The Effect of Computer Interactive Simulation on Situational Decision-Making and Competency Development of Experienced Staff Nurses

Abstract

THE EFFECT OF COMPUTER INTERACTIVE SIMULATION ON SITUATIONAL DECISION-MAKING AND COMPETENCY DEVELOPMENT OF EXPERIENCED STAFF NURSES ABSTRACT Simulation and gaming as learning methodologies are increasing in use. Many institutions, including hospitals, are developing simulation programs as an alternative to or in conjunction with the traditional classroom as an instructional method. Many educators believe that learning preferences have changed and that simulation is more effective and motivating to the new generation of learners. The purpose of this study was to test whether computer interactional simulation is more effective as an instructional methodology than the traditional classroom setting in promoting clinical competency in experienced staff nurses. This study was designed to evaluate the effects of simulation on knowledge development and improved situational understanding/critical thinking (decision-making skills) related to the safe management of patients requiring restraints. In this study, nurses with a minimum of one year of experience were randomly selected to participate. Subjects who agreed to participate were randomly assigned to either a control group (traditional classroom, n=11) or the treatment group (simulation, n=21). A literature review was conducted to develop operational definitions and determine the clinical applicability of electronic simulation as an instructional methodology for developing competency in nursing practice. Group differences were analyzed using analysis of covariance (ANCOVA) in a pretest-posttest design that included a demographics instrument. Analysis of the demographics of both groups showed no differences. ANCOVA results showed no significant differences in overall competency development or critical thinking between the two groups. Knowledge scores for the traditional classroom group were significantly higher than the treatment group. Although the literature revealed that simulation and gaming has been used widely in many technical and professional settings to promote situational understanding/critical thinking skills and to increase knowledge, this study raises the question as to whether simulation and gaming is any more effective in competency development in experienced staff nurses than the traditional classroom instruction.