The effects of three different methods in stoma care education on the knowledge and skill levels of nursing students

Aim This study was designed to determine the effect of standardized patients, manikinbased simulation and traditional methods used in stoma care education on the knowledge and skill levels of nursing students. Method The research consisted three stages. In the first stage, the validity and reliability of the "Simulation Based Learning Assessment Scale" were evaluated. The data were gathered from the students (n=185) who studied at the Nursing Department of the Acıbadem Mehmet Ali Aydınlar University between 20-30 September 2016. In the second stage, the effects of the three different methods on the knowledge and skill levels of the students were analyzed. The experimental group consisted students of the Department of Nursing of Acıbadem Mehmet Ali Aydınlar University, who took a Surgical Diseases Nursing course between September 2016 and February 2017 (Standardized Patient Group= 32, Manikin Based Simulation Group= 32). The control group consisted students of the Nursing Faculty of Dokuz Eylül University, who took a similar course between October 2016 and November 2016 (Traditional Method=34). The data were collected with the Stoma Skill Form, Stoma Information Form and Simulation Based Learning Assessment Scale after the scenario applications in the experiment group. In the third stage, the skill levels of the students in the patient care environment were analyzed. The data were collected from three university hospitals an one research hospital in Istanbul between October 2016 and February 2017 for the Experimental Group and from an university hospital in İzmir between February 2017 and April 2017 for the Control Group. The data were collected with the Diagnosis Form for the Individuals with Stoma, the Stoma Skill Form and the Patient Intervention SelfConfidence/ Competence Scale. Results In the scale validity and reliability stage, the data were collected from 185 students in total. As a result of expert opinions, the Content Validity Index was found as 0.89, while Cronbach's Alpha was found as 0.957. KMO sampling adequacy value was 0.930, confirmatory factor analysis showed a good agreement with model in all concordance indexes. Pre and post-test stoma knowledge level scores were found to be significantly lower compared to the other groups (p=0.001, p=0.001, p<0.01). The post test scores of the group of standardized patients were found to be significantly higher compared to the manikin based group (p=0.032, p<0.05). Skill level score of the group who learned stoma treatment by traditional method was found to be significantly lower than the other groups (p=0.001, p=0.001, p<0.01). No statistically significant difference was found between the standardized patient and manikin-based simulation groups' skill scores (p>0.05). Simulation Based Learning Assessment Scales "Communication" subscale scores of the standardized patient group was significantly higher compared to manikin based simulation group (p=0.048, p<0.05). No significant difference was found between the skill level scores of the standardized patient and manikin based simulation groups in the patient care environment (p>0.05) while the conventional method group was found to be significantly lower (p=0.001, p=0.001, p<0.01). There was no difference between self-confidence/ competence perceptions of the standardized patient and manikin-based simulation groups in the patient care environment (p>0.05). The "Clinical Practice" subscale score of the group who learned the traditional method was significantly lower compared to the other groups (p=0.002, p=0.008, p<0.01). Conclusion In the context of the study, it was determined that "Simulation Based Learning Assessment Scale", which assesses the effectiveness of the simulation based learning outcomes and scenarios, is a valid and reliable tool for Turkey. It was determined that the simulation-based teaching techniques with increased reality and structured in accordance with the standards are effective in reinforcing the knowledge and skills, improves the skills in the clinical practice environment and increases self-confidence during the skill application. It is believed that increasing the reality environment during simulation based education helps the student to prepare for the clinical environment and gave competence to the patient.