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Original Article
Comparison of Learning Effects using High-fidelity and Multi-mode Simulation: An Application of Emergency Care for a Patient with Cardiac Arrest
Eon-Na Ryoo1, Eun-Ho Ha2, Jin-Young Cho3
Journal of Korean Academy of Nursing 2013;43(2):185-193.
DOI: https://doi.org/10.4040/jkan.2013.43.2.185
Published online: April 12, 2013

1Department of Nursing, Shinsung University, Dangjin, Korea

2Red Cross College of Nursing, Chung-Ang University, Seoul, Korea

3Graduate School of Nursing, Inha University, Incheon, Korea

1Department of Nursing, Shinsung University, Dangjin, Korea

2Red Cross College of Nursing, Chung-Ang University, Seoul, Korea

3Graduate School of Nursing, Inha University, Incheon, Korea

Address reprint requests to : Ha, Eun-Ho Red Cross College of Nursing, Chung-Ang University, 8 Gyunggyojang-gil, Jongno-gu, Seoul 110-102, Korea Tel: +82-2-3700-3681 Fax: +82-2-3700-3400 E-mail: rnhaeunho@cau.ac.kr
• Received: September 4, 2012   • Revised: October 5, 2012   • Accepted: November 8, 2012

Copyright © 2013 Korean Society of Nursing Science

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    Simulation-based learning has become a powerful method to improve the quality of care and help students meet the challenges of increasingly complex clinical practice settings. The purpose of this study was to identify the learning effects using high-fidelity SimMan and multi-mode simulation.
  • Methods
    Participants in this study were 38 students who were enrolled in an intensive course for a major in nursing at R college. Collected data were analyzed using Chi-square, t-test, and independent t-test with the SPSS 18.0 for Windows Program.
  • Results
    There were no statistically significant differences in learning effects between high-fidelity SimMan and multi-mode simulation group. However, skills in clinical performance in the high-fidelity SimMan group were higher than in the multi-mode group (p= .014), communication in clinical performance in multi-mode simulation group was higher than in the high-fidelity SimMan group (p< .001).
  • Conclusion
    Multi-mode simulation with a standardized patient is an effective learning method in many ways compared to a high-fidelity simulator. These results suggest that multi-mode simulation be offered to students in nursing colleges which cannot afford to purchase a high-fidelity simulator, or offered as an alternative.
Figure 1.
Study process.
jkan-43-185f1.jpg
Table 1.
Homogeneity Test for General Characteristics of Participants (N=38)
Characteristics Categories SimMan group (n=20)
Multi-mode group (n=18)
χ2 or t p
n (%) or M±SD n (%) or M±SD
Age (year) 29.05±2.65 27.56±3.86 −1.40 .168
Gender Male 1 (5.0) 1 (5.6) 1.000*
Female 19 (95.0) 17 (94.4)
Work place ER/ICU 4 (20.0) 2 (11.1) 4.78 .239*
Medical-Surgical 5 (25.0) 9 (50.0)
Specialization 4 (20.0) 5 (27.8)
School/Institution 7 (35.0) 2 (11.1)
Working period (month) 60.35±25.37 53.28±38.06 −0.68 .501
Belong to Large hospital (over 500 beds) 12 (60.0) 15 (83.3) .297*
Medium-sized hospital (300-499 beds) 5 (25.0) 2 (11.1)
School/Institution 3 (15.0) 1 (5.6)
Midterm scores 20.00±2.71 19.44±4.03 −0.50 .618
Simulation Yes 2 (10.0) 1 (5.6) .541*
experience No 18 (90.0) 17 (94.4)

ER=Emergency room; ICU=Intensive care unit.

*Fisher’s exact test.

Table 2.
Comparison between SimMan Group and Multi-mode Group for Mean Scores of Variables (N=38)
Variables SimMan group (n=20)
Multi-mode group (n=18)
t p
M±SD M±SD
Knowledge 20.25±2.02 18.72±3.08 −1.82 .077
Clinical competency 3.03±0.36 2.98±0.78 −0.23 .819
  Skills 3.56±0.49 2.98±0.85 −2.57 .014
  Job management 3.05±0.58 3.00±1.03 −0.18 .854
  Team work 2.86±0.46 2.66±0.72 −0.98 .334
  Situational awareness 3.05±0.26 3.08±0.75 0.17 .860
  Decision making 3.00±0.63 3.12±1.06 0.43 .669
  Communication 1.77±0.60 2.79±0.84 4.21 <.001
Satisfaction 4.21±0.69 4.15±0.53 −0.29 .772
  Suitability of learning contents 4.65±0.55 4.37±0.69 −1.35 .184
  Learning achievement 4.09±0.89 4.15±0.57 0.26 .792
  Appropriateness of learning evaluation 4.51±0.74 4.06±0.53 −0.39 .692
  Learning motive provocation 4.48±0.60 4.38±0.55 −0.50 .620
  Learner satisfaction 4.37±0.82 4.08±0.71 −1.16 .254
  • Ackermann A D. 2009;Investigation of learning outcomes for the acquisition and retention of CPR knowledge and skills learned with the use of high-fidelity simulation. Clinical Simulation in Nursing. 5(6):e213–e222. http://dx.doi.org/10.1016/j.ecns.2009.05.002Article
  • Agency for Healthcare Research and Quality. 2011, July 16;TeamSTEPPS: National implementation. Retrieved March 20, 2012, from. http://team-stepps.ahrq.gov/abouttoolsmaterials.htmArticle
  • Alinier G, Hunt B, Gordon R &, Harwood C. 2006.Effectiveness of intermediate-fidelity simulation training technology in undergraduate nursing education. Journal of Advanced Nursing. 54(3): p. 359–369. http://dx.doi.org/10.1111/j.1365-2648.2006.03810.xArticlePubMed
  • Becker K L, Rose L E, Berg J B, Park H &, Shatzer J H. 2006;The teaching effectiveness of standardized patients. Journal of Nursing Education. 45(4):103–111.Article
  • Crea K A. 2011;Practice skill development through the use of human patient simulation. American Journal of Pharmaceutical Education. 75(9):188http://dx.doi.org/10.5688/ajpe759188ArticlePubMedPMC
  • Crofts J F, Bartlett C, Ellis D, Hunt L P, Fox R &, Draycott T J. 2006;Training for shoulder dystocia: A trial of simulation using low-fidelity and high-fidelity mannequins. Obstetrics and Gynecology. 108(6):1477–1485. http://dx.doi.org/10.1097/01.AOG.0000246801.45977.c8PubMed
  • Crofts J F, Bartlett C, Ellis D, Winter C, Donald F, Hunt L P. . 2008.Patient-actor perception of care: A comparison of obstetric emergency training using manikins and patient-actors. Quality & Safety in Health Care. 17(1): p. 20–24. http://dx.doi.org/10.1136/qshc.2006.02 1873Article
  • Dreifuerst K T. 2012;Using debriefing for meaningful learning to foster development of clinical reasoning in simulation. Journal of Nursing Education. 51(6):326–333. http://dx.doi.org/10.3928/01484834-20120409-02Article
  • Gates M G, Parr M B &, Hughen J E. 2012;Enhancing nursing knowledge using high-fidelity simulation. Journal of Nursing Education. 51(1):9–15. http://dx.doi.org/10.3928/01484834-20111116-01ArticlePubMed
  • Gordon J A, Brown D F &, Armstrong E G. 2006;Can a simulated critical care encounter accelerate basic science learning among preclinical medical students? A pilot study. Simulation in Healthcare. 1:13–17.ArticlePubMed
  • Hatala R, Issenberg S B, Kassen B, Cole G, Bacchus C M &, Scalese R J. 2008;Assessing cardiac physical examination skills using simulation technology and real patients: A comparison study. Medical Education. 42(6):628–636. http://dx.doi.org/10.1111/j.1365-2923.2007.02953.xArticlePubMed
  • Kardong-Edgren S, Anderson M &, Michaels J. 2007;Does simulation fidelity improve student test scores? Clinical Simulation in Nursing. 3(1):e21–e24. http://dx.doi.org/10.1016/j.ecns.2009.05.035Article
  • Kardong-Edgren S, Lungstrom N &, Bendel R. 2009;VitalSim® versus SimMan®. A comparison of BSN student test scores, knowledge retention, and satisfaction. Clinical Simulation in Nursing. 5(3):e105–e111. http://dx.doi.org/10.1016/j.ecns.2009.01.007Article
  • Kneebone R, Kidd J, Nestel D, Asvall S, Paraskeva P &, Darzi A. 2002;An innovative model for teaching and learning clinical procedures. Medical Education. 36(7):628–634.ArticlePubMedPDF
  • Lee S J, Roh Y S, Kim J O, Jang K I, Ryoo E N &, Park Y M. 2010;Comparison of multi-mode simulation and SimMan® simulation on evaluation of nursing care for patients with dyspnea. Journal of Korean Academy Society of Nursing Education. 16(1):51–60.
  • Marken P A, Zimmerman C, Kennedy C, Schremmer R &, Smith K V. 2010;Human simulators and standardized patients to teach difficult conversations to interprofessional health care teams. American Journal of Pharmaceutical Education. 74(7):120. ArticlePubMedPMC
  • Maxson P M, Dozois E J, Holubar S D, Wrobleski D M, Dube J A, Klipfel J M. . 2011;Enhancing nurse and physician collaboration in clinical decision making through high-fidelity interdisciplinary simulation training. Mayo Clinic Proceedings. 86(1):31–36. http://dx.doi.org/10.4065/mcp.2010.0282ArticlePubMedPMC
  • McGaghie W C, Issenberg S B, Petrusa E R &, Scalese R J. 2010;A critical review of simulation-based medical education research: 2003-2009. Medical Education. 44(1):50–63. http://dx.doi.org/10.1111/j.1365-2923.2009.03547.xArticlePubMed
  • Park J S. 2012, March.Accreditation standards for nursing education accreditation assessment. Paper presented at the Korean Accreditation Board of Nursing Education. Seoul.
  • Riley R H. 2010.Manual of simulation in healthcare. Korean Society for Simulation in Healthcare, Trans.. Seoul: Yedangbook (Original work published 2008).
  • Ryan C A, Walshe N, Gaffney R, Shanks A, Burgoyne L &, Wiskin C M. 2010;Using standardized patients to assess communication skills in medical and nursing students. BMC Medical Education. 10:24http://dx.doi.org/10.1186/1472-6920-10-24ArticlePubMedPMCPDF
  • Schlegel C, Woermann U, Shaha M, Rethans J J &, van der Vleuten C. 2012;Effects of communication training on real practice performance: A role-play module versus a standardized patient module. Journal of Nursing Education. 51(1):16–22. http://dx.doi.org/10.3928/01484834-20111116-02ArticlePubMed
  • Seybert A L &, Kane-Gill S L. 2011;Elective course in acute care using online learning and patient simulation. American Journal of Pharmaceutical Education. 75(3):54. ArticlePubMedPMC
  • Sleeper J A &, Thompson C. 2008;The use of hi fidelity simulation to enhance nursing students' therapeutic communication skills. International Journal of Nursing Education Scholarship. 5:1–12. http://dx.doi.org/10.2202/1548-923x.1555Article
  • Taekman J M &, Shelley K. 2010;Virtual environments in healthcare: Immersion, disruption, and flow. International Anesthesiology Clinics. 48(3):101–121. http://dx.doi.org/10.1097/AIA.0b013e3181eace73Article
  • Thomas C &, Mackey E. 2012;Influence of a clinical simulation elective on baccalaureate nursing student clinical confidence. Journal of Nursing Education. 51(4):236–239. http://dx.doi.org/10.3928/01484834-20120224-03ArticlePubMed
  • Wisborg T, Brattebo G, Brinchmann-Hansen A &, Hansen K S. 2009;Mannequin or standardized patient: Participants' assessment of two training modalities in trauma team simulation. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 17:59http://dx.doi.org/10.1186/1757-7241-17-59ArticlePubMedPMC
  • Wotton K, Davis J, Button D &, Kelton M. 2010;Third-year undergraduate nursing students' perceptions of high-fidelity simulation. Journal of Nursing Education. 49(11):632–639. http://dx.doi.org/10.3928/01484834-20100831-01ArticlePubMed
  • Yoo M S &, Yoo I Y. 2001;The effectiveness of standardized patient managed instruction for a fundamentals of nursing course. Journal of Nursing Query. 10(1):89–109.

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      Comparison of Learning Effects using High-fidelity and Multi-mode Simulation: An Application of Emergency Care for a Patient with Cardiac Arrest
      J Korean Acad Nurs. 2013;43(2):185-193.   Published online April 12, 2013
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    Comparison of Learning Effects using High-fidelity and Multi-mode Simulation: An Application of Emergency Care for a Patient with Cardiac Arrest
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    Figure 1. Study process.
    Comparison of Learning Effects using High-fidelity and Multi-mode Simulation: An Application of Emergency Care for a Patient with Cardiac Arrest
    Characteristics Categories SimMan group (n=20)
    Multi-mode group (n=18)
    χ2 or t p
    n (%) or M±SD n (%) or M±SD
    Age (year) 29.05±2.65 27.56±3.86 −1.40 .168
    Gender Male 1 (5.0) 1 (5.6) 1.000*
    Female 19 (95.0) 17 (94.4)
    Work place ER/ICU 4 (20.0) 2 (11.1) 4.78 .239*
    Medical-Surgical 5 (25.0) 9 (50.0)
    Specialization 4 (20.0) 5 (27.8)
    School/Institution 7 (35.0) 2 (11.1)
    Working period (month) 60.35±25.37 53.28±38.06 −0.68 .501
    Belong to Large hospital (over 500 beds) 12 (60.0) 15 (83.3) .297*
    Medium-sized hospital (300-499 beds) 5 (25.0) 2 (11.1)
    School/Institution 3 (15.0) 1 (5.6)
    Midterm scores 20.00±2.71 19.44±4.03 −0.50 .618
    Simulation Yes 2 (10.0) 1 (5.6) .541*
    experience No 18 (90.0) 17 (94.4)
    Variables SimMan group (n=20)
    Multi-mode group (n=18)
    t p
    M±SD M±SD
    Knowledge 20.25±2.02 18.72±3.08 −1.82 .077
    Clinical competency 3.03±0.36 2.98±0.78 −0.23 .819
      Skills 3.56±0.49 2.98±0.85 −2.57 .014
      Job management 3.05±0.58 3.00±1.03 −0.18 .854
      Team work 2.86±0.46 2.66±0.72 −0.98 .334
      Situational awareness 3.05±0.26 3.08±0.75 0.17 .860
      Decision making 3.00±0.63 3.12±1.06 0.43 .669
      Communication 1.77±0.60 2.79±0.84 4.21 <.001
    Satisfaction 4.21±0.69 4.15±0.53 −0.29 .772
      Suitability of learning contents 4.65±0.55 4.37±0.69 −1.35 .184
      Learning achievement 4.09±0.89 4.15±0.57 0.26 .792
      Appropriateness of learning evaluation 4.51±0.74 4.06±0.53 −0.39 .692
      Learning motive provocation 4.48±0.60 4.38±0.55 −0.50 .620
      Learner satisfaction 4.37±0.82 4.08±0.71 −1.16 .254
    Table 1. Homogeneity Test for General Characteristics of Participants (N=38)

    ER=Emergency room; ICU=Intensive care unit.

    Fisher’s exact test.

    Table 2. Comparison between SimMan Group and Multi-mode Group for Mean Scores of Variables (N=38)


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