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The Effect of Simulation Training on Baccalaureate Nursing Students' Competency in Performing Intramuscular Injection

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Description: Simulation is a teaching method that closely replicates reality by integrating all three learning domains: cognitive, affective, and psychomotor. Despite the widespread use of simulation in nursing education today, there is a dearth of empirical evidence supporting the use of simulation to teach psychomotor skills. Furthermore, there is no evidence in the nursing literature supporting the transfer of psychomotor skills learned through simulation to actual patient care. More specifically, though consistently identified as an important nursing skill, effective methods to teach injections to nursing students have not been studied. This research study used a pre-test/ post-test design with three measurement times to evaluate the effect of low-fidelity simulation with role play scenarios on baccalaureate nursing students' competency in intramuscular (IM) injection in both a traditional learning laboratory setting as well as an actual patient care setting. After receiving standard education and being pre-tested in IM injection competency in a learning laboratory setting, traditional four-year baccalaureate nursing students and accelerated second-degree baccalaureate nursing students were randomly assigned to either a control or experimental group. The experimental group received a scenario-based, low-fidelity simulation intervention related to IM injection administration while the control group individually practiced the skill in a standard learning laboratory setting with supervision. Subjects were then post-tested in two different settings: a traditional learning laboratory environment and in an actual patient care situation at a flu clinic. A task-specific checklist was used to collect data at all three time points. Data were analyzed using a 2x3 repeated measures analysis of covariance (RM-ANCOVA). A total of 55 subjects participated in this study. Due to missing data, the data were analyzed twice- once using pairwise deletion and a second time using mean substitution. Though the experimental group had higher IM injection competency means at both post-testing times, RM-ANCOVA revealed no statistically significant difference in IM injection competency between members of the experimental group and members of the control group with either analysis method (F 2,70 = 2.101, p = 0.130; F 1.681,89.117 = 1.203, p = 0.299). Furthermore, there was no statistically significant difference in skill transfer between the two groups. The calculated power for this study was low (0.418) indicating that the sample size may have been insufficient to detect a statistically significant difference and a Type II error may have occurred. Consequently, further nursing education research is needed in this area to support the use of simulation as a more effective teaching strategy than traditional learning laboratory education in evidence-based nursing education.
Language: English
Format: Degree Work