A Phase 1 Study of a Kolb-influenced, High Fidelity Simulation Intervention Implemented to Improve Nursing Students' Use of a Conflict Resolution Skill

Interpersonal task-related conflict that arises within nursing practice can contribute to issues regarding patient safety. Exposure to conflict within practice occurs as soon as the undergraduate nursing student’s first clinical placement. Yet studies have shown that students, as well as practitioners, are not utilizing a conflict management style conducive to safe patient care. Few educational interventions have incorporated the teaching of conflict resolution skills to nursing students. Therefore, a high fidelity simulation intervention (two scenarios, each followed by a debriefing session) was developed and refined to teach the two-challenge rule to Year 2 nursing students. The Medical Research Council Framework informed the intervention’s design and refinement strategy, while Kolb’s Experiential Learning Theory provided the foundation to implement the entire, refined intervention. A Phase 1 study with two successive components, refinement and single-group post-test, was conducted to determine the feasibility for a future randomized controlled trial (RCT) of this high fidelity simulation intervention. Forty eligible Year 3 nursing students participated in the refinement phase during a 2-week period. For the single-group post-test component, 35 Year 2 nursing students participated in the entire, refined high fidelity simulation intervention which included a 5-week spacing period. The refinement strategy improved the high fidelity simulation intervention’s overall design features. For Scenario 1, the Simulation Design Scale (SDS) mean score reached a high on Day 5 of 4.86 (SD = 0.14) in contrast to a score of 3.45 (SD = 0.17) on Day 1. For Scenario 2, the SDS specific mean score was 4.75 (SD = 0.16) on Day 5, which represented a mean score increase of 1.01 from the score on Day 1. Of the Year 2 students who participated in the refined intervention, 88.7% rated its quality at 4 or higher on the Educational Practices Questionnaire. Year 2 nursing students (82.9%) also rated their satisfaction and self-confidence after participating in the entire refined intervention at 4 or higher on the Satisfaction and Self-Confidence in Learning scale. Additionally, the Year 2 students utilized the two-challenge rule 74.3% of the time after participating in the second high fidelity simulation scenario. Overall, the results of the Phase 1 study were favourable and will contribute to planning a future RCT.Ph.D