DOI QR코드

DOI QR Code

Clinical Competence and Self-confidence of New Graduate Nurses with an Integrated Nursing Curriculum of Simulation with Problem-Based Learning

문제중심학습 연계 시뮬레이션 기반 통합간호교육과정을 이수한 신졸업간호사의 간호수행능력과 자신감

  • 노영숙 (중앙대학교 적십자간호대학) ;
  • 김성희 (중앙대학교 적십자간호대학) ;
  • 양선희 (중앙대학교 적십자간호대학) ;
  • 강윤숙 (알엠컨설팅)
  • Received : 2013.04.04
  • Accepted : 2013.07.11
  • Published : 2013.07.31

Abstract

The purpose of this study was to verify the effectiveness of an integrated nursing curriculum based on simulation with problem-based learning (PBL) by comparing the clinical competence and the self-confidence of newly graduated nurses. A non-equivalent control group post-test design was employed to compare the clinical competence and the self-confidence in the clinical performance examination using standardized patients between 39 newly graduated nurses with the traditional nursing curriculum and 35 with the integrated nursing curriculum. Data analysis involved Fisher's exact test, t-test, Pearson's correlation coefficient, and ANCOVA with the SPSS 19.0 program. The total clinical competence mean score graded by the standardized patients was not different between the two groups. However, the total clinical competence mean score graded by faculty was significantly higher in the integrated curriculum group than the traditional curriculum group. The mean self-confidence score was significantly higher in the integrated curriculum group than the traditional curriculum group. Active teaching-learning strategies including simulation or PBL in the nursing curriculum could benefit for nursing students by inducing favorable clinical competence and self-confidence. Longitudinal follow-up studies based on observation are needed to explore the patient outcomes in addition to the learner outcomes in clinical settings.

본 연구의 목적은 PBL 연계 시뮬레이션 기반 통합간호교육과정을 이수한 신졸업간호사와 교과목 중심의 전통적 간호교육과정을 이수한 신졸업간호사간의 간호수행능력정도와 간호수행능력 자신감의 차이를 표준화환자 기반 간호수행평가를 활용하여 비교분석하는 것이다. 연구대상자는 전통적 간호교육과정을 이수한 신졸업간호사 39명과 통합간호교육과정을 이수한 신졸업간호사 35명, 총 74명이었다. 연구방법은 두 대상자 그룹간에 표준화환자 기반 간호실무능력 평가 시험에서 간호수행능력 평가점수와 간호수행능력 자신감을 비교하기 위한 비동등성 대조군 사후 시차설계를 적용한 유사 실험 연구로 수집된 자료는 SPSS 19.0 프로그램을 사용하여, Fisher's exact test, t-test, Pearson's correlation coefficient, ANCOVA를 이용하여 분석하였다. 표준화환자를 활용한 간호실무수행능력 평가시험을 실시한 결과 통합간호교육과정 이수 신졸업간호사와 교과목 중심의 전통적 간호교육과정 이수 신졸업간호사 간에 표준화 환자가 채점한 간호수행능력 점수는 차이가 없었으나, 통합간호교육과정 이수 신졸업간호사의 교수자가 평가한 기술적 술기 점수, 비기술적 술기 점수와 간호수행능력에 대한 자신감이 대조군에 비해 유의하게 높았다. 본 연구의 결과를 바탕으로 간호교육과정에 PBL 연계 시뮬레이션 기반 교과를 적용할 것을 제언하며, 통합간호교육과정을 이수한 신졸업간호사의 임상간호 현장에서의 실무능력과 환자 성과 변화를 장기추적 관찰하는 추후 연구가 필요하다.

Keywords

References

  1. Mennenga, H. A., & Smyer, T. (2010). A model for easily incorporating team-based learning into nursing education. International Journal of Nursing Education Scholarship, 7(1), Article4. Advanced online publication. DOI: http://dx.doi.org/10.2202/1548-923X.1924.
  2. Rideout, E., & Carpio, B. (2001). The problem-based learning model of nursing education. In Rideout, E(Ed.), Transforming nursing education through problem-based learning (pp.21-49). Mississauga: Jones and Barlett Publishers.
  3. K. K. Kim, B. Yun, H. S. Jang & E. S. Kong. (2002). A study on the methods of nursing curriculum integration for problem-based learning. Journal of Margaret Pritchard University, 14(1), 149-164.
  4. J. Yoon. (2008). A study on the critical thinking disposition of nursing students-Focusing on a school applying integrated nursing curriculum. The Journal of Korean Nursing Administration Academic Society. 14(2), 159-166
  5. Reilly, A., & Spratt, C. (2007). The perceptions of undergraduate student nurses of high-fidelity simulationbased learning: a case report from the University of Tasmania. Nurse Education Today, 27(6), 542-550. DOI: http://dx.doi.org/10.1016/j.nedt.2006.08.015
  6. Rochmawati, E., & Wiechula, R. (2010). Education strategies to foster health professional students' clinical reasoning skills. Nursing and Health Sciences, 12(2), 244-250. DOI: http://dx.doi.org/10.1111/j.1442-2018.2009.00512.x
  7. Yuan, H., Williams, B. A., & Fan, L. (2008). A systematic review of selected evidence on developing nursing students' critical thinking through problem-based learning. Nurse Education Today, 28(6), 657-663. DOI: http://dx.doi.org/10.1016/j.nedt.2007.12.006
  8. Harder, B. N. (2010). Use of Simulation in Teaching and Learning in Health Sciences: A Systematic Review. Journal of Nursing Education, 49(1), 23-28. DOI: http://dx.doi.org/10.3928/01484834-20090828-08
  9. Issenberg, S. B., McGaghie, W. C., Petrusa, E. R., Lee Gordon, D., & Scalese, R. J. (2005). Features and uses of high-fidelity medical simulations that lead to effective learning: A BEME systematic review. Medical Teacher, 27(1), 10-28. DOI: http://dx.doi.org/10.1080/01421590500046924
  10. May, W., J. H. Park, & J. P. Lee. (2009). A ten-year review of the literature on the use of standardized patients in teaching and learning: 1996-2005. Medical Teacher, 31(6), 487-492. DOI: http://dx.doi.org/10.1080/01421590802530898
  11. Maxwell, N. L., Mergendoller, J. R., & Bellisimo, Y. (2004). Developing a problem-based learning simulation: An economics unit on trade. Simulation & Gaming, 35(4), 488-498. DOI: http://dx.doi.org/10.1177/1046878104264789
  12. Docherty, C., Hoy, D., Topp, H., & Trinder, K. (2005). E-Learning techniques supporting problem based learning in clinical simulation. International Journal of Medical Informatics, 74(7-8), 527-533. DOI: http://dx.doi.org/10.1016/j.ijmedinf.2005.03.009
  13. Liaw, S. Y., Chen, F. G., Klainin, P., Brammer, J., O'Brien, A., & Samarasekera, D. D. (2010). Developing clinical competency in crisis event management: An integrated simulation problem-based learning activity. Advances in Health Sciences Education: Theory and Practice, 15(3), 403-413. DOI: http://dx.doi.org/10.1007/s10459-009-9208-9
  14. M. S. Chu., Y. Y. Hwang, & C. S. Park. (2006). Development and application of PBL module using simulator- Focused on SimMan. Journal of Korean Academy of Fundamentals of Nursing, 13(2), 182-189.
  15. J. Y. Kim., & E. Y. Choi. (2008). Learning element recognition and academic achievement of nursing student receiving PBL with simulation education. Journal of Korean Academy of Adult Nursing, 20(5), 731-742.
  16. W. S. Lee, K. C. Cho, S. H. Yang, Y. S. Roh, & G. Y. Lee. (2009). Effects of problem-based learning combined with simulation on the basic nursing competency of nursing students. Journal of Korean Academy of Fundamentals Nursing, 16(1), 65-73.
  17. Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175-191. DOI: http://dx.doi.org/10.3758/BF03193146
  18. M. R. Eom, H. S. Kim, E. K. Kim & K. Y. Seong. (2010). Effects of teaching method using standardized patients on nursing competence in subcutaneous injection, self-directed learning readiness, and problem solving ability. Journal of Korean Academy of Nursing, 40(2), 151-160. DOI: http://dx.doi.org/10.4040/jkan.2010.40.2.151
  19. Wallace, P. (2007). Coaching standardized patients: For use in the assessment of clinical competence. New York: Springer Publishing.
  20. M. S. Yoo, & I. Y. Yoo. (2003). Effects of OSCE method on performance of clinical skills of students in fundamentals of nursing course. Journal of Korean Academy of Nursing, 33(2), 228-235.
  21. Ericsson, K. A. (2004). Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Academic Medicine, 79(10Suppl), S70-81.
  22. Wayne, D. B., Butter, J., Siddall, V. J., et al. (2006). Mastery learning of advanced cardiac life support skills by internal medicine residents using simulation technology and deliberate practice. Journal of General Internal Medicine, 21(3), 251-256. DOI: http://dx.doi.org/10.1111/j.1525-1497.2006.00341.x
  23. J. Y. Choi, K. S. Jang, S. H. Choi & M. S. Hong. (2008). Validity and reliability of a clinical performance examination using standardized patients. Journal of Korean Academy of Nursing, 38(1), 83-91. DOI: http://dx.doi.org/10.4040/jkan.2008.38.1.83
  24. Farrand, P., McMullan, M., Jowett, R., & Humphreys, A. (2006). Implementing competency recommendations into pre-registration nursing curricula: effects upon levels of confidence in clinical skills. Nurse Education Today, 26(2), 97-103. DOI: http://dx.doi.org/10.1016/j.nedt.2005.06.002
  25. Lauder, W., Watson, R., Topping, K., et al. (2008). An evaluation of fitness for practice curricula: self-efficacy, support and self-reported competence in preregistration student nurses and midwives. Journal of Clinical Nursing, 17(14), 1858-1867. DOI: http://dx.doi.org/10.1111/j.1365-2702.2007.02223.x
  26. Kable, A. K., Arthur, C., Levett-Jones, T., & Reid-Searl, K. (2012). Student evaluation of simulation in undergraduate nursing programs in Australia using quality indicators. Nursing & Health Sciences. DOI: http://dx.doi.org/doi/10.1111/nhs.12025

Cited by

  1. Effects of an Education Program for Effective Nursing Intershift Handoff Communication on Nurses' Intershift Performance, Self-Efficacy, and Interrelationship Stress among Clinical Nurses: A Pilot Study vol.25, pp.3, 2016, https://doi.org/10.12934/jkpmhn.2016.25.3.176
  2. Effects of Simulation with Problem-based Learning on Care for Patients with Autonomic Dysreflexia vol.20, pp.2, 2017, https://doi.org/10.7587/kjrehn.2017.140