Use of a human patient simulator with undergraduate nursing students: a prototype evaluation of critical thinking and self-efficacy

An instructional development pilot project with enrichment activities was undertaken to determine the effect of using a human patient simulator (HPS) on critical thinking and self-efficacy in a sample of nursing students. Twenty-five nursing students in their 3rd semester during 2003 at a private university completed the project. Dependent variables were the gain scores from the critical thinking and self-efficacy instruments, with prescores as covariates. Independent variables were the group and learning style. Participants were stratified by learning style and randomly assigned to one of two enrichment activity groups. Group 1 discussed the patient cases in a classroom setting. Group 2 used a HPS to simulate actual patient cases and to perform nursing actions. Comparison of the two groups was performed using a general linear model procedure in which there were two factors, namely group and learning style quadrant, with the pretest score included as a covariate. Neither enrichment group had significant gain in critical thinking disposition scores. However, significant critical thinking skills total gain scores, F (8, 16) = 20.74, p = .000, and self-efficacy total gain scores, F (8, 16) = 4.58, p = .01, were noted for Groups 1 and 2. The gains were not predicted by learning style or group. Both enrichment groups showed increased critical thinking skills and self-efficacy scores; however, the HPS group was more enthused about learning and expressed a desire for further sessions. The HPS group said "learning by doing was helpful and felt more confident in caring for patients.""