File Download
Supplementary

postgraduate thesis: A cluster randomized controlled trial of using structured debriefing to enhance knowledge retention in nurses undergoing simulation-based resuscitation training

TitleA cluster randomized controlled trial of using structured debriefing to enhance knowledge retention in nurses undergoing simulation-based resuscitation training
Authors
Issue Date2015
PublisherThe University of Hong Kong (Pokfulam, Hong Kong)
Citation
Chan, C. J. [陳俊傑]. (2015). A cluster randomized controlled trial of using structured debriefing to enhance knowledge retention in nurses undergoing simulation-based resuscitation training. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. Retrieved from http://dx.doi.org/10.5353/th_b5558905
AbstractThe competency retention rate of Advanced Cardiac Life Support (ACLS) among nurses was poor. The knowledge retention rate among those who have completed an ACLS course rapidly declined to 37% at three months, and 14% at one year. Extending the course duration did not show any improvement in the retention rate. Structured debriefing may be a possible solution, but its efficacy on knowledge retention among nurses has not been examined. The aims of this thesis are to perform linguistic and psychometric evaluation of a Chinese version of Student Satisfaction and Self-confidence (SSSC), and to assess the effects in knowledge retention of nurses in a simulation-based resuscitation training, using the Gather-Analysis- Summary (GAS) model of structured debriefing. In this thesis, the reliability and scale structure of the Chinese SSSC were assessed in 161 nurses when they attended an ACLS course. Confirmatory factor analysis showed that a two-factor structure had satisfactory with χ^2 = 92.12 (df = 54), RMSEA = .07 (90% CI = .04 to .09), CFI = .98 and NNFI = 0.96. The two factors are the satisfaction and self-confidence which had high internal reliability with Cronbach's alpha as .95 and .97, respectively. The Chinese SSSC is a reliable and valid tool to assess student satisfaction and self-confidence in simulation training. A cluster randomized controlled trial (RCT) was conducted to assess the efficacy of the GAS model. The primary outcome in this study was knowledge competency. It was assessed by the written test of the American Heart Association ACLS provider course. The secondary outcomes in this study were perceived skills, and self-efficacy. They were assessed using our validated Chinese SSSC and the General Self-Efficacy scale. In the intervention arm, the instructor conducted 18 scenarios and structured debriefing using the GAS model. Each GAS model of debriefing session consisted of three phases, namely: "Gather", "Analysis", and "Summary". The debriefing session was conducted to help participants to self-reflect on the learning objectives. Each debriefing session lasted about 5 to 10 minutes. In the control arm, participants had 36 scenario as usual teaching plan instead of debriefing at the end of each scenario. A follow-up assessment were conducted at Day Two and Week 24. A total of 161 nurses were recruited in this study. They were divided into 32 groups and randomized by groups to either the intervention arm (n=85, 15 groups) or the control arm (n=76, 17 groups). The effects of the GAS model were examined using a linear mixed effects model to take account of the extra-covariance among participants in the same group. The test showed that the GAS model debriefing improved knowledge retention after Day Two follow-up. However, it was marginally significant (estimated coefficient= 2.56, 95% CI= .17 to 4.95, d=.22, p=.036). Perceived skills (estimated coefficient=.01, 95% CI= -.24 to. 27, d=.15, p=.918), and self-efficacy (estimated coefficient= -.01 95% CI= -1.27 to 1.24, d=.06, p=.984) were also not significant. After adjusting the baseline by adding three significant different baseline factor, namely: education level, rank, and prior ACLS certification, the knowledge (estimated coefficient=1.54, 95% CI=-1.06 to 4.16, d=.22, p=.242). Perceived skills (estimated coefficient=.01, 95% CI= -.26 to .28, d=.15, p=.967), and self-efficacy (estimated coefficient= -.31, 95% CI=-1.64 to 1.02, d=.06, p=.648) were insignificant. There were 73 nurses (45.3%) dropped out before 24 weeks. Overall, only 22 out of the remaining 88 (25%) nurses passed the follow-up written test. Although debriefing based on the GAS model showed a sizable effect on knowledge retention at Week 24. the improvement was not significant (estimated coefficient=5.01, 95% CI= -1.02 to 11.04, d=.17, p=.101). The effects of debriefing on perceived skills (estimated coefficient=.09, 95% CI= -.89 to 2.7, d=.22, p=.317), and self-efficacy (estimated coefficient=.51, 95% CI= -2.19 to 3.2, d=.12, p=.707) were also not significant. After the baseline adjustment, the debriefing effects on knowledge (estimated coefficient=2.15, 95% CI= -4.26 to 8.56, d=.17, p=.503), perceived skills (estimated coefficient=.92, 95% CI= -.98 to 2.82, d=.22, p=.336), and self-efficacy (estimated coefficient= -.11, 95% CI= -3.02 to 2.79, d=.12, p=.938) remained insignificant. This is the first RCT to assess the effect of structured debriefing in ACLS simulation. The study showed that the GAS model of structured debriefing has potential effect on knowledge retention after 24 weeks. However, further larger-scale studies with stronger incentives are needed.
DegreeDoctor of Nursing
SubjectNurses - Training of
Cardiac resuscitation
Cardiac arrest - Treatment
Cardiovascular emergencies
Dept/ProgramNursing Studies
Persistent Identifierhttp://hdl.handle.net/10722/221012

 

DC FieldValueLanguage
dc.contributor.authorChan, Chun-kit, Jacky-
dc.contributor.author陳俊傑-
dc.date.accessioned2015-10-22T23:11:39Z-
dc.date.available2015-10-22T23:11:39Z-
dc.date.issued2015-
dc.identifier.citationChan, C. J. [陳俊傑]. (2015). A cluster randomized controlled trial of using structured debriefing to enhance knowledge retention in nurses undergoing simulation-based resuscitation training. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. Retrieved from http://dx.doi.org/10.5353/th_b5558905-
dc.identifier.urihttp://hdl.handle.net/10722/221012-
dc.description.abstractThe competency retention rate of Advanced Cardiac Life Support (ACLS) among nurses was poor. The knowledge retention rate among those who have completed an ACLS course rapidly declined to 37% at three months, and 14% at one year. Extending the course duration did not show any improvement in the retention rate. Structured debriefing may be a possible solution, but its efficacy on knowledge retention among nurses has not been examined. The aims of this thesis are to perform linguistic and psychometric evaluation of a Chinese version of Student Satisfaction and Self-confidence (SSSC), and to assess the effects in knowledge retention of nurses in a simulation-based resuscitation training, using the Gather-Analysis- Summary (GAS) model of structured debriefing. In this thesis, the reliability and scale structure of the Chinese SSSC were assessed in 161 nurses when they attended an ACLS course. Confirmatory factor analysis showed that a two-factor structure had satisfactory with χ^2 = 92.12 (df = 54), RMSEA = .07 (90% CI = .04 to .09), CFI = .98 and NNFI = 0.96. The two factors are the satisfaction and self-confidence which had high internal reliability with Cronbach's alpha as .95 and .97, respectively. The Chinese SSSC is a reliable and valid tool to assess student satisfaction and self-confidence in simulation training. A cluster randomized controlled trial (RCT) was conducted to assess the efficacy of the GAS model. The primary outcome in this study was knowledge competency. It was assessed by the written test of the American Heart Association ACLS provider course. The secondary outcomes in this study were perceived skills, and self-efficacy. They were assessed using our validated Chinese SSSC and the General Self-Efficacy scale. In the intervention arm, the instructor conducted 18 scenarios and structured debriefing using the GAS model. Each GAS model of debriefing session consisted of three phases, namely: "Gather", "Analysis", and "Summary". The debriefing session was conducted to help participants to self-reflect on the learning objectives. Each debriefing session lasted about 5 to 10 minutes. In the control arm, participants had 36 scenario as usual teaching plan instead of debriefing at the end of each scenario. A follow-up assessment were conducted at Day Two and Week 24. A total of 161 nurses were recruited in this study. They were divided into 32 groups and randomized by groups to either the intervention arm (n=85, 15 groups) or the control arm (n=76, 17 groups). The effects of the GAS model were examined using a linear mixed effects model to take account of the extra-covariance among participants in the same group. The test showed that the GAS model debriefing improved knowledge retention after Day Two follow-up. However, it was marginally significant (estimated coefficient= 2.56, 95% CI= .17 to 4.95, d=.22, p=.036). Perceived skills (estimated coefficient=.01, 95% CI= -.24 to. 27, d=.15, p=.918), and self-efficacy (estimated coefficient= -.01 95% CI= -1.27 to 1.24, d=.06, p=.984) were also not significant. After adjusting the baseline by adding three significant different baseline factor, namely: education level, rank, and prior ACLS certification, the knowledge (estimated coefficient=1.54, 95% CI=-1.06 to 4.16, d=.22, p=.242). Perceived skills (estimated coefficient=.01, 95% CI= -.26 to .28, d=.15, p=.967), and self-efficacy (estimated coefficient= -.31, 95% CI=-1.64 to 1.02, d=.06, p=.648) were insignificant. There were 73 nurses (45.3%) dropped out before 24 weeks. Overall, only 22 out of the remaining 88 (25%) nurses passed the follow-up written test. Although debriefing based on the GAS model showed a sizable effect on knowledge retention at Week 24. the improvement was not significant (estimated coefficient=5.01, 95% CI= -1.02 to 11.04, d=.17, p=.101). The effects of debriefing on perceived skills (estimated coefficient=.09, 95% CI= -.89 to 2.7, d=.22, p=.317), and self-efficacy (estimated coefficient=.51, 95% CI= -2.19 to 3.2, d=.12, p=.707) were also not significant. After the baseline adjustment, the debriefing effects on knowledge (estimated coefficient=2.15, 95% CI= -4.26 to 8.56, d=.17, p=.503), perceived skills (estimated coefficient=.92, 95% CI= -.98 to 2.82, d=.22, p=.336), and self-efficacy (estimated coefficient= -.11, 95% CI= -3.02 to 2.79, d=.12, p=.938) remained insignificant. This is the first RCT to assess the effect of structured debriefing in ACLS simulation. The study showed that the GAS model of structured debriefing has potential effect on knowledge retention after 24 weeks. However, further larger-scale studies with stronger incentives are needed.-
dc.languageeng-
dc.publisherThe University of Hong Kong (Pokfulam, Hong Kong)-
dc.relation.ispartofHKU Theses Online (HKUTO)-
dc.rightsThe author retains all proprietary rights, (such as patent rights) and the right to use in future works.-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.lcshNurses - Training of-
dc.subject.lcshCardiac resuscitation-
dc.subject.lcshCardiac arrest - Treatment-
dc.subject.lcshCardiovascular emergencies-
dc.titleA cluster randomized controlled trial of using structured debriefing to enhance knowledge retention in nurses undergoing simulation-based resuscitation training-
dc.typePG_Thesis-
dc.identifier.hkulb5558905-
dc.description.thesisnameDoctor of Nursing-
dc.description.thesislevelDoctoral-
dc.description.thesisdisciplineNursing Studies-
dc.description.naturepublished_or_final_version-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats