High-Fidelity Simulation: A New Method for Improving Medication Administration Skills of Undergraduate Nursing Students in Jordan
Mohammad, Anas Ahmad Ali
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Although administering medicines is one of the core nursing actions, errors surrounding this task are prevalent amongst nurses and nursing students. Continued dependence on traditional teaching methods and greater demand and competition for clinical placements are some barriers to expanding medication administration practices for nursing students. High Fidelity Simulation (HFS) is one promising approach; however, there is a dearth of literature examining whether medication-related skills gained from simulation translate into actual clinical settings. A theory-guided, randomized, two-group, observer-blind, repeated measures (one pretest measurement and two posttest measurements) experimental design was utilized to investigate and compare the effectiveness of HFS and traditional lecture to decrease nursing student medication administration errors in an actual medical-surgical setting in Jordan. A convenience sample of 89 second-year BSN students who had no previous experience with medication administration and simulation was recruited. Nursing students were randomly assigned to either HFS group (n = 45), who attended a 1.5-hour HFS scenarios on medication administration, or traditional lecture group (n = 44) who received a 1.5-hour PowerPoint presentation on the same topic. Five blind raters—who demonstrated high inter- and intra-rater reliability—scored students medication administration practices during the third week (Time 1: pretest), sixth week (Time 2: posttest one), and eleventh week (Time 3: posttest two) of Adult Health Nursing II Clinical rotation using a vailed and reliable tool called the Medication Administration Safety Assessment Tool (MASAT). A two (lecture vs. HFS) by three (Time 1 vs. Time 2 vs. Time 3) mixed ANOVA was used to examine within group changes, between group difference, and the interaction between time and group. The results revealed that the means medication error score on the MASAT for the two treatment groups significantly decreases over time. However, the HFS group had a larger decrease in the mean medication error score on the MASAT at Time 2 (posttest one) and Time 3 (posttest two) compared to the lecture group. Thus, HFS is superior and significantly improves students’ medication administration skills. This study can contribute to a needed paradigm shift in Jordan’s nursing education, moving to more advanced educational methods.