Scenario-based clinical simulation: Bridging the gap between intern-students' anxiety and provision of holistic nursing care for preterm neonates

Abstract

Aim: This study aimed to determine the effect of Scenario-Based Clinical Simulation (SBCS) on nursing students' anxiety and skills related to providing holistic nursing care for preterm neonates.

Background: Nursing students who are caring for preterm neonates experience high level of anxiety that might negatively influence their clinical performance. Clinical nurse educators face the challenge of preparing skilful and competent students within the constraints of limited orientation time in the Neonatal Intensive Care Unit (NICU). The application of SBCS provides students with opportunities to practice critical thinking, problem-solving and communication skills, pose questions and remediate their clinical deficiencies in non-threatening learning enviroment.

Design: A quasi-experimental, two groups, pre-post test study was carried out in the NICU of Specialized Hospital at Smouha, Alexandria.

Method: Sixty students completed a baseline skills assessment, as students' clinical skills were scored on a 148-item checklist and participants rated their anxiety. All participants received a didactic lecture and demonstrated nursing procedures. Research team facilitated an interactive SBCS session for the intervention group focused on the holistic care of preterm neonates and the common health problems affecting them. Two weeks later, two independent raters re-assessed the students' skills on the admitted preterms, and participants completed the anxiety questionnaire again.

Results: It is revealed that all participants in the intervention group (100%) had good skills after two weeks of SBCS compared to 20% of the control group (P < 0.001). Moreover, 43.3% of the nursing students in control group experienced severe anxiety compared to only 6.7% of those in the intervention group who attended the SBCS (P < 0.001).

Conclusion: The application of SBCS in NICU provided an interactive learning experience, improved and sustained students' clinical skills. They reflected on their performance and remediated their skills in a conducive environment. So, they encountered less anxiety while providing holistic care for preterm neonates.

Keywords: Anxiety; Clinical scenario; Internship; NICU; Preterm neonates; Simulation; Skills.