Patient Assessment, and Anxiety and Self-Confidence With Clinical Decision Making in Auscultation Skills With Simulation

The Effect of Simulation in the Teaching of Auscultation Skills on Patient Assessment, and Anxiety and Self-Confidence With Clinical Decision Making

This research is a randomized controlled experimental design. This research will be applied within the scope of the Health Assessment Course. The population of the research will be the students enrolled in the Health Assessment Course (n=138). The sample will consist of students who volunteered to participate in the research.

Introductory Specifications Form, Nursing Anxiety and Self-Confidence with Clinical Decision-Making scale, Auscultation of Heart, Lung, and Bowel Sounds Checklist, and Opinions of Students about the Auscultation Skills Training will be used in the implementation of the research.

Permission was obtained from the Gazi University Ethics Committee and the Dean of the Faculty of Health Sciences to conduct the research. Informed consent will be obtained from the students who will participate in the research.

Study Overview

• Status: Completed
• Conditions: Anxiety; Self-Confidence
• Intervention / Treatment: Other: education with simulated patient; Other: education with simulator; Other: control group

Detailed Description

This research will be applied within the scope of the Health Assessment Course in Gazi University Faculty of Nursing in the fall and spring semesters of the 2022-2023 academic year. The population of the research will be the students enrolled in the Health Assessment Course (n=138). The sample will consist of students who volunteered to participate in the research.

Introductory Specifications Form, Nursing Anxiety and Self-Confidence with Clinical Decision-Making scale, Auscultation of Heart, Lung, and Bowel Sounds Checklist, and Opinions of Students about the Auscultation Skills Training will be used in the implementation of the research.

The researcher will teach all students the theoretical content of the subject. The students who meet the criteria for inclusion in the research will then be given the Introductory Specifications Form and the Nursing Anxiety and Self-Confidence with Clinical Decision-Making scale (pre-test). Students will be divided into three groups based on their academic averages and scale scores using stratified randomization. Students in experimental group 1 will be trained with a standardized patient, students in experimental group 2 will be trained with a high-fidelity simulator, and students in the control group will be trained with their peers. Following the completion of the application, the students will participate in a debriefing session. Students will be evaluated using checklists one week after submitting their applications. At this point, students in experimental group 1 will practice auscultation of heart, lung, and bowel sounds on a standardized patient, students in experimental group 2 will practice on a high-fidelity simulator, and students in the control group will practice on their peers.

While the students are applying, the observers will fill out the checklist for each item from the "observed," "incorrect/incomplete," and "not observed" options. Following the application, students will complete the Nursing Anxiety and Self-Confidence with Clinical Decision-Making scale (post-test).

During the spring semester, students will participate in clinical practice at various clinics two days per week as part of the Surgical Nursing Course. They also use auscultation skills in clinical settings. Students in the Experimental 1, Experimental 2, and Control groups will complete the Nursing Anxiety and Self-Confidence with Clinical Decision-Making scale and Opinions of Students about the Auscultation Skills Training at the end of the spring semester (when clinical applications are completed) (follow-up test).

Permission was obtained from the Gazi University Ethics Committee and the Dean of the Faculty of Health Sciences to conduct the research. Informed consent will be obtained from the students who will participate in the research.

The quantitative data from this study will be digitized in the SPSS package program, and the necessary statistical analyses will be performed.

• Study Type: Interventional
• Enrollment (Actual): 90
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Ankara, Turkey, 06490
    • Gazi University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Enrolling in the Health Assessment Course for the first time
• Volunteering to participate in research

Exclusion Criteria:

• Having a high school, associate, or undergraduate degree in a health-related field,
• Take a previous course in health assessment

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: education with simulated patient; Participants will be given training on auscultation skills with a simulated patient.	Other: education with simulated patient; Students in the education with the simulated patient group will practice auscultation skills on the simulated patient with heart, lung, and bowel sounds. There will be a lecturer at the head of the group who will provide the necessary coordination. A debriefing session will be held with the students by the educator right after the students have finished the application.
Experimental: education with simulator; Participants will be given training on auscultation skills with a simulation.	Other: education with simulator; Students in the simulator group will practice auscultation skills on high fidelity simulator with heart, lung, and bowel sounds. There will be a lecturer at the head of the group who will provide the necessary coordination. A debriefing session will be held with the students by the educator right after the students have finished the application.
Active Comparator: control group; Participants will be given training on auscultation skills with their peer students.	Other: control group; Students in the control group will practice auscultation skills on their peers with heart, lung, and bowel sounds. There will be a lecturer at the head of the group who will provide the necessary coordination.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The Change of the Nursing Anxiety and Self-Confidence with Clinical Decision-Making	This scale consists of 27 questions. Separate scores are obtained for self-confidence and anxiety from the scale. For both self-confidence and anxiety sections of the scale; It has three sub-dimensions: "Using resources to obtain information and listening fully (13 questions)", "Using the information at hand to determine the problem (7 questions)" and "knowing and acting (7 questions)". As the scores obtained from the self-confidence section and its sub-dimensions increase, the self-confidence level of the student increases, and the low scores obtained from the anxiety section and its sub-dimensions indicate a low level of anxiety. In the scale prepared in a six-point likert type; The lowest score that can be obtained from the self-confidence and anxiety sections is 27, and the highest score is 162.	5 months
Auscultation of Heart, Lung and Bowel Sounds Checklist	The checklist has been prepared in line with the objectives of the course content on heart, lung and bowel sounds. It consists of application steps that include the process steps in detail. It was created in the form of a rubric in order to observe the students objectively. Each item in the checklist has different scores according to its importance. The total score to be taken from all of them is 50. Expert opinion of the checklist was taken by 5 faculty members who are experts in the field.	One week

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Opinions of students about the auscultation skills training	The form will be used in order to learn the reflection of auscultation skills education in clinical practice. The interview questions in the form were created in line with the academic experiences of the researchers. The interview form consists of 3 open-ended questions: 1) how the training affected their feelings and thoughts in clinical practice, 2) how it affected their application of physical examination skills for the patients they care for in the clinic, and 3) what would have changed if you had gone to the clinic without this training. This form will be evaluated by thematic analysis.	one week

Collaborators and Investigators

• Sponsor: Gazi University
• Investigators: Study Director: Nurcan Çalışkan, Prof., Gazi University

Publications and helpful links

General Publications

• Bektaş, İ., Yardımcı, F., Bektaş, M., & White, K. A. (2017). Psychometric properties of the Turkish version of nursing anxiety and self-confidence with clinical decision-making scale (NASC-CDM-T). Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 10(2), 83-92.
• Gawlik, K.S., Melnyk, B.M., Teall, A.M. (Eds.), (2022), Evidence-based physical examination handbook, Springer Publishing Company, LLC
• Hogan-Quigley, B., Palm, M.L., Bickley, L.S., (2012). Bates' nursing guide to physical examination and history taking. Wolters Kluwer Health | Lippincott Williams & Wilkins.

Study record dates

Study Major Dates

• Study Start (Actual): December 5, 2022
• Primary Completion (Actual): July 6, 2023
• Study Completion (Actual): July 6, 2023

Study Registration Dates

• First Submitted: December 12, 2022
• First Submitted That Met QC Criteria: December 20, 2022
• First Posted (Actual): December 29, 2022

Study Record Updates

• Last Update Posted (Actual): August 23, 2023
• Last Update Submitted That Met QC Criteria: August 21, 2023
• Last Verified: August 1, 2023

More Information

Terms related to this study

• Keywords: Nursing; Simulation; Auscultation; Patient assessment
• Additional Relevant MeSH Terms: Mental Disorders; Anxiety Disorders
• Other Study ID Numbers: GaziU-SBF-SA-2

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: There is no plan to share IPD.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No