Abstract:

The paper presents an evaluation of students’ experiences in an innovative international project between the University of Stavanger (UoS) in Norway, the Catholic University of Valencia (UCV), Spain and the University of Nottingham (UoN), UK. The project involves developing a Smartphone app for student nurses to develop and self and peer assess their competence in performing clinical skills.

Background:
Clinical skills training is complex. Nursing students report high levels of anxiety and a lack of confidence when delivering practical skills in the clinical area. There are also patient safety issues so this Smartphone app will provide students with safe, accessible skills training to practice their skills individually or collaboratively with ‘built in’ and peer feedback on their performance.

Method:
A simulation Smartphone app incorporating a package of simulation scenarios was developed addressing the following clinical skills:
- Blood Pressure and Pulse
- Handwashing
- Wound care
- Subcutaneous injection
- Catheterisation
- NG tube insertion
- Tracheostomy care
- Sterile gloves
- Blood glucose measurement

These procedures have been completed in three languages and are currently being piloted across the three European Universities. The development methodology used a participatory approach between undergraduate nurses, learning technologists and lecturers. This iterative, exploratory process evolved and refined the content and design of the application and unveiled interesting differences in practice between the countries.

Evaluation:
A process evaluation was undertaken with nursing students from the three institutions.
Feedback from student representatives was gathered throughout the different phases of the project, an online survey and by a continuous communication between app developers and the students.

All methods of feedback evaluation used questions focusing on these themes:
• Does the video follow a logical order?
• Does the wording in each of the steps make sense?
• Would any other instructions help for this particular skill?
• Are any of the terms used unclear?
• Do you think the checklist is helpful in practicing/learning this skills? If not what else would help?
• Does the app seem a useful tool for increasing confidence in undertaking clinical skills?

Findings:
The apps are considered to be useful tools to promote learning and confidence when undertaking clinical skills.
Video clips with narration were perceived to be helpful as they offer students a stepped approach to conducting the skill. The apps allow student to practice real life situations with peers and work as team when undertaking each clinical procedure.
The option of slowing down the video when practicing the procedure initially and then increasing the speed as competence develops. Students also reported a need for audio prompts for example, more narration on complex skills, which will be available on completion of the app.

Conclusions:
Using a participatory approach between undergraduate nurse, learning technologists and academics across 3 international settings to develop and refine the apps is an integral element of the Digisim project. It is evident from the student experience of using the apps during the exploratory process that the apps are considered to be an innovative and exciting learning technology that enhances student confidence and facilitates a peer approach to skills based learning.

Keywords:

Simulation skills, nursing students, simulation app, clinical skills.