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Jiraporn Pengrachrong, M.N.S.
Siriwan Baitrakul, M.N.S.
Jitravee Kiatsuwan, M.N.S.
Nishakan Nakawirot, M.N.S.
Pannee Paisantusin, Ph.D.
Junjeera Yanachai, M.P.H.
Wipa Iamsamang Jaaramille, Ph.D.
Wanida Indracha, M.N.S.


Backgrounds: Evaluation is a critical component of transformative learning of nursing students. Traditional test-based evaluation does not always reflect genuine students learning outcomes.

Objective: We report our experiences from using a high fidelity clinical simulation as a method of evaluation of nursing students learning outcomes in critical care nursing course.

Participants and Methods: We designed three critical care scenarios, namely, acute exacerbation of COPD, acute myocardial infarction, and hypovolemic shock using interactive SIMMAN. Altogether, 214 third-year nursing students were enrolled in critical care nursing course. These students were assigned to work in a group of 10-11 in a class combining of lecture and problem-based learning. Formative and summative evaluations based on tests were conducted throughout and at the end of the course. The additional simulation-based evaluation was conducted at one week after the traditional summative evaluation. Each group was asked to review the critical care concepts before the simulation. Half of the students in each group participated in a simulation-based evaluation while the rest observed the scenario through the SIM View. The students were blind to the scenes. Eight lecturers who performed the evaluation worked together to develop an evaluation tool to maximize consistency across the lecturers. During the simulation, each lecturer independently assessed the students, later compared and agreed on the evaluation results. Students reflected on their performance and experiences in writing.

Results: The high fidelity clinical simulation-based evaluation allowed the lecturers to correctly and genuinely evaluate the students learning, especially clinical decision making and teamwork. Therefore it helped identify students learning needs. The evaluations were highly consistent across the lecturers. Students became aware of their current level of knowledge and skills as well as the deficits. They recognized the barriers to the application of their knowledge and skills in clinical scenarios. They identified ways to improve their performance in the future learning.

Conclusion & Recommendation: High fidelity clinical simulation-based evaluation is an effective method of the assessment, especially when it deals with higher-order thinking such as application and decision making.

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