Decision-Making During a Disaster-Scenario Tabletop Exercise by Prelicensure Student Nurses - A Replication Study

"Determine which clients to recommend for discharge in a disaster situation" is a Registered Nurse Activity Statement on the National Council Licensing Exam test plan. The activity statement raised the nursing education research question: could senior student nurses transfer their learning to a novel circumstance, with a high degree of risk, making decisions using patient assessments and determining resource needs? A study with a descriptive quantitative approach was designed with 2 aims. The first was to describe students' transfer of learning for basic disaster and medical-surgical knowledge and make recommendations for patient dispositions. The second aim was to describe students' attitudes about their transfer of learning during the tabletop exercise.

A researcher-designed disaster-scenario tabletop exercise and 3 instruments with subject-matter-expert feedback captured participants' decisions. Eligible senior student nurses volunteered to participate in the replicated study that was extended to 2 universities. Participant decisions and attitude responses were statistically analyzed.

Descriptive and difficulty index statistics described students' transfer of learning for basic disaster and medical-surgical topics, patient disposition recommendations, and attitudes. The cut-score for optimal transfer of learning was difficulty index (DI) ≤ .49.

Students had positive attitudes and transferred learning to most decisions. Decision DIs ≤ .49 were remediated.