Introduction: The purposes of this study were to describe the simulation integrated with problem-based learning (SIM-PBL) module to educate the nursing process for clients with hypertension and to evaluate its effectiveness on nursing students’ self-efficacy (SE). Methods: This study was a one group pre- and post-test design. Twenty five students received a 5-hour SIM-PBL program focused on nursing care of clients with hypertension. A newly developed self-report questionnaire was used to assess SE in four areas of the nursing process with a scale of 0 (not at all confident) to 10 (totally confident). The four areas were subjective data assessment, physical examination, prioritizing nursing care and health promotion advices. Results: At baseline, students’ SE ranged from 5.5 ± 1.4 (prioritizing nursing care) to 7.6 ± 1.4 (subjective data assessment). After SIM-PBL education, all areas of nursing process presented statistically significant improvements of SE. The improvements were most noticeable in prioritizing nursing care. Conclusion: The SIM-PBL module was effective in improving the students’ self-efficacy in the nursing process for patients with hypertension. Further studies are recommended in developing SIM-PBL modules for diverse nursing topics and evaluating their effectiveness in various aspects of students’ competency.
Cite this paper
Sohn, M. , Ahn, Y. , Lee, M. , Park, H. and Kang, N. (2013) The problem-based learning integrated with simulation to improve nursing students’ self-efficacy. Open Journal of Nursing
, 95-100. doi: 10.4236/ojn.2013.31012
 Profetto-McGrath, J. (2005) Critical thinking and evidence-based practice. Journal of Professional Nursing, 21, 364-371. doi:10.1016/j.profnurs.2005.10.002
 Solomon, S. (2011) Problem-based learning. In: Bradshaw, M.J. and Lowenstein, A.J., Eds., Innovative Teaching Strategies in Nursing and Related Health Professions, 5th Edition, Jones and Bartlett, Sudbury.
 Hwang, S.Y. and Kim, M.J. (2006) A comparison of problem-based learning and lecture-based learning in an adult health nursing course. Nurse Education Today, 26, 315-321. doi:10.1016/j.nedt.2005.11.002
 Harden, R.M. and Davis, M.H. (1998) The continuum of problem-based learning. Medical Teacher, 20, 317-322.
 Hovancsek, M.T. (2007) Using simulations in nursing education. In: Jeffries, P.R., Ed., Simulation in Nursing Education, National League for Nursing, New York, 1-9.
 McGaughey, J. (2009) Acute care teaching in the undergraduate nursing curriculum. Nursing in Critical Care, 14, 11-16. doi:10.1111/j.1478-5153.2008.00303.x
 Thompson, T.L. and Bonnel, W.B. (2008) Integration of high-fidelity patient simulation in an undergraduate pharmacology course. Journal of Nurse Education, 47, 518-521. doi:10.3928/01484834-20081101-10
 Gantt, L.T. and Webb-Corbett, R. (2010) Using simulation to teach patient safety behaviors in undergraduate nursing education. Journal of Nursing Education, 49, 48-51. doi:10.3928/01484834-20090918-10
 Lee, W.S., Cho, K.C., Yang, S.H., Roh, Y.S. and Lee, G.Y. (2009) Effect of problem-based learning combined with simulation on the basic nursing competency of nursing students. Journal of Korean Academy of Fundamental Nursing, 16, 64-72.
 Kameg, K., Howard, V.M., Clochesy, J., Mitchell, A.M. and Suresky, J.M. (2010) The impact of high fidelity human simulation on self-efficacy of communication skills. Issues in Mental Health Nursing, 31, 315-323.
 Liaw, S.Y., Chen, F.G., Klainin, P., Brammer, J., O’Brien, A. and Samaraseker, D.D. (2010) Developing clinical competency in crisis event management: An integrated simulation problem-based learning activity. Advances in Health Sciences Education, 15, 403-413.
 Steadman, R.H., Coates, W.C., Huang, Y.M., Matevosian, R., Larmon, B.R., McCullough, L. and Ariel, D. (2006) Simulation-based training is superior to problem-based learning for the acquisition of critical assessment and management skills. Critical Care Medicine, 34, 151-157.
 Kim, J.Y. and Choi, E.Y. (2008) Learning element recognition and academic achievement of nursing student receiving PBL with simulation education. Journal of Korean Academy of Adult Nursing, 20, 731-742.
 Chu, M.S., Hwang, Y.Y. and Park, C.S. (2006) Development and application of PBL module using simulator. Journal of Korean Academy of Fundamental Nursing, 13, 182-189.
 Ackley, B.J. and Ladwig, G.B. (2010) Nursing diagnosis handbook. A guide to planning care. Mosby, St. Louis
 Korean Centers for Disease Control and Preventions. (2009) Korea national health and nutrition examination surveys. http://knhanes.cdc.go.kr
 Bandura, A. (1997) The anatomy of stages of change. American Journal of Health Promotion, 12, 8-10.
 Walton, H.J. and Matthews, M.B. (1989) Essentials of problem-based learning. Medical Education, 23, 542-558.
 Distler, J. (2008) Problem-based learning: an innovative approach to teaching physical assessment in advanced practice nursing curriculum. International Journal of Nursing Education Scholarship, 5, Article 23.
 Ko, I.S., Kim, H.S., Kim, I.S., Kim, S.S., Oh, E.G., Kim, E.J., Lee, J.H. and Kang, S.W. (2010) Development of a scenario and evaluation for simulation learning of care for patients with asthma in emergency units. Journal of Korean Academy of Fundamental Nursing, 17, 371-381.
 Kern, D.H., Mainous, A.G., III, Carey, M. and Beddingfield, A. (2011) Simulation-based teaching to improve cardiovascular exam skills performance among third-year medical students. Teaching and Learning in Medicine, 23, 15-20. doi:10.1080/10401334.2011.536753