Abstract

Simulation is an innovation used in most developed countries in the field of nursing education to supplement clinical teaching which has been proven to successfully boost the cognitive, affective, psychomotor skills, self-efficacy and patient safety of undergraduate nurses. Unfortunately, the use of simulation does not seem to be a norm in Cameroon and the few schools who tried to engage simulation into the curriculum of which does not reflect any degree of fidelity are used for the teaching practical skills. The objective of this study was to determine the factors affecting simulation learning in undergraduate nursing students in Biaka university institute of Buea (BUIB) in Fako Division. In order to achieved the study objectives, a sample size of 107 (students 87 and nurse educators 20) were selected randomly to participate in the study using a structure questionnaire. Data was analysed in SPSS (21.0), Descriptive statistics of variables was calculated. Results revealed, the mean age of the students was (25±1.12) years. Majority of the students were female (65.0%), and 50.0% were undergoing their HND programs. Checklist analysis shows that though there is a stimulation learning institution put in place, most of the learning center lack as Instructional materials (e.g. mannequin, low fidelity and high fidelity simulation are present in the lab), absence of qualified staffs and the learning activities incorporated during the simulation session help students to learn were some of the ways in which school environment affects student’s stimulation learning. While factors that hinders the learning of stimulation learning were overcrowding of students in classroom, not working with real patients and lack of well-trained staffs. It was recommended that, well trained and competent staffs should be put in place in other to ease the learning of stimulation by students.

Key words: Stimulation learning, nursing students, school environment

 

CHAPTER ONE

INTRODUCTION

1.0 Introduction

Simulation; is a technique for practice and learning that can be applied to many different disciplines and types of trainees. It is a technique (not a technology) to replace and amplify real experiences with guided ones, often “immersive” in nature, that evoke or replicate substantial aspects of the real world in a fully interactive fashion. “Immersive” here implies that participants are immersed in a task or setting as if it were the real world (Emerg; 2010).

New graduates’ nurses can be overwhelming with clinical challenges they faced. To guide and help nursing students address this challenges with confidence and greater skills, many schools provide their students learning through simulated experiences. This allows students to practice or experience patient care situations such as obstetrical, pediatric and other hospital emergencies. Simulation experience has the potential to improve undergraduate affective, cognitive and psychomotor skills and making it possible to engage in significant practice (Parker et al, 2011). Despite the wide spread of simulation learning some questions still remain unanswered as well as this learning is being transferred to the clinical environment. Some nursing scholars assert that simulation technology has been used in advanced of sufficient research evidence to justify integration of simulation activities into nursing education (Schiavento, 2009). Hence, the factors affecting simulation learning in undergraduate nurses and it transfer to the clinical environment in a school in Fako Division a study in which will answer some of the unanswered question in simulation learning and it transfer.

 

1.1 Background of the study

Historically, simulation has mainly been used to teach students hand-on skills in a relatively safe environment. With changes in the patient population professional regulations and clinical environments, clinical simulation practice (CSP) must assist students to integrate and apply their theoretical knowledge and skills with their critical thinking clinical judgment, prioritization, problem solving, decision making, and teamwork skills to provide holistic care and treatment to their patient. (Khalili, 2015).

Simulation in nursing has been used primarily in undergraduate education to teach nursing skills. The first manikin was a life-size doll named Mrs. Chased. She was built in 1911 by a doll maker, Martha Jenkins Chase, to train nurses to dress, turn and transfer patients (Weir, 2012). Some early simulation laboratories were called demonstration rooms, the skills laboratory, or the nursing laboratory (Nickerson and Pollard, 2010). Nursing students would practice on manikin as Mr. Chase or on teach others by using various training devices to learn to administer injections, insert a nasogastric tube, and other basic nursing skills.

Nurses practicing in the 21^st century are challenged to deliver safe, high-quality nursing care to patients who are older as well as more diverse with respect to race, ethnicity and socio-economic factors. The increasingly vast body of nursing knowledge, combined with continuous medical and technological advancements, and high patient acuity, require that nurses have finely turned critical thinking (CT) skills. Patient safely depends upon a competent nurse to recognize changes in a patient’s condition and to intervene appropriately (Benner, Sutphen, Leonard, Day, 2010, Candela, Bowels 2008; National Advisory Council on Nurse Education and Practice (NACNEP), 2010; Tanner, 2006a).

Educationally constructivist learning can occur while under instruction, through facilitation, collaboratively or independently. This connects strongly with education and practice scaffolding strategies and techniques. Constructivism provides a sound educational foundation for other education theories to build on and relate to. As such Constructivist Learning resonates strongly with simulation, given simulation – as an education and learning method – provides opportunities for both deconstructing and reconstructing previous perspectives and practices, and/or the constructing of new viewpoints and practices. In this chapter those education theories repeatedly identified in the literature as being particularly pertinent to simulation and thus will contribute to the development of a Conceptual Framework for Simulation in Healthcare Education as an educational tool and technique, Lateef (2010) supported that simulation can be used to create guided experience needed i n acquiring necessary skills and patient’s safety. There is also evidence that simulation is mostly effective in the development of psychomotor skills, critical thinking and reflection on practices (Sanford, 2010; Martins et al., 2012), understanding of disease complex processes and the ability to make positive decisions on health issues. The above scenario is suggestive, highlighting the crucial benefits in applying simulation as an educational technique in health, education and applied sciences.

Contextual factors such as circumstances and setting impact every aspect of the simulation and are an important starting point in designing or evaluating simulation. The context may include the place (academic vs. practice; in situ vs. lab) and the overarching purpose of the simulation, for example, whether the simulation is for evaluation or instructional purposes.

 

1.2 Problem statements

Simulation learning is a growing practice in healthcare nursing schools in the African context, of it being an integral part of many undergraduate nursing programs throughout the country and yet the training and education of nurses among other healthcare providers cannot be effective without the help of simulation. Simulation is an innovation used in most developed countries in the field of nursing education to supplement clinical teaching which has been proven to successfully boost the cognitive, affective, psychomotor skills, self-efficacy and patient safety of undergraduate nurses. Unfortunately, the use of simulation does not seem to be a norm in Cameroon and the few schools who tried to engage simulation into the curriculum of which does not reflect any degree of fidelity are used for the teaching practical skills. This implies that some factors affect the exposure to simulation practice in undergraduate nurses.

 

1.3 Objectives

1.3.1 General objective

To determine the factors affecting simulation learning in undergraduate nursing students.

1.3.2 Specific objectives

1. To identify how the school environment, affect simulation learning.
2. To determine the perception of students on the factors affecting simulation learning
3. To determine the perception of nurse educators on the factors affecting simulation learning.

 

• 1.4 Research questions
• 1. How does the school environment affects simulation learning in undergraduate nursing students?
• 2. What is the perception of students on the factors affecting simulation learning?
• 3. What is the perception of nurse educators on the factors affecting simulation learning?

1. 1.5 Significance of study

• This study is going to create an awareness to the ministries involved in healthcare on the importance of simulation education in other to impose rules and regulations to place simulation practice as part of their curricula and measures to follow during simulation learning to healthcare nursing institutions.
• Also going to help healthcare institutions and nurse educators on how to carry out this practice to their students.
• As well as creating an awareness on the importance of simulation learning to undergraduate nurses, academicians and to the general public.

1.6 Scope of study

Since this study is based on the factors affecting simulation learning in undergraduate nursing students, the study examined a school in Fako Division and also examine the school environment and not extended to the clinical environment.

 

1.7 Definition of terms

• Simulation learning: as a process “to replicate some or nearly all of the essential aspects of a clinical situation so that the situation may be more readily understood and managed when it occurs for real in clinical” (David, 2016).