HKU_Newsletter_Issue43_0128

The Project Content This project adopted the FIRST 2 ACT (Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends) model which was developed by Cooper et al. (2012). FIRST 2 ACT is an evidence-based educational model that provided a framework for this project. It includes five components: 1) developing core knowledge; 2) assessment; 3) simulation; 4) reflective review; 5) performance feedback (Buykx et al., 2011). All final year nursing students were invited to participate in the project which was conducted in four phases: Phase 1: Developing a set of simulation teaching kit A set of simulation teaching kit, which included briefing materials, case scenarios and assessment tools, was developed. The nursing students’ knowledge, confidence and competence in managing a deteriorating patient were assessed. The Situation Awareness Global Assessment (SAGAT) Technique (Cooper et al., 2012) was also used to investigate nursing students’ ability in managing a deteriorating patient and the Laster Clinical Judgement Rubric was used to engage students in reflection- on and reflection-in their action during the learning process which allowed development of new perspectives for further improvement in clinical judgement. Phase 2: Briefing for students, assessors and simulated patients A briefing session with students was conducted to inform them of the aims and objectives, logistics and expectations on their performance. Another briefing session was provided to the teachers in assessing and debriefing students’ performance. Simulated patients were briefed on their act so that they could facilitate students’ performance. Phase 3: Simulation exercise In this phase, nursing students worked in teams of 3-4 to practice in an hour of simulation exercise and were required to manage two scenarios with patients’ health conditions deteriorating. They were not only expected to be alert to patients’ physical changes but also to patients’ safety in general. A 20-minute debriefing on students’ performance was conducted after the first session. Students then had five minutes for self-reflection before working on the second scenario. Phase 4: Focus group interview Focus groups were conducted after the simulation exercise in order to gain more information to enable us to develop new simulation programs and scenarios. Conclusion This project demonstrated that simulation-based education can enhance nursing students’ clinical judgement and situation awareness. A five minutes reflection after debriefing allowed students to have reflected-on and reflected-in their action which enhance their critical thinking and improve their performance. Acknowledgements: This study was supported by a Teaching Development Grant (2017-2018) awarded by the University Grants Council (UGC) in Hong Kong. We would like to thank the clinical teachers (Mr. Joseph Chan, Ms. Joyce Chong, Ms. Iris Ho, Ms. Kathy Kan, Ms. Maggie Pun, Ms. Cherry Sun, Ms. Denise Tang and Ms. Vivien Tsang) and our alumni (Mr. Cheung Ching Lun Leon, Mr. Chang Tang Fai Stephen, Mr. Cheung Wing Chun Ronald and Mr. Kwok Tze Man) who participated in the project. References: Buykx, P., Kinsman, L., Cooper, S., McConnell-Henry, T., Cant, R., Endacott, R., & Scholes, J. (2011). FIRST 2 ACT: educating nurses to identify patient deterioration - a theory-based model for best practice simulation education. Nurse Education Today , 31(7), 687-693. Cooper, S., Beauchamp, A., Bogossian, F., Bucknall, T., Cant, R., Devries, B.,…Young, S. (2012). Managing patient deterioration: a protocol for enhancing undergraduate nursing students’ competence through web-based simulation and feedback techniques. BMC Nursing , 11 (1), 18. Harder, B. N. (2010). Use of simulation in teaching and learning in health sciences: a systematic review. Journal of Nursing Education , 49(1), 23-28. Reese, C. E., Jefferies, P. R., & Engum, S.A. (2010). Using simulations to develop nursing and medical student collaboration. Nursing Education Perspectives , 31(1), 33-37. 5 Issue 43 Jan 2019