한국산학기술학회논문지 (Journal of the Korea Academia-Industrial cooperation Society)

  • 제17권3호
  • /
  • Pages.177-189
  • /
  • 2016
  • /
  • 1975-4701(pISSN)
  • /
  • 2288-4688(eISSN)
한국산학기술학회 (The Korea Academia-Industrial cooperation Society)
권호 표지
DOI QR코드

DOI QR Code

고충실도 시뮬레이터를 활용한 모성간호 시뮬레이션 교육의 효과

Effects of Maternity Nursing Simulation using High-fidelity Patient Simulator for Undergraduate Nursing Students

  • Kim, Ahrin (Department of Nursing, Cheongju University)
  • 투고 : 2016.01.12
  • 심사 : 2016.03.03
  • 발행 : 2016.03.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

본 연구는 간호대학생에게 고충실도 시뮬레이터를 활용한 모성간호 시뮬레이션 교육을 적용하고, 그 효과를 평가하기 위한 단일군 전후설계 유사실험연구이다. 간호학과 4학년에 재학 중인 학생들에게 고충실도 환자 시뮬레이터를 활용하여 임부, 산부, 산욕부 간호에 대한 시뮬레이션 교육을 실시하였고, 교육기간은 2014년 11월 10일부터 3주간이었으며, 차시별 3시간씩 총 9시간에 걸쳐 진행되었다. 교육 전후 설문을 통해 자료수집을 실시하였고, 분석에 사용된 대상자 수는 83명이었다. 수집된 자료는 IBM SPSS Statistics 20.0 프로그램을 이용하여 실수와 백분율, 평균과 표준편차, paired t-test, independent t-test, Pearson's correlation coefficients를 분석하였다. 시뮬레이션 교육 후 시뮬레이션 효과성은 총점 26점 만점에 17.4이었으며, 시뮬레이션 교육 전과 후에 의사소통능력(t=4.58, p=<.001)과 모성간호 수행에 대한 자신감(t=9.70, p=<.001)은 유의하게 향상되었으나, 문제해결능력에는 차이가 없었다. 임상실습에 만족하는 경우에 시뮬레이션 교육 후 시뮬레이션 효과성(t=2.09, p=.040), 문제해결능력(t=3.13, p=.002), 의사소통능력(t=3.54, p=.001), 모성간호 수행에 대한 자신감(t=2.64, p=.010)이 유의하게 높은 것으로 나타났으며, 시뮬레이션 효과성은 문제해결능력(r=.494, p<.001), 의사소통능력(r=.361, p<.001) 및 모성간호에 대한 자신감(r=.497, p<.001)과 유의한 양의 상관관계가 있었다. 따라서 현 임상실습의 한계에 대한 대안이자, 학생들의 임상 간호에서 필요한 역량을 강화하기 위한 전략으로써 고충실도 시뮬레이터를 활용한 모성간호 시뮬레이션 교육이 적용될 수 있으며, 이 때 학습 과정 동안 학습자의 학습경험이 학습성과로 이어질 수 있도록 하기 위한 체계적인 시뮬레이션 교수학습 전략이 필요할 것이다.

This study examined the effectiveness of maternity nursing simulations using a high-fidelity simulator for undergraduate nursing students. One-group pretest-posttest design was used. The simulation-based education program consisted of three sessions, including the clinical scenarios about prenatal, childbearing and postpartum care. The program provided for 3 weeks in November 2014. Data was collected before and after the simulation education using self-reported questionnaires, which included simulation effectiveness, problem solving ability, communication skills and self-confidence in maternity nursing. The data of 83 participants were analyzed using the IBM SPSS 20.0 program. After simulation education, the overall score of the simulation effectiveness was 17.4 out of 26.0. Communication skill (t=4.58, p=<.001) and self-confidence in maternity nursing (t=9.70, p=<.001) increased significantly in the posttest. On the other hand, there was no significant change in the problem solving ability. The simulation effectiveness correlated significantly with the problem solving ability (r=.494, p<.001), communication skill (r=.361, p<.001), and self-confidence in maternity nursing (r=.497, p<.001) after simulation-based education. These findings suggest that the high-fidelity simulation in maternity nursing education could be used not only to enhance the nursing competency, but also to deal with the limitations of the clinical practicum in the current situation.

키워드

참고문헌

  1. J. H. Kim, I. H. Park, S. Shin, S. "Systematic Review of Korean Studies on Simulation within Nursing Education.," The Journal of Korean Academic Society of Nursing Education, Vol. 19, No. 3, 307-319, 2013. DOI: http://dx.doi.org/10.5977/jkasne.2013.19.3.307
  2. S. Kim, Y. Ham, “A Meta-analysis of the Effect of Simulation based Education: Korean Nurses and Nursing Students,” Journal of Korean Academic Society of Nursing Education, Vol. 21, No. 3, pp. 308-319, 2015. DOI: http://dx.doi.org/10.5977/jkasne.2015.21.3.308
  3. J. H. Song, M. J. Moon, "Frequency and Importance of Nursing Practice between Novice Nurses and Student Nurses," Journal of Korean Academy of Fundamentals of Nursing, Vol. 15, No. 1, 22-33, 2008.
  4. Y. Kim, N. Chun, E. H. Lee, I. S. Cho, S. Ahn, J. Kim, M. H. Hur, S. Lee, H. Lee, C. Chung, N. M. Kang, H. W. Kim. "Student Experience and Satisfaction with Clinical Nursing Practice in Women's Health Nursing," Korean Journal of Women Health Nursing, Vol. 17, No. 3, pp. 225-242, 2011. DOI: http://dx.doi.org/10.4069/kjwhn.2011.17.3.225
  5. P. R. Jeffries, "A Frame Work for Designing, Implementing, and Evaluating Simulations Used as Teaching Strategies in Nursing," Nursing Education Perspectives, Vol. 26, No. 2, 96-103, 2005.
  6. W. M. Nehring, F. R. Lashley, "Nursing Simulation: A Review of the Past 40 Years". Simulation & Gaming, Vol. 40, No. 4, pp. 528-552. 2009. DOI: http://dx.doi.org/10.1177/1046878109332282
  7. C. Lee, H. So, Y. Kim, J. Kim, M. An, “The Effects of High Fidelity Simulation-based Education on Clinical Competence and Confidence in Nursing Students-A Systematic Review-,” Journal of the Korea Contents Association, Vol. 14, No. 10, pp. 850-861, 2014. DOI: http://dx.doi.org/10.5392/JKCA.2014.14.10.850
  8. R. P. Cant, S. J. Cooper, “Simulation-Based Learning in Nurse Education: Systematic Review,” Journal of Advanced Nursing, Vol. 66, No. 1, pp. 3-15, 2010. DOI: http://dx.doi.org/10.1111/j.1365-2648.2009.05240.x
  9. A. Weaver, “High-fidelity Patient Simulation in Nursing Education: An Integrative Review,” Nursing Education Perspectives, Vol. 32, No. 1, pp. 37-40, 2011. DOI: http://dx.doi.org/10.5480/1536-5026-32.1.37
  10. J. I. Kim, H. Kang, S. Park, S. Ahn, "Current Status of Women's Health Nursing Practicum and Direction" Korean Journal of Women Health Nursing, Vol. 20, No. 2, 173-183, 2014. DOI: http://dx.doi.org/10.4069/kjwhn.2014.20.2.173
  11. K. A. Adamson, S. Kardong-Edgren, J. Willhaus, "An Updated Review of Published Simulation Evaluation Instruments". Clinical Simulation in Nursing, Vol. 9, No. 9, e393-e400. 2013. DOI: http://dx.doi.org/10.1016/j.ecns.2012.09.004
  12. D. L. Kirkpatrick. Evaluating Training Programs: The Four Levels, San Francisco. CA: Berrett-Koehler Publishers, 1994.
  13. J. R. Boulet, P. R. Jeffries, R. A. Hatala, J. R. Korndorffer Jr, D. M. Feinstein, J. P. Roche, "Research Regarding Methods of Assessing Learning Outcomes," Simulation in Healthcare, Vol. 6, No. 7, S48-S51. 2011. https://doi.org/10.1097/SIH.0b013e31822237d0
  14. H. Shin, K. K. Shim, "Nursing Student's Experiences on Pediatric Nursing Simulation Practice," Journal of East-West Nursing Research, Vol. 16, No. 2, pp. 147-155. 2010.
  15. J. H. Lee, M. N. Choi, “Evaluation of Effects of a Clinical Reasoning Course among Undergraduate Nursing Students,” Korean Journal of Adult Nursing, Vol. 23, No. 1, pp. 1-9, 2011.
  16. H. Shin, Y. N. Lee, D. H. Rim, “Evaluation of Algorithm-based Simulation Scenario for Emergency Measures with High-Risk Newborns Presenting with Apnea,” Child Health Nursing Research, Vol. 21, No. 2, pp. 98-106, 2015. DOI: http://dx.doi.org/10.4094/chnr.2015.21.2.98
  17. V. L. Elfrink Cordi, K. Leighton, N, Ryan-Wenger, T. J. Doyle, P. Ravert. "History and Development of the Simulation Effectiveness Tool (SET)," Clinical Simulation in Nursing, Vol. 8, No. 6, e199-e210, 2012. DOI: http://dx.doi.org/10.1016/j.ecns.2011.12.001
  18. H. K. Burns, J. O'Donnell, J. Artman, "High-fidelity Simulation in Teaching Problem Solving to 1st-year Nursing Students: A Novel Use of the Nursing Process," Clinical Simulation in Nursing, Vol. 6, No. 3, e87-e95. 2010. DOI: http://dx.doi.org/10.1016/j.ecns.2009.07.005
  19. D. A. Cook, R. Hatala, R. Brydges, B. Zendejas, J.H. Szostek, A. T. Wang, P. J. Erwin, S. J. Hamstra, “Technology-enhanced simulation for health professions education: a systematic review and meta-analysis,” JAMA, Vol. 306, No. 9, pp. 978-988, 2011. DOI: http://dx.doi.org/10.1001/jama.2011.1234
  20. K. Miller, W. Riley, S. Davis, "Identifying Key Nursing and Team Behaviours to Achieve High Reliability," Journal of Nursing Management, Vol. 17, No. 2, pp. 247-255. 2009. DOI: http://dx.doi.org/10.1111/j.1365-2834.2009.00978.x
  21. K. K. Miller, W. Riley, S. Davis, H. E. Hansen, "In Situ Simulation: A Method of Experiential Learning to Promote Safety and Team Behavior," The Journal of Perinatal & Neonatal Nursing, Vol. 22, No. 2, pp. 105-113. 2008. DOI: http://dx.doi.org/10.1097/01.JPN.0000319096.97790.f7
  22. J. T. Alderman, "Using Simulation to Teach Nursing Students and Licensed Clinicians Obstetric Emergencies," MCN: The American Journal of Maternal/Child Nursing, Vol. 37, No. 6, pp. 394-400. 2012. https://doi.org/10.1097/NMC.0b013e318264bbe7
  23. K. Lasater, "High-fidelity Simulation and the Development of Clinical Judgment: Students' Experiences," Journal of Nursing Education, Vol. 46, No. 6, pp. 269-276. 2007.
  24. G. T. Leigh, "High-fidelity Patient Simulation and Nursing Students' Self-efficacy: A Review of the Literature". International Journal of Nursing Education Scholarship, Vol. 5, No. 1, pp. 1-17. 2008. DOI: http://dx.doi.org/10.2202/1548-923X.1561
  25. K. M. Lundberg, “Promoting Self-confidence in Clinical Nursing Students,” Nurse Educator, Vol. 33, No. 2, pp. 86-89, 2008. DOI: http://dx.doi.org/10.1097/01.NNE.0000299512.78270.d0
  26. H. Y. Kim, E. Ko, E. S. Lee, "Effects of Simulation-based Education on Communication Skill and Clinical Competence in Maternity Nursing Practicum," Korean Journal of Women Health Nursing, Vol. 18, No. 4, pp. 312-320. 2012. DOI: http://dx.doi.org/10.4069/kjwhn.2012.18.4.312
  27. C. W. Chung, H. S. Kim, Y. S. Park, "Effects of High-fidelity Simulation-based Education on Maternity Nursing," Perspectives in Nursing Science, Vol. 8, No. 2, pp. 86-96. 2011.
  28. S. Kim, S. K. Lee, H. J. Chae, “Effects of Clinical Practice and Simulation-based Practice for Obstetrical Nursing,” Korean Journal of Women Health Nursing, Vol. 18, No. 3, pp. 180-189, 2012. DOI: http://dx.doi.org/10.4069/kjwhn.2012.18.3.180
  29. S. H. Kim, “Effects of Simulation-based Practice using Standardized Patients for the Care of Women with Postpartum Hemorrhage on Nursing Student's Clinical Performance Competence and Critical Thinking Deposition,” Korean Parent-Child Health Journal, Vol. 15, No. 2, pp. 71-79, 2012.
  30. H. Chae. "The Needs and Effects of Convergence-based Simulation Practice for Obstetrical Nursing," Journal of Digital Convergence, Vol. 13, No. 9, pp. 377-386, 2015. DOI: http://dx.doi.org/10.14400/JDC.2015.13.9.377
  31. W. S. Lee, M. Kim, “Effects and Adequacy of High-Fidelity Simulation-based Training for Obstetrical Nursing,” Journal of Korean Academy of Nursing, Vol. 41, No. 4, pp. 433-443, 2011. DOI: http://dx.doi.org/10.4040/jkan.2011.41.4.433
  32. S. E. Lee, “Evaluation of the Standardized Patients(SP) Managed Instruction for a Clinical Maternity Nursing Course,” The Journal of Korean Academic Society of Nursing Education, Vol. 17, No. 1, pp. 14-24, 2011. DOI: http://dx.doi.org/10.5977/JKASNE.2011.17.1.014
  33. Y. A. Song, Y. J. Son. "Effects of Simulation-based Practice Education for Core Skill of Maternity Nursing," Korean Parent Child Health Journal, Vol. 16,No. 1, pp. 37-44. 2013.
  34. Y. A. Song, “Effect of Simulation-based Practice by Applying Problem based Learning on Problem Solving Process, Self-confidence in Clinical Performance and Nursing Competence,” Korean Journal of Women Health Nursing, Vol. 20, No. 4, pp. 246-254, 2014. DOI: http://dx.doi.org/10.4069/kjwhn.2014.20.4.246
  35. C. S. Shim, M. K. Park, J. H. Kim. "Effects of Simulation-based Delivery Education Regarding to Obstetric Clinical Practice before and after of Nursing Students," Journal of the Korean Society of Maternal and Child Health, Vol. 18, No. 1, pp. 125-133, 2014. https://doi.org/10.21896/jksmch.2014.18.1.125
  36. Korean Society of Women Health Nursing. Learning Objectives of Maternity Nursing. Korean Nurse Association, 2012.
  37. National Health Personnel Licensing Examination Board. A Study on the Job Analysis for Nurse. National Health Personnel Licensing Examination Board, 2012.
  38. D. Ellis, J. F. Crofts, L. P. Hunt, M. Read, R. Fox, M. James, “Hospital, Simulation Center, and Teamwork Training for Eclampsia Management: A Randomized Controlled Trial,” Obstetrics & Gynecology, Vol. 111, No. 3, pp. 723-773, 2008. DOI: http://dx.doi.org/10.1097/AOG.0b013e3181637a82
  39. S. H. Kim, "Effects of Simulation-based Practice using Standardized Patients for the Care of Women with Postpartum Hemorrhage on Nursing Student's Clinical Performance Competence and Critical Thinking Deposition," Korean Parent-Child Health Journal. Vol. 15.No. 2. pp. 71-79. 2012.
  40. J. Scholes, R. Endacott, M. Biro, B. Bulle, S. Cooper, M. Miles, C. Gilmour, P. Buykx, L. Kinsman, R. Boland, J. Jones, F. Zaidi. "Clinical Decision-making: Midwifery Students' Recognition of, and Response to, Postpartum Haemorrhage in the Simulation Environment," BMC Pregnancy and Childbirth, Vol. 12. No. 1, 19. 2012. DOI: http://dx.doi.org/10.1186/1471-2393-12-19
  41. Y. S. Lee et al. Maternity & Women's Health Nursing, Seoul: Hyunmoonsa, 2014.
  42. Institute for Healthcare Improvement. SBAR Technique for Communication: A Situational Briefing Model [Internet]. Cambridge (MA): Institute for Healthcare Improvement, c2014, Available From: http://www.ihi.org/resources/Pages/Tools/SBARTechniqu eforCommunicationASituationalBriefingModel.aspx (accessed Sep 30, 2014)
  43. C. A. Tanner, “A Thinking Like a Nurse: A Research-based Model of Clinical Judgment in Nursing,” Journal of Nursing Education, Vol. 45, No. 6, pp. 204-211, 2006.
  44. S. J. Lee, Y. K. Jang, H. N. Lee, K. Y. Park, "A Study on the Development of Life-Skills: Communication, Problem Solving, and Self-Directed Learning," Korean Educational Development Institute (RR2003-15-03), 2003.
  45. I. Ko, H. Kim, I. Kim, S. Kim, E. Oh, E. Kim, J. Lee, S. Kang, “Development of a Scenario and Evaluation for Simulation Learning of Care for Patients with Asthma in Emergency Units,” The Journal of Fundamentals of Nursing, Vol. 17, No. 3, pp. 371-381, 2010.
  46. Korean Accreditation Board of Nursing Education. Nurses' Core Competence and Program Outcome for Nursing Education. Seoul: Korean Accreditation Board of Nursing Education, c2011, Available From: http://kabone.or.kr/(accessed Sep 30, 2014)
  47. A. Lee, J. Yeo, S. Jung, S. S. Byun. "Relations on Communication Competence, Job-stress and Job-satisfaction of Clinical Nurse," Journal of the Korea Contents Association, Vol. 13, No. 12, pp. 299-308, 2013. https://doi.org/10.5392/JKCA.2013.13.12.299
  48. S. H. Kim, M. A. Lee, "Effects of Emotional Labor and Communication Competence on Turnover Intention in Nurses," The Journal of Korean Nursing Administration Academic Society, Vol. 20, No. 3, pp. 333-342. 2014. DOI: http://dx.doi.org/10.11111/jkana.2014.20.3.332
  49. J. H. Park, I. S. Chun, “The Lived Experience of Newly Employed Nurses: Phenomenological Study,” Journal of Qualitative Research, Vol. 9, No. 2, pp. 99-110, 2008.
  50. C. M. Thomas, E. Bertram, D. Johnson, “The SBAR Communication Technique: Teaching Nursing Students Professional Communication Skills,” Nurse Educator, Vol. 34, No. 4, pp. 176-180, 2009. DOI: http://dx.doi.org/10.1097/NNE.0b013e3181aaba54
  51. M. R. Eom, H. S. Kim, E. K. Kim, K. Seong, "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, Vol. 40, No. 2, pp. 151-160. 2010. DOI: http://dx.doi.org/10.4040/jkan.2010.40.2.151
  52. Y. H. Kim, K. S. Jang, "Effect of a Simulation-based Education on Cardio-pulmonary Emergency Care Knowledge, Clinical Performance Ability and Problem Solving Process in New Nurses," Journal of Korean Academy of Nursing, Vol. 41, No. 2, 245-255, 2011. DOI: http://dx.doi.org/10.4040/jkan.2011.41.2.245
  53. M. S. Lee, S. W. Hahn, "Effect of Simulation-based Practice on Clinical Performance and Problem Solving Process for Nursing Students," The Journal of Korean Academic Society of Nursing Education, Vol. 17, No. 2, pp. 226-234, 2011. DOI: http://dx.doi.org/10.5977/JKASNE.2011.17.2.226
  54. D. H. Kim, Y. Lee, M. S. Hwang, J. H. Park, H. S. Kim, H. G. Cha, “Effects of a Simulation-based Integrated Clinical Practice Program (SICPP) on the Problem Solving Process, Clinical Competence and Critical Thinking in a Nursing Student,” The Journal of Korean Academic Society of Nursing Education, Vol. 18, No. 3, pp. 499-509, 2012. DOI: http://dx.doi.org/10.5977/jkasne.2012.18.3.499