32 (.749)   5.1±1.10b 4.4±1.29 2.57 (.012) 1.74 (.085)
                a vs b
Self confidence to take care of patients with urinary problems 20.3±3.28       18.3±3.71       3.98 (＜.001)
  20.5±2.98 20.1±3.66c 0.57 (.569)   18.8±3.27d 16.6±4.43 2.52 (.014) 2.07 (.041)
                c vs d
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      DOI: https://doi.org/10.7475/kjan.2013.25.1.170
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      The Effects of Simulation Training With Hybrid Model for Nursing Students on Nursing Performance Ability and Self Confidence
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      DOI: https://doi.org/10.7475/kjan.2013.25.1.170
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      The Effects of Simulation Training With Hybrid Model for Nursing Students on Nursing Performance Ability and Self Confidence
      Image
      Figure 1. A perception of satisfaction on simulation practice in the experimental group.

      Figure 1.

      The Effects of Simulation Training With Hybrid Model for Nursing Students on Nursing Performance Ability and Self Confidence

      General and Nursing Practice-related Characteristics (N=180)

      Characteristics Categories Exp. (n=96) Cont. (n=84) x2 or t p
      n (%) n (%)
      Age (year) ≤19 34 (35.4) 26 (31.0) 0.47 .789
      20 25 (26.0) 22 (26.2)
      ≥21 37 (38.6) 36 (42.8)
      Gender Female 89 (92.7) 75 (89.3) 0.65 .421
      Male 7 (7.3) 9 (10.7)
      The anxious things before clinical practicum† Assessment ability for patient 31 (32.3) 31 (36.9) 0.42 .516
      Deficiency of knowledge for nursing 69 (71.9) 53 (63.1) 1.58 .209
      Communication with medical staffs 40 (41.7) 37 (44.0) 0.10 .747
      Human relationship with patients and their families 17 (17.7) 24 (28.6) 3.01 .083
      Deficiency of nursing performance ability 55 (57.3) 46 (54.8) 0.12 .733
      Stress level of clinical practice (n=82 in Cont) Low 12 (12.5) 10 (12.2) 1.66 .436
      Middle 34 (35.4) 22 (26.8)
      High 50 (52.1) 50 (61.0)
      NA experience in clinical practicum‡ Experience of observation 54 (56.3) 62 (73.8) 6.13 .047
      Experience of performance 1 (1.0) 0 (0.0)
      No experience 41 (42.7) 22 (26.2)

      Exp.=Experimental group; Cont.=Control group; NA=nursing activities (for patients with urinary problem).

      †Multiple response;

      ‡Fisher's exact test.

      Differences of Nursing Performance Ability and Self Confidence between the Two Groups according to Experience of Caring Patients with Urinary Problem (N=180)

      Variables Categories Experimental group Control group t (p)
      Total (n=96) Experience in clinic (n=55) No-experience in clinic (n=41) t (p) Total (n=84) Experience in clinic (n=62) No-experience in clinic (n=22) t (p)
      M±SD M±SD M±SD M±SD M±SD M±SD
      Pre-nursing performance ability Total 41.2±6.27       40.5±6.54       0.69 (.492)
        41.2±5.18 40.9±7.61 0.33 (.742)   41.2±6.70 38.3±5.66 1.78 (.078)  
      Assessment 8.6±1.75       8.5±1.82       0.14 (.889)
        8.5±1.56 8.6±1.99 -0.01 (.990)   8.8±1.73 7.8±1.89 2.11 (.042)  
      Intervention 13.2±2.54       13.2±2.54       -0.40 (.689)
        13.3±2.21 13.2±3.00 0.20 (.845)   13.6±2.98 12.9±2.61 0.98 (.332)  
      Communication 14.3±2.41       13.8±2.45       1.47 (.143)
        14.5±2.04 14.2±2.89 0.64 (.525)   14.0±2.49 13.4±2.32 0.99 (.323)  
      Evaluation 5.0±0.93       4.8±1.01       1.46 (.147)
        5.0±0.96 5.0±0.91 0.06 (.954)   4.9±1.03 4.5±0.93 1.56 (.123)  
      Post-nursing performance ability Total 47.1±7.32       41.6±8.13       4.73 (＜.001)
        47.1±7.05 47.0±7.70a 0.08 (.934)   43.5±7.37b 36.4±8.05 3.16 (＜.001) 2.32 (.023)
                      a vs b
      Assessment 10.2±1.57       8.9±1.88       5.07 (＜.001)
        10.1±1.54 10.4±1.61a -0.98 (.330)   9.2±1.67b 7.9±2.10 3.12 (.003) 3.39 (.001)
                      a vs b
      Intervention 15.0±2.94       13.2±3.08       4.04 (＜.001)
        14.9±2.73 15.2±3.23a -0.52 (.603)   13.9±2.84b 11.1±2.89 3.88 (＜.001) 2.12 (.037)
                      a vs b
      Communication 16.3±2.69       14.6±3.06       3.97 (＜.001)
        16.6±2.67 15.9±2.72a 1.24 (.218)   15.2±2.92b 13.0±2.89 3.03 (.002) 1.28 (.208)
                      a vs b
      Evaluation 5.6±1.12       5.0±1.19       3.57 (＜.001)
        5.6±1.18 5.5±1.04a 0.32 (.749)   5.1±1.10b 4.4±1.29 2.57 (.012) 1.74 (.085)
                      a vs b
      Self confidence to take care of patients with urinary problems 20.3±3.28       18.3±3.71       3.98 (＜.001)
        20.5±2.98 20.1±3.66c 0.57 (.569)   18.8±3.27d 16.6±4.43 2.52 (.014) 2.07 (.041)
                      c vs d
      Table 1. General and Nursing Practice-related Characteristics (N=180)

      Exp.=Experimental group; Cont.=Control group; NA=nursing activities (for patients with urinary problem).

      Multiple response;

      Fisher's exact test.

      Table 2. Differences of Nursing Performance Ability and Self Confidence between the Two Groups according to Experience of Caring Patients with Urinary Problem (N=180)

      Table 1.

      Table 2.

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