The Extent of Implementation and Level of Importance of Clinical Simulation of the CSA-B Nursing Program.

This correlational research which aimed to determine the extent of implementation and the level of importance of the specific features and the gaps in the utilization of the instructor-made clinical simulation scenarios used the national League for Nursing (NLN) Simulation Design questionnaire as the main instrument in collecting data. it also used Gaps Analysis in determining the gaps in the expected outcomes and actual performance on the utilization of clinical simulation scenario. The participants of the study were nursing students who were exposed to the instructor-developed clinical simulation scenarios made by the College of Health and Allied Professions. A very great extent of implementation was seen in the five features of simulation namely Objectives, Support, Problem Solving, Feedback , Fidelity with median scores of 5.5, 4.8, 5.0, and 4.68 respectively. On the level of importance of the five features, results revealed a median score of 5.0 in all the features and 4.92 as a whole which suggests that it was very important. Further, they showed that a relationship exists between the implementation and importance on the specific features of case scenarios with a tau-b correlation for Objective and Information: 0.44, Support: 0.48, Problem Solving: 0.40, Feedback/ Guided Reflection: 0.36, Fidelity: 0.27, and as a whole: 0.39. On the Gaps between expected outcomes and actual performance on the purpose and objectives, it revealed that goals of the clinical scenario were aligned with the level competencies provided by the curriculum. However, there was an inconsistent evaluation of the students' performance. In the area of support, students' need for help was recognized and was supported with the learning process during the simulation, however, too many cues/prompts were provided that limit the critical thinking ability of the students. In Problem Solving, the clinical scenario was designed for some specific level of knowledge and skills of students, nevertheless, scenarios for both levels II and IV consider revision. On Feedback/ Guided Reflection, constructive feedback was provided. However, opportunities for repeated practice with feedback and structured learner reflection may be provided. Fidelity revealed the accurate representation of the clinical environment and participation of the Clinical Instructors who have had the experience and mastery of the given scenario. Thus, a recommendation for more Simulation Clinical Experience (SCE) -trained clinical instructors to address the identified gaps is needed.