The use of a simulation ward activity to enhance students’ intrinsic motivation – Veronica SF Lam and Quality & Safety Subcommittee
Motivation cannot be taught as it contains both intrinsic and extrinsic factors. Extrinsic factors, such as parents’ expectation and study grade and scholarship, easily motivate a student to study hard, but they do not work over the long term. Intrinsic factors include a sense of the study being relevant to life and the world and a sense of self-accomplishment in mastering the task or helping others. Intrinsic motivation is an internal locus of control that can be long-lasting and self-sustaining. Nursing educators keep emphasising nourishing students to be competent nurses as healthcare arena is complex and practices are always evolving. The precondition for the nursing students’ competence is therefore facilitating their intrinsic motivation, not only for the success of their study, but also for facing challenges in future.
One of the aims of designing the ‘Simulation Ward’ project is to facilitate students’ intrinsic motivation. In the design, we tried to make sense of their knowledge of practice and also support students to achieve a sense of accomplishment in mastering nursing care. We targeted the Year 4 students because they had already received certain levels of nursing knowledge, and their timetable was not as busy as the Year 5 students comparatively. The Quality and Safety Subcommittee team members wrote more than 30 scenarios, including scenarios related to Accident and Emergency Department, medical and surgical ward and intensive care unit for the high-fidelity simulators and standardized patient. Three students supervised by a teacher were required to look after four patients, including two high-fidelity simulators, one mid-fidelity simulator and one standardized patient in various settings and provided nursing care to them within an hour followed by a comprehensive debriefing session. The rationales for designing this project were to encourage students to practice what they learnt, to support students’ onsite practice in order to maximise their sense of accomplishment in caring and communicating with patients.
From the project evaluation, some students expressed that the project enhanced their confidence in caring the real patients, practised what they thought was correct without doing any harm to real patients, and also enhanced their communication skills and teamwork. Additionally, students also expressed that although the teacher did not provide guidance intensively, their presence enhanced students’ confidence to continue the nursing care and minimize their fear of failure and uncertainty when performing nursing care. Lastly, students also stated they would like the School of Nursing to conduct similar simulation activities again.
These activities not only facilitate students’ intrinsic motivation, but also provide a mutual learning opportunity for teachers. It further raises our teachers’ enthusiasm and deepens their experience in simulation-based education. For instance, they are keen to provide an authentic learning environment for students by creating realistic moulage for simulators and standardized patients. Teachers also gain experiences from conducting more than one scenario in one go and conducting the debriefing session more systematically.
To summarize, William Bulter Yeats stated “Education is not the filling of a pail, but the lighting of a fire.” If we want to be successful in motivating our students in university learning, besides external motivation factors, we should light up their internal motivation elements. This project gave us an opportunity to enable students to master the nursing care in various simulation settings by using knowledge in their pail, and I hope the students’ desire to provide excellent nursing care to patients can be lightened up. Last but not least, I would like to acknowledge the support by the Teaching Development Grant in 2019.
Quality and Safety Subcommittee aims to facilitate nursing students to provide quality and safety nursing care to patients during clinical practice. The team supports and facilitates teachers in School of Nursing to integrate simulation-based education to their teaching, e.g. the use of simulation activity and virtual reality.
