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      Enhancing Surgical Nursing Student Performance: Comparative Study of Simulation-Based Learning and Problem-Based Learning

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          Abstract

          Background

          Surgical nursing is a high-risk, high-pressure, and complex field. Nurses need extensive knowledge, skills, and abilities. Problem-Based Learning (PBL) and Simulation-Based Learning (SBL) are effective student-centered methods. Which method is better for surgical nurse training? More research is needed to determine the best approach for undergraduate surgical nurse education.

          Purpose

          To compare the impact of PBL and SBL on undergraduate nursing students’ performance and improve learning outcomes in surgical nursing education.

          Methods

          We used a pretest/post-test design with 318 nursing undergraduates randomly assigned to two groups. Participants completed three progressive scenarios focused on surgical nursing cases. Experts blindly reviewed video recordings using the 70-item Korean Nurses’ Core Competence Scale (KNCCS) to assess performance. The 13-item Satisfaction and Self-confidence in learning Scale (SSS) measured learning confidence and satisfaction. SBL participants also completed the 16-item Educational Practices in Simulation Scale (EPSS) and 20-item Simulation Design Scale (SDS).

          Results

          The study found significant positive effects on both groups, with noticeable improvements in post-test, retention, and follow-up test results ( P < 0.001). The SBL group showed higher competency levels in nurses ( P < 0.001). The Cohen’s d and effect size (r) for various skills were as follows: clinical performance (0.84767 and 6.39023), critical thinking (0.31017 and 0.15325), professional attitude (0.85868 and 0.39452), and communication skills (1.55149 and 0.61294). The satisfaction and self-confidence of nurses were higher in the SBL group (4.53±0.596; 4.47±0.611) compared to the PBL group (4.32±0.689; 4.25±0.632) in all dimensions of SSS (all P < 0.05). The SBL group also scored high in simulation design and EPSS. However, improvements are needed in fidelity, objectives, information, and students’ expectations.

          Conclusion

          SBL and PBL improve nurses’ core competence, satisfaction, and self-confidence. SBL is superior. This study promotes student-centered education, enhancing surgical nursing professionals’ quality and ensuring future patient safety.

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          Most cited references45

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          Problem-Based Learning: What and How Do Students Learn?

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            Overview of Problem-based Learning: Definitions and Distinctions

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              Virtual Patient Simulations in Health Professions Education: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration

              Background Virtual patients are interactive digital simulations of clinical scenarios for the purpose of health professions education. There is no current collated evidence on the effectiveness of this form of education. Objective The goal of this study was to evaluate the effectiveness of virtual patients compared with traditional education, blended with traditional education, compared with other types of digital education, and design variants of virtual patients in health professions education. The outcomes of interest were knowledge, skills, attitudes, and satisfaction. Methods We performed a systematic review on the effectiveness of virtual patient simulations in pre- and postregistration health professions education following Cochrane methodology. We searched 7 databases from the year 1990 up to September 2018. No language restrictions were applied. We included randomized controlled trials and cluster randomized trials. We independently selected studies, extracted data, and assessed risk of bias and then compared the information in pairs. We contacted study authors for additional information if necessary. All pooled analyses were based on random-effects models. Results A total of 51 trials involving 4696 participants met our inclusion criteria. Furthermore, 25 studies compared virtual patients with traditional education, 11 studies investigated virtual patients as blended learning, 5 studies compared virtual patients with different forms of digital education, and 10 studies compared different design variants. The pooled analysis of studies comparing the effect of virtual patients to traditional education showed similar results for knowledge (standardized mean difference [SMD]=0.11, 95% CI −0.17 to 0.39, I2=74%, n=927) and favored virtual patients for skills (SMD=0.90, 95% CI 0.49 to 1.32, I2=88%, n=897). Studies measuring attitudes and satisfaction predominantly used surveys with item-by-item comparison. Trials comparing virtual patients with different forms of digital education and design variants were not numerous enough to give clear recommendations. Several methodological limitations in the included studies and heterogeneity contributed to a generally low quality of evidence. Conclusions Low to modest and mixed evidence suggests that when compared with traditional education, virtual patients can more effectively improve skills, and at least as effectively improve knowledge. The skills that improved were clinical reasoning, procedural skills, and a mix of procedural and team skills. We found evidence of effectiveness in both high-income and low- and middle-income countries, demonstrating the global applicability of virtual patients. Further research should explore the utility of different design variants of virtual patients.
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                Author and article information

                Journal
                J Multidiscip Healthc
                J Multidiscip Healthc
                jmdh
                Journal of Multidisciplinary Healthcare
                Dove
                1178-2390
                07 March 2024
                2024
                : 17
                : 991-1005
                Affiliations
                [1 ]Nursing College of Shanxi Medical University , Taiyuan, People’s Republic of China
                [2 ]Department of Foreign Language, Shanxi Medical University , Taiyuan, People’s Republic of China
                [3 ]Department of General Surgery, First Affiliated Hospital of Shanxi Medical University , Taiyuan, People’s Republic of China
                Author notes
                Correspondence: Rui Yan, Nursing College of Shanxi Medical University , No. 56 of Xinjian Road, Yingze District, Taiyuan, Shanxi, 030001, People’s Republic of China, Tel +86 13934168679, Email yanruifl29@outlook.com
                Article
                440333
                10.2147/JMDH.S440333
                10929122
                38476255
                55794b5a-a2ca-4975-9269-66680d339e3c
                © 2024 Ma et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 14 September 2023
                : 14 February 2024
                Page count
                Figures: 2, Tables: 5, References: 45, Pages: 15
                Funding
                Funded by: the Natural Science Foundation of China;
                Funded by: the Natural Science Foundation for Young Scientists of Shanxi Province, China;
                Funded by: the General project of soft science research in Shanxi Province;
                This study was supported by grants from the Natural Science Foundation of China (No. 82001872); the Natural Science Foundation for Young Scientists of Shanxi Province, China (No. 201701D221251); the General project of soft science research in Shanxi Province (No. 2017041036-5).
                Categories
                Original Research

                Medicine
                baccalaureate nursing,education,problem-based learning,simulation training,surgical nursing

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