Impact of a web based interactive simulation game (PULSE) on nursing students'experience and performance in life support training — A pilot study

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85 Citations (Scopus)


The delivery of effective life support measures is highly associated with the quality, design and implementation of the education that underpins it. Effectively responding to a critical event is a requirement for all nurses illustrating the need for effective educational approaches from pre-registration training through to enhancing and maintaining life support skills after qualification. This paper reports the findings of utilising a web-based multimedia simulation game PULSE (Platform for Undergraduate Life Support Education). The platform wasdeveloped to enhance the student experience of life support education, to motivate on-going learning and engagement and to improve psychomotor skills associated with the provision of Intermediate Life Support(ILS) training. Pre training participants played PULSE and during life support training data was collected from an intervention and a control group of final year undergraduate nursing students (N=34). Quantitative analysis of performance took place and qualitative data was generated from a questionnaire assessing thelearning experience. A statistically significant difference was found between the competence the groups displayed in the three skills sets of checking equipment, airway assessment and the safe/effective use of defibrillatorat ILS level, and PULSE was positively evaluated as an educational tool when used alongside traditional life support training.
Original languageEnglish
Pages (from-to)714-720
JournalNurse Education Today
Publication statusPublished (in print/issue) - 2012

Bibliographical note

Reference text: Allery, L.A., 2004. Educational games and structured experiences. Medical Teacher 26
(6), 504–505.
Beaubien, J.M., Baker, D.P., 2004. The use of simulation for training teamwork skills in
health care: how long can you go? Quality & Safety in Health Care Sppl 1 (15), 1–6.
Beggs, R., 2007. What women want: Investigation into games based learning and serious
gaming needs. Submitted in fulfillment of requirements for MSc in eLearning;
Interactive Teaching Technologies, Jordanstown: University of Ulster.
Beggs, R., O'Neill, P., Virapen, K., 2009. The perception of gaming in higher education:
gaming habits of University of Ulster staff. First International IEEE Conference in
Serious Games and Virtual Worlds, March 23–24, Coventry.
Blakely, G., Skirton, H., Cooper, S., Allum, P., Nelmes, P., 2009. Educational gaming in the
health sciences: systematic review. Journal of Advanced Nursing 65 (2), 259–269.
Bradley, E.H., Curry, L.A., Devers, K.J., 2007. Qualitative data analysis for health services
research. Developing Taxonomy, Themes, and Theory Health Services Research 42
(4), 1758–1772.
Brindley, P.G., Suen, G.I., Drummond, J., 2007. Part two: medical simulation. how to
build a successful and long lasting programme. Canadian Journal of Respiratory
Therapy 43 (5), 31–34.
Bruce, S.A., Scherer, Y.K., Curran, C.C., Urschel, D.M., Erdley, S., Ball, L.S., 2009. A collaborative
exercise between graduate and undergraduate nursing students using a
computer assisted simulator in a mock cardiac arrest. Nursing Education Perspective
30 (1), 22–27.
Chamberlain, D.A., Hazinski, M.F., 2003. Education in resuscitation. Resuscitation 59,
Chamberlain, D.A., Smith, A., Woollard, M., 2002. Trials of teaching methods in basic life
support: comparison of simulated CPR performance after first training and at
6 months, with a note on the value of re-training. Resuscitation 53 (2), 179–187.
Creutzfeldt, J., Hedman, L., Medin, C., Heinrichs, W.L., Felländer-Tsai, L., 2010. Exploring
virtual worlds for scenario-based repeated team training of cardiopulmonary resuscitation
in medical students. Journal of Medical Internet Research 12 (3), e38.
Davies, N., Gould, D., 2000. Updating cardiopulmonary resuscitation skills: a study to
examine the efficacy of self-instruction on nurses' competence. Journal of Clinical
Nursing 9, 400–410.
DeVita, M.A., Schaefer, J., Lutz, J., Wang, H., Dongilli, T., 2005. Importing medical emergency
team (MET) performance using a novel curriculum and a computerised
human patient simulator. Quality & Safety in Health Care 14, 326–331.
Gordon, C.J., Buckley, T., 2009. The effect of high-fidelity simulation training on medical–
surgical graduate nurses' perceived ability to respond to patient clinical emergencies.
Journal of Continuing Education in Nursing 40 (11), 491–498.
Handley, A., Handley, S., 2003. Improving CPR performance using an audible feedback
system suitable for incorporation into an automated external defibrillator. Resuscitation
57 (1), 57–62.
Hillman, K., Chen, J., Cretikos, M., Belliomo, R., Brown, D., Doig, G., 2005. Introduction of
the medical emergency team (MET) system: a cluster-randomised controlled trial.
Lancet 365 (9477), 2091–2097.
Horan, K., 2009. Using the human patient simulator to foster critical thinking in critical
situations. Nursing Education Perspectives 30 (1), 28–30.
Issenberg, S.S., Gordon, M.S., Gordon, D.L., Safford, R.E., Hart, I.R., 2001. Simulation and
new learning technologies. Medical Teaching 23 (1), 16–23.
Issenberg, S.B., McGaghie, W.C., Petrusa, E.R., Lee, G.D., Scalese, R.J., 2005. Features and
uses of high-fidelity medical simulations that lead to effective learning: a BEME
systematic review. Medical Teaching 27, 10–28.
Jones, I., Handley, A.J., Whitfield, R., Newcombe, R., Chamberlain, D., 2007. A preliminary
feasibility study of a short DVD-based distance-learning package for basic
life support. Resuscitation 75 (2), 350–356.
Kiili, K., Lainema, T., 2008. Foundation for measuring engagement in educational
games. Journal of Interactive Learning Research 19 (3), 469–488.
Madden, C., 2006. Undergraduate nursing students' acquisition and retention of CPR
knowledge and skills. Nurse Education Today 26, 218–227.
Natale, M.J., 2002. The effect of a male-oriented computer gaming culture on careers in
the computer industry. Computers and Society 32 (2), 24–31.
Niemi-Murola, L., Mäkinen, M., Castren, M., 2007. Medical and nursing students' attitudes
toward cardiopulmonary resuscitation and current practice guidelines. Resuscitation
72, 257–263.
Nyman, J., Sihvonen, M., 2000. Cardiopulmonary resuscitation skills in nurses and nursing
students. Resuscitation 47, 179–184.
Perkins, G.D., Boyle,W., Bridgestock, H., Davies, S., Oliver, Z., Bradburn, S., Green, C., Davies,
R.P., Cooke,M.W., 2008. Quality of CPR during advanced resuscitation training. Resuscitation
77, 69–74.
Peters, M., 2000. Does constructivist epistemology have a place in nurse education?
Journal of Nursing Education 39 (4), 166–172.
Perkins, G.D., 2007. Simulation in resuscitation training. Resuscitation 73, 202–211.
Prensky, M., 2001. Digital natives, digital immigrants. On the Horizon 9 (5), 1–6.
Ravenscroft, A., Matheson, M.P., 2002. Developing and evaluating dialogue games for
collaborative e-learning. Journal of Computer Assisted Learning 18 (1), 93–101.
Ricketts, B., 2010. The role of simulation for learning within pre-registration nursing
education: A literature review. Nurse Education Today 31 (7), 650–654.
Ryan, G.W., Bernard, H.R., 2003. Techniques to identify themes. Field Methods 15 (1),
Sealover, P., Henderson, D., 2005. Scoring rewards in nursing education with games.
Nurse Educator 30 (6), 247–250.
Skrifvars, M.B., Castren, M., Kurola, J., Rosenberg, P.H., 2002. In-hospital cardiopulmonary
resuscitation: organization, management and training in hospitals of different
levels of care. Acta Anaesthesiologica Scandinavica 46, 458–463.
Szögedi, I., Zrínyi, M., Betlehem, J., Újváriné, A.D., Tóth, H., 2010. Training nurses for
CPR: support for the problem-based approach. European Journal of Cardiovascular
Nursing 9, 50–56.
Valenzuela, T.D., Roe, D.J., Nichol, G., Clark, L.L., Spaite, D.W., Hardman, R.G., 2000. Outcomes
of rapid defibrillation by security officers after cardiac arrest in casinos. The
New England Journal of Medicine 343, 1206–1209.
Wallin, C.J., Meurling, L., Hedman, L., Hedegård, J., Felländer-Tsai, L., 2007. Target-focused
medical emergency team training using a human patient simulator: effects
on behaviour and attitude. Medical Education 41 (2), 173–180.
Wayne, D.B., Butter, J., Siddall, V.J., Fudala, M.J., Linquist, L.A., Feinglass, J., Wade, L.D.,
McGaghie, W.C., 2005. Simulation-based training of internal medicine residents
in advanced cardiac life support protocols: a randomized trial. Teaching and Learning
in Medicine 17 (3), 202–208.
Wildman, S., Reeves, M., 1996. The utilization and evaluation of a simulation game in
pre-registration nurse education. Nurse Education Today 16 (5), 334–339


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