The Effect of Clinical Simulation on Student Self Efficacy in Learning at NSU - Research Paper Example

? The Effect of Clinical Simulation on Self Efficacy in learning at NSU Marline Whigham Nova Southeastern This dissertation was intended to analyze the effects of clinical simulation on self-efficacy of students under health care training. The main aspect of this research was to collect data from group of students currently being educated in institutes which incorporate clinical simulation as a part of their curriculum. As medical practice cannot be made directly on a patient and one cannot wait for a medical emergency to practice one’s skills, clinical simulation provides an effective doorway to practicing clinical medicine. Hence, clinical simulation has been integrated into certification and licensure requirements for personnel belonging to health care profession. Furthermore, it is very effective in preparing students for crisis management as it attains a higher level than conventional training in management of a rare crisis; mainly due to the ability to provide a student with unlimited practice in a secure yet familiar atmosphere. Keeping this concept in mind, the writer vigilantly assesses the need of clinical simulation in order to build up the self-confidence and to improve the efficiency of students in their career. Additionally, for future reference the writer tries to investigate whether clinical simulation has any implications on development of future techniques to improve health care. The following exposition revolves around the basic idea, advantages, disadvantages and its probable effects on self efficacy of students and professionals of one of the methods widely used in practical learning; Simulation. For decades, research on the ways to make teaching methods more effective has been carried out around the world. Whether it be health, sports, law, politics or any other profession, incorporation of practical work is now essential in educating students belonging to diverse professions. As teaching methods have progressed over the years, constant modifications to cultivate students learning potential and to make them better professionals, is essentially incorporated in teaching curriculums. From doctors, nurses, medical students to therapeutic staff, clinical simulation has become part of teaching at all levels and therefore effects their learning outcomes in the form of their practical work. Health care profession demands high standards of work ethics and faultlessness. Therefore, if these standards are not met self confidence tends to deteriorate. In such conditions, one tends to feed anxiety because failure is anticipated, which undermines one’s self-efficacy (Watt & Stewart, 2008). Examining the social learning theory proves to be valuable in discussing the effect of clinical simulation on self efficacy of students. According to the social learning theory, self efficacy refers to an individual's belief that he or she is capable of performing a task, in terms of organizational behavior; the higher the self efficacy, the more confidence one has in one’s capacity to perform a duty (Robbins, 2010). To explain the importance of clinical simulation, one needs to collect data regarding the incorporation of this method in teaching curriculum. Focusing on this point, clinical simulation has become an essential part of learning; state boards of nursing approve specific substitutions count between 10% and 25% of simulation time as clinical experience (Gaberson, Gaberson & Oermann, 2010). Nevertheless, complete comprehensive data and the performance of students need to be collected for complete analysis of the effects of clinical simulation. This study targets the students or health care professionals currently training in programs which include dealing with clinical simulation. It will give an in depth insight about the effects of clinical simulation on the future medical practice of students. Simulation is a goal-directed experimentation with dynamic models, which has time-varying characteristics and can be mathematical, symbolic or physical (Sokolowski & Banks, 2009). Simulation symbolizes pretence and not the actual existent process. Its main aim is to stimulate the idea of reality without actually experiencing it, beneficially allowing one to re-do it again and again until perfection is achieved. The key elements of a simulation include: a realistic scenario, a demanding management task, a set of believable characters, a range of managerial actions and a realistic role for the troupe (Nejdl, 2006). Analyzing these elements as a whole, simulation programs should have the most superior form of impact from a real life experience, only then can the beneficial effects of a reality based learning program be observed. The purpose of this study is to closely evaluate the pros and cons of clinical stimulation and all the possible ways in which one can affect the students under medical training. In depth to the whole idea of clinical simulation, emphasis is based on the self-efficacy of the medical professionals trained through clinical simulation and whether this routine has a positive or negative effect on it. Furthermore, we explore whether using artificial means of clinical education, in contrast to an actual interaction with a patient, can successfully prepare students for challenging medical emergencies they shall encounter in professional careers. After explaining the definition of simulation and its basic concepts, an in depth explanation and review is now required. Worldwide clinical simulation is used to educate trainees in the health care profession. Health care is a profession that demands perfection, since health is the most precious gift any human can have. Accordingly, when a human life is endangered or is in a detrimental condition, it is the utmost priority of health professionals to relieve the patient from any element harmful to the body and provide the highest level of care and protocol. With this being said, dealing with human lives everyday is challenging, stressful, and tiring since precision and errorless practice is expected from every health professional. It is now that we can completely understand the role of clinical simulation coming into play. Health care teaching is more complicated than any other professional training, mainly because absolute meticulousness is to be practiced while dealing with a patient. Since humans cannot be used as lab rats, the highest level of clinical simulation is needed to give the most absolute standard of real life experience. With so much responsibility, naturally fear encompasses every health care profession student. To counter this fear and to make a student respond confidently to a medical situation, repeated practical exercises are necessary. In the same regard, health care profession co-ordination and team work is essential. Therefore, clinical simulation not only applies to the individual, but also to the harmony of crews, teams, work units and organizations, making it vital for promoting a culture of safety and competency-based practice (Nehring & Lashley, 2010). Going further deep into this concept, personnel with lower self-efficacy will be more prone to lessen their efforts, or in some cases give up, in challenging and provoking situations as compared to those with a higher self-efficacy. Furthermore, those with higher self-efficacy respond with added enthusiasm to negative or demeaning feedback. Therefore, the level of self-efficacy will play a key role in determining an individual’s performance while carrying out a certain task. With different demands by different professions, specifically in health care, self-efficacy can be a vital attribute of an individual belonging to this field. Self-confidence is one of the major components of having command over one’s skills. One of the aspects of self-confidence is self-efficacy and is greatly influenced by training and experience (Wart, 2007). With advancement in teaching modus operandi, clinical simulation is increasingly being used to teach psychomotor skills and critical thinking dexterity. The reasons for this inclination include: cost containment changes in the conventional health care system which have resulted in fewer learning experiences with less supervision and mentoring; increased patient insight and technological interventions requiring better prepared novice learners (Feingold, Calaluce & Kallen, 2004). Furthermore, educational sites have moved from hospital based programs to university settings, making clinical simulation a necessary part of the curriculum. Therefore research is needed to be carried out in order to analyze in depth the pros and cons of clinical simulation. To carry out this analysis, in person observation and surveys need to be carried out to observe the health care abilities of students who are in programs that include clinical simulation. One critical variable of this research is the self-efficacy of the students under observation. Furthermore, effects of repeated sessions of clinical simulation need to be investigated for a thorough concept. The question now arises whether clinical simulation will have a positive outcome on the self-efficacy of students, which is our major concern. An important factor to be focused is the comfort of students who become a part of this survey. They should be able to answer the research questions with ease and without any pressure from the administration. Furthermore, students are to be completely assured of confidentiality regarding the questionnaire. The feature of this research which makes it different from all others conducted previously is that it focuses on one element of a health care professional’s medical skills. The research questions need to be understandable and accurately target the aim of the research. While forming questions a few aspects need to be kept in mind. Firstly the self-efficacy factor of clinical simulation and the question formed can be: what factors regarding clinical simulation has affected the self-efficacy of students? In the next question we focus on how clinical simulation provides a solid substitute for an actual patient. Reading from books and memorizing without practicing is not sufficient, especially in health care. Thus clinical simulation can be an effective means of ensuring that what is learned can affectively be applied (Fisher & Frey, 2008). In addition, research has shown that students highlight the need for learning experiences within clinical simulation to be more authentic, to improve the theory to practice gap (Pike & O’Donnell 2009). Hence, the second question can be: How effectively does clinical simulation link theory and practice? Thirdly clinical documentation exercises have been used to duplicate common experiences that nurses or healthcare professionals might come across (Harris, 2009). Hence, the next question is; how has clinical simulation helped you prepare for common situations frequently experienced? Complex and intricate situations can be presented to students to improve their process and polish their minds to look into every minuscule aspect of a scenario. This can additionally improve the decision-making skills of the students. One learns from experience and applies one’s improved decision making skills to next problem (Parcon, 2006). Keeping this aspect in mind the fourth question is: How intensely has clinical simulation helped decision making skills of health care professionals? Furthermore, trainees usually tend to find simulation sessions less boring than traditional learning (Wong, Ng & Chen, 2002). The next question is: What are the benefits of coupling clinical simulation with lectures? Also we need to design questions to cover the views of students on the negative aspect of clinical simulation, in order to provide research information for the developers of clinical simulation on how it can be improved. The human body is complexly constructed, and a specific treatment can have a range of outcomes on every individual depending on their current health status. Clinical simulation in that case is limited. It cannot cover all aspects of the human body such as facial expressions, skin color, skin turgor and pallor which can never change in a simulation (Lorna & Hostad, 2007). Consequently, the fifth question is: Does clinical simulation limit learning with regard to certain aspects of human body, (skin color, facial expressions and pallor) which remain constant? Furthermore, one question should focus on the future possible uses of clinical simulation. With advanced technological advances, the simulation of needle insertion under ultrasound guidance is being used to plan and train a number of clinical procedures (Jiang, 2010). The constantly advancing technology allows surgeons to practice virtual surgeries in simulated conditions without risk to patients. Apart from the practical skills, simulation can be extensively used to support clinical drug development at all phases (Robertson & Williams, 2008). With reference to this finding the sixth question is: Is continuation of clinical simulation in teaching beneficial for future developments in medical profession? These six questions completely cover all aspects of this research and can provide useful insight for future researches and technological advancements with reverence to clinical simulation. Additionally, another aspect to be kept in mind is that with the finances that are required to be spent on clinical simulation, one question’s whether spending so much on technology, which can be otherwise spent of machinery for treating patients, is cost effective. Hence, cost is often the deterrent in development of clinical simulation labs (LePlatte, 2003). The methodology used to carry out this research will be questionnaire, which carries six questions and will comprehensively cover the data required. The target population in this case is the students under medical training, medical students, nursing students and other clinical staff under training. While searching for the target population, particular emphasis should be on ensuring that the individuals becoming a part of this research have been trained under clinical simulation sessions. Demographic information includes age 18-30 years, marital status includes married or bachelor, gender male or female, and profession. With reference to profession, it should definitely be a student but should specify from which specific department i.e. medicine, nursing or any other subdivision. The procedure used in this case is non-probability purposive sampling. The reason for this selection is that we need to extract information from a specific group and not a randomized selection. The target population specifically includes students under clinical simulation training. Since selection is on the basis of our own knowledge of the population, its elements and the nature of our research aims – in short, based on our judgment and purpose of the study, therefore we use non-probability purposive sampling (Maxfield & Babbie 2008). The instrument used to collect data for this research is questionnaire. Appropriate questions will be formed and printed on a single sheet of paper and handed to the individual part of the population under the research. In each scale five levels can be set with a statement to be judge. This is done by using the Likert scale, which measures the strength of the respondent’s perceived agreement or disagreement (Schmee & Oppenlander 2010). These five levels are; strongly disagree, disagree, neither agree nor disagree, agree and strongly agree. The questionnaire can be distributed to a group of students in a medical training institute. To analyze the data we can use the polytomous Rasch model which is used when the data is by nature polytomous (i.e. more than two responses categories). In order to check reliability the questionnaire needs to be handed out in person and collect orderly after the individual is done completing it. Allotment of time required to finish the questionnaire can be made according to the number of items. It is to be assured that no questionnaire is misplaced and that the questions are understood completely by every individual. No individual is given permission to carry the questionnaire around or ask for help, except from the person in charge of distributing and collecting the questionnaire. These measures can help to increase the authenticity of the survey carried out. Health care simulation is therefore, a very effective way of preparing medical professionals for their medical practice on real-life patients and serious practical problems, since students can practice skills in a simulation laboratory without the constraint of a real-life situation (Oermann & Gaberson 2009). Since medical simulation gives an opportunity to experience a diverse range of situations, it helps enable medical professionals to deal with sudden unfamiliar complicated situations arising in real-life. References Ayala, J. E. (2008). The theory and practice of item response theory: Methodology in the social sciences. New York, NY: Guilford Press. Feingold, C. E., Calaluce, M. & Kallen, M. A. 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