Effect of simulation-based emergency cardiac arrest education on nursing students' self-efficacy and critical thinking skills: Roleplay versus lecture

Background: Simulation education is a learning method for improving self-efficacy and critical thinking skills. However, not much study has been done on how to use it for education on emergency cardiac arrest situations, for which a multidisciplinary team approach is required. Objectives: This study investigated the effects of simulation education on nursing students' self-efficacy and critical thinking skills in emergency cardiac arrest situations. Design: A quasi-experimental research approach with a crossover design was used to compare two types of simulation instruction methods. Participants and Setting: This study was conducted with 76 nursing students divided into two groups by order of instruction methods, in November and December 2016. Methods: Both groups of participants experienced a simulation lesson based on the same emergency scenario. Group A first completed a roleplay of an emergency cardiac arrest situation in a clinical setting, while Group B first listened to a lecture on the procedure. After ten days, Group A repeated the simulation exercise after listening to the lecture, while Group B completed the simulation exercise after the roleplay. The students' self efficacy and critical thinking skills were measured using a questionnaire before and after each session. Results: In the first session, self-efficacy and critical thinking skills scores increased greatly from pretest to posttest for Group A in comparison to Group B; no statistically significant difference was found between the two groups. In the second session, Group B showed a significant increase between pretest and posttest, while Group A showed no significant difference. Conclusions: Conducting the simulation exercise after the roleplay was a more effective teaching method than conducting it after the lecture. Moreover, having the nursing students assume various roles in realistic roleplay situations combined with simulation exercises led to a deeper understanding of clinical situations and improved their self-efficacy and critical thinking skills.