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Is history taking a dying skill? An exploration using a simulated learning environment.
Lisa McKenna1, Kelli Innes, Jill French
1School of Nursing & Midwifery, Monash University, Clayton Campus, Clayton, Victoria 3800, Australia. lisa.mckenna@monash.edu
Nurse Education in Practice
|January 4, 2011
Summary
Simulated patient scenarios with video review significantly improved nursing students' history-taking and assessment skills. This method highlighted missed cues and enhanced care planning, addressing a gap in clinical training.
Area of Science:
- Nursing Education
- Clinical Skills Development
- Patient Assessment
Background:
- Effective history taking is crucial for nurses to identify patient care priorities.
- Developing strong interviewing and assessment skills is challenging for nursing students.
- Traditional clinical placements may not offer sufficient opportunities for comprehensive history taking.
Purpose of the Study:
- To evaluate the effectiveness of video-recorded simulated patient experiences with facilitated review for enhancing nursing students' history-taking and assessment skills.
- To identify specific areas where students struggle in history taking, such as cue identification and exploring emerging data.
- To explore student feedback on the utility of simulated patient encounters and video debriefing.
Main Methods:
- Development of realistic patient scenarios with embedded cues for history taking.
- Utilizing actors as simulated patients for student history-taking sessions, with video recording.
- Facilitated review of video recordings by students and lecturers to identify missed cues and areas for improvement.
- Analysis of recordings for common patterns of missed social cues and incomplete data exploration.
- Conducting focus groups to gather student feedback on the learning experience.
Main Results:
- Video-recorded simulated patient encounters with debriefing were found to be a valuable learning exercise for nursing students.
- Students demonstrated a limited prior appreciation for the impact of factors like lifestyle on care planning.
- Analysis revealed common omissions in identifying social cues and fully exploring patient-reported data.
- Many students reported insufficient opportunities to practice full history taking during clinical placements.
Conclusions:
- Video-recorded simulated patient experiences with facilitated review are effective in enhancing nursing students' history-taking and assessment skills.
- The intervention highlighted deficits in students' ability to identify and explore crucial social and emerging data cues.
- This approach provides a valuable supplement to clinical placements, improving preparedness for patient assessment and care planning.
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