간호시뮬레이션에서 나타나는 임상판단과정 분석

심가가(Kaka Shim),신현숙(Hyunsook Shin),임다해(Dahae Rim) 한국산학기술학회 2018 한국산학기술학회논문지 Vol.19 No.9

본 연구는 간호 학생을 대상으로 아동 간호학 실습 교육의 시뮬레이션 상황에서 일어나는 임상적 판단과정을 파악하고자 한다. 이를 위해 LCJR을 적용한 기술적 서술 연구(descriptive study)로 진행되었다. S시에 소재한 2개의 대학의 간호대학생을 대상으로 2013년 9월부터 2014년 12월 까지 모의 환자를 포함한 발열 시나리오와 무호흡 시나리오를 사용하여 시뮬레이션이 진행되었다. 본 연구 결과 간호 대학생의 임상판단 점수는 남학생 30.50(±2.77)점, 여학생29.32(±2.67)점이었으며, 무호흡 시나리오 임상판단 점수(31.20±2.84)가 발열 시나리오 점수(28.71±2.63)보다 높았고, 학습자의 자가평가(.911)와 교수자의 평가(.921)에서 반응(responding)영역이 유의한 상관관계가 있는 것으로 나타났다. 교수자와 학습자의 자가 평가 간 비교에서는 해석(interpreting)영역과 반영(reflecting)영역이 유의하게 나타났다. 본 연구는 간호 대학생의 임상 판단력을 높일 수 있는 실습과정을 수정 및 개발하는데 있어 기초 자료가 될 수 있다. 이 후 시뮬레이션 프로그램 내에 디브리핑 동안에 학생들의 간호 수행과 판단을 토론할 수 있는 경험을 제공하는 것이 필요하다. This study was a descriptive study, analyzing the clinical judgment process that occurs in a simulation of practice education for nursing students applying to LCJR. Subjects were two nursing college students in S city. Fever scenario and apnea scenario, including mock patient, were implemented. Data collection was conducted between September, 2013 and December, 2014. Data analysis was performed using descriptive statistics, paired t-test, and Pearson’s correlation of PASW statistics 18.0 program. The result of this study revealed that the clinical judgment scores of nursing college students were 30.50 for males and 29.32 for females. Nursing Clinical judgment score for the apnea scenario was higher than the score for the febrile scenario, and nursing students’ self-evaluation and professors’ evaluation showed a significant correlation with respect to the responding domain. In comparison the student and faculty ratings, domain of interpreting and domain of reflecting were significant This study will provide educators with foundational knowledge of program development to enhance nursing students’ clinical judgment abilities. We suggest more discussion on their nursing practice and judgment during debriefing session may be beneficial for students.

표준화환자를 활용한 아동간호 시뮬레이션이 간호학생의 불안, 자기효능감 및 비판적사고 성향에 미치는 효과

심가가(Kaka Shim),손미선(MiSeon Son),지은선(EunSun Ji) 한국산학기술학회 2017 한국산학기술학회논문지 Vol.18 No.10

본 연구는 표준화환자를 활용한 아동간호 시뮬레이션이 간호학생의 불안, 자기효능감 및 비판적사고 성향에 미치는 효과를 검정하기 위하여 시도된 단일군 사전사후 설계(one group pre test-post test design)연구이다. 대상자는 C시에 소재한 일개 대학교의 간호학과 4학년 재학생 62명이다. 표준화환자를 활용한 아동간호 시뮬레이션은 사전학습 및 오리엔테이션 60분, 시나리오 구현 60-80분과 성찰일지 작성 및 디브리핑 30분 등을 포함하여 실습조별로 약 3.5시간동안 진행되었다. 자료수집은 2016년 3월에 시작되어 2016년 12월까지 진행되었다. 자료 분석은 SPSS 21.0 프로그램의 기술 통계 및 paired t-test, pearson’s correlation을 이용하여 분석하였다. 본 연구 결과, 표준화환자를 활용한 아동간호 시뮬레이션 후 간호학생의 불안(p<.001)은 역할극에 비하여 통계적으로 유의하게 낮았으며, 자기효능감(p<.001)과 비판적사고 성향(p<.001)은 유의하게 증가되었다. 표준화환자를 활용한 시뮬레이션 실습 교육은 간호학생의 불안을 감소시키고, 자기효능감과 비판적사고 성향 향상에 효과적인 것으로 나타났다. 아동간호학 교육에서 표준화환자를 활용한 시뮬레이션 실습은 간호학생의 핵심역량을 강화시키므로 다양한 시나리오를 개발해야 함을 제안한다. This study was conducted to investigate the effects of child nursing simulation using standardized patient on nursing student"s anxiety, self-efficacy, and critical thinking disposition. A one group pre test-post test design was used. The subjects of the study were 62 students in the nursing department and 4th year students at the university in C city. The hospitalized child nursing simulation was conducted for approximately 3.5 hours, including 60 minutes of pre-study and orientation, 60-80 minutes of hands-on scenarios, and 30 minutes of reflection diary writing and debriefing. The data collection was conducted from March to December 2016. Statistical analyses of the collected data were conducted, including t-tests, Pearson"s correlation coefficient, and Cronbach"s α. Analyses were conducted using SPSS 21.0. The results of the study showed that anxiety (p <.001) was significantly lower and self-efficacy (p<.001) and critical thinking disposition (p<.001) were higher. Therefore, we propose that various scenarios for simulation practice that utilize standardized patients to enhance core nursing abilities be developed.

Mobile Technology in Undergraduate Nursing Education: A Systematic Review

이혜정,민해영,오수미,Kaka Shim 대한의료정보학회 2018 Healthcare Informatics Research Vol.24 No.2

Objectives: This study aimed to identify and systematically review the literature on the use of mobile technology in nursing education. The research findings could evidence the effectiveness of mobile technology in undergraduate nursing students’ learning outcomes. Methods: Computerized searches were conducted using the Ovid-MEDLINE, Ovid-EMBASE, Cochrane Library, and CINAHL databases for relevant primary studies and limited to those between 2000 and February 2018. Only randomized controlled trials (RCTs) and quasi-experimental studies published in either English or Korean were included and critically appraised using Joanna Briggs Institute tools. Results: Seven RCTs and 7 quasi-experimental studies were identified. The mobile device and intervention applied varied throughout all the studies. Studies published earlier in the 2000s found that immediate access to clinical and pharmacological referencing information through the mobile device increased students’ efficacy in clinical practice. Later studies, which were mostly conducted in Korea, reported that smartphone-based applications could promote nursing students’ learning motivation and satisfaction but not their clinical skills and knowledge. Conclusions: We still seem to be in the beginning stage of implementing mobile technology in nursing education due to the limited implication of mobile technology and inconsistent research conclusions. In the future, rigorous primary empirical studies are needed to suggest the effective use of mobile devices in nursing education.

Collaborative disaster governance recognized by nurses during a Pandemic

Hyunsook Shin,Dahae Rim,Hyejin Jeon,Jieun Kim,Hyojin Chun,Hee Oh,Soonyoung Shon,Kaka Shim,Kyung Mi Kim 한국간호과학회 2021 한국간호과학회 학술대회 Vol.2021 No.10

Aim: To identify collaborative disaster governance through the demand and supply analysis of resources recognized by nurses during the COVID-19 pandemic. Methods: We used a mixed method, primarily qualitative and then quantitative study. Participants were 630 nurses practicing at public health offices, hospitals, and schools. In the beginning, forty-seven nurses were invited to learn about their resource use experiences during COVID-19. The themes from this focus-group study were used to develop the survey tool. Using the tool, an online survey was conducted among nurses. Demand and supply analysis was used to analyze which resources needed attention for supporting nurses. Results: The 45 items from the in-depth interviews were delineated and three items were deleted through expert validation. The factor analysis yielded seven factors explaining a total of 65.66 % of the variance for the entire set of variables. Demand and supply analysis showed that supplies procurement, cooperation, education, and environment factors clustered in the high demand and supply quadrant while labor condition, advocacy, emotional support, and workload adjustment factors clustered in the high demand but low supply indicating strong needs for those resources were present. The nurses practicing at the public health offices and schools showed major factors plotted in the second quadrant, indicating weak collaborative governance of resources. Conclusions: These findings showed that there was an unbalanced distribution among nurses resulting in major challenges in collaborative disaster governance during COVID-19. The collaborative disaster governance through improved distribution in future as well as the current pandemic is useful for helping nurses to achieve more required resources and more effective pandemic response.

Development and validation of a nursing response model to pandemic disasters

Hyunsook Shin,Dahae Rim,Hyejin Jeon,Jieun Kim,Hyojin Chun,Hee Oh,Soonyoung Shon,Kaka Shim,Kyung Mi Kim 한국간호과학회 2021 한국간호과학회 학술대회 Vol.2021 No.10

Aim(s): To explore the nursing responses and experiences among nurses practicing at different types of institutions against the COVID-19 pandemic, to develop and validate a nursing response model for use in future pandemic disasters. Method(s): We used a mixed method, primarily qualitative and then quantitative study. Participants were 46 nurses for 14 focus group interviews and 563 nurses for an online survey. Participants were nurses working at public health offices and hospitals, as managers, and as school nurses. In the qualitative phase, the interview protocol was developed to conduct focus-group interviews by the international team workshops. Fortysix Korean nurses practicing in the different settings were invited to learn about their experiences during COVID-19. The themes found from this focus-group study were used to develop a tool. Using the tool, an online survey was conducted among nurses. Exploratory and confirmatory Factor analysis were performed using the AMOS to extract the new factor structure of the dataset and to establish the structural validity of the developed tool. Result(s): The main themes from the focus-group interviews through comparative analysis were situational awareness, emotional responses, strategies, nursing values, and remains from the COVID-19 pandemic. 47 original items under the five domains of nursing response on a pandemic disaster were delineated and 42 final items’ content validity was established by experts and practitioners. Exploratory factor analysis indicated that three distinct factors were underlying nurse responses to the pandemic response items and that these factors were internally consistent. In the confirmatory factor analysis, three-factor model showed an acceptable fit. Conclusion(s): The developed nursing response model to pandemic situations was delineated based on nurses’ experiences and it is not surprising that nurses learned how to work and deal with an unknown crisis or in an unfamiliar situation. The created nursing response model to a pandemic can be used to prepare for a future pandemic or crisis.