Board 182 - Program Innovations Abstract Development And Evaluation Of Simulation-Based Fever Management Module For Children With Febrile Convulsion (Submission #479)

Introduction/Background Simulation-based education gives students an opportunity to lessen the gap between academic and clinical settings, learn core nursing skills and enhance self-confidence through learning. Student performance evaluation is a very important step during simulation-based practice.23 Although a module may be well developed, a standardized evaluation checklist is essential for confirming the effectiveness of simulation-based practice. To enhance the effectiveness of simulations in nursing education, a reliable and valid evaluation instrument is needed to measure student performance. Furthermore, a valid instrument is required for the simulation to be considered a formalized implementation and evaluation tool. Fever is a common symptom found in children with disease in pediatric care units. Fever in children has been acknowledged as a common occurrence in pediatric nursing. Students may frequently encounter children with febrile convulsions in a clinical setting. Simulation modules may provide a comprehensive understanding of fever and fever management. However, there is no evaluation checklist to measure systematically simulation-based performance of students dealing with febrile convulsions. Furthermore, students satisfaction with the simulation is important for meaningful learning and facilitating active participation.22 Therefore, a simulation-based fever management module for children with febrile convulsions is needed, since this is one of the most frequent problems experienced by a student in a clinical nursing setting. This study focuses on pediatric nursing education and nursing practice. The following research issues were addressed: a) to develop a simulation-based fever management module for pediatric febrile convulsions and b) to evaluate students performances and satisfaction. Methods The development of the simulation-based fever management module and evaluation checklist for treating children with febrile convulsions was a three-stage process. Stage I: developing the simulation-based module; Stage II: developing programs for nursing students; and Stage III: evaluating the simulation-based module and validating the dimensions.The module included an algorithm with the scenario, evaluation checklist and debriefing plan. For scenario development, we collected information on nursing care from child health nursing textbooks and nursing journals. This scenario was based on a real febrile convulsion case that had occurred in a general hospital. The evaluation checklist focused on the attainment of nursing goals based on nursing processes rather than outcomes. The categories were divided into assessment, problem identification, intervention and evaluation. The evaluation checklist score was based on a 4-point Likert scale. The higher the evaluation checklist score, the higher the performance rating. The researchers developed the following debriefing questions: a) What did you learn?; b) How did you feel?; c) What did you do?; d) What were your strong and weak points? Debriefing was conducted at the end of the study and took about 20-30 minutes per group of 3-4 students. Students’ satisfaction with the clinical simulation was measured using the Satisfaction of Simulations Experience [SSE] scale developed by Levett-Jones and colleagues (2011). This scale consists of 18 items: debrief and reflection (9 items), clinical reasoning (5 items), and clinical learning (4 items). Each item was scored on a 5-point Likert scale. Higher scores indicated higher satisfaction. The target population for this study included undergraduate students. One hundred forty-seven nursing students were selected from two universities located in Seoul, South Korea. Data were collected from April 29, 2013 to June 14, 2013. Each simulation lasted 20-30 minutes, with both the simulation and simulation class taking about two hours per group. In addition, an SSE was used to measure student satisfaction with the simulation. Collected data were analyzed using SPSS 18.0 for Windows to calculate descriptive statistics for the evaluation checklist and the SSE. Debriefing data were analyzed using the Matrix Method. A scenario script was formulated to treat the patient’s health issues. The algorithm proceeded as follows: identification of patients’ condition (Step I), nursing intervention (Step II), and outcome evaluation and feedback (Step III). To test the internal consistency and reliability of the evaluation checklist and each subscale, Cronbach’s alpha coefficient was measured. Cronbach’s alpha for the evaluation checklist was .865; each subcategory ranged from .706 to .808. The evaluation checklist consisted of four categories based on nursing processes: assessment, problem identification, intervention and evaluations. The total mean score of the evaluation checklist was 2.67 (± .32). The mean score of each category was as follows: assessment, 2.35 (± .37); problem identification, 2.94 (± .46); intervention, 2.89 (± .40); and evaluation, 2.82 (± .56). The categories were as follows: non-technical skill (30.7%), self-efficacy (29.8%), critical thinking (21.8%), and technical skill (17.8%). The most frequent categories, in order, were teamwork and collaboration (n = 27), reflection (n = 26), situation recognition (n = 21), core nursing skills (n = 21), emotional support (n = 21), and therapeutic communication (n = 21). The total mean score of SSE was 4.48 (± .42). The mean score for debrief and reflection was 4.55 (± .43), clinical reasoning was 4.39 (± .50), and clinical learning was 4.43 (±.48). Results: Conclusion This study was able to develop more reliable algorithms and evaluation tools for fever management in nursing care. This study identified a nursing care module for children with febrile convulsions. The implications for nursing education include determining how nursing students care for patients using critical thinking and nursing skills. This study also provides a blueprint for simulation-based practice for both nursing educators and nursing students. Furthermore, this study recommends developing an evaluation checklist for other nursing education programs. A large sample size in more than one geographic location will provide valid and reliable data for this module and the evaluation checklist. In addition, this study highlights the need for the full integration of simulations into nursing curricula. References 1. Abdo, A., Ravert, P. 2006. Student satisfaction with simulation experiences. Clinical Simulation in Nursing Education, 2, e13-e16. 2. Berragan, L. 2011. 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