Acquisition of physical assessment skills among undergraduate nursing students using simulation-based assessment: A mixed-methods study

Abstract

Background: The ABCDE (Airway, Breathing, Circulation, Disability, and Exposure) approach is a valid model for teaching physical examination skills. Aim: Evaluate how physical examination is carried out based on the ABCDE approach using simulation training. Methods: Mixed-methods study on undergraduate nursing students during the 2022 to 2023 academic year at University of Barcelona. For the quantitative analysis, the Clinical Simulation Evaluation Tool was used. Results: About 887 students evaluated in 45 simulation sessions with high-fidelity manikins in second year, and 90 scenarios in third and fourth year respectively. Pulmonary auscultation was not performed as students advanced through the degree (p < 0.001). Instead, they became more competent in identifying changes in the patient (p < 0.001). Seven categories emerged from the qualitative analysis: previous experience, importance of physical assessment, feelings and emotions generated by the simulation, learning enablers, learning obstacles, personal knowledge gaps and autonomous study time. Conclusions: By means of more simulation sessions, students gain the capacity to identify changes in the patient’s condition, but as more hours of clinical practice are accumulated, pulmonary auscultation is no longer performed.