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Learning manual and procedural clinical skills through simulation in health care education
Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
2012 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

The general aim of this thesis was to contribute to a deeper understanding of students’ perceptions of learning in simulation skills training in relation to the educational design of the skills training. Two studies were conducted to investigate learning features, what clinical skills nursing students learn through simulation, and how.

Undergraduate nursing students were chosen in both studies. Study I was conducted in semester three, and study II in semester six, the last semester. Twenty-two students in study I practised intravenous catheterisation in pairs in the regular curriculum with an additional option of using two CathSim® simulators. In study II, ten students practised urethral catheterisation in pairs, using the UrecathVision™ simulator. This session was offered outside the curriculum, one pair at a time.

In study I, three questionnaires were answered - before the skills training, after the skills training and the third after the skills examination but before the students’ clinical practice. The questions were both closed and open and the answers were analysed with quantitative and qualitative methods. The results showed that the simulator was valuable as a complement to arm models. Some disadvantages were expressed by the students, namely that there was no arm model to hold and into which to insert the needle and that they missed a holistic perspective. The most prominent learning features were motivation, variation, realism, meaningfulness, and feedback. Other important features mentioned were a safe environment, repeated practice, active and independent learning, interactive multimedia and a simulation device that was easy to use.

In study II the students were video-recorded during the skills training. Afterwards, besides open questions, the video was used for individual interviews as stimulated recall. The interview data were analysed with qualitative content analysis. Three themes were identified: what the students learn, how the students learn, and how the simulator can contribute to the students’ learning. When learning clinical skills through simulation, motivation, meaningfulness and confidence were expressed as important factors to take into account from a student perspective. The students learned manual and procedural skills and also professional behaviour by preparing, watching, practising and reflecting.

From an educational perspective, variation, realism, feedback and reflection were seen as valuable features to be aware of in organising curricula with simulators. Providing a safe environment, giving repeated practice, ensuring active and independent learning, using interactive multimedia, and providing a simulation tool that is easy to use were factors to take into account. The simulator contributed by providing opportunities to prepare for skills training, to see the anatomy, to feel resistance to catheter insertion, and to become aware of performance ability. Learning features, revealed from the students’ thoughts and experiences in these studies, are probably general to some extent but may be used to understand and design clinical skills training in all health care educations. In transferring these results it is important to take the actual educational context into account.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2012. , 69 p.
Series
Linköping Studies in Health Sciences. Thesis, ISSN 1100-6013 ; 120
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-75505ISBN: 978-91-7519-985-6 (print)OAI: oai:DiVA.org:liu-75505DiVA: diva2:507532
Presentation
2012-03-23, Aulan, Hälsans Hus, Campus US (ingång 16), Campus US, Linköpings universitet, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2012-03-05 Created: 2012-03-05 Last updated: 2015-03-24Bibliographically approved
List of papers
1. Learning features in computer simulation skills training
Open this publication in new window or tab >>Learning features in computer simulation skills training
2010 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 10, no 5, 268-273 p.Article in journal (Refereed) Published
Abstract [en]

New simulation tools imply new opportunities to teach skills and train health care professionals. The aim of this study was to investigate the learning gained from computer simulation skills training. The study was designed for optimal educational settings, which benefit student-centred learning. Twenty-four second year undergraduate nursing students practised intravenous catheterization with the computer simulation program CathSim. Questionnaires were answered before and after the skills training, and after the skills examination. When using CathSim, the students appreciated the variation in patient cases, the immediate feedback, and a better understanding of anatomy, but they missed having an arm model to hold. We concluded that CathSim was useful in the students’ learning process and skills training when appropriately integrated into the curriculum. Learning features to be aware of when organizing curricula with simulators are motivation, realism, variation, meaningfulness and feedback.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-67085 (URN)10.1016/j.nepr.2009.11.018 (DOI)
Available from: 2011-03-29 Created: 2011-03-29 Last updated: 2017-12-11Bibliographically approved
2. Students’ experiences of learning manual clinical skills through simulation
Open this publication in new window or tab >>Students’ experiences of learning manual clinical skills through simulation
2013 (English)In: Advances in Health Sciences Education, ISSN 1382-4996, E-ISSN 1573-1677, Vol. 18, no 1, 99-114 p.Article in journal (Refereed) Published
Abstract [en]

Learning manual skills is a fundamental part of health care education, and motor, sensory and cognitive learning processes are essential aspects of professional development. Simulator training has been shown to enhance factors that facilitate motor and cognitive learning. The present study aimed to investigate the students’ experiences and thoughts about their learning through simulation skills training. The study was designed for an educational setting at a clinical skills centre. Ten thirdyear undergraduate nursing students performed urethral catheterisation, using the virtual reality simulator UrecathVision™, which has haptic properties. The students practised in pairs. Each session was videotaped and the video was used to stimulate recall in subsequent interviews. The interviews were analysed using qualitative content analysis. The analysis from interviews resulted in threethemes: what the students learn, how the students learn, and the simulator’s contribution to the students’ learning. Students learned manual skills, how to perform the procedure, and professional behaviour. They learned by preparing, watching, practising and reflecting. The simulator contributed by providing opportunities for students to prepare for the skills training, to see anatomical structures, to feel resistance, and to become aware of their own performance ability. The findings show that the students related the task to previous experiences, used sensory information, tested themselves and practised techniques in a hands-on fashion, and reflected in and on action. The simulator was seen as a facilitator to learning the manual skills. The study design, with students working in pairs combined with video recording, was found to enhance opportunities for reflection.

Keyword
Learning theory; professional development; qualitative content analysis; simulation; skills training; undergraduate nursing education
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-75504 (URN)10.1007/s10459-012-9358-z (DOI)000314767300009 ()
Available from: 2013-04-02 Created: 2012-03-05 Last updated: 2017-12-07Bibliographically approved

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