Home care simulation for student nurses: medication management in the home

Preparing students to provide medication management in home care (HC) settings is challenging. Simulation methodology for teaching of complex skills has been successful in other clinical areas.

This study tested a HC simulation model of education and examined student scores on tests of confidence and knowledge in managing medications and pre filling patient medication boxes in a HC setting.

This quasi-experimental study of pre-licensure nursing students (N=60) enrolled in a Baccalaureate program was conducted at a private university in the Northeastern United States.

Bandura's self efficacy instrument was modified to measure confidence in students' knowledge of and skills in pre-filling medication boxes in patient homes. Participants were randomly assigned to control (n=30) or experimental groups (n=30) where both groups received traditional classroom teaching about medication management, and the experimental group also received simulation education. Both groups completed a pre test prior to the medication module. At the end of the module, both groups completed a post test measuring confidence, as well as a multiple choice (MC) test measuring knowledge of medication management skills in HC settings.

Paired T tests revealed a significant increase in perceived self confidence from pre (mean score=4.6) to post simulation (mean score=8.6) (p<.01). Knowledge test results demonstrated a statistically significant difference overall between groups (p=.02).

Students have limited access to medication management in HC settings during clinical rotations. This study supports the need for home care focused simulations, especially given errors detected during the simulation experience. Students improved their pre to post test confidence scores and reported the activity was "valuable", "made them think", and provided a safe arena for them to learn.