Abstract:

The COVID-19 pandemic has greatly impacted nursing-student clinical practicum programs. How to cooperate with the government's pandemic-prevention policies and reduce the gap between education and clinical practice represent significant challenges. Simulation-based education appears to be a practical and flexible instructional design to achieve variable levels of knowledge, skills, and attitude training. The simulation training both takes into account the safety of students and has achieved emergency nursing practice goals. In this paper, we aim is to provide a brief scheme on how simulation-based training can be adapted the emergency nursing practicum programs to the current pandemic. In addition, we will be sharing our simulation experience in emergency care based on the ADDIE model at Open University of Hong Kong.

The ADDIE model is an instructional design model that systematically direct the design of effective support tools. It has been widely adopted to develop curriculum in fields such as library instruction, healthcare, and online education. The ADDIE model comprises of five phases including analysis, design, development, implementation and evaluation. All the phases are iterative and cyclical in nature. The analysis phase prompts to identify the instructional problem and objectives which are perceived high-risk of exposure to COVID-19 and need to substitute the clinical practicum with a flexible learning processes. The design phase develops the blueprint of training included the plan, case scenarios, materials and assessment methods. The development phase aligns with learning objectives to create the alternative modes of the plan generated from the design step. In the implementation phase, the simulation training as alternative mode for clinical practicum was implemented. Nursing students were assigned into groups and attended the simulation training in a face-to-face mode. The evaluation phase aims to measure whether the simulation training has achieved its intended learning objectives. The ADDIE model ensures that the alternative modes adopted are more effective, efficient, and relevant to the registration governing body's requirement.

In our simulation training, our final year bachelor and high diploma nursing students who participated in a five-hour per day for a total of 10 hours simulation training, had completed an online survey at the end of each day of training, to evaluate the simulation training’s content, structure and progress regarding to their academic and professional development. The contents and complexity of each day of the simulation activities targeted specific skills which include applying safety measures appropriately, communicate with the patient, teammates and others effectively, obtaining appropriate subjective and objective data immediately, performing nursing intervention and treatment appropriately and documentation of findings. The simulation training immersed students in real-life clinical scenarios in emergency clinical setting and tailored to the students’ learning pace. Day 1 training focused on selecting the appropriate triage category for the patients and Day 2 training reinforced safety measures and effective communication between team members.

The scenarios are relevant to students' professional development that reflect real-life situations for example making triage decision and implementing nursing process for emergency cases. Two days of simulation training provides a reproducible framework for future training that could be applied within various clinical teaching and nursing specialties such as intensive care practicum.

Keywords:

Simulation, ADDLE Model, Clinical Practicum, COVID-19