Short simulation exercises to improve emergency department nurses' self-efficacy for initial disaster management: Controlled before and after study.
Introduction Head nurses at emergency departments often assume responsibility for managing the initial response to a major incident, and to create surge capacity. Training is essential to enable these nurses to perform an effective disaster response. Evaluating the effects of such training is however complicated as real skill only can be demonstrated during a real major incident. Self-efficacy has been proposed as an alternative measure of training effectiveness. Purpose The aim of this study was to examine if short, small-scale computer-based simulation exercises could improve head emergency nurses' general and specific self-efficacy and initial incident management skills. Method A within-group pretest-posttest design was used to examine 13 head nurses' general and specific self-efficacy before and after an intervention consisting of three short computer based simulation exercises during a 1-h session. Management skills were assessed using the computer simulation tool DigEmergo. Results The exercises increased the head nurses' general self-efficacy but not their specific self-efficacy. After completing the first two exercises they also exhibited improved management skills as indicated by shorter time to treatment for both trauma and in-hospital patients. Conclusion This study indicates that short computer based simulation exercises provide opportunities for head nurses to improve management skills and increase their general self-efficacy.
Statistical analysis of pretest and posttest questionnaires, as well as statistical analysis of the seconds to treatment of trauma and in-hospital patients during the exercises in the simulation.
A within-group pretest-posttest design was used to examine 13 head nurses’ general and specific self-efficacy before and after an intervention consisting of three short computer based simulation exercises during a 1 hour session. Management skills were assessed using the computer simulation tool DigEmergo.
Pretest and posttest general self-efficacy, pretest and posttest specific self-efficacy, seconds to treatment of trauma patients, seconds to treatment of in hospital patients.
The study used a quantitative experimental method with a withingroup design, in which participants' self-efficacy was measured using questionnaires before and after partaking in three simulated surge capacity scenarios. An a priori power analysis indicated a minimum participant sample of 12 to detect a large effect
The study used a quantitative experimental method with a within-group design, in which participants’ self-efficacy was measured using questionnaires before and after partaking in the three simulated surge capacity scenarios. 13 head nurses participated in the study.
The aim of this study was to examine if short, small-scale computer-based simulation exercises could improve head emergency nurses general and specific self-efficacy and initial incident management skills.
Short computer based simulation exercises provide opportunities for head nurses to improve management skills and increase their general self-efficacyIt is important not to overestimate the association between reported self-efficacy and abilities.There are two ways to interpret the results: i) that the trainees have improved general skill of managing surge which will translate to more efficient handling during a real MI, or ii) that the trainees have improved specifically in their skill at running the simulator only and will be no better at handling a real MI.It is not possible from this study alone to conclude anything about the simulation validity.Further studies are needed specifically aimed at addressing the question of simulation validity
The exercises increased the head nurses’ general self-efficacy but not their specific self-efficacy. After completing the first two exercises they also exhibited improved management skills as indicated by shorter time to treatment for both trauma and in-hospital patients.
All local, regional and national guidelines for ethical permission were followed. Ethical consideration was given with regard to the need for consent, the information requirement, confidentiality obligations and utilization requirements. The participation was voluntary, and all participants gave written informed consent for participation.
Short, small-scale computer-based simulations to improve head emergency nurses’ general and specific self-efficacy and management skills.
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