Teaching cardiovascular physical examination in nursing: clinical simulation

To evaluate, in Nursing students, the effect of clinical simulation as an educational strategy for learning about the cardiovascular physical examination.

Methods:

Quasi-experimental study, with the placement of 30 undergraduate nursing students, from a public university in Northeast Brazil, in two groups - intervention and control. The educational intervention consisted of a clinical simulation applied to the intervention group. The control group received only the usual class. Pre-test and post-test were applied with questions about cardiovascular physical examination for both groups. In the inferential analysis, we used chi-square or Fisher’s exact tests for categorical variables; and the Student’s t-test for independent samples.

Results:

The results showed that the difference in correct answers between the intervention and control groups was statistically significant, with a value of p of 0.05.

Conclusion:

We concluded that the applied educational strategy had a positive effect on undergraduate nursing students to learn the cardiovascular physical examination.

Descriptors:
Nursing; Simulation Training; Physical Examination; Education, Graduate; Learning

	Intervention		Control		p value
Variables	n	%	n	%	p value
Gender
Female	11	73.3	13	86.7	0.524² 2 Fisher's exact test.
Male	4	26.7	2	13.3	0.524² 2 Fisher's exact test.
Marital Status
Married	3	20.0	4	26.7	0.363² 2 Fisher's exact test.
Single	12	80.0	11	73.3	0.363² 2 Fisher's exact test.
Origin
Capital	5	33.3	11	73.3	0.404¹ 1 Chi-square test;
country	6	40.0	3	20.0
Other	4	26.7	1	6.7
First undergraduate course
Yes	11	73.3	9	60.0	0.524² 2 Fisher's exact test.
No	4	26.7	6	40.0	0.524² 2 Fisher's exact test.
Started undergraduate course at another university
Yes	4	26.7	3	20.0	0.637² 2 Fisher's exact test.
No	11	73.3	12	80.0	0.637² 2 Fisher's exact test.
Failure
Yes	1	6.7	5	33.3	0.667² 2 Fisher's exact test.
No	14	93.3	10	66.7	0.667² 2 Fisher's exact test.
Nursing technical course
Yes	1	6.7	2	13.3	0.867² 2 Fisher's exact test.
No	14	93.3	13	86.7	0.867² 2 Fisher's exact test.
Research group on the nursing process or physical examination
Yes	2	13.3	3	20.0	0.371² 2 Fisher's exact test.
No	13	86.7	12	80.0	0.371² 2 Fisher's exact test.
Research, extension, or monitoring projects
Yes	3	20.0	3	20.0	0.516² 2 Fisher's exact test.
No	12	80.0	12	80.0	0.516² 2 Fisher's exact test.

	Pre-test			Post-test
Questions	Intervention	Control	p value	Intervention	Control	p value
1	53.3	66.7	0.427¹ 1 Fisher's exact test.	86.7	60.0	0.343¹ 1 Fisher's exact test.
2	66.7	66.7	0.434¹ 1 Fisher's exact test.	100.0	66.7	-
3	93.3	80.0	0.800¹ 1 Fisher's exact test.	100.0	93.3	-
4	93.3	80.0	0.800¹ 1 Fisher's exact test.	93.3	73.3	0.733¹ 1 Fisher's exact test.
5	20.0	6.7	0.800¹ 1 Fisher's exact test.	53.3	20.0	0.446¹ 1 Fisher's exact test.
6	73.3	80.0	0.637¹ 1 Fisher's exact test.	73.3	86.7	0.476¹ 1 Fisher's exact test.
7	60.0	60.0	0.455¹ 1 Fisher's exact test.	93.3	80.0	0.800¹ 1 Fisher's exact test.
8	60.0	53.3	0.622¹ 1 Fisher's exact test.	60.0	60.0	0.168¹ 1 Fisher's exact test.
9	86.7	60.0	0.657¹ 1 Fisher's exact test.	93.3	66.7	0.667¹ 1 Fisher's exact test.
10	33.3	20.0	0.629¹ 1 Fisher's exact test.	20.0	20.0	0.081¹ 1 Fisher's exact test.

Variables	Extremely satisfactory	Very satisfactory	Satisfactory	Not very satisfactory	Unsatisfactory
Satisfaction with the practical dimension
Global satisfaction	26,7%	33,3%	40,0%	0%	0%
with the simulation	20,0%	60,0%	20,0%	0%	0%
Learning achieved	46,7%	33,3%	20,0%	0%	0%
Motivation when coming to the course	46,7%	20,0%	26,7%	6,6%	0%
Dynamics of simulation	40,0%	26,7%	13,3%	13,3%	6,7%
Active participation in the developed scenario	60,0%	20,0%	20,0%	0%	0%
Interaction with colleagues	66,7%	20,0%	6,7%	6,6%	0%
Interaction with Teaching Staff	40,0%	40,0%	13,3%	6,7%	0%
Satisfaction with the degree of difficulty of the scenario	40,0%	26,7%	33,3%	0%	0%
Satisfaction with the "realism" dimension
Realism of the developed scenario	53,3%	40,0%	6,7%	0%	0%
Credibility during the scenario	53,3%	40,0%	6,7%	0%	0%
Quality of the material used	46,7%	33,3%	20,0%	0%	0%
Quality of equipment used	46,7%	33,3%	20,0%	0%	0%
Quality of the simulator	46,7%	40,0%	13,3%	0%	0%
Satisfaction with the cognitive dimension
Satisfaction with the discussion post-scenario ( debriefing )	33,3%	40,0%	26,7%	0%	0%
Linking the scenario to the theory	66,7%	26,7%	6,6%	0%	0%
Adequacy to themes classes	60,0%	33,3%	6,7%	0%	0%

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[1] Corresponding author: Renata Marinho Fernandes. E-mail: remarifernandes@gmail.com