Simulation Today Autumn 2021

More documents

Recommendations

Info

FEATURE WHAT ARE THE BARRIERS THAT INHIBIT NURSES FROM ACCESSING SIMULATION- BASED LEARNING EDUCATION WHILE WORKING IN THE EMERGENCY DEPARTMENT? Justin Walford - Senior Practice Development Nurse SIMULATION TODAY - AUTUMN 2021 Introduction This article is going to discuss the barriers that inhibit nurses from accessing simulation-based learning education (SBLE) while working in the Emergency Department (ED). SBLE has become a popular form of teaching (teaching and learning method) in recent years (Becker and Hermosura 2019). This can occur in a variety of setting, it can happen in a classroom, in a staged area or in a clinical area, (known as in-situ simulation) (Sørensen et al 2017). SBLE is designed to provide immersive learning experiences that expose students to unfolding “real-life” clinical situations within a safe environment (Gabba, 2004). SBLE training is defined as a structured activity that represent actual or potential situations either in education or practice. This allows participants to develop or enhance their knowledge, skills, and attitudes, or to analyse and respond to realistic situations in a simulated environment (Society for Simulation in Healthcare 2020). Poore et al (2014) states the theory of using SBLE as a teaching tool fits with Kolb’s reflective cycle (Kolb 1984). The learning cycle, created by Kolb, consists of four phases these include (a) concrete experience where the learner participates in an experience such as a simulation, (b) reflective observation where the learner reflects on the experience, (c) abstract conceptualization where the student considers thoughts and reflections to identify the significance of the learning experience that has just occurred and considers factors that may have been done differently to improve the outcome, and (d) active experimentation which involves using what was learned to direct future practice. It could be argued though that SBLE creates a memorable concrete experience. The reflective observations can be done though self / peer / facilitator reflection. The abstract conceptualisation can be incorporated in the feedback (i.e. if you did this would have happened). Then the active experimentation could happen retrospectively, potentially in the student’s thoughts afterwards or the simulation is repeated. SBLE are designed to put the patient and their care at the centre all learning, the simulations can provide an immersive learning experiences that expose students to unfolding “real-life” clinical situations within a safe environment (Health Education England 2019). They are used widely in undergraduate nurse education (Bruce et al 2019) and is seen as essential for emergency medicine training (Takahashi et al 2019). It is used in certain settings to develop emergency nurses (Fry et al 2020), it can potentially improve patient safety and clinical outcomes (Boyde et al 2018). However, it is only used in small amounts in postgraduate nursing education (citation needed). SBLE can be used to assess a variety of roles such as teaching, preventing skill deterioration, checking systems or to improve a system, to investigate problems or test potential problems (Kenny et al 2019). Hung et al (2016) highlights that SBLE also improves psychomotor skills, assessment abilities, decision-making and critical thinking. Lewis et al (2019) highlights that there is a lack rigorous evidence to support the argument that SBLE improves patient safety. However, Davison et al (2017) highlights that SBLE improves significant increases in participants’ confidence levels in treating new or rare scenarios. Literature search A literature review forms the basis of any academic inquiry knowledge advancement must be built on prior existing work, enhance the knowledge frontier, we must know where the boundaries currently are (Xiao and Watson 2019). The literature that was studied was taken from a variety of sources publications, these include articles, text-books and journals. Sources from worldwide were considered. A comprehensive and systematic literature review must include all relevant databases and should include “Grey Literature”. Grey literature is unpublished literature (Bootland et al 2017). This means literature such as academic assignments were considered, however the strength of the piece of work was scrutinised. The healthcare database advisory system was used to search the following databases. 1. EMBase 2. EMCare 3. CINAHL 4. PyscINFO 5. Medline The key search words were used, but the ED has numerous names. Therefore, using a Boolean search the following terms were used to find articles relevant to the ED. * Emergency Room * Emergency Ward * Emergency Department * Accident and Emergency * Accident & Emergency * A&E * A & E * A and E * ED * ER 6
FEATURE Furthermore, to find any articles that could have been missed by these search terms the term “emergency ADJ1 care” was searched. This means that any words that had emergency and care one word apart would be included in the search (NICE 2020). The search was further augmented by the terms EMERGENCY HEALTH SERVICE”/ OR *”HOSPITAL EMERGENCY SERVICE. In some databases there were headings that were relevant, these include * Emergency Nursing * Emergency patient 2. Do you work in the ED? 3. How frequently do you participant in simulation? 4. How useful do you find simulation to improve your practice (1-5)? 5. What factors enable you to attend simulation teaching while at work? 6. What factors inhibit simulation you to attend simulation teaching while at work? 7. Do you enjoy attending simulation teaching? 8. What are the last three digits of your telephone number? 9. What is your age? Recruitment The term “SIMULATION TRAINING” was explored. Polit and Beck (2017) suggests improving the search by the truncation symbol “*(asterisk)”, this expands the root word, (in this case simulat* was used) to form all other versions of the word. The results of the database searches have been summarised in table 1. Table 1: Database Results Database Emergency Dept Simulation Combined EMBase 107,528 25,521 635 EMCare 444,427 101,484 1,572 CINAHL 191,366 16,983 980 PyscINFO 37,016 54,758 267 Medline 270,340 99,836 839 Due to large number of articles any article not written in English or over 10 years-old was excluded. A secondary search of relevant paper was performed, to strengthen the search. A total of 74 articles were selected for further analysis. It appears there is a paucity in the literature around the factors that both enable and inhibit all healthcare professionals from undertaking simulation at work, as none of the articles discuss these factors. The field of healthcare that has the most literature written about SBLE is medicine. Other allied healthcare professionals’ fields such as nursing, paramedics, have limited literature. Of the 74 article selected only three seemed to be very relevant to this topic. But all failed to mention any factors that motivate or inhibit SBLE for emergency nurses. The literature that is published tends to focus on the pre-registered nurse education or emergency medicine or the effect the simulation had on individuals. There is very little written on factors which inhibit nurses from undertaking simulation in the ED or generally. Due to the lack of literature the author felt that to properly assess the barriers that inhibit nurses from accessing simulation training while working in the ED that emergency nurses needed to be asked directly. Therefore, a short questionnaire was created. Questionnaire The survey had nine questions and was entitles ‘simulation for nurses in the ED’ so people knew it was for nursing staff. The questions asked were 1. Are you a nurse? One of the problems of using questionnaires as a methodology for data collection is, it has a poor response rate (Holloway & Galvin 2017). All members of nursing staff for one ED were emailed once, then to augment this one message was placed on emergency care association (ECA) Facebook and Twitter accounts. The ECA is the Royal College of Nursing’s forum for emergency care (RCN 2020). Furthermore, three other matrons or heads of nursing were emailed once to recruit their staff. After 3 months the survey was closed. All but one participant worked in an ED, this individual had only left a few weeks before and still worked as a casual member of staff. To improve the reliability of this questionnaire, question 8 was asked to prevent individuals from repeatedly answering. Inclusion criteria Respondent’s needed to be working in the ED as a member of nursing staff, this could be part time or full time. Casual members of staff would be considered provided they worked regularly in an ED. Exclusion criteria The exclusion criteria were anyone who did not work as a member of nursing staff in an ED. Bias To prevent bias from nurses, both factors that enabled and inhibited simulation were requested. Bias can be created by individuals is known as the Hawthorne effect which is a change in response or behaviour of subjects when included in study (Garg 2016), by asking nurses about both sides it may prevent them from being either overly positive or negative. Results The questionnaire gained 50 responses. From the respondents 86% were registered nurses and 14% were unregistered. Cultural backgrounds were not assessed but age was, the breakdown of the age can be seen in table 2. The age was asked as the author wanted to explore whether the age of participants was related to simulation enjoyment. As anecdotally the author has seen several older nurses stating that they don’t like SIMULATION TODAY - AUTUMN 2021 7
Page 1 and 2: Volume 3 No. 3 Autumn 2021 Simulati
Page 3 and 4: CONTENTS 4 EDITORS COMMENT 6 FEATUR
Page 5: Visit safeguardmedical.com
Page 9 and 10: FEATURE ADVANCE YOUR TRAINING OF AN
Page 11 and 12: iRIS Health FEATURE Simulation Auth
Page 13: FEATURE reduced by completing an SB

Simulation Today Autumn 2021

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?