Using Online Interactive Simulation Teaching Material to Assess the Learning Effectiveness for Critical Care Nurses – A Case Study on Alarm Troubleshooting of Continuous Renal Replacement Therapy

• Main Authors: Yang, Yu-Hui, 楊渝惠
• Other Authors: Liou, Chuen-He
• Format: Others
• Language: zh-TW
• Published: 2019
• Online Access: http://ndltd.ncl.edu.tw/handle/bxw78k

碩士 === 國立臺北護理健康大學 === 醫護教育暨數位學習研究所 === 107 === Continuous Renal Replacement Therapy (CRRT) is a common treatment for critically-ill patients with acute kidney injury. However, patient prognosis may not be compromised if the CRRT care is inappropriately performed. In the real world, Intensive Care Unit (ICU) nurses have limited opportunities to practice alarm troubleshooting, to reflect on feedbacks, and to be evaluated again. Therefore, in order to improve the nursing skills of critical care nurses on handling CRRT alarm troubleshooting, nursing staff can continue to practice using the online interactive simulation exercise in the safe online environment until they are well-trained. The study purpose was to investigate the learning outcomes of critical care nurses after the intervention of the online interactive simulation exercise on CRRT alarm troubleshooting training. The outcomes were evaluated by the CRRT alarm troubleshooting knowledge test, self-evaluation, learning satisfaction, material satisfaction, and feedback. This study adopted a quasi-experimental design which included pre-tests, post-tests, and delay-tests in a single group of 82 ICU nurses from a medical center of Taipei City, Taiwan. The nurses must have CRRT care experience and completed the technical examination. All nurses received the pre-, post- and delay-tests before and after the intervention. The content of the pre-test included a knowledge test and a self-evaluation. After three weeks of intervention using the online materials, the nurses must complete the learning records and provide feedback. The post-test includes a knowledge test, a self-evaluation, and satisfaction surveys of both the online tool and the materials. After six to eight weeks, the delay-test were conducted including a knowledge test and a self-evaluation. Data analysis was performed used SPSS 21.0 for descriptive statistics and Generalized estimating equation analysis. The results of the study showed that: (1) The average scores of the knowledge on CRRT alarm care were significantly higher in the post-test and delay-test comparing with the pre-test. (2) The average scores of CRRT care self-evaluation were also significantly higher in the post-test and delay-test than that in the pre-test. (3) The average satisfaction scores for the learning experience using the online simulation interactive exercise was 4.15 (SD = 0.65). (4) The average satisfaction scores for the online materials was 4.21 (SD = 0.57), and the overall satisfaction was 84.2%. (5) Qualitative analysis and the overall feedback toward the online interactive simulation exercise included promoting clinical knowledge, cultivating the clinical skills of critical care, cultivating the clinical confidence in critical care, advantages of digital learning, suggestions and restrictions of digital learning, recommending digital learning for future on-the-job training. Based on the results of this study, we have the following suggestions: (1)The application of the online interactive, situational simulation exercise could be promoted in clinical nursing education; (2)Teacher training program could be arranged to encourage clinical teachers to combine professional knowledge with information technology; (3)Clinical scenarios may be combined into the online interactive simulation exercises for medical education; (4)Teaching materials are provided for applying Scratch to design online interactive, situational simulation exercises; Hence, we could access the learning effectiveness of the online situational simulation interactive teaching materials and use it to solve clinical problems, thereby achieving the goal of providing safe and high-quality care for critically ill patients on continuous hemodialysis.