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The Impact of High Fidelity Simulation Debriefing Modalities on Cardiac Emergency Knowledge & Leadership Skills among Acute Care Nurse Practitioner Students.

Alhaj Ali, Abeer A., Ph.D.

Abstract Details

2018, PhD, University of Cincinnati, Nursing: Nursing - Doctoral Program.
Background: Changes in the United States (US) health care delivery system require more advanced nursing education and training to prepare nursing graduates for their leading role. Acute care nurse practitioners (ACNP) play a vital role in hospitals and critical care settings. ACNPs require special training and educational preparation to meet their role expectations such as leading a cardiovascular resuscitation team. Using high fidelity simulation (HFS) with debriefing modalities is considered one of the innovative learning strategies in graduate nursing which provide the opportunity to practice their leadership capabilities within safe, nonthreatening learning environment. Purposes: The purpose of this study was to examine the difference in ACNP students' knowledge, team leader skills and self-efficacy using two debriefing modalities: verbal debriefing (VD) vs. video-assisted debriefing (VAD) guided by Kolb's experiential learning theory (ELT). Additionally, this study explored ACNP students' evaluation and perceptions of the debriefing experience and how this experience impacts the transferability of simulation-based learning into clinical settings. Method: A two group, pretest-posttest quasi-experimental design was used. This study was conducted in two phases. Phase I was quantitative and Phase II included qualitative data collection using two focus group interviews. A total 28 ACNP students were recruited from an acute care nurse practitioner program or post master's acute care certificate program at a university in the Midwest United States during the fall of 2017. ACNP students participated in HFS scenario managing emergency dysrhythmias during a code experience. Then the students were evaluated using many tools followed by two focus group interviews. Results: There were no significant differences between the two groups in knowledge acquisition/retention, leadership skills, and self-efficacy, but there was a significant difference in self-efficacy in both groups between two-time points. There was also a general improvement in team performance and the students' evaluation of their debriefing experience. In addition, a statistically significant difference occurred between VAD and VD groups in the Debriefing Experience Scale (DES)/opinion scale. Qualitatively, six themes emerged from focus groups data analysis: Debriefing/Debriefer Importance and Impact, Learning Transferability, Role Change registered nurse (RN) vs. Advanced Practice Registered Nurse (APRN), VAD vs. VD, Experience Influences and Considerations and Debriefing/Debriefer Demand in Real Situations. Three publishable papers were written that reflect the current state of the literature about simulation debriefing methods and the findings of the study. Conclusions: Qualitatively, debriefing sessions were highly valued by ACNP students, independent of the use of video. Quantitatively, students preferred VD over VAD. Advanced education and special training are required to prepare students for their new role expectations. This study added valuable information about ACNP students' perspectives of the debriefing experience's impact on their learning, transferability of the simulated experiences to the clinical environment and the benefit of using technology in their training. More research focusing on simulation-based education for ACNPs and advanced practice nurses is required. This study was one of the first studies to examine different debriefing modalities in advanced nursing education. Additionally, this study's findings support the importance of ACNP educational preparation focusing on leadership skills training using a combination of HFS and debriefing.
Elaine Miller, Ph.D. (Committee Chair)
Tamilyn Bakas (Committee Member)
Kathleen Ballman (Committee Member)
Gary Geis (Committee Member)
Jun Ying, Ph.D. (Committee Member)
165 p.

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Citations

  • Alhaj Ali, A. A. (2018). The Impact of High Fidelity Simulation Debriefing Modalities on Cardiac Emergency Knowledge & Leadership Skills among Acute Care Nurse Practitioner Students. [Doctoral dissertation, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1522164911599868

    APA Style (7th edition)

  • Alhaj Ali, Abeer. The Impact of High Fidelity Simulation Debriefing Modalities on Cardiac Emergency Knowledge & Leadership Skills among Acute Care Nurse Practitioner Students. 2018. University of Cincinnati, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1522164911599868.

    MLA Style (8th edition)

  • Alhaj Ali, Abeer. "The Impact of High Fidelity Simulation Debriefing Modalities on Cardiac Emergency Knowledge & Leadership Skills among Acute Care Nurse Practitioner Students." Doctoral dissertation, University of Cincinnati, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1522164911599868

    Chicago Manual of Style (17th edition)