Videotape Vignettes and High-Fidelity Human Simulation - Essay Example

? Critique of Quantitative Research Article The primary aim of this paper is to illustrate the study overview of a report carried out to assess the relationship between critical thinking and the overall performance of nurses in a clinical set up. The study involves the use of videotape vignettes (VTV) and high fidelity human simulation (HFHS). In VTV, the test candidate is evaluated by the response that they write down after watching a video recording of a situation in a clinical set up involving an actor who assumes the role of a patient. In HFHS, the candidate is evaluated using their reaction to a human like a mannequin that responds to external stimuli like a real patient would. The study used two other evaluation methods to augment the results of VTV and HFHS in relation to critical thinking. These were the California Critical Thinking Disposition Inventory (CCTDI) and California Critical Thinking Skill Test (CCTST). CCTDI and CCTST join the link between physical performance and the mental capacity engaged in this type of response. The study aims at establishing if there is a link between critical thinking and the overall performance of a practicing nurse in the real world clinical situations. This is done by comparing the performance scores in HFHS and VTV assessments and determining if there is a relationship between simulations based performances and critical thinking. In the nursing profession, there is the need for a high degree of competency in handling medical situations and emergencies. How a nurse responds to a situation is meaningful for a patient’s recovery or their demise. The proper identification of a problem and the appropriate subsequent response to the problem is linked to how effective that person is at handling such situations, and it has been linked to a person’s state of mind. Critical thinking is an essential component in the performance of a nurse, their cognitive abilities to be able to identify a clinical condition for what it is. Sound critical thinking enhances the performance of a nurse and the overall care that a patient receives. The induction of efficient critical thinking begins at the onset of life, and is influenced by the external surrounding and the type of education that one is exposed to in terms of quality and relevance. The assessment of critical thinking through the use of question and answer methods fail to bring out the actual capability of a nurse in a real clinical situation. They do help to gauge their cognitive abilities, but do not show their level performance, in a practical scenario, where their actions and judgments are required immediately to save a life. The development of simulated assessment methods present a better method of assessing the performance of an individual, and it makes it easier for them to provide rationale, for their actions because simulations engage multiple sensory pathways making them dynamic, thus giving the nurse a variety of options to choose from, in regards to the one that is best suited for the situation at hand. Videotape vignettes (VTV) is an assessment method that requires a test candidate to watch a video where an actor assumes the condition of a patient suffering from a specific ailment and the candidate writes down how they would respond in such a situation and reasons supporting their decisions. In the assessment method of High fidelity Human Simulation (HFHS), the candidate is exposed to controlled experimental type scenario where a human like mannequin that can respond to external stimuli is programmed to mimic a person who is suffering from a certain ailment. The candidate’s performance is evaluated by gauging how they handle the ‘patient’ and what type of actions they initiate to mitigate the unfolding situation. To be able to gauge the critical thinking capacity of candidate accurately, these assessments are coupled to California Critical Thinking Disposition Inventory (CCTDI) and California Critical Thinking Skill Test (CCTST) as a way of trying to create a link between performance and mental acuity. These two assessment instruments are the ones that are predominantly used, in the nursing population (Nehring & Lashley, 2010). Critical thinking is the ability to recognize a problem or discern the existence of a certain situation, determine evidence supporting the assertion and the application of knowledge and attitudes to initiate an appropriate response (Nehring & Lashley, 2010). When both CCTST and CCTD are applied concurrently with VTV and HFHS, they help establish insights into the person’s critical thinking aptitude. CCTST and CCTD rate the candidates overall performance and knowledge through gauging their ability to recognize clinical problems, report clinical data, initiate proper interventions, how they anticipate medical instructions, the rationale they provide for their decisions and to what category they put the patient’s condition (Leninger & McFarland, 2006). The assessment is carried out in phases that allow time for orientation in the different procedures involved. On completion, the groups exchange and they undergo the procedure that they had not participated in. Concurrent assessments are done using CCTDI and CCTST tests. CCTDI gauges the individual’s motivation to use their critical thinking skills to make judgments when tackling problems (Nehring & Lashley, 2010). CCTST evaluates the ability of a candidate to make informed decisions after an analysis or evaluation of a patient. It measures the participant’s skills in analyzing, drawing inferences based on their deductive and inductive reasoning capabilities (Leninger & McFarland, 2006). The study through reference to other existing research works established that scores recorded from various assessment methods did not match correspondingly. Meaning that a high score, in VTV, does not guarantee a high score in CCTST or CCTDI, or vice versa. The same case applied to HFHS. In the case of this specific study, retaking a CCTST test and a VTV as an addition, did not improve the score in CCTST. To be able to use VTV effectively, it has been suggested to use it along side Performance Based Development system (PBDS). It has its own scoring scale, and the score a candidate garners shows that candidate’s ability to meet the expected performance threshold. The study showed that there was no relationship between the CCTST scores and HFHS, but there was a significant relationship statistically, between the performances, in HFHS and scores, in CCTDI. HFHS engages the participant both physically and mentally because it entails the candidate taking action on the ‘patient’ like measuring of blood pressure, taking a lung ultrasound scan and verbally reassuring the ‘patient’. HFST increases the competency and confidence, and their proficiency in operating, in an actual clinical setting, unlike VTV that only engages the cognitive abilities of a nurse. A high performance score in VTV does not guarantee reproducibility in real-world clinical settings (Leninger & McFarland, 2006). HFHS promises a higher degree of ensuring that results from its use can be reproduced, in an actual clinical set up because it offers a near real-life experience, in the candidate. In the use of VTV and HFHS, differences were exposed between what a person states they will do, and what they actually do when confronted, by the actual situation (Quinn, 2000). The participants were acquired through a volunteer initiative basing their candidature on different educational backgrounds and qualifications. Their experience was also considered, and they were categorized into inexperienced candidates with less than one year experience and those who had more than one year experience. In studies involving VTV, the performance and scores involving CCTST and CCTDI were independent of age and experience because the input required is theoretical and acquired through learning. On the other hand, those candidates who had more experience showed better performances in HFHS and higher scores especially in CCTDI. The evaluation was conducted against a control model that was put in place by professional raters who provided the marking scheme for the evaluation. They determine what is graded as an acceptable response. The validity and reliability of VTV and HFHS is ensured by involving independent professional raters who are blinded to the candidate’s assignments and their responses compared. Candidates are rated on their ability to prioritize clinical care, recognition of clinical problems and the form of intervention they initiate. In conducting the study, ethical considerations were taken into account and approvals from the relevant authorities were sought from the institutions involved. The participants were required to sign informed written agreements that outlined their consent to participating in the study. Gender and racial balancing was also factored in the recruitment of participants. VTV and HFHS are excellent tools for evaluating competencies in the nursing profession because they give an almost true impression, of the expected performances of nurses, especially for fresh graduates. It is an applicable tool for assessing competencies of incoming nurses and those already practicing to gauge their progress. Enhanced competence is characterized by the ability of a nurse to recognize fluctuations in a patient’s status, ability to anticipate risks and interpret assessment data by taking part in the decision making process (Quinn, 2000). Question and answer evaluation methods do not give the true ability of a nurse in handling a clinical problem. Simulation based tests are better at indicating the performance of a nurse in a real-world clinical set up. VTV and CCTST are good ways of assessing the knowledge that a nurse has on how to handle clinical problems involving patients. HFHS and CCTDI are strong evaluation method for measuring the capability of a nurse’s pro-activeness, in handling a real-life clinical situation, where a patient requires immediate attention. In the ever evolving field of evaluation techniques, the use of VTV and HFHS is the best way to analyze competences which can reduce the reoccurrence of clinical problems and reduce risks associated with delayed reaction time and inappropriate responses on the part of nurses and enhance competency. References Nehring W, Lashley F. (2010). High-Fidelity Patient Simulation in Nursing Education. Jones & Bartlett Learning, 2010 Leninger M. M, McFarland M. R. (2006). Culture Care Diversity and Universality: A Worldwide Nursing Theory. 2nd Illustrated Edition. Jones & Bartlett Learning, 2006. Quinn F. M. (2000). Principles and Practice of Nurse Education. 4th Edition. Nelson Thornes, 2000. Read More