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Short simulation exercises to improve emergency department nurses self-efficacy for initial disaster management: Controlled before and after study
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.ORCID iD: 0000-0003-1383-375x
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
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2017 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 55, p. 20-25Article in journal (Refereed) Published
Abstract [en]

Introduction: Head nurses at emergency departments often assume responsibility for managing the initial response to a major incident, and to create surge capacity. Training is essential to enable these nurses to perform an effective disaster response. Evaluating the effects of such training is however complicated as real skill only can be demonstrated during a real major incident. Self-efficacy has been proposed as an alternative measure of training effectiveness. Purpose: The aim of this study was to examine if short, small-scale computer-based simulation exercises could improve head emergency nurses general and specific self-efficacy and initial incident management skills. Method: A within-group pretest-posttest design was used to examine 13 head nurses general and specific self efficacy before and after an intervention consisting of three short computer based simulation exercises during a 1-h session. Management skills were assessed using the computer simulation tool DigEmergo. Results: The exercises increased the head nurses general self-efficacy but not their specific self-efficacy. After completing the first two exercises they also exhibited improved management skills as indicated by shorter time to treatment for both trauma and in-hospital patients. Conclusion: This study indicates that short computer based simulation exercises provide opportunities for head nurses to improve management skills and increase their general self-efficacy.

Place, publisher, year, edition, pages
CHURCHILL LIVINGSTONE , 2017. Vol. 55, p. 20-25
Keywords [en]
Management; Mass casualty incident; Nurses; Simulation training; Surge capacity
National Category
Nursing
Identifiers
URN: urn:nbn:se:liu:diva-139548DOI: 10.1016/j.nedt.2017.04.020ISI: 000404700900005PubMedID: 28505521OAI: oai:DiVA.org:liu-139548DiVA, id: diva2:1130040
Note

Funding Agencies|Swedish Civil Contingencies Agency (MSB) [2011-4957]

Available from: 2017-08-08 Created: 2017-08-08 Last updated: 2018-05-02
In thesis
1. Studying Simulations with Distributed Cognition
Open this publication in new window or tab >>Studying Simulations with Distributed Cognition
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Simulations are frequently used techniques for training, performance assessment, and prediction of future outcomes. In this thesis, the term “human-centered simulation” is used to refer to any simulation in which humans and human cognition are integral to the simulation’s function and purpose (e.g., simulation-based training). A general problem for human-centered simulations is to capture the cognitive processes and activities of the target situation (i.e., the real world task) and recreate them accurately in the simulation. The prevalent view within the simulation research community is that cognition is internal, decontextualized computational processes of individuals. However, contemporary theories of cognition emphasize the importance of the external environment, use of tools, as well as social and cultural factors in cognitive practice. Consequently, there is a need for research on how such contemporary perspectives can be used to describe human-centered simulations, re-interpret theoretical constructs of such simulations, and direct how simulations should be modeled, designed, and evaluated.

This thesis adopts distributed cognition as a framework for studying human-centered simulations. Training and assessment of emergency medical management in a Swedish context using the Emergo Train System (ETS) simulator was adopted as a case study. ETS simulations were studied and analyzed using the distributed cognition for teamwork (DiCoT) methodology with the goal of understanding, evaluating, and testing the validity of the ETS simulator. Moreover, to explore distributed cognition as a basis for simulator design, a digital re-design of ETS (DIGEMERGO) was developed based on the DiCoT analysis. The aim of the DIGEMERGO system was to retain core distributed cognitive features of ETS, to increase validity, outcome reliability, and to provide a digital platform for emergency medical studies. DIGEMERGO was evaluated in three separate studies; first, a usefulness, usability, and facevalidation study that involved subject-matter-experts; second, a comparative validation study using an expert-novice group comparison; and finally, a transfer of training study based on self-efficacy and management performance. Overall, the results showed that DIGEMERGO was perceived as a useful, immersive, and promising simulator – with mixed evidence for validity – that demonstrated increased general self-efficacy and management performance following simulation exercises.

This thesis demonstrates that distributed cognition, using DiCoT, is a useful framework for understanding, designing and evaluating simulated environments. In addition, the thesis conceptualizes and re-interprets central constructs of human-centered simulation in terms of distributed cognition. In doing so, the thesis shows how distributed cognitive processes relate to validity, fidelity, functionality, and usefulness of human-centered simulations. This thesis thus provides a new understanding of human-centered simulations that is grounded in distributed cognition theory.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2018. p. 94
Series
Linköping Studies in Science and Technology. Dissertations, ISSN 0345-7524 ; 1913
National Category
Human Computer Interaction
Identifiers
urn:nbn:se:liu:diva-145307 (URN)10.3384/diss.diva-145307 (DOI)9789176853481 (ISBN)
Public defence
2018-04-19, Ada Lovelace, B-huset, Campus Valla, Linköping, 13:15 (English)
Opponent
Supervisors
Available from: 2018-03-20 Created: 2018-03-20 Last updated: 2018-03-21Bibliographically approved

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Jonson, Carl-Oscar

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Division of Surgery, Orthopedics and OncologyFaculty of Medicine and Health SciencesCenter for Disaster Medicine and TraumatologyDepartment of Clinical and Experimental MedicineHuman-Centered systemsFaculty of Arts and Sciences
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