가상시뮬레이션 게임 기반 실습이 간호대학생의 지식, 자기효능감, 임상수행능력에 미치는 효과

Abstract

본 연구는 COVID-19 환자 간호를 위한 가상시뮬레이션 게임 기반 실습이 간호대학생의 지식, 자기효능감, 임상수행능력에 미치는 효과를 검증함으로써 간호대학생을 위한 가상시뮬레이션 게임 기반 실습 프로그램 개발을 위한 기초자료를 제공하고자 시도되었다. 본 연구는 비 동등성 전 후 설계를 적용한 유사실험연구로, 2021년 10월 11일부터 10월 22일까지 간호대학생 3학년과 4학년을 나누어 등록되는 순서대로 실험군과 대조군에 배정하였으며, 최종 분석 대상은 실험군 30명, 대조군 30명으로 총 60명이었다. 실험군은 사전학습(약 15분) 후, 익일 COVID-19 환자 간호 가상시뮬레이션 게임 기반 실습과 디브리핑(약 45분)을 진행하였고, 대조군은 사전학습(약 10분) 후, 익일 COVID-19 환자 간호 실습 동영상 강의(약 35분)를 청취하였다. 연구 도구는 COVID-19 지식, 자기효능감, 임상수행능력으로 설문 수집을 하였다. 수집된 자료는 SPSS/WIN 21.0 프로그램으로 실수와 백분율 및 평균과 표준편차로 일반적 특성을 분석하였고, 동질성 검정은 x2 test, Fisher’s exact test, independent t-test로 분석하였다. 실험군과 대조군의 종속변수 동질성 검증은 Independent t-test로 분석하였다. 실험군과 대조군, 두 집단 간의 실험 전 후 점수 차이 비교는 Independent t-test로 분석하였다. 연구결과는 다음과 같다. 1) 중재 전 후 COVID-19 지식 점수 차이는 실험군이 4.07±3.77점, 대조군이 3.40±2.88점으로, 두 집단 간의 차이는 통계적으로 유의하지 않았다. 따라서 제 1가설 ‘COVID-19 환자 간호 가상시뮬레이션 게임 기반 실습을 적용한 실험군은 실습 동영상 강의를 받은 대조군보다 중재 전 후 지식 점수의 차이가 클 것이다.’는 기각되었다. 2) 중재 전 후 자기효능감 점수 차이는 실험군이 10.16±11.35점, 대조군이 3.13±11.47점으로, 두 집단 간의 차이는 통계적으로 유의하였다(t=2.386, p=.020). 따라서 제 2가설 ‘COVID-19 환자 간호 가상시뮬레이션 게임 기반 실습을 적용한 실험군은 실습 동영상 강의를 받은 대조군보다 중재 전 후 자기효능감 점수의 차이가 클 것이다.’는 지지되었다. 3) 중재 전 후 임상수행능력 점수 차이는 실험군이 17.23±12.60점, 대조군이 4.67±13.93점으로, 두 집단 간의 차이는 통계적으로 유의하였다(t=3.735, p<.001). 따라서 제 3가설은 ‘COVID-19 환자 간호 가상시뮬레이션 게임 기반 실습을 적용한 실험군은 실습 동영상 강의를 받은 대조군보다 중재 전 후 임상수행능력 점수의 차이가 클 것이다.’는 지지되었다. 본 연구는 가상시뮬레이션에 게임 요소가 삽입된 가상시뮬레이션 게임 기반 실습의 효과를 확인하였다. 연구 결과, 실험군의 자기효능감과 임상수행능력 향상에 긍정적인 효과가 확인되었으며, 향후 간호대학의 실습 교육의 대체 방안 및 실습 환경 개선의 기초 자료로 활용될 수 있을 것이다. 이에 따라, 근거 기반의 다양한 임상 상황이 반영된 가상시뮬레이션 게임 기반 실습 프로그램의 지속적인 개발이 필요할 것으로 보이며, 간호대학에서는 간호대학생의 자기효능감, 임상수행능력을 배양할 수 있도록 가상시뮬레이션을 활용한 게임 기반 실습을 간호교육과정내에 적극적으로 운영 및 활용을 제언한다. ;The purpose of this study was to test the effectiveness of virtual simulation game-based practice programs for COVID-19 patent care of nursing students. A non-equivalent pre-posttest study design was adopted. From October 11 to October 22, 2021, 3rd and 4th year nursing students were recruited and sequentially assigned to the experimental group and the control group. Total number of sample was 60, 30 in experimental group or 30 in the control group. The experimental group underwent COVID-19 patient nursing virtual simulation game-based practice for 2 times, and the control group listened to the video lecture on COVID-19 patient care practice for 2 times. The COVID-19 knowledge, self-efficacy, and clinical performance were assessed. The collected data were analyzed using the SPSS/WIN 21.0 program using percentages, mean and standard deviation, and homogeneity tests were analyzed by X² test, Fisher's effect test, and independent t-test. The homogeneity verification of the dependent variables of the experimental group and the control group was analyzed by the Independent t-test. The comparison of score differences before and after the experiment between the experimental group and the control group was analyzed by the Independent t-test. The research results are as follows. 1. The differences in the COVID-19 knowledge scores before and after the intervention were 4.07±3.77 points in the experimental group and 3.40±2.88 points in the control group, and the difference between the two groups was not statistically significant. Therefore, the first hypothesis which is 'The experimental group applying COVID-19 patient nursing virtual simulation game-based practicum will have a greater difference in knowledge score before and after intervention than the control group who received the practice video lecture' was rejected. 2. The differences in self-efficacy scores before and after the intervention were 10.16±11.35 points in the experimental group and 3.13±11.47 points in the control group, and the difference between the two groups were statistically significant (t=2.386, p=.020) Therefore, the second hypothesis which is 'The experimental group applying COVID-19 patient nursing virtual simulation game-based practicum will have a greater difference in self-efficacy score before and after intervention than the control group who received the practice video lecture' was supported. 3. The differences in clinical performance scores before and after the intervention were 17.23±12.60 points in the experimental group and 4.67±13.93 points in the control group, and the difference between the two groups showed statistically significant differences (t=3.735, p<.001). Therefore, the third hypothesis which is 'The experimental group applying COVID-19 patient nursing virtual simulation game-based practicum will have a greater difference in clinical performance scores before and after intervention than the control group who received the practice video lecture.' was supported. This study identified the effects of virtual simulation game-based practicum for COVID-19 patient care on the knowledge, self-efficacy and clinical performance of nursing college students. As a result of the study, it was confirmed that COVID-19 patient care virtual simulation game-based practicum had no significant effect on nursing college students' knowledge improvement compared to video lectures, but both the experimental group and the control group improved their knowledge scores. Self-efficacy and clinical performance were confirmed to be effective as COVID-19 patient nursing virtual simulation game-based practicum was statistically significantly improved compared to video lectures. Overall, this study presented a virtual simulation game-based practice in which game elements are inserted into virtual simulation. This has been confirmed to have a positive effect on improving the self-efficacy and clinical performance of nursing students and can be used as a basic data for improving the practice environment and alternative measures for nursing college training in the future. Accordingly, it is necessary to further develop a virtual simulation game-based practice program that reflects various evidence-based clinical situations utilization of game-based practice using virtual simulations would benefit nursing students' knowledge, self-efficacy, and clinical performance.