Board #225 - Program Innovation Development of Epidural Analgesia Education for Health Professional Students
Bibliographic record
Abstract
Objectives Research indicates nurses’ knowledge related to epidural analgesia and complications is poor and outweighs skill performance and decision-making.1-2 Pre-licensure nursing students receive no epidural training despite exposure in clinical settings and potential for devastating adverse effects. Education for nurses is provided through an authorization process testing knowledge and skill, but not ability to critically think through adverse events. The objective of this pilot project with senior nursing students was to develop a workshop on assessment and care of patients receiving epidural analgesia. Our overall objective is to fill a current regional gap in regulated health professional learners’ education with the ultimate goal of improving patient safety. Our specific evaluation questions are the following: 1) Is the use of a novel instructional module using SPs a feasible approach for pre-registration health professional students to learn the safe care of individuals receiving epidural analgesia? 2) Does progression through the learning process of knowledge through skills acquisition to implementation using SPs improve the pre-registration health professional students’ application of the critical assessment components for individuals receiving epidural analgesia? Description Content of the learning guide and workshop included care of the patient receiving continuous or intermittent epidural as well as the side effects and complications associated with these modalities. The three-hour workshop was led by a nurse practitioner from the Acute Pain Management Service of the local acute care hospital. In addition to traditional didactic teaching, sessions with standardized patients (SPs) were included to enhance learner application of knowledge and skill to clinical scenarios requiring critical thinking. The workshop session consisted of: 1) large group didactic session and demonstration; 2) small group practice scenarios with SPs and feedback from the educators; and 3) individual learner evaluation with SPs. The workshop allowed learners repeated opportunities to practice skills and critical thinking associated with safe monitoring of patients receiving epidural analgesia within three practice standardized patient scenarios and one of three assessment scenarios. Skill and critical thinking were evaluated using a performance checklist and the Sweeney-Clark’s Simulation Performance Rubric.3 A pre- and post-epidural knowledge quiz (2) and survey evaluated confidence and satisfaction with the learning module. Conclusion Forty-eight senior (4th year BNSc) nursing students participated in the pilot implementation of the workshop. All were females between the ages of 20 and 24 years. Learner confidence with epidural analgesia increased significantly (p=0.001) following participation in the module and learner knowledge increased non-significantly (p=.341). Learners performed an average of 86 % of the skills checklist items correctly. One learner (3.4%) performed at a novice critical thinking level; 25 (58.1%) performed at an advanced beginner level, and 17 (39.5%) performed at a competent level. Learner satisfaction was very high. This pilot project demonstrated an epidural analgesia workshop using SPs is feasible and results in high satisfaction and positive learning outcomes with senior nursing students. As a result, the session will become mandatory for all nursing students in the fall 2014 semester. Plans are also underway to implement the module as an interprofessional educational event for prelicensure nursing, medical and physiotherapy students. The overall goal of this line of research is to contribute to improved patient safety by enhancing critical thinking skills and better preparing health professions students to transition to their professional practice roles. References 1. Sandie CL, Heindel LJ. The knowledge and attitudes of nonanesthesia nurses regarding postoperative epidural analgesia. AANA Journal 1999;67(5):455-460. 2. Bird A, Wallis M, Chaboyer W. Registered nurses’ and midwives’ knowledge of epidural analgesia. Collegian 2009;16(4):193-200. 3. Gantt, LT. Using the Clark Simulation Evaluation Rubric with associate degree and baccalaureate nursing students. Nurs Educ Perspect 2010;31(2):101-105. Disclosures None
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".