Committee on the Use of Human Subjects (CUHSR/IRB)

PROPOSAL ID:3680
TITLE:IMPROVING NURSING STUDENTS’ CONFIDENCE AND ATTITUDES TOWARDS END-OF-LIFE CARE THROUGH INTERPROFESSIONAL SIMULATION.
PRINCIPLE INVESTIGATOR:GILLIES, SARAH
NURSING
8166746354
SANDREWS3@MISSOURIWESTERN.EDU
OTHER INVESTIGATORS:
IRB SUMMARY: File Created: April 20, 2022
Department Chair Action Date: April 20, 2022
Current Status: Extension of Approval Granted
Action Date: April 26, 2022
Confidentiality Data are not linked to individuals

STATEMENT OF PURPOSE

The purpose of this research is to develop an effective end-of-life care simulation for nursing students who normally would not experience the event in “real life” while completing their clinical rotation. Nurses spend the most time with patients at the end of their life than any other healthcare professional. Due to several factors, including limited clinical placement related to COVID-19 and patients’ desires to experience end-of-life care at home and not in the hospital setting, most nursing students will not care for patients who require this type of nursing care while still in school. Students report having low self-confidence in this area of nursing, as well as feelings of fear when they have not had practice in this type of sensitive situation. The simulation with high-fidelity manikins and live actors will provide a safe space for nursing students to learn to provide compassionate, educated end-of-life care with positive attitudes towards the scenario. I expect that this simulation will increase students' confidence and improve attitudes towards EOL care. This simulation is part of my teaching curriculum at Benedictine College. The approval I am seeking from MWSU's IRB is for the questionnaires I will ask participants to fill out before and after the simulation for my MSN thesis in MWSU's MSN-Educator program. I have received approval from Benedictine IRB that I will attach.

STATEMENT OF RESEARCH METHODOLOGY

Student subjects will be given the Frommelt Attitudes Towards Care of the Dying Scale (FATCOD-B) questionnaire (Appendix A) to assess initial attitudes surrounding end-of-life and loss prior to the simulation as a “pre-test”. The FATCOD-B uses a Likert-type scale for responses. The form asks participants for the last four digits of their social security number at the bottom of the scale, but this will not be included in this study to maintain privacy and safety. Completion of the questionnaire will serve as consent. A letter of introduction and consent is attached to this application (Appendix B). Student subjects will also complete a demographics form to assess related variables such as age, gender, the influence of religious beliefs, and past/present experience with death, dying, and loss (Appendix C). The simulation will take place in the Mother Teresa Nursing Simulation Lab at Benedictine College and will have three parts (A, B, and C). A high-fidelity manikin, which is a mechanical manikin that can mimic human body functions such as breathing, eye blinking, and has speakers attached to a microphone in a separate room, will be used as the patient in the scenario. The scenario will follow a patient with advanced lung cancer who is admitted to the hospital for care related to increased pain and difficulty breathing. As the simulation progresses, the patient will continue to deteriorate until the last part when they ultimately die. The subjects will act as the primary nurses and interact with the patient (simulator) and live actor volunteers, who act as the patient’s family member, the attending physician, and the hospital chaplain. The students will have learning objectives to meet through the simulation, such as assessing pain, blood pressure, heart rate, and respiratory rate; contacting the patient’s physician for additional medications; comforting the patient’s family member; and partnering with the hospital chaplain. There will be no video or audio recording of the simulation. Student subjects will then be given the FATCOD-B questionnaire again to assess attitudes surrounding end-of-life and loss after experiencing the simulation as a “post-test.” These results will be statistically compared to the pre-test to determine if a significant difference in attitudes is present. To assess satisfaction and confidence after the simulation, the subjects will be given the “Student Satisfaction and Self-Confidence in Learning” questionnaire (Appendix D). This is a 13-item Likert-type survey.

ANTICIPATED RISKS AND BENEFITS

Due to the inherently distressing nature of death and dying, it is possible some student subjects may feel some degree of psychological stress while completing the simulation and/or questionnaire. However, I do not believe this stress would be any higher than the usual stress associated with nursing school and the stress they experience caring for acutely ill patients during all their clinical rotations. Faculty will be present to provide support to the students during the simulation.

SUBJECT SELECTION

The subjects are selected based on enrollment status in NURS-4500 at Benedictine College, which will be approximately 32 students. Student subjects will be informed of the simulation, and it will take place while the end-of-life care information is being taught in the classroom. Participation in the simulation is a learning activity for the students, but they are required to participate for the class. However, there will be no points associated with the completion of the surveys, so their grade will not be impacted if they elect to not complete the surveys. There will be no subject compensation in this study.

CONFIDENTIALITY

All questionnaires will be delivered electronically through a link made available to the participants and email addresses will not be collected. Participants will be assigned random numbers to connect their responses for the purpose of discarding data should a participant wish to withdraw from the study. The final data will be reported as a cohort, not individuals.

PRIMARY SUPPORTING DOCUMENT

Click for Word Document

Extension Request on 06-03-2022

Data collection will begin in September 2022 and end in December 2022.

Extension Request on 06-26-2022

Data collection has not yet begun.

Extension Request on 07-26-2022

I will be collecting data in the fall semester

Extension Request on 08-25-2022

Collecting data in October

Extension Request on 09-23-2022

Collecting data this month.

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Any questions about proposals, procedures, etc. should be directed to the chair of the CUHSR