A comparison of educational strategies for the acquisition of medical-surgical nursing knowledge and critical thinking skills: Human patient simulator vs. the interactive case study approach

This study determined whether the use of the human patient simulator (HPS) as an educational intervention with nursing students was more effective than the use of interactive case studies (ICS) with respect to knowledge gain and critical thinking abilities and assessed the learner's perspective related to the experiences. Kolb's Experiential Learning Theory provided the framework. A multi-site, quantitative quasi-experimental two group pre-test and post-test design was utilized with a sample of 49 nursing students from two different nursing programs at a simulation center. After permission was obtained, the diploma and baccalaureate nursing students were pre-tested using a custom-designed Health Education Systems Incorporated (HESI) exam based upon ICS and HPS content, randomly assigned to either the ICS or HPS group, received the educational intervention, then were post-tested using another HESI exam based upon the same test blueprint. The HESI Scores were used to measure knowledge gain and critical thinking ability. Students also completed a researcher developed ICS/HPS evaluation form to assess their perspective of the teaching strategies.;Analysis of covariance (ANCOVA) revealed a significant difference with respect to knowledge gain using the HESI Conversion Score (p=.018) and HESI Scores (p=.037), and a significant difference with respect to critical thinking ability using the Critical Thinking subscore (p=.051), with the HPS group scoring significantly higher on the posttest. Descriptive statistics revealed that the student's perspective of the HPS experience was significantly more positive when compared to the case study group with respect to the stimulation of critical thinking abilities (p=.070), perceived value (p=.001), the ability to transfer learning to the clinical setting (p=.059), need for inclusion in undergraduate education (p=.010), understanding of concepts (p=.010), invoking nervousness (p=.001), decreasing anxiety in the clinical setting (p=.074), and substitution for clinical experiences (p=.027). The results supported the use of simulation technology in undergraduate nursing education, demonstrated the effectiveness of the use of simulation as an innovative teaching strategy, validated the nursing students' positive experience with respect to simulation, and confirmed the cost-benefit ratio with respect to the resources needed to integrate simulation into an undergraduate nursing curriculum.