Development of a Scenario and Evaluation for Simulation Learning of Care for Patients with Hyperkalemia of Liver Cirrhosis in Emergency Unit

간호시뮬레이션 학습시나리오의 개발 및 평가 -응급실 내원 간경화증 환자사례를 중심으로-

  • 강희영 (조선대학교 의과대학 간호학과) ;
  • 김은정 (조선대학교 대학원 간호학과) ;
  • 오윤정 (조선대학교 대학원 간호학과)
  • Received : 2013.06.14
  • Accepted : 2013.08.02
  • Published : 2013.09.28


The purpose of this study was to develop a scenario suited for our clinical situations and evaluate the application possibility by evaluating students' problem solving ability and learning satisfaction in simulation learning. This study consisted of contents which could be applied for varied situations such as complications and symptoms related to liver cirrhosis, looking into hyperkalemia symptoms of patients with liver cirrhosis in emergency unit. The stage of developing scenario was organized in the order of setting simulation learning objectives and situations of scenario, making algorithm, writing checklists of clinical performance appraisal, and debriefing. The scenario was constructed with monitor setting(actions), patient/mannequin(actions), expected interventions(events), and cues in chronological order, according to the scenario progression outline of Jeffries (2007). The scenario was used in 2011, consisting of 4-5 people per group of 53 senior nursing students who registered for 'clinical performance appraisal' course. The problem solving ability improved from a score of 4.05 before simulation learning to a score of 4.30 after simulation learning (t=-3.97, p<.001). The score for learning satisfaction after the simulation learning was high (4.09/5). Considering that simulation learning encouraged students to be the main body of class, this learning method can be the effective way of nursing education.


Patient Simulation;Hyperkalemia;Scenario Development


  1. 김윤민, "간호대학 신입생들의 문제해결력에 미치는 영향 요인", 간호행정학회지, 제16권, 제2호, pp.190-197, 2010.
  2. 이주희, 김소선, 여기선, 조수진, 김현례, "일 대학 간호대학생의 시뮬레이션 교육 경험 분석", 한국간호교육학회지, 제15권, 제2호, pp.183-193, 2009.
  3. S. Lapkin and T. Levett-Jones, "A cost-utility Analysis of Medium Versus High Fidelity Human Patient Simulation Manikins in Nursing Education," J. of Clinical Nursing, Vol.20, No.23-24, pp.3543-3552, 2011.
  4. J. Cooper and V. Taqueti, "A brief history of the Development of Mannequin Simulators for Clinical Education and Training," Postgraduate Medical Journal, Vol.84, No.997, pp.563-570, 2008.
  5. P. Weis and J. Guyton-Simmons, "A Computer Simulation for Teaching Critical Thinking Skills," Nurse Educator, Vol.23, No.2, pp.30-33, 1998.
  6. P. Jeffries, Simulation in Nursing Education: From Conceptualization to Evaluation, National League for Nursing, 2007.
  7. R. Kneebone, "Simulation in Surgical Training: Educational Issues and Practical Implications," Medical Education, Vol.37, No.3, pp.267-277, 2003.
  8. 전시자, 성인간호학, 현문사, 2009.
  10. 신규성, 파워 내과, 군자출판사, 2009.
  11. P. Heppner and C. Petersen, "The Development and Implications of Personal Problem-Solving Inventory," Journal of Counseling Psychology, Vol.29, No.1, pp.66-75, 1982.
  12. 강명희, 송윤희, 박성희, "웹 기반 문제 중심학습에서 메타인지, 몰입, 상호작용과 문제해결력의 관계", 교과교육학연구, 제12권, 제2호, pp.293-315, 2008.
  13. 한미현, "간호학생의 OSCE모듈 개발 및 실기평가의 경험", 간호행정학회지, 제12권, 제3호, pp.365-372, 2006.
  14. W. Eppich, V. Howard, J. Vozenilek, and I. Curran, "Simulation-Based Team Training in Healthcare," Simulation in Healthcare, Vol.6, No.7, pp.14-19, 2011.
  15. S. Beyea and L. Kobokovich, "Humal Patient Simulations: A Teaching Strategy," Association of Operating Room Nurses, Vol.80, No.4, pp.738-742, 2004.
  16. J. Childs and S. Sepples, "Clinical Teaching by Simulation: Lessons Learned from a Complex Patient Care Scenario," Nursing Education Perspectives, Vol.27, No.3, pp.154-158, 2006.
  17. 고일선, 김희순, 김인숙, 김소선, 오의금, 김은정, 이주희, 강세원, "SimMan 시뮬레이션 학습 시나리오의 개발 및 학습 수행 평가 -응급실 내원 천식 환자사례를 중심으로-", 기본간호학회지, 제17권, 제3호, pp.371-381, 2010.
  18. 김해란, 최은주, "SimBaby 시뮬레이션 학습 시나리오의 개발 평가 -응급실 내원 발열 환아를 중심으로-", 한국콘텐츠학회논문지, 제11권, 제6호, pp.279-288, 2011.
  20. M. Bremner, K. Aduddell, D. Bennett, and J. VanGeest, "The Use of Human Patient Simulators: Best Practice with Novice Nursing Students," Nurse Educator, Vol.31, No.4, pp.170-174, 2006.
  21. 양진주, "간호학생을 위한 시뮬레이션 기반교육 과정 개발 및 평가", 성인간호학회지, 제20권, 제4호, pp.548-560, 2008.
  22. C. Rauen, "Simulation as a Teaching Strategy for Nursing Education and Orientation in Cardiac Surgery," Critical Care Nurse, Vol.24, pp.46-51, 2004.