The effect of simulation method on knowledge, critical thinking and clinical decision making level of nursing students for the management of pregnancy with preeclampsia

This study conducted in order to determine the effect of scenario-based HFS method on level of knowledge, critical thinking and clinical decision making for the management of pregnancy with preeclampsia of nursing students and to evaluate student's opinions about the HFS method. The study was a randomized controlled intervention research in the mixed method type, in which both quantitative and qualitative research methods was used. The sample of the research consisted of 107 students (intervention=53, control=54) enrolled Obstetrics and Gynecology Nursing course in the Department of Nursing, Faculty of Health Sciences, Ankara Yıldırım Beyazıt University during the fall semester of 2017-2018 academic years. The students in the sampling group were assigned to the intervention and control groups by randomize sampling method. All students have participated in "Training on Management of Pregnancy with Preeclampsia" and after the training, the intervention group were applied scenario based HFS method, while in the control group no simulation method was applied. Quantitative data for the study were obtained by Student Descriptive Characteristics Data Gathering Form, Knowledge Evaluation Form, The California Critical Thinking Disposition Inventory, Clinical Decision Making in Nursing Scale and Simulation Design Scale. Qualitative data for the study were obtained by the Semi-structured Focus Group Interview Questionnaire with students in the intervention group. Data collection forms were applied before the training, after of the HFS applications and after one month of the HFS application to the students. "Simulation Application Checklist of Pregnancy with Preeclampsia" was applied for the students the intervention group during the simulation. For the evaluation of quantitative data; percentage, numbers, average, chi square, t test in independent groups, Mann Whitney U test, Wilcoxon test, friedman test and correlation analysis; for the evaluation of qualitative data, content analysis were used. In the study, it was determined that scenario-based HFS method for the management of pregnancy with preeclampsia were increased students' total point average of level of knowledge (p<0.001), retention of knowledge (p<0.001), critical thinking disposition (p<0.05) and clinical decision making (p<0.05). In addition, students had positive thoughts about the HFS method. In the focus group interviews conducted after the intervention, five theme were identified including the development of learning, the transfer of theoretical knowledge to clinical practice, gaining decision-making skill and self-confidence, preparation for professional role and recommendations. As a result of the research, it is suggested that to use the scenario-based HFS method in training on management of pregnancy with preeclampsia and integrated into the undergraduate nursing education curriculum. Keywords: Clinical decision making, cognitive skills, critical thinking, high fidelity simulation, nursing students, preeclampsia, simulation training