Plastic with personality: Increasing student engagement with manikins
Introduction
Simulation has become an essential element of nursing education (Foronda et al., 2013). The range of different types of simulations utilized in nursing education can include standardized and simulated patients, task trainers, computer-assisted or virtual instruction, hybrids and role-play (McAllister et al., 2013). All of these simulation modalities can provide active learning opportunities for health professions students, foster development of clinical reasoning skills (Jensen 2013) and increase student confidence prior to clinical practice (Ricketts, 2011). Using simulation also allows students to practice key psychomotor skills and gain technical proficiency with no risk to patients (Cant, RP and Cooper, SJ, 2010, Schiavenato, M, 2009).
Like medicine, nursing has embraced the use of manikins. The use of manikins in nursing has been considered particularly valuable because it can expose students to complex sets of physiological symptoms, allowing them to think critically and exercise decision-making skills (Shin, S, et al., 2015, Yeun, EJ, et al., 2015). Patients' backgrounds and social perspectives can be incorporated into complex case studies but there can be a disconnect when extending the context of the story into a simulation scenario where the manikin represents the patient. If the expectation is for students to engage in nurse–patient interactions and develop the nuances of professional practice, additional strategies to link the manikin with the patient's story and context are necessary. Yet there is a distinct lack of empirical research investigating the effectiveness of the full range of simulation modalities for student learning and development of clinical expertise in nursing (Schiavenato, M, 2009, Walton, J, et al., 2011).
Section snippets
Background
A commonly reported issue is students struggling to suspend disbelief in clinical simulation scenarios (McAllister et al., 2013). Current manikins lack the physical characteristics of movement particularly facial expressions and the subtleties of human responses (Kameg et al., 2010). Students particularly find it difficult to talk to, and relate to a manikin authentically as a patient (Barry et al., 2012). Yet discussion in the literature regarding enhancing nursing student engagement with
Context
The innovation was trialed in Medical Surgical Nursing, a second year core subject of a Bachelor of Nursing program in a large urban Australian university in the first semester of 2014. This subject builds on students' previous clinical experiences to develop their critical application and judgment about nursing methods and practices for optimizing management of acute medical–surgical conditions in tertiary-care settings. The student cohort is split between two semesters with an average of 450
Findings
Four clustered themes emerged from the data: Getting past the plastic; knowing what to say; connecting and caring; and, embracing diversity.
Discussion
The main aim of the current study was to explore student perspectives of the use of vignettes to increase engagement with case study manikins. The participants in the current study articulated an increasing engagement with manikins as a consequence of the vignettes and layered approach to the case studies; however, they also provided advice for future improvements. These centered around providing verbal responses from the manikins. Achieving this with large cohorts of students presents some
Limitations
This study was limited to a single cohort of second year undergraduate nurses. Typically respondents to student feedback survey open response comments, and students who volunteer for focus groups, are likely to be students who are either highly engaged or have a particular opinion about the subject they want to share. The opinions of other students who did not complete the survey or participate in the focus group are unknown. The student feedback survey and focus group both occurred before the
Conclusion
Originally conceived as a technique to increase students' engagement with manikins in practical laboratory classes, the benefits for students of introducing A-V patient vignettes as a part of multi-layered case studies have been enlightening. In addition to the intended outcomes, more subtle advantages such as allowing students to reflect on their own values and pre-conceived notions of people from diverse backgrounds were realized. Using narrative pedagogy and increased realism has the
Acknowledgements
We would like to acknowledge Jacqueline Benson and Joshith Van Houten for their generous contributions to this project.
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