Using Simulation-based Practice Labs to Promote Instructional Effectiveness and Community Cohesion in a Blended Distance Nursing Program

Abstract

An on-site simulation-based practice lab was conducted with 42 students enrolled in a blended distance practical nursing diploma program at the end of their first year of study, prior to their clinical placements. The six-hour practice lab involved an orientation, small group activities involving three obstetric-related scenarios using the moderate fidelity simulator Noelle®, and a debriefing activity. An evening social activity was also provided. The study used a mixed method research design involving both quantitative and qualitative methods. Data were collected using a demographic questionnaire, a 20-item pre-test/post-test knowledge quiz, and three National League for Nursing (NLN) instruments — the Simulation Design Scale, the Educational Practices in Simulation Scale, and the Learner Satisfaction and Self-Confidence in Learning Scale — as well as a pre- and post-lab administration of Rovai’s (2002b) Classroom Community Scale. The qualitative component of the study involved semi-structured interviews with 25 students, three lab facilitators, and five clinical placement instructors. Analysis of data collected before and after the simulation-based lab revealed a significant increase in knowledge and sense of community in the group as a whole. Analysis of the results of the NLN instruments indicated that the simulation-based practice lab was instructionally effective. Students were highly positive in their ratings of the design elements and implementation of the simulation-based practice lab, satisfied with the simulation-based learning activities, and confident in their ability to provide patient care. The qualitative analysis added a rich, descriptive understanding of how the simulation-based practice lab promoted instructional effectiveness (i.e., skills and knowledge, confidence, and learner satisfaction), preparation for clinical placement, and community cohesion. Thematic analysis of the interview data identified the following major themes: benefits to distance learners, nurse-patient interaction, theory to practice, positive experience, sense of community, and supportive learning (student interviews); benefits of simulation experience, facilitator role, and technology (facilitator interviews); and theory to practice, positive experience, and sense of community (clinical instructor interviews). This research supports the use of on-site simulation-based practice labs as a means to provide greater readiness for clinical practice and strengthen the sense of community among distance learners.