VAKA TEMELLİ ÖĞRENME YÖNTEMİNİN PEDİATRİ HEMŞİRELİĞİ ÖĞRENCİLERİNİN KLİNİK KARAR VERME SÜRECİNDE ÖZGÜVEN VE ANKSİYETE ÜZERİNE ETKİSİ

Öz

Giriş ve Amaç: Klinik karar verme, hemşireler tarafından problem çözme yaklaşımı olarak benimsenen hemşirelik sürecinin ve hasta bakım planının önemli bir parçasıdır. Bu çalışmada, pediatri hemşireliği dersinde vaka temelli öğrenme yöntemlerinin, öğrencilerin klinik karar vermede özgüven ve anksiyetesine etkisinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Bu çalışma iki gruplu yarı deneysel olarak tasarlanmıştır. Birinci grup vaka temelli öğrenme grubu (n=38) iken, ikinci grup vaka temelli öğrenmeye ek olarak simülasyon (n=47) grubu olarak tasarlanmıştır. Bulgular: Öğrencilerin ders öncesinde yaş, cinsiyet, gelir düzeyi, ikamet ettikleri bölge, mesleğe yönelik algıları, teorik bilgileri pratikte kullanabilmeleri yönünden, klinik karar vermede özgüven ve anksiyete toplam ve alt ölçek puan düzeyleri benzerdi (p>0.05). Her grubun son test özgüven puan ortalamalarında artış, anksiyete puan ortalamalarında azalma olduğu belirlendi (p<0.05). Son test puan ortalamalarında gruplar arasında anlamlı bir fark bulunmamakla birlikte vaka temelli öğrenme/simülasyon grubunun özgüven puan ortalamaları (özgüven:115.74±20.08, kaygı: 59.59±22.96) daha yüksek, anksiyete puan ortalamaları daha düşüktü (p>0.05). Sonuç: Vaka temelli öğrenme ve vaka temelli öğrenme/simülasyon gibi aktif katılımlı zenginleştirilmiş öğretim yöntemlerinin pediatri hemşireliği öğrencilerinin özgüvenlerini artırmada ve kaygılarını azaltmada etkili olduğu belirlenmiş ve bu konu üzerine daha fazla araştırma yapılması önerilmiştir.

Anahtar Kelimeler

• Vaka temelli öğrenme
• pediatri hemşireliği
• simülasyon
• klinik karar verme
• anksiyete
• özgüven.

THE EFFECT OF CASE-BASED LEARNING METHODS ON SELF-CONFIDENCE AND ANXIETY OF PEDIATRIC NURSING STUDENTS IN CLINICAL DECISION MAKING PROCESS

Öz

Objective: Clinical decision making is an essential part of nursing process and patient care plan adopted by nurses as a problem solving approach. This study aimed to evaluate the effect of case-based learning methods on self-confidence and anxiety of the students in clinical decision-making process in pediatric nursing lecture. Materials and Methods: This study was designed as quasi-experimental with two groups. While the first group was a case-based learning group (n=38), the second group was designed as simulation group in addition to case-based learning(n=47). Results: There was a similarity between the groups in the mean age, gender, income level of the students, area of residence, perception of the profession, their ability to use theoretical knowledge in practice, self-confidence in clinical decision-making before the lecture, anxiety total score, and the mean subscale scores (p>0.05). It was identified that there was an increase in the post-test mean scores of self-confidence for each group, and a decrease in the mean anxiety scores (p<0.05). Although there was no significant difference between the groups in the post-test mean scores, it was found that the mean scores of self-confidence of the case-based learning/simulation group (self-confidence:115.74±20.08, anxiety: 59.59±22.96) were higher, and the mean scores of anxiety were lower (p>0.05). Conclusion: Enriched teaching methods with active participation such as case-based learning and case-based learning/simulation was determined to be effective on boosting self-confidence and reducing anxiety of pediatric nursing students and it was suggested that more studies would be done on the topic.

Anahtar Kelimeler

• Case-based learning
• pediatric nursing
• simulation
• clinical decision making
• anxiety
• self-confidence.

Kaynakça

1. Azak, A, Tasci, S, Clinical decision making and nursing: review, Türkiye Klinikleri Journal of Medical Ethics, 2009, 17 (3), 176-183.
2. White, K.A, Development and validation of a tool to measure self-confidence and anxiety in nursing students during clinical decision making, Journal of Nursing Education, 2014, 53(1), 14-22.
3. Birol, L, Nursing Process, 10th ed. Etki publishing; 2009.
4. Chen, S.L, Hsu, H.Y, Chang, C.F, Lin, E.C, An exploration of the correlates of nurse practitioners’ clinical decision-making abilities, Journal of Clinical Nursing, 2016, 25, 1016–1024.
5. Johansen, M.L, O’Brien, J.L, Decision making in nursing practice: a concept analysis, Nursing Forum, 2016, 51(1), 40-48.
6. Al-Dossary, R.N, Kinsantas, P, Maddox, P.J, Clinical decision-making among new graduate nurses attending residency programs in Saudi Arabia, Applied Nursing Research, 2016, 29, 25-30.
7. Choi, M, Kim, J, Relationships between clinical decision-making patterns and self-efficacy and nursing professionalism in Korean pediatric nurses, Journal of Pediatric Nursing, 2015, 30,81-88.
8. World Health Organization (WHO). Nursing & midwifery human resources for health, global standards for the initial education of professional nurses and midwives. http://www.who.int/hrh/nursing_midwifery/en/. (accessed 22.06.2021)

9. Bucknall, T.K, Forbes, H, Phillips, N.M, Hewitt, N.A, Cooper, S, Bogossian, F, et al. An analysis of nursing students’ decision making in teams during simulations of acute patient deterioration, Journal of Advanced Nursing, 2016,72, 2482-2494.
10. Jahanpour, F, Sharif, F, Salsali, M, Kaveh, M.H, Williams, L.M, Clinical decision-making in senior nursing students in Iran, International Journal of Nursing Practice, 2010,16,595-602.
11. Ozden, D, Ozveren, H, Gülnar, E, Nurse students’ clinical decision-making abilities level and the factors that affect abilities, Dokuz Eylul University E-Journal of Nursing Faculty, 2018,11 (1),41-47.
12. Espinosa-Rivera, B.P, Morán-Peña, L, García-Piña, M.A, González-Ramírez, P, López-Ruíz, C.M, Self-confidence and anxiety as intervening factors in clinical decision-making in newly nursing bachelor graduates, American Journal of Nursing, 2019, 8(2), 59-67.
13. Durmaz Edeer, A, Sarıkaya, A, The use of simulation in nursing education and simulation types, Journal of Education and Research in Nursing, 2015,12(2),121-125.
14. Cobbet, S, Snelgrove-Clark, E, Virtual versus face-to-clinical simulation in relation to student knowledge, anxiety, and self-confidence in maternal-newborn nursing:A randomized controlled trial, Nurse Education Today, 2016,45, 179-184.
15. Demir Acar M, Bulut E. A qualitative study on the motivations of neonatal ıntensive care nurses, Journal of Hacettepe University Faculty of Nursing, 2021,8(2),223-230.
16. Azizi-Fini, I, Hajibagheri, A, Adib-Hajbaghery, M, Critical thinking skills in nursing students: a comparison between freshmen and senior students, Nursing Midwifery Studies, 2015, 4 (1), e25721.
17. Braeckman, L, Kint, L.T, Bekaert, M, Cobbaut, L, Janssens, H, Comparison of two case-based learning conditions with real patients in teaching occupational medicine, Journal of medical Teaching, 2014,36 (4),340-346.
18. Yoo, M.S, Park, J.H, Effect of case-based learning on the development of graduate nurses' problem-solving ability. Nurse Education Today, 2014, 34 (1),47-51.
19. Chan, A.W, Chair, S.Y, Sit, J.W, Wong, E.M, Lee, D.T, Fung, O.W, Case-based web learning versus face-to-face learning: a mixed-method study on University nursing students, J. Nurs. Res, 2016, 24 (1),31-40.
20. Thistlethwaite, J.E, Davies, D, Ekeocha, S, Kidd, J.M, MacDougall, C, Matthews Purkis, J, Clay, D, The effectiveness of case-based learning in health professional education. A BEME systematic review, Medical Teacher, 2012,34(6), e421-e444.
21. Hacıalioğlu, N, Hemşirelikte öğretim öğrenme ve eğitim. 3th ed. Nobel Tıp Kitabevleri; 2013.
22. Sanemoglu, N, Gelişim öğrenme ve öğretim, kuramdan uygulamaya. 21th ed. Yorum Matbaası; 2005.
23. Van Gaalen, A.E.J, Brouwer, J, Schönrock-Adema, J, et al. Gamification of health professions education: a systematic review, Advances in Health Science Education, 2021, 26(2), 683-711.
24. Demir Acar, M, Bayat, M, The Effect of diet-exercise trainings provided to overweight and obese teenagers through creative drama on their knowledge, attitude and behaviors, Childhood Obesity, 2019,15(2), 93-104.
25. Adiguzel, O, Eğitimde Yaratıcı Drama. 5th ed. Naturel Publishing; 2010.
26. Joronen, K, Rankin, S.H, Astedt-Kurki, P, School-based drama interventions in health promotion for children and adolescent: systematic review, Journal of Advanced Nursing, 2008,63,116-131.
27. Bektaş, I, Yardimci, F, Bektaş, M, White, K, Psychometric properties of the Turkish version of nursing anxiety and self confidence with clinical decision making scale (NASC-CDM-T), Dokuz Eylul University E-Journal of Nursing Faculty, 2017,10 (2),83-92.
28. Thompson, C, Aitken, L, Doran, D, Dowding, D, An agenda for clinical decision making and judgement in nursing research and education, International Journal of Nursing Studies, 2013, 50(12),1720-1726.
29. Bektas, I, Yardimci, F, The effect of web‐based education on the self‐confidence and anxiety levels of paediatric nursing interns in the clinical decision‐making process, Journal of Computer Assisted Learning, 2018,34(6), 899-906.
30. Hong, S, Yu, P, Comparison of the effectiveness of two styles of case-based learning implemented in lectures for developing nursing students’ critical thinking ability: A randomized controlled trial, International Journal of Nursing Studies, 2017,68,16-24.
31. Yuan, H.B, Williams, B. A, Fang, J.B, The contribution of high‐fidelity simulation to nursing students' confidence and competence: a systematic review, International Nursing Review, 2012,59(1), 26-33.
32. Norman, G, Dore, K, Grierson, L, The minimal relationship between simulation fidelity and transfer of learning, Medical Education, 2012, 46(7), 636-647.
33. Ruzgar Emir, M, Aslan, B, Eğitim programlarının ve öğretimin temel ilkeleri. 5th ed. Pegem Akademi Baskı; 2014.
34. Bowling, A.M, Underwood, P.W, Effect of simulation on knowledge, self‐confidence, and skill performance in the USA: A quasi‐experimental study, Nursing & Health Sciences, 2016, 18(3), 292-298.
35. Li, S, Ye, X, Chen, W, Practice and effectiveness of “nursing case-based learning” course on nursing student's critical thinking ability: A comparative study, Nurse Education in Practice, 2019,36, 91-96.
36. Lee, W.S, Cho, K.C, Yang, S.H, Roh, Y.S, Lee, G.Y, Effects of problem-based learning combined with simulation on the basic nursing competency of nursing students, Journal of Korean Academy Fundamental Nursing, 2009,16, (1), 64-72.
37. Tadeu-Shinyashiki, G, Costa-Mendes, I.A, Trevizan, M.A, Day, R.A, Professional socialization: students becoming nurses, Rev Latino-am Enfermagem, 2006,14(4),1-10.
38. Ma, C, Zhou, W, Effects of unfolding case-based learning on academic achievement, critical thinking, and self-confidence in undergraduate nursing students learning health assessment skills, Nurse Education in Practice, 2022, 60, 103321.
39. Kim, Y.J, Noh, G.O, Im, Y.S, Effect of step-based prebriefing activities on flow and clinical competency of nursing students in simulation-based education, Clinical Simulation in Nursing, 2017, 13(11), 544-551.
40. Kang, K.A, Kim, S, Kim, S.J, Oh, J, Lee, M, Comparison of knowledge, confidence in skill performance (CSP) and satisfaction in problem-based learning (PBL) and simulation with PBL educational modalities in caring for children with bronchiolitis, Nurse Education Today, 2015, 35(2), 315-321.