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Does Learning with High-Fidelity Human Patient Simulation (Hfhps)

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Does Learning with High-Fidelity Human Patient Simulation (Hfhps) DOES LEARNING WITH HIGH-FIDELITY HUMAN PATIENT SIMULATION (HFHPS) IN NURSING SCHOOL IMPACT CAREER RETENTION IN THE NURSING PROFESSION DURING THE FIRST TWO YEARS OF LICENSURE? A DISSERTATION IN NURSING Presented to the faculty of the University of Missouri-Kansas City in partial fulfillment of the requirements for the degree DOCTOR OF PHILOSOPHY By Christine M. Zimmerman B.S.N., Creighton University, 1995 M.S.N., University of Missouri-Kansas City, 2002 Kansas City, Missouri 2011 @ 2011 CHRISTINE M. ZIMMERMAN ALL RIGHTS RESERVED DOES LEARNING WITH HIGH-FIDELITY HUMAN PATIENT SIMULATION (HFHPS) IN NURSING SCHOOL IMPACT CAREER RETENTION IN THE NURSING PROFESSION DURING THE FIRST TWO YEARS OF LICENSURE? Christine M. Zimmerman, Candidate for the Doctor of Philosophy Degree University of Missouri-Kansas City, 2011 ABSTRACT High Fidelity Human Patient Simulation (HFHPS) is becoming an increasingly common component of undergraduate nursing education. Research has not captured the long term impact of this learning modality on retention in the profession of nursing. The purpose of this exploratory descriptive study was to determine if experience with HFHPS during undergraduate nursing education effects career retention within the profession of nursing during the first two years following initial Registered Nurse (RN) licensure. Three research questions guided this study: What is the strength of correlation between the amount of time spent participating in HFHPS scenarios while enrolled in nursing school and the Registered Nurse graduates‟ retention in the nursing profession within the first two years of initial licensure? What is the relationship between participation in clinically specialized HFHPS scenarios and retention in corresponding clinical specialty areas within the first two years of initial licensure? iii Does the association between amount of time spent participating in HFHPS scenarios and retention in the nursing profession within the first two years of initial licensure vary among students graduating from different degree programs (Baccalaureate or Associate)? A postcard invitation to participate in an on-line survey was sent to 1427 RNs in the Kansas City metropolitan area. Respondents (n=89) self-disclosed demographic information, describing their retention in the nursing workforce and experiences with HFHPS during undergraduate nursing education. Results indicated that participation in HFHPS scenarios during undergraduate does not correlate with attrition from either the profession of nursing or the original unit of hire during the first two years of practice after initial RN licensure. iv APPROVAL PAGE The faculty listed below, appointed by the Dean of the School of Nursing have examined a dissertation titled “Does Learning with High-Fidelity Human Patient Simulation During Nursing School Impact Career Retention in the Nursing Profession During the First Years of Licensure?”, presented by Christine M. Zimmerman, candidate for the Doctor of Philosophy degree, and certify that in their opinion it is worthy of acceptance. Supervisory Committee Peggy Ward-Smith, R.N., Ph.D., Committee Chair School of Nursing Bonita Butner, Ph.D. School of Education Christopher Kennedy, M.D. Pediatric Emergency Medicine Fellowship Director Children‟s Mercy Hospital Jane Peterson, R.N., Ph.D. School of Nursing Katharine Smith, R.N., Ph.D. School of Nursing v CONTENTS ABSTRACT ......................................................................................................................... iii LIST OF ILLUSTRATIONS .................................................................................................. ix LIST OF TABLES ................................................................................................................... x ACKNOWLEDGEMENTS .................................................................................................... xi Chapter 1. INTRODUCTION .............................................................................................................. 1 Background ......................................................................................................................... 1 Purpose of the Study ........................................................................................................... 3 HFHPS .......................................................................................................................... 4 Attrition .......................................................................................................................... 4 Conceptual Framework ....................................................................................................... 5 Conclusion .......................................................................................................................... 6 2. REVIEW OF THE LITERATURE ..................................................................................... 8 Introduction ......................................................................................................................... 8 Search of Pertinent Literature ............................................................................................. 8 HFHPS ........................................................................................................................ 10 General Use of HFHPS in Nursing ....................................................................... 10 History of HFHPS ................................................................................................. 11 Aviation.......................................................................................................... 11 Healthcare ...................................................................................................... 13 Operational Definition of HFHPS ......................................................................... 16 vi Attrition ........................................................................................................................ 16 Factors Which Contribute to Attrition ................................................................... 17 Poor Mastery of Complex Skills .................................................................... 17 Impaired Communication .............................................................................. 18 Lack of Preparation for Clinical Practice....................................................... 20 Lack of Confidence ........................................................................................ 22 HFHPS Addressing Attrition Factors ............................................................................... 22 Improved Skills Performance ................................................................................ 23 Improved Communication ..................................................................................... 25 Increased Preparation for the Clinical Environment ............................................. 28 Increased Confidence ............................................................................................ 29 Conceptual Framework ..................................................................................................... 31 Good Practice Encourages Contact Between Students and Faculty ...................... 32 Good Practice Encourages Reciprocity and Collaboration Among Students ....... 33 Good Practice Promotes Active Learning ............................................................. 34 Good Practice Promotes Prompt Feedback ........................................................... 34 Good Practice Reinforces Time Management ....................................................... 35 Good Practice Demonstrates High Expectations ................................................... 36 Good Practice Respects Diversity of Learning Styles ........................................... 36 Conclusion ........................................................................................................................ 37 3. METHODOLOGY .......................................................................................................... 39 Introduction ...................................................................................................................... 39 vii Development and Pilot Testing of the Simulation Attrition Survey (SAS) ..................... 39 Results of the Pilot Testing ................................................................................... 41 Dissertation Study ............................................................................................................ 42 Methods ................................................................................................................. 42 Procedures ............................................................................................................. 43 Data Analysis ................................................................................................................... 44 Research Question 1 .............................................................................................. 44 Research Question 2 .............................................................................................. 44 Research Question 3 .............................................................................................. 45 Protection of Subjects ...................................................................................................... 45 4. RESULTS .......................................................................................................................
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