Postpartum Kanamanın Yönetiminde Hemşirelik Öğrencilerinin Bilgi ve Becerilerinin Geliştirilmesinde Farklı Simülasyon Yöntemlerinin Etkinliğinin Değerlendirilmesi

Abstract

This study has been conducted as a randomized controlled intervention in order to evaluate the efficiency of different simulation methods for the improvement of information and skills of nursing students for the management of postpartum bleeding. The study has been implemented in the nursing skills laboratory and high fidelity simulation laboratory at Nursing Faculty, Hacettepe University; standardized patient laboratory at the Faculty of Medicine and at a university hospital and two training research hospitals within the province of Ankara. The sampling of the study consisted of 84 students of Hacettepe University, Nursing Faculty, attending Obstetrics and Gynecology Nursing lecture in the autumn semester of 2014-2015 academic year. All of the students have accepted to participate in the study. The students were separated into eight different groups depending on three different training environments; nursing skill laboratory, standard patient laboratory and simulation laboratory in order to make practice. All of the students except postpartum hemorrhage management skills they use the simulation laboratory for the development of other skills. The control group, the 8th group, did not participate in postpartum bleeding management skill training program. Data for the study were obtained by Student Descriptive Characteristics Data Gathering Form, Student Satisfaction Evaluation Form, Effective Communication Skills Evaluation Form, Spielberger's State Anxiety Inventory, Postpartum Bleeding Management Skill Evaluation Form, Pre and Post Tests for Postpartum Bleeding Management Skill Evaluation Form and Patient Intervention Self-Confidence/Competence Scale. For the evaluation of data; percentage numbers, average, chi square, single direction variance analysis, Duncan test, and "t" test in dependent and independent groups were used. According to the findings of research; the 1st group which participated to nursing skill, standardized patient and simulation laboratory environments has the highest score averages for cognitive (52,61±12,74), psychomotor (83,53±7,40) and communication skill (90,54±6,21); as the application is repeated by the group it has been observed that psychomotor (F=18,733 p=0,001) and communication skills (F=19,533 p=0,001) have improved; on the other hand, the control group, the 8th group, received the lowest average scores in cognitive (16,96±12,46), psychomotor (36,29±11,64) and communication skills (65,00±12,08). It has been determined that the students' state anxiety levels did not increase in different skill improvement environments (p>0,05). In conclusion, it could be said that providing the opportunity to use different simulation methods and repeating the skill improvement applications until becoming sufficient for the students help them to improve their cognitive, psychomotor and communication skills. A positive result of the study was to observe that the anxiety levels of the students did not increase in different training environments and that their satisfaction rates were high. Therefore, it is considered that in the management of postpartum bleeding, which affects the health of mother and the new born negatively; using different simulation methods will be effective to improve the knowledge and skills of the nursing students and to increase their satisfaction.