The Effect of Human Patient Simulation on Medical-Surgical Nurses’ Self-Efficacy in Cardiac Emergency Management


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Over 200,000 in-hospital cardiac arrests (IHCA) occur each year, making code management education and training a priority for first responders within the hospital. Medical-surgical nurses, who are frequently the first nurses to arrive at an IHCA, must begin immediate patient resuscitation. It is imperative for these first responders to remain confident in their own abilities. Therefore, the purpose of this study was to explore the effect of education intervention (simulation and traditional) on perceived self-efficacy of medical-surgical nurses in managing cardiac emergencies. An experimental, repeated measures, two-group pre-test/post-test design was used with 132 subjects. Both groups received traditional training, and the experimental group receiving additional high-fidelity simulation training. The Modified Self-Efficacy (MSE) scale was used to measure perceived self-efficacy pre-test (T1), immediately post-test (T2), and four to six weeks post-test (T3). A Repeated Measures ANCOVA controlling for self-efficacy pre-test scores (T1) revealed that self-assessed means of the nurses increased for the simulation and traditional groups: (T2, 56.59, 55.82) (T3, 58.21, 58.76), respectively. Stepwise forward and backward multiple regressions using education, age, years of nursing experience, and certification status as predictors indicated that years of nursing experience was the best predictor at T1 (P=.006) and T2 (p=.05) for both groups. At T3, which added the variable of participated in a code since education, the best predictors of self-efficacy were ACLS certification and subjects’ education level (p=.02). This study suggested that both simulation and traditional education increased the self-efficacy scores of medical-surgical nurses, yet there was no difference between groups in this increase across time. Further, it may be concluded that years of nursing experience, education level, and ACLS status were predictive of perceived self-efficacy of medical-surgical nurses in managing cardiac emergencies.



Simulation, Self-Efficacy, Nursing, Medical Surgical, Cardiac Emergency, Code Blue, Education