Virtual patient simulation to improve nurses’ relational skills in a continuing education context: a convergent mixed methods study

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Abstract

Background

Effective provider-patient communication is crucial to the delivery of high-quality care. Communication roadblock such as righting reflex is widely observed among providers and can lead to relational disengagement. In previous work, nurses felt ill-equipped to communicate effectively with HIV-positive patients to support medication adherence. Providing nurses with continuing education opportunities to improve their relational skills is a major target for optimizing the quality of care. Virtual patient simulation is one promising strategy that needs to be evaluated among graduate nurses. This study aimed to assess the acceptability of a virtual patient simulation to improve nurses’ relational skills in a continuing education context.

Methods

We conducted a convergent mixed methods study by combining a quantitative pre-experimental, one-group post-test design and a qualitative exploratory study. We used convenience and snowball sampling approaches to select registered nurses ( n = 49) working in Quebec, Canada. Participants completed an online sociodemographic questionnaire, consulted the automated virtual patient simulation (informed by motivational interviewing), and filled out an online post-test survey. Descriptive statistics (mean, SD, median, interquartile range) were used to present quantitative findings. From the 27 participants who completed the simulation and post-test survey, five participated in a focus group to explore their learning experience. The discussion transcript was subjected to thematic analysis. At the final stage of the study, we used a comparison strategy for the purpose of integrating the quantitative and qualitative results.

Results

Nurses perceived the simulation to be highly acceptable. They rated the global system quality and the technology acceptance with high scores. They reported having enjoyed the simulation and recommended other providers use it. Four qualitative themes were identified: motivations to engage in the simulation-based research; learning in a realistic, immersive, and non-judgmental environment; perceived utility of the simulation; and perceived difficulty in engaging in the simulation-based research.

Conclusions

The simulation contributed to knowledge and skills development on motivational interviewing and enhanced nurses’ self-confidence in applying relational skills. Simulation holds the potential to change practice, as nurses become more self-reflective and aware of the impact of their relational skills on patient care.

Trial registration

ISRCTN18243005, retrospectively registered on July 3 2020.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00740-x

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Most cited references 59

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Using thematic analysis in psychology

Virginia Braun, Victoria Clarke (2014)

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Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

A Tong, P SAINSBURY, J. Craig (2007)

Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.

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Is Open Access

Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework

Mandeep Sekhon, Martin Cartwright, Jill Francis (2017)

Background It is increasingly acknowledged that ‘acceptability’ should be considered when designing, evaluating and implementing healthcare interventions. However, the published literature offers little guidance on how to define or assess acceptability. The purpose of this study was to develop a multi-construct theoretical framework of acceptability of healthcare interventions that can be applied to assess prospective (i.e. anticipated) and retrospective (i.e. experienced) acceptability from the perspective of intervention delivers and recipients. Methods Two methods were used to select the component constructs of acceptability. 1) An overview of reviews was conducted to identify systematic reviews that claim to define, theorise or measure acceptability of healthcare interventions. 2) Principles of inductive and deductive reasoning were applied to theorise the concept of acceptability and develop a theoretical framework. Steps included (1) defining acceptability; (2) describing its properties and scope and (3) identifying component constructs and empirical indicators. Results From the 43 reviews included in the overview, none explicitly theorised or defined acceptability. Measures used to assess acceptability focused on behaviour (e.g. dropout rates) (23 reviews), affect (i.e. feelings) (5 reviews), cognition (i.e. perceptions) (7 reviews) or a combination of these (8 reviews). From the methods described above we propose a definition: Acceptability is a multi-faceted construct that reflects the extent to which people delivering or receiving a healthcare intervention consider it to be appropriate, based on anticipated or experienced cognitive and emotional responses to the intervention. The theoretical framework of acceptability (TFA) consists of seven component constructs: affective attitude, burden, perceived effectiveness, ethicality, intervention coherence, opportunity costs, and self-efficacy. Conclusion Despite frequent claims that healthcare interventions have assessed acceptability, it is evident that acceptability research could be more robust. The proposed definition of acceptability and the TFA can inform assessment tools and evaluations of the acceptability of new or existing interventions. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2031-8) contains supplementary material, which is available to authorized users.

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Author and article information

Contributors

Geneviève Rouleau:

ORCID: http://orcid.org/0000-0003-1093-6577

genevieve.rouleau.chum@ssss.gouv.qc.ca

Journal

Journal ID (nlm-ta): BMC Nurs

Journal ID (iso-abbrev): BMC Nurs

Title: BMC Nursing

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6955

Publication date (Electronic): 4 January 2022

Publication date PMC-release: 4 January 2022

Publication date Collection: 2022

Volume: 21

Electronic Location Identifier: 1

Affiliations

[1 ]GRID grid.23856.3a, ISNI 0000 0004 1936 8390, Faculty of Nursing, , Université Laval, Pavillon Ferdinand-Vandry, ; 1050 De la Médecine Ave., Québec City, QC G1V 0A6 Canada

[2 ]Research Chair in Innovative Nursing Practices, 850 St-Denis St., Tour S, Montréal, QC H2X0A9 Canada

[3 ]GRID grid.23856.3a, ISNI 0000 0004 1936 8390, Vitam Research Center in Sustainable Health, , Université Laval, ; 2525 De la Canardière Rd., Québec City, QC G1J 0A4 Canada

[4 ]GRID grid.411081.d, ISNI 0000 0000 9471 1794, Population Health and Optimal Health Practices Axis, , CHU de Québec-Université Laval Research Centre, ; 1050 Sainte-Foy Rd., Québec City, QC G1S 4L8 Canada

[5 ]GRID grid.14848.31, ISNI 0000 0001 2292 3357, Faculty of Nursing, , Université de Montréal, ; 2375 Côte Ste-Catherine Rd., Pavillon Marguerite d’Youville, Montréal, QC H3T 1A8 Canada

[6 ]GRID grid.410559.c, ISNI 0000 0001 0743 2111, Centre de recherche du Centre hospitalier de l’Université de Montréal, ; 850 St-Denis St, Tour S, Montréal, QC H2X0A9 Canada

[7 ]GRID grid.29980.3a, ISNI 0000 0004 1936 7830, Department of General Practice and Rural Health, Dunedin School of Medicine, , University of Otago, ; 55 Hanover Street, Dunedin, 9016 New Zealand

[8 ]GRID grid.265702.4, ISNI 0000 0001 2185 197X, Université du Québec à Rimouski, ; 300 Allée des Ursulines, Rimouski, QC G5L 3A1 Canada

Author information

Geneviève Rouleau http://orcid.org/0000-0003-1093-6577

Article

Publisher ID: 740

DOI: 10.1186/s12912-021-00740-x

PMC ID: 8725454

PubMed ID: 34983509

SO-VID: c60bb838-0dda-4260-8b5a-ec02bd2312cc

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 14 June 2020

Date accepted : 17 October 2021

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100000024, Canadian Institutes of Health Research;

Award ID: 144030

Award ID: 337439

Award Recipient : Geneviève Rouleau

Funded by: FundRef http://dx.doi.org/10.13039/100013188, Réseau de recherche portant sur les interventions en sciences infirmières du Québec;

Custom metadata

ScienceOpen disciplines: Nursing

Keywords: computer simulation,communication,nursing continuing education,motivational interviewing,mixed method,nurses,relational skills,simulation training,virtual patient simulation,hiv

Data availability:

ScienceOpen disciplines: Nursing

Keywords: computer simulation, communication, nursing continuing education, motivational interviewing, mixed method, nurses, relational skills, simulation training, virtual patient simulation, hiv

Virtual patient simulation to improve nurses’ relational skills in a continuing education context: a convergent mixed methods study

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Abstract

Background

Methods

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Trial registration

Supplementary Information

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Journal of Health Sciences

Most cited references 59

Using thematic analysis in psychology

Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework

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