Hi, My name is Jennifer Gasit and my masters project is an educational
improvement activity that focused on using simulation to improve novice nursing
students communication and assessment skills.
Today I will outline the purpose of my project, the main goals and
what an examination of current literature revealed about educating students on
taking a health history and communication skills.
I will then share how the project was developed and executed.
Feedback from students surveys and implications for current and
future nursing education needs.
Competent assessment skills are foundational for all nursing care.
Taking a patient's health history is integral to nursing assessment, yet
it remains a difficult skill for novice nurses to learn.
Currently, history taking has taught the first year of the nursing
program with health assessment.
In the skills lab, students practice on each other by rotating nurse and
patient roles, which does not provide a realistic
opportunity to genuinely practice interviewing in a clinical setting.
A student centered active learning experience was created for
students in the health assessment skills lab.
The purpose of the simulation was to reinforce concepts learned in the health
assessment across the lifespan course.
Students practice using effective patient centered communication and
interviewing skills to illicit an accurate and thorough focused health history.
The simulation allowed students to practice assessment, interviewing and
patient centred communication skills, improve confidence and
build self confidence for future clinical experiences.
A review was conducted to examine what current literature shows about educating
students on health history and communication skills.
Populations included undergraduate nursing students, medical residents,
social work students and radiology trainees.
Literature analysis included 15 articles relevant to history taking skills and
the use of simulation for a health assessment course and
or communication skills.
Three main themes emerged from the literature.
One the importance of history taking skills,
two strategies to improve communication and assessment skills, and three,
the use of simulation and standardized patients and health assessment.
Students improved competency of focused assessment skills by participating in
a one on one encounter with a standardized patient who presented with abdominal pain.
Prior to the activity,
students were encouraged to review lecture information from recorded Panopto videos,
PowerPoint handouts and recommended readings in their textbook.
Students participated in a virtual role play in a semi structured interaction with
a standardized patient who was portrayed by TW nursing education graduate student.
Due to COVID-19 precautions,
the simulation took place via Zoom in the following sequence.
First, the nurse educator playing the patient began the session by setting
the stage with a briefing of the scenario and explain the activity,
objectives, expected behavior and essential skills.
Next, the scenario ran with the student using open ended communication and
appropriate interpersonal skills to obtain additional patient information.
Then, relevant information was used to conduct a focused abdominal assessment.
For the virtual simulations, students watched a brief video demonstration of
the physical assessment in lieu of being in person.
The nurse educator used the diamond method to help lead debriefing with the student,
including discussion, reflection and evaluation of the role playing experience.
This allowed students to reflect on performance and build self confidence for
future clinical experience.
The total planned activity time was 30 minutes.
Students completed surveys on their perceptions of the simulations effect on
learning and confidence prior to clinical placement.
Before the simulation,
students were asked at this stage of their course to rate how confident they felt in
caring for patients similar to those they would see in the simulation.
Using a five point lacquered scale, 76% of students felt somewhat confident,
while 20% of respondents were not so confident.
Following the simulation, participants were asked to again rate how confident
they felt in caring for patients similar to those in the simulation.
Students confidence levels improved as 86% reported feeling very confident and
7% felt extremely confident.
All students responded that the simulation assisted them in preparing for
upcoming clinical placement, either a great deal or a lot.
So in conclusion, there are a few key implications for current and
future nursing education practice.
First of all, role playing simulation allow for students to practice
communication and assessment skills in a much more realistic scenario.
Secondly, a semi structured scenario that was created for both in person and
virtual options allows for more flexibility during COVID-19 restrictions.
Finally, nursing education students who serve as the standardized patient
can serve as role models to undergraduate students as they highlight best practice,
create learning experiences and provide support and constructive feedback.
Thank you so much for your time.