Theses and Dissertations at Montana State University (MSU)
Permanent URI for this collectionhttps://scholarworks.montana.edu/handle/1/733
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Item Improving preeclampsia outcomes: a high-fidelity simulation for undergraduate nursing students(Montana State University - Bozeman, College of Nursing, 2023) Tonkin, Katlin Rose; Chairperson, Graduate Committee: Sandra KuntzPreeclampsia, a hypertensive disorder of pregnancy, commonly affects women and fetuses/neonates, significantly increasing the risk for morbidity and mortality. Underutilization of evidence-based practice standards intensifies complications. Montana has limited resources to care for high-risk pregnancies, especially in rural areas of the state. However, patient outcomes can be improved with standardized care and collaboration. Therefore, it is imperative that all hospitals in the state join forces to improve evidence-based practices for obstetric patients. This quality improvement (QI) teaching project aimed to inform future advocates, nursing students, of the evidence-based guidelines and collaborative tools available in Montana to care for maternal-fetal patients with preeclampsia. The QI project adapted a preeclampsia-focused high-fidelity simulation (HFS) scenario in collaboration with a school of nursing in Montana. The purpose of the HFS scenario was to aid undergraduate nursing students in developing knowledge, psychomotor (technical), and affective (values) skills to manage intrapartum care for a patient with preeclampsia. Senior-level nursing students participated in the simulation process including preparation, pre-briefing, scenario, and debriefing. The students were evaluated on meeting the safe-care measures for an HFS patient with preeclampsia while monitoring for fetal intolerance to labor. Qualitative data were collected based on Kirkpatrick's Four Levels of Training Evaluation tool. The data revealed the students' reactions to the simulation process, plans to apply what was learned, and how the teaching modality helped achieve the learning objectives. The QI teaching project subjectively and objectively improved the students' knowledge, psychomotor skills, and values in caring for a maternal-fetal patient with preeclampsia. Students were also provided with reference materials to use as registered nurses in the event of caring for patients who develop preeclampsia in healthcare facilities throughout Montana.Item The evidence-based benefits of a dedicated simulation lab coordinator for a rural nursing program(Montana State University - Bozeman, College of Nursing, 2023) Garcia (Valdez), Jamie Michelle; Chairperson, Graduate Committee: Sandra KuntzProblem/Purpose: The pandemic created extreme challenges for the healthcare workforce and impacted the availability of clinical placement sites for students. Student nurses accustomed to direct patient care experiences at a hospital or clinic site were barred from these settings and redirected to learn skills exclusively in simulation labs and online environments. Initially unprepared to educate and account for all required clinical hours for multiple cohorts of students, faculty were forced to take stock of their resources, keep students safe, and prepare for the unpredictable and lengthy COVID-19 event. This project aimed to establish the evidence-based benefits of a dedicated sim lab coordinator/educator and describe the role and expectations of a dedicated sim lab coordinator for a rural-based nursing program. Procedure: A microsystem assessment of the Community College Nursing Program (CCNP) and a review of pertinent literature identified the value of a dynamic, well-managed, and expertly staffed clinical simulation lab as a possible solution. Results: This project addressed the need for simulation preparation training and implementation among faculty by utilizing the education outlined in the simulation handbook. This education provides a foundation for simulation implementation for faculty. In addition, the implementation of simulation with the National League for Nursing (NLN) simulation template is utilized by all faculty to provide consistent simulation methods for students at the CCNP. By using a standardized template and having faculty educated in the development and implementation of simulation, the nursing students will gain clarity regarding what to expect and how to prepare for the simulation. Ongoing assessments of the simulation program are conducted using faculty and student evaluations, thus allowing the CCNP to facilitate changes and improvements as deemed necessary. Conclusions: Expected outcomes include consistency in simulation education and implementation. A well-prepared simulation coordinator manages the lab, educates faculty and students, and creates an environment where academic and clinical learning confidence is nurtured. A coordinator guided by evidence-based best practices provides controlled, managed, and consistent clinical learning experiences for students and fosters readiness for practice as registered nurses.Item Improving experimental methods: exploring procedural mechanisms affecting participant behaviors(Montana State University - Bozeman, College of Engineering, 2016) Page, Lenore Trinette; Chairperson, Graduate Committee: David ClaudioResearch with human participants involves a complex combination of procedural elements in order to establish internal, external and measurement validity. Examining the accuracy of research equipment and methods that elicit similar behaviors as the general public is difficult. This research used driving as a model to address elements in the procedures that participants experience to elicit realistic behaviors. An instrumented vehicle (IV) and driving simulator (SIM) measured experimental behaviors for average approach speed (in the 20m before the legal stop line); lateral distance from curb at 20m; lateral distance from curb at legal stop line (0m) and the stopping location (distance before or after 0m); and, compared with measured general driving public behaviors at stop-controlled intersections. The linear mixed effect analyses combined two experiments. In both, surveys were administered to gather driver's trait anxiety, driving anxiety and social desirability scores. Experiment One drivers (36% female) were grouped as Novice (5, 16-17 year olds who just obtained driving license), Young (4, 16-17 year olds who obtained license over a year ago) and Adult (5, 30-55 year olds licensed near age 16). Experiment Two drivers (47 SIM, 44 IV; 35% female) were College age (18-21 year olds licensed near age 16) and exposed to 1 of 16 different combinations (one of those treatments matched Experiment One's procedure) of procedural changes for: researcher attire (casual or formal), researcher proximity (control room, front or rear passenger seat), mode of instruction delivery (spoken, read or video) and hypothesis statement (none or explicit). At the end of Experiment Two, participants' understanding of the experiment was coded into three debriefing variables. Absolute behavioral validity of the IV to public behavior was achieved in one treatment (formal, front seat, spoken and no hypothesis) and including the debriefing variables in the model; no SIM combination achieved this. Trait anxiety scores appeared to explain behaviors in the IV or SIM and improved result interpretation as interactions with other independent variables. For improved research methods, it is recommended that coded debriefing variables, specific procedural elements, and trait anxiety scores be included and used to explain interactions or differences in participant behaviors.Item Driving in a simulator versus on-road : the effect of increased mental effort while driving on real roads and a driving simulator(Montana State University - Bozeman, College of Engineering, 2015) Mueller, Jessica Anne; Chairperson, Graduate Committee: Laura StanleyThe objective of this thesis is to study human response to increased workload while driving in a driving simulator compared to real world behavior. Driving simulators are a powerful research tool, providing nearly complete control over experimental conditions-- an ideal environment to quantify and study human behavior. However, participants are known to behave differently in a driving simulator than in an actual real-world scenario. The same participants completed both on-road and virtual drives of the same degree of roadway complexity, with and without a secondary task conditions. Data were collected to describe how the participants' vehicle-handling, gaze performance and physiological reactions changed relative to increases in mental workload. Relationships between physiology and performance identified physiological, performance, and gaze-related metrics that can show significant effects of driving complexity, environment, and task. Additionally, this thesis explores the inadequacy of multinomial predictive models between the simulator and instrumented vehicle. Relative validity is established in the performance-physiology relationship for on- and off-road fixation frequencies, but few correlations between the simulator and instrumented vehicle are apparent as mental workload increases. These findings can be applied to the real world by providing specific variables that are adequate proxies to detect changes in driver mental workload in on-road driving situations; valuable for in-vehicle driver assistance system research. Overall, the simulator was a suitable proxy to detect differences in mental workload in driving task; and initial steps have been taken to establish validity, and to supplement on-road driving research in these high-demand driving scenarios.