SIMULATED PATIENT VERSUS HIGH-FIDELITY SIMULATOR: SATISFACTION, SELF-CONFIDENCE AND KNOWLEDGE AMONG NURSING STUDENTS IN BRAZIL

Santos, Elaine Cristina Negri; Almeida, Rodrigo Guimarães dos Santos; Meska, Mateus Henrique Gonçalves; Mazzo, Alessandra

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Sumário

ORIGINAL ARTICLE • Cogit. Enferm. 26 • 2021 • https://doi.org/10.5380/ce.v26i0.76730 copy

SIMULATED PATIENT VERSUS HIGH-FIDELITY SIMULATOR: SATISFACTION, SELF-CONFIDENCE AND KNOWLEDGE AMONG NURSING STUDENTS IN BRAZIL

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

to assess and compare satisfaction, self-confidence and knowledge among Nursing students in the use of simulated patients and high-fidelity simulators.

Method

a quasi-experimental study conducted in 2017 with 150 students from a private university The participants answered a pre-test to assess knowledge and participated in a lecture and in skills training. After the simulation, the students answered the Satisfaction with Simulated Clinical Experiences scale and the Satisfaction and Self-confidence in Learning and Knowledge scale. The data were analyzed based on non-parametric tests.

Results

the students showed high rates of satisfaction (93.5 and 92.5), self-confidence (4.3 and 4.4) and knowledge gain (6.2 and 6.4). There were no significant differences in the comparison between the simulated patient group and the high-fidelity simulator group regarding satisfaction, self-confidence and knowledge.

Conclusion

the findings showed that well-prepared settings can be obtained with lower costs, and with an effective impact on the students’ learning.

DESCRIPTORS
Simulation; Patient Simulation; Training with High-Fidelity Simulation; Nursing Students; Learning

		Simulated Patient Group n (%)	High-Fidelity Simulator Group n (%)
	Participants	72 (48,0)	78 (52,0)
Gender
	Female	65 (90,2)	71 (91,0)
	Male	7 (9,8)	7 (9,0)
Age
	Mean	26,4	26
	Standard Deviation	±7,8	±6,1
	Mode	22	21
	Minimum	20	19
	Maximum	50	51
Semester
	Sixth	35 (48,6)	29 (37,2)
	Seventh	7 (9,7)	25 (32,0)
	Eighth	30 (41,7)	24 (30,8)
Occupation
	Student	49 (68,0)	63 (80,8)
	Student or working in the Nursing area	13 (18,1)	8 (10,3)
	Student or working in another area	10 (13,9)	7 (8,9)
Preference in relation to learning modalities
	Expository-dialog class	33 (45,8)	28 (35,9)
	Active teaching-learning methodologies	39 (54,2)	50 (64,1
Training
	Nursing assistant	3 (4,2)	15 (19,2)
	Nursing technician	5 (6,9)	8 (10,2)
	Higher Education in another area	1 (1,4)	2 (2,5)
	No previous training	63 (87,5)	53 (68,1)
Experience with clinical simulation and stomas
	Previous activity in simulation lab	72 (100,0)	78 (100,0)
	Skills training ^* * There was more than one answer per subject.	69 (95,9)	74 (94,8)
	Setting with high-fidelity simulator ^* * There was more than one answer per subject.	36 (50,0)	45 (57,7)
	Setting with simulated patient ^* * There was more than one answer per subject.	46 (63,9)	46 (58,9)
	Previous event about stomas	12 (16,7)	12 (15,4)
	Previous stoma-related assistance	21 (29,2)	19 (24,3)

		Mean (SD)		Minimum		Maximum
		SPG ^‡ ‡ Simulated Patient Group; HFSG:	HFSG ^§ § High-Fidelity Simulator Group.	SPG ^‡ ‡ Simulated Patient Group; HFSG:	HFSG ^§ § High-Fidelity Simulator Group.	SPG ^‡ ‡ Simulated Patient Group; HFSG:	HFSG ^§ § High-Fidelity Simulator Group.
ESECS ^* * ESECS - Escala de Satisfação com as Experiências Clínicas Simuladas (Scale of Satisfaction with Simulated Clinical Experiences);
	General	93,5±5,4	92,5±6,5	72,3	67,6	100	100
	Practice	91,8±6,9	89,6±8,6	66,6	56,6	100	100
	Realism	95,3±6,6	95,5±6,1	76	76	100	100
	Cognitive	95,5±5,2	95,8±5,9	80	80	100	100
ESAA ^† † ESAA - Escala de Satisfação e Autoconfiança no Aprendizado (Scale of Satisfaction and Self-Confidence in Learning); SPG:
	General	4,3±0,3	4,4±0,3	3	3,3	5	5
	Satisfaction	4,6±0,4	4,6±0,4	3	3,4	5	5
	Self-confidence	4,1±0,4	4,3± 0,4	2,5	3,2	5	5
Assessment of the Theoretical Knowledge
	Pre-test	4,7±1,75	5,1±1,63	1	1	9	9
	Post-test	6,2± 1,52	6,4±1,54	2	2	9	9

Dimension		Mean		Comparison between groups SPG ^‡ ‡ Simulated Patient Group; HFSG: - HFSG ^§ § High-Fidelity Simulator Group.
Dimension		SPG ^‡ ‡ CI – Confidence Interval; SPG‡: Simulated Patient Group; HFSG	HFSG ^§ § High-Fidelity Simulator Group.	Estimated difference ^* * ESAA - Escala de Satisfação e Autoconfiança no Aprendizado (Scale of Satisfaction and Self-Confidence in Learning) †ESECS - Escala de Satisfação com as Experiências Clínicas Simuladas (Scale of Satisfaction with Simulated Clinical Experiences);	CI (95%)	p-value<0,05
ESECS
	ESECS - General	93,5	5,4	1,02	-4,09	0,33
	ESECS - Practice	91,8	6,9	2,22	-5,32	0,1
	ESECS - Realism	95,3	6,6	-0,21	-4,32	0,85
	ESECS - Cognitive	95,5	5,2	-0,54	-3,78	0,57
ESAA
	ESAA - General	4,3	4,4	-0,06	-0,26	0,4
	ESAA - Satisfaction	4,6	4,6	0,01	-0,3	0,91
	ESAA - Self-confidence	4,1	4,3	-0,1	-0,31	0,22

		Mean grade (SD)		Estimated difference	CI (95%)	p-value
		Pre-test	Post-test	Estimated difference	CI (95%)	p-value
Sixth semester
	SPG ^‡ ‡ Simulated Patient Group; HFSG	4,54 (1,79)	6,17(1,65)	1,63	1,12; 2,14	<0,01
	HFSG ^§ § High-Fidelity Simulator Group.	4,97 (1,55)	6,1 (1,42)	1,14	0,58; 1,70	<0,01
Seventh semester
	SPG ^‡ ‡ Simulated Patient Group; HFSG	5 (1,63)	6,29(0,76)	1,29	0,14; 2,43	0,03
	HFSG ^§ § High-Fidelity Simulator Group.	4,6 (1,5)	6,36(1,52)	1,76	1,16; 2,36	<0,01
Eighth semester
	SPG ^‡ ‡ Simulated Patient Group; HFSG	5 (1,76)	6,27(1,53)	1,27	0,72; 1,82	<0,01
	HFSG ^§ § High-Fidelity Simulator Group.	5,96 (1,63)	6,83(1,69)	0,88	0,26; 1,49	<0,01
GENERAL
	SPG ^‡ ‡ Simulated Patient Group; HFSG	4,78 (1,75)	6,22(1,52)	1,39	0,94; 1,85	<0,01
	HFSG ^§ § High-Fidelity Simulator Group.	5,15 (1,64)	6,41(1,55)	1,26	0,91; 1,60	<0,01

Knowledge (post – pre-test) Variable	Estimate	CI‡ (95%)	p-value
SPG ^‡ ‡ CI – Confidence Interval; SPG‡: Simulated Patient Group; HFSG ^§ § HFSG: High-Fidelity Simulator Group.	0,37	-0,24; 0,87	0,15
ESAA ^* * ESAA - Escala de Satisfação e Autoconfiança no Aprendizado (Scale of Satisfaction and Self-Confidence in Learning) – Satisfaction	-0,88	-1,50; -0,25	<0,01
ESAA ^* * ESAA - Escala de Satisfação e Autoconfiança no Aprendizado (Scale of Satisfaction and Self-Confidence in Learning) – Self-confidence	0,62	0,02; 1,22	0,04
ESECS ^† † ESECS - Escala de Satisfação com as Experiências Clínicas Simuladas (Scale of Satisfaction with Simulated Clinical Experiences); – Practice	2,22	-0,44; 4,88	0,1
ESECS ^† † ESECS - Escala de Satisfação com as Experiências Clínicas Simuladas (Scale of Satisfaction with Simulated Clinical Experiences); – Realism	-0,21	-2,37; 1,95	0,85
ESECS ^† † ESECS - Escala de Satisfação com as Experiências Clínicas Simuladas (Scale of Satisfaction with Simulated Clinical Experiences); – Cognitive	-0,54	-2,43; 1,35	0,57

Universidade Federal do Paraná Av. Prefeito Lothário Meissner, 632, Cep: 80210-170, Brasil - Paraná / Curitiba, Tel: +55 (41) 3361-3755 - Curitiba - PR - Brazil
E-mail: cogitare@ufpr.br

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[1] Corresponding author
Alessandra Mazzo Universidade de São Paulo – Bauru, SP, Brasil E-mail: amazzo@usp.br