Sustainable healthcare education using cooperative simulation in developing nursing students' knowledge, attitude and skills: A randomized controlled study

IF 3.6 2区医学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Nurse Education Today Pub Date : 2025-03-20 DOI:10.1016/j.nedt.2025.106706

Nagihan İlaslan , Nuray Şahin Orak

{"title":"Sustainable healthcare education using cooperative simulation in developing nursing students' knowledge, attitude and skills: A randomized controlled study","authors":"Nagihan İlaslan , Nuray Şahin Orak","doi":"10.1016/j.nedt.2025.106706","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The effectiveness of sustainable healthcare education in improving nursing students' knowledge and attitudes has been demonstrated through short-term studies with pre-post test design. However, there is a need to study long-term retention of students' knowledge and attitudes, also their skills in achieving sustainable healthcare from the use to disposal of healthcare resources by providing a hands-on learning experience via simulation.</div></div><div><h3>Aim</h3><div>This study investigated the effects of sustainable healthcare education using cooperative simulation on nursing baccalaureate students' sustainable nursing knowledge, attitude and skills by comparing the self-directed learning.</div></div><div><h3>Design</h3><div>This randomized controlled experimental study with pre-post-follow up design was registered under <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> with number <span><span>NCT05504421</span><svg><path></path></svg></span>.</div></div><div><h3>Settings</h3><div>The study was conducted at a nursing faculty in a state university.</div></div><div><h3>Participants</h3><div>The study sample comprised 70 third grade nursing students.</div></div><div><h3>Methods</h3><div>Following narrative-based lectures explaining sustainability in nursing, students were randomly assigned to two study groups; an intervention group using cooperative learning-based NurSusToolkit Project cases and the control group using self-directed learning throughout 4 consecutive weeks. Both groups then performed a high-fidelity simulation practice focusing on sustainable healthcare. Data were collected using the Sustainability Attitudes in Nursing Survey, Sustainable Healthcare Knowledge Form, Skill Checklist and Debriefing Form. Quantitative data were analyzed using <em>t</em>-tests, Friedman test, Fisher's Exact test, intraclass correlation coefficients and Cohen Kappa calculations in IBM SPSS Statistics version 23 software. Qualitative data were analyzed via an inductive approach. Ethical approval and official permission were obtained. The students completed informed consent forms.</div></div><div><h3>Results</h3><div>In the post-test, no significant differences were determined between the groups in terms of sustainable nursing knowledge (U = 557.5, <em>p</em> = 0.503), motivation (U = 514.5, <em>p</em> = 0.237) and attitudes (U = 610, <em>p</em> = 0.976). In the follow-up test, the sustainable nursing knowledge (U = 221.500), motivation (U = 282.500) and attitudes (U = 191) were significantly higher in the intervention group (<em>p</em> < 0.001). In the simulation practice, the intervention group had higher rates of correct separation of nursing care-related waste (intervention group = 77.77 % for both observers, the control group was 0 % and 11.11 % for observer 1 and 2, respectively, Cohen Kappa = 0.898, <em>p</em> < 0.001). In the debriefing, the intervention group requested more simulation practices (33.33 %) to acquire sustainable nursing skills, while the control group did not.</div></div><div><h3>Conclusions</h3><div>Sustainable healthcare education using cooperative simulation that has long-term effects can enable future nurses to lead the shift towards climate-smart and sustainable nursing care.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"151 ","pages":"Article 106706"},"PeriodicalIF":3.6000,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nurse Education Today","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S026069172500142X","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"EDUCATION, SCIENTIFIC DISCIPLINES","Score":null,"Total":0}

引用次数: 0

Abstract

Background

The effectiveness of sustainable healthcare education in improving nursing students' knowledge and attitudes has been demonstrated through short-term studies with pre-post test design. However, there is a need to study long-term retention of students' knowledge and attitudes, also their skills in achieving sustainable healthcare from the use to disposal of healthcare resources by providing a hands-on learning experience via simulation.

Aim

This study investigated the effects of sustainable healthcare education using cooperative simulation on nursing baccalaureate students' sustainable nursing knowledge, attitude and skills by comparing the self-directed learning.

Design

This randomized controlled experimental study with pre-post-follow up design was registered under ClinicalTrials.gov with number NCT05504421.

Settings

The study was conducted at a nursing faculty in a state university.

Participants

The study sample comprised 70 third grade nursing students.

Methods

Following narrative-based lectures explaining sustainability in nursing, students were randomly assigned to two study groups; an intervention group using cooperative learning-based NurSusToolkit Project cases and the control group using self-directed learning throughout 4 consecutive weeks. Both groups then performed a high-fidelity simulation practice focusing on sustainable healthcare. Data were collected using the Sustainability Attitudes in Nursing Survey, Sustainable Healthcare Knowledge Form, Skill Checklist and Debriefing Form. Quantitative data were analyzed using t-tests, Friedman test, Fisher's Exact test, intraclass correlation coefficients and Cohen Kappa calculations in IBM SPSS Statistics version 23 software. Qualitative data were analyzed via an inductive approach. Ethical approval and official permission were obtained. The students completed informed consent forms.

Results

In the post-test, no significant differences were determined between the groups in terms of sustainable nursing knowledge (U = 557.5, p = 0.503), motivation (U = 514.5, p = 0.237) and attitudes (U = 610, p = 0.976). In the follow-up test, the sustainable nursing knowledge (U = 221.500), motivation (U = 282.500) and attitudes (U = 191) were significantly higher in the intervention group (p < 0.001). In the simulation practice, the intervention group had higher rates of correct separation of nursing care-related waste (intervention group = 77.77 % for both observers, the control group was 0 % and 11.11 % for observer 1 and 2, respectively, Cohen Kappa = 0.898, p < 0.001). In the debriefing, the intervention group requested more simulation practices (33.33 %) to acquire sustainable nursing skills, while the control group did not.

Conclusions

Sustainable healthcare education using cooperative simulation that has long-term effects can enable future nurses to lead the shift towards climate-smart and sustainable nursing care.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Nurse Education Today 医学-护理

CiteScore

6.90

自引率

12.80%

发文量

349

审稿时长

58 days

期刊介绍： Nurse Education Today is the leading international journal providing a forum for the publication of high quality original research, review and debate in the discussion of nursing, midwifery and interprofessional health care education, publishing papers which contribute to the advancement of educational theory and pedagogy that support the evidence-based practice for educationalists worldwide. The journal stimulates and values critical scholarly debate on issues that have strategic relevance for leaders of health care education. The journal publishes the highest quality scholarly contributions reflecting the diversity of people, health and education systems worldwide, by publishing research that employs rigorous methodology as well as by publishing papers that highlight the theoretical underpinnings of education and systems globally. The journal will publish papers that show depth, rigour, originality and high standards of presentation, in particular, work that is original, analytical and constructively critical of both previous work and current initiatives. Authors are invited to submit original research, systematic and scholarly reviews, and critical papers which will stimulate debate on research, policy, theory or philosophy of nursing and related health care education, and which will meet and develop the journal''s high academic and ethical standards.