The effect of deliberate practice combined with high-fidelity simulation scenarios on psychomotor skill competency and retention in prelicensure nursing education: A mixed methods pilot study

CYNTHIA E. JOHNSON THE EFFECT OF DELIBERATE PRACTICE COMBINED WITH HIGH-FIDELITY SIMULATION SCENARIOS ON PSYCHOMOTOR SKILL COMPETENCY AND RETENTION IN PRELICENSURE NURSING EDUCATION: A MIXED METHODS PILOT STUDY Under the direction of Laura P. Kimble, Ph.D., RN Graduating students who are proficient in the representative skills of nursing are vital for providing safe, quality patient care. The purpose of this pilot mixed method study was to examine the combined effect of deliberate skill practice prior to high-fidelity simulation (HFS) sessions and skill practice during HFS scenarios of the urinary catheter insertion skill on psychomotor skill competency and retention in prelicensure nursing students. The study was based on Ericsson’s framework of deliberate practice for skill acquisition and expert performance. Using a randomized controlled experimental design, a convenience sample of 28 senior level prelicensure nursing students (mean age 21.82, SD 2.9, 96% Caucasian) were randomized into one o f three groups. Each group participated in four, five-hour HFS scenario sessions with three different teaching methodologies. The control group (Group A) participated in the traditional HFS education method and no skill practice occurred. The second group (Group B) participated in deliberate practice of a different previously learned skill prior to each session. Then Group B participated in HFS scenarios in which the urinary catheter insertion skill was performed. Group C participated in deliberate practice of the urinary catheter insertion skill prior to each HFS session and then performed the urinary catheter insertion skill during each HFS scenario. Quantitative data collection consisted of a urinary catheter insertion pre-test skill competency assessment, a post-test skill competency assessment, and a post-test skill retention assessment. Qualitative data collection with seven students occurred after the completion o f the quantitative strand with face-to-face semi-structured interviews Results revealed no statistically significant difference in the groups on skill competency. However, the participants in the deliberate practice with HFS group (Group C) demonstrated an improvement in the overall total mean scores on urinary catheter insertion assessment and a medium eta effect size was found. Thus, the intervention of combining deliberate skill practice prior to HFS along with skill practice during HFS had a direct effect on the dependent variable (urinary catheter insertion competency assessment). In the qualitative strand, three themes were identified including Not the Best Place for Learning a Skill, Learning Skills with Peers, and Performing Skills fo r a Grade. The qualitative data supported the quantitative findings and resulted in the discovery of the value of consistent peer to peer deliberate urinary catheter insertion practice prior to HFS scenario skill practice. This study provides preliminary data on the combination of deliberate peer to peer practice prior to FIFS scenario skill practice may improve student urinary catheter insertion skill acquisition and retention. Because of the pilot nature of the study, the findings need to be confirmed in a larger clinical trial.