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Development of student simulated patient training and evaluation indicators in a high-fidelity nursing simulation: a Delphi consensus study†

Hao-Bin Yuan
Hao-Bin Yuan
   | 30 abr 2021
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Article Category: Original article
Publicado en línea: 30 abr 2021
Páginas: 23 - 31
Recibido: 08 jun 2020
Aceptado: 21 jul 2020
DOI: https://doi.org/10.2478/fon-2021-0003
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© 2021 Hao-Bin Yuan, published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1

Strategic key elements of SSP training.
Strategic key elements of SSP training.

Figure 2

SSP training process and the design of simulated scenario.
SSP training process and the design of simulated scenario.

The weight of judgment basis (Ca).

Judgment basis Large Median Small
Theoretical knowledge 0.30 0.20 0.10
Experience 0.45 0.35 0.20
References 0.20 0.15 0.10
Intuition 0.05 0.05 0.05

Characteristics of participants in Delphi consultations (n = 20).

Characteristics n % M ± SD
Age (years)
  30–39 3 15
  40–49 8 40
  50–59 9 45
Working area
  Clinical nursing 6 30
  Nursing education 10 50
  Nursing management 4 20
Academic degree
  Bachelor of nursing science 5 25
  Master of nursing science 8 40
  Doctor of philosophy in nursing science 7 35
Job title/classification
  Senior registered nurse/senior lecturer 5 25
  Associate professors 7 35
  Professors 8 40
  Nursing administrator 4 20
  Nursing teacher/clinical preceptor 16 80
  Master supervisor 9 45
  Doctor supervisor 5 25
Research expertise
  Clinical nursing 10 50
  Nursing education 16 80
  Nursing management 4 20
Years of experience in nursing 25.55 ± 9.57
  5–9 2 10
  9–19 3 15
  20–29 7 35
  30–40 8 40

The descriptions of SSP evaluation indicators after expert consultations.

Dimension Indicator Importance Coefficient of variation Weight
Mean SD
1. Disease knowledge 3.87 0.63 0.16 0.211
1.1. Symptoms and signs 3.80 0.77 0.20 0.041
1.2. Treatment and prognosis 3.95 0.69 0.17 0.042
1.3. Physical examinations, laboratory and imaging examinations 3.85 0.75 0.19 0.043
2. Role portrayal 4.63 0.29 0.06 0.253
2.1. Complete presentations of symptoms 4.90 0.31 0.06 0.053
2.2. Complete presentations of signs 4.75 0.44 0.09 0.051
2.3. Clear and fluent expression 4.85 0.37 0.08 0.052
2.4. Consistency with the script plot 4.85 0.37 0.08 0.052
2.5. Accurate and complete memory of plot lines 4.85 0.37 0.08 0.052
2.6. Accurate and complete memory of case data 4.90 0.31 0.06 0.053
2.7. Answer given only if be asked 4.05 0.60 0.15 0.044
2.8. Respond promptly 3.90 0.85 0.22 0.042
3. Performance fidelity 4.83 0.35 0.07 0.264
3.1. Mimicking symptoms 4.95 0.22 0.05 0.054
3.2. Mimicking signs 4.85 0.37 0.08 0.052
3.3. Mimicking tone and intonation 4.75 0.55 0.12 0.051
3.4. Mimicking facial features and expression 4.80 0.52 0.11 0.052
3.5. Mimicking postures and behaviors 4.75 0.55 0.12 0.051
3.6. Realistic psychological and emotional responses 4.85 0.37 0.08 0.052
4. Being a rater 4.95 0.22 0.05 0.271
4.1. Paying attention to students’ performance 4.95 0.22 0.05 0.054
4.2. Completion of assessment 4.95 0.22 0.05 0.054
4.3. Accuracy of assessment 4.95 0.22 0.05 0.054

The description of the coordination of expert consultations.

Consultation Item Kendall’s Rank correlation test
Coordination coefficient (w) Degrees of freedom χ2 value P value
First round SSP training content
  Dimension 0.377 4 30.159 0.000
  Indicator 0.326 16 104.400 0.000
SSP evaluation
  Dimension 0.447 4 35.731 0.000
  Indicator 0.311 17 105.886 0.000
Second round SSP training content
  Dimension 0.918 3 55.091 0.000
  Indicator 0.548 16 175.351 0.000
SSP evaluation
  Dimension 0.594 4 47.528 0.000
  Indicator 0.530 19 201.555 0.000

The descriptions of SSP training content after expert consultations.

Dimension Indicator Importance Coefficient of variation Weight
Mean SD
1. Role and responsibility of SP 4.25 0.29 0.07 0.239
1.1. SP concept 3.95 0.60 0.15 0.053
1.2. The performance is consistent with the plot of the play 4.80 0.41 0.09 0.064
1.3. Handling the events that may be encountered 4.00 0.46 0.11 0.053
1.4. Each performance is consistent 4.65 0.59 0.13 0.062
1.5. Punctuality and dedication 3.85 0.49 0.13 0.051
2. Script interpretation 4.47 0.35 0.08 0.252
2.1. Disease knowledge: symptoms, signs, treatment 4.05 0.39 0.10 0.054
2.2. The progress of script plot 4.75 0.44 0.09 0.063
2.3. Characteristics of patient 4.85 0.37 0.08 0.065
2.4. Health concerns 4.70 0.57 0.12 0.063
2.5. The relevant physical examinations, and laboratory and imaging examinations 4.00 0.56 0.14 0.053
3. Plot performance 4.55 0.36 0.08 0.257
3.1. Memory: medical history and health concerns 3.75 0.69 0.17 0.049
3.2. Demonstrations of symptoms 4.80 0.41 0.09 0.064
3.3. Demonstrations of signs 4.80 0.52 0.11 0.064
3.4. Demonstrations of psychological and emotional responses 4.85 0.49 0.10 0.065
4. Training for a rater 4.45 0.44 0.10 0.251
4.1. Assessment content 4.80 0.52 0.11 0.064
4.2. Scoring criteria for each indicator 4.70 0.57 0.12 0.063
4.3. Paying attention to students’ performance 3.85 0.59 0.15 0.051
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