Quality improvement for self-confidence, critical-thinking, and psychomotor skills in basic life support of nursing health professionals through case-scenario simulation training
Bibliographic record
Abstract
Background: Recognition and timely management of medical emergencies in non-critical care units are essential in initiating and delivering high quality care. Simulation training is a constructive tool that can be utilized to refresh and maintain knowledge and skills for staff that may not encounter medical emergencies frequently. This study examined staff that work at the John D. Dingell VA Medical Center Community Living Center (CLC), a subacute and inpatient rehabilitation unit, on their critical thinking skills, knowledge, role responsibilities and confidence levels prior to and after implementation of a mixed intervention of a one-hour webinar didactic and one-hour case-based simulation with debriefing. The purpose of the study was to improve non-critical care staff critical thinking, knowledge and confidence when working with a deteriorating patient.Methods: A pretest-posttest study design was used to conduct the study. Pre and post surveys were given to 42 health professionals which included registered nurses (RN), licensed practical nurses (LPN) and nursing aides after participating in a case scenario using a high-fidelity mannequin to simulate a medical emergency. Analyses were performed using the two-tailed t-test with p-value significance of less than .05 using Excel and JMP by SAS.Results: Among the 42 participants, there was a significant improvement in confidence for recognizing signs of patient deterioration for timely activation of code team (p < .001). Critical thinking skills and knowledge on appropriate activation of the type of response team based on patients’ speed of deterioration also improved after the intervention (p < .001). Overall, the staff felt more comfortable, confident and knowledgeable concerning their roles and local policy of emergent situations.Conclusions: A team-based case scenario simulation course may improve non-critical care nursing staff confidence, knowledge and critical thinking as it pertains to activation of code teams and willingness to actively participate in medical emergencies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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 source (direct Gemma or distilled Codex), 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".