1. LEARNERS GAIN
SELF-CONFIDENCE
FOR NURSING SKILLS
THROUGH SIMULATION
YOSHIKAZU ASADA, YOSHIHIKO SUZUKI,
ALAN LEFOR AND RYUTARO KAWANO

2. BACKGROUND
• Evaluation of simulation is important
to check the effectiveness of learning.
• Simulation training programs should be modified
by the results of evaluations.
• The acquisition of self-confidence can be checked by
asking learners for comments, and comparing
responses before and after simulation.

3. AIM
To determine whether or not nurses are able to build
their self-confidence through simulation exercises.

4. METHODS
Questionnaires were given twice
• before simulation training
• after training
Using the same questions to evaluate self-confidence,
rating were made on a 7-point Likert scale.
Questions: “Suppose you are going to do the procedure now.”
(1) “Can you do it accurately?"
(2) “Can you do it calmly?"

5. METHODS
Questionnaires were used in three different simulation
training programs given to nurses
• ICLS (Immediate Cardiac Life Support), 6 hour course
• Multi-Tasking Exercise training, 1.5 hour course
• Blood-draw training, 1 ~ 1.5 hour course

6. RESULTS
ICLS : N=87(pre), 88 (post)
Multi-tasking Exercise : N = 79(pre), 96(post)
Blood Draw Training : N = 57(pre), 49 (post)
Using 7 point Likert scale:
7(Agree Very Strongly), 6(Agree Strongly),
5(Agree), 4(Undecided), 3(Disagree),
2(Disagree Strongly), 1(Disagree Very Strongly)

7. RESULTS
ICLS
Question 1 : Can you do it accurately?
7
6
5
4
3
2
1
mean
pre
2
2
19
23
13
15
13
3.4
post
6
36
34
7
1
3
1
5.3
Question 2 : Can you do it calmly?
7
6
5
4
3
2
1
mean
pre
0
3
11
11
22
20
21
2.8
post
5
30
27
11
8
3
4
4.9

8. RESULTS
MULTI-TASKING
Question 1 : Can you do it accurately?
7
6
5
4
3
2
1
mean
pre
5
16
32
16
9
1
0
4.9
post
10
24
40
15
6
1
0
5.2
Question 2 : Can you do it calmly?
7
6
5
4
3
2
1
mean
pre
7
10
27
20
14
1
0
4.7
post
8
21
40
17
8
1
1
5.0

9. RESULTS
BLOOD DRAW
Question 1 : Can you do it accurately?
7
6
5
4
3
2
1
mean
pre
10
12
14
9
4
4
4
4.8
post
16
20
7
2
2
2
0
5.8
Question 2 : Can you do it calmly?
7
6
5
4
3
2
1
mean
pre
5
14
7
15
4
5
7
4.3
post
8
20
9
5
4
1
2
5.2

10. STATISTICAL ANALYSIS
(MANN-WHITNEY U TEST)
ICLS
• Accurately : p < 0.01
• Calmly: p < 0.01
Multi-tasking
• Accurately : p > 0.05
• Calmly: p < 0.05
Blood draw
• Accurately : p < 0.01
• Calmly: p < 0.01

11. RESULTS
FREE FORM COMMENTS
ICLS
• “I know how to do it, but I can’t move
because I am upset.”
Multi-tasking
• “We need to review and re-train.”
• “Training after debriefing is easier than the first training.”
Blood draw
• “That frightened me very much.”

12. CONCLUSIONS
In the three different simulation programs
(ICLS, multi-tasking and blood draw) evaluated,
nurses gained self-confidence.
In multi-tasking training, effectiveness was less than
other two possibly because of
• Lack of time for training
• Difficult objectives for new nurses