The effects of using high-fidelity simulators and standardized patients on the thorax, lung, and cardiac examination skills of undergraduate nursing students

• The use of either high-fidelity simulators or standardized patients as an educational technique in teaching thorax, lung, and cardiac examination skills was effective in improving student knowledge levels.
• When the two techniques were compared, use of standardized patients was more effective in increasing student knowledge levels.
• The use of either high-fidelity simulators or standardized patients in teaching thorax, lung, and cardiac examination skills improved student performance levels better. Both techniques equally improved student performance.
• Practice on real patients in clinical practice improved student performance after simulations.

BackgroundExisting research literature indicates that the use of various simulation techniques in the training of physical examination skills develops students' cognitive and psychomotor abilities in a realistic learning environment while improving patient safety.ObjectivesThe study aimed to compare the effects of the use of a high-fidelity simulator and standardized patients on the knowledge and skills of students conducting thorax-lungs and cardiac examinations, and to explore the students' views and learning experiences.DesignA mixed-method explanatory sequential design.SettingsThe study was conducted in the Simulation Laboratory of a Nursing School, the Training Center at the Faculty of Medicine, and in the inpatient clinics of the Education and Research Hospital.ParticipantsFifty-two fourth-year nursing students.MethodsStudents were randomly assigned to Group I and Group II. The students in Group 1 attended the thorax-lungs and cardiac examination training using a high-fidelity simulator, while the students in Group 2 using standardized patients. After the training sessions, all students practiced their skills on real patients in the clinical setting under the supervision of the investigator.ResultsKnowledge and performance scores of all students increased following the simulation activities; however, the students that worked with standardized patients achieved significantly higher knowledge scores than those that worked with the high-fidelity simulator; however, there was no significant difference in performance scores between the groups. The mean performance scores of students on real patients were significantly higher compared to the post-simulation assessment scores (p < 0.001).ConclusionsResults of this study revealed that use of standardized patients was more effective than the use of a high-fidelity simulator in increasing the knowledge scores of students on thorax-lungs and cardiac examinations; however, practice on real patients increased performance scores of all students without any significant difference in two groups.