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Measuring Efficiency in Nursing Student Patient Care Skills Using Virtual Patient Simulations
Conflicts of Interest
The authors of this presentation are employed by a publishing company specializing in scientific, technical, and medical content, including simulations for nursing education.
No additional funding was received for this project.
Challenges for Recent Graduates
Face the responsibility of providing patient care without the safety net of their nursing program faculty.
Struggle with developing efficiency in their patient care as the responsibility shifts from learning under clinical faculty to the reality of caring for their patients.
Nurses feel that time pressure prevents them from identifying patient needs Vinckx et al., 2018), and the patients of time-pressed nurses have a lower quality care experience (Teng et al., 2010).
Appropriate and efficient communication can improve the quality of nursing care while allowing nurses to manage their time (Bundgaard et. al, 2019; Jones, 2010).
Research Question
Do learners become more efficient in the collection of subjective and objective data, therapeutic communication, and care planning as they go through a virtual patient simulation?
Virtual Patient Simulation
Virtual patient simulation (VPS) is the use of partial immersion through a digital learning environment to foster a perceived lived experience for an intended outcome (Foronda, 2021).
Compared with traditional education, VPS can effectively improve knowledge, clinical reasoning, procedural skills, and a mix of procedural and team skills Kononowicz et al., 2019).
Effectively supports several student learning outcomes and skills in nursing education (Foronda et al., 2020).
- History taking (Luo et al., 2019).
- Empathy (Strekalova et al., 2016).
- Diagnostic reasoning (Duff et al., 2016).
- Debriefing (Verkuyl et al., 2020).
- Cultural humility and competence (Chae et al., in press; Tyerman et al., 2021).
Can be used to replace traditional clinical hours!
Digital Clinical Experience
Pre-brief
- Provide learner with the context and information they may need before encountering scenario.
- Set up learner’s role and expectations.
- Outline simulation objectives and what will be evaluated.
Assessment
- Interview digital standardized patient.
- Conduct physical assessments.
- Document findings in EHR.
- Apply therapeutic communication.
Care Plan
- Synthesize data collected.
- Develop a nursing diagnosis.
- Identify a treatment goal.
- Plan interventions and evaluations
- Discuss care.
- Assess whether care goals were achieved.
Feedback
- Obtain assignment performance score.
- View score breakdown by learning activity.
- Review model responses.
The Research Process
Used a sample of 2,246 first semester, pre licensure nursing students enrolled in a health assessment course at a public university in the Southwestern United States.
Health assessment course integrated the VPS in simulation pre and post test with a cardiovascular focused assessment assignment in the spring of 2021.
Efficiency was defined by the number of correct findings per minute spent with the simulated virtual patient across all components of learner performance, including subjective and objective patient data collection, therapeutic communication, and care plan creation.
Results 1
Results 2
Conclusion and Implications for Practice
- Learners demonstrated significant efficiency gains as measured by findings per minute from the pre test to the post test.
- These results indicate that VPS can be a useful tool for improving learners’ practice readiness.
- As learners progress through VPS scenarios, they become more comfortable with how to collect data and determine how to dig deeper with their questions and uncover important data points.
- Developing the skill for efficient data collection in the simulated environment boosts learners’ ability to become more efficient in their patient interactions while at the same time providing high quality care.
References
Bundgaard, K., Delmar, C. & Soerensen , E.E. (2019). Fundamentals of care in time limited encounters: Exploring strategies that can be used to support establishing a nurse patient relationship in time limited encounters. Journal of Nursing Studies and Patient Care, 1(1), 8-16.
Jones, T.L. (2016). What nurses do during time scarcity and why. Journal of Nursing Administration, 46(9), 449-454. doi : 10.1097/NNA.0000000000000374
Teng, C., Hsiao, F. & Chou, T. (2010). Nurse perceived time pressure and patient perceived care quality. Journal of Nursing Management, 18, 275-284. doi : 10.1111/j.1365 2834.2010.01073.x
Vinckx , M.A., Bossuyt , I. & Dierckx de Casterlé , B., (2018). Understanding the complexity of working under time pressure in oncology nursing: A grounded theory study. International Journal of Nursing Studies, 87, 60-68. doi : https://doi.org/10.1016/j.ijnurstu.2018.07.010
Wong, K., Valimaki , J., Zimmerman, J., Bennett, S. & Calero, M.A. (2021, January). Nursing Linkages: Research Insights. Elsevier Nursing and Health Education.
Thank You!
Francisco A. Jimenez: francisco@shadowhealth.com
Cheryl Wilson: cheryl.wilson@shadowhealth.com
Natalie Wright: natalie.wright@shadowhealth.com