The effects of using high-fidelity simulators and standardized patients on the thorax, lung, and cardiac examination skills of undergraduate nursing students

Background: Existing research literature indicates that the use of various simulation techniques in the training of physical examination skills develops students' cognitive and psychomotor abilities in a realistic learning environment while improving patient safety. Objectives: The study aimed to compare the effects of the use of a high-fidelity simulator and standardized patients on the knowledge and skills of students conducting thorax-lungs and cardiac examinations, and to explore the students' views and learning experiences. Design: A mixed-method explanatory sequential design. Settings: The study was conducted in the Simulation Laboratory of a Nursing School, the Training Center at the Faculty of Medicine, and in the inpatient clinics of the Education and Research Hospital. Participants: Fifty-two fourth-year nursing students. Methods: Students were randomly assigned to Group I and Group II. The students in Group 1 attended the thorax-lungs and cardiac examination training using a high-fidelity simulator, while the students in Group 2 using standardized patients. After the training sessions, all students practiced their skills on real patients in the clinical setting under the supervision of the investigator. Results: Knowledge and performance scores of all students increased following the simulation activities; however, the students that worked with standardized patients achieved significantly higher knowledge scores than those that worked with the high-fidelity simulator; however, there was no significant difference in performance scores between the groups. The mean performance scores of students on real patients were significantly higher compared to the post-simulation assessment scores (p < 0.001). Conclusions: Results of this study revealed that use of standardized patients was more effective than the use of a high-fidelity simulator in increasing the knowledge scores of students on thorax-lungs and cardiac examinations; however, practice on real patients increased performance scores of all students without any significant difference in two groups. (C) 2016 Elsevier Ltd. All rights reserved.