Comparaison de l'impact de deux méthodes d'apprentissage sur la sécurité d'administration des médicaments : stages cliniques versus simulation

Introduction
Drug administration is the act nurses most frequently do. However, 50% of errors occur during administration.
The damage these errors causes to patients, results in excess mortality rates and health care costs, hence leading to a major public health problem. Therefore, it is advisable to consider the training of future nurses on the practice of this delicate act.
The objective of this study is to evaluate the impact of teaching by simulation combined with the internship on the safety administration of intravenous drugs by nursing students, compared to just the internship alone.
Material and method
A selection of 99 students from the bachelors’ block two of the Namur-Liege-Luxembourg Higher Institute of Nursing met the inclusion criteria under consideration. They were divided into two groups, one experimental group which participated in a simulation session and a control group, the latter did not participate in the simulation session. At the start of the research, all students were assessed by an objective structured clinical examination (OSCE) with the theme of modifying infusion and syringe flow rates. They were also asked to complete a questionnaire concerning their knowledge and self-efficacy feeling related to drug administration. The experimental group then participated in the simulation sessions. The experimental group and the control group also went into four weeks of training in medical or surgical services before participating in the second stage of the study. The latter consisted of the same tests and questionnaires as stage one of the study. The evolution of the results of the two groups was first observed separately before being compared.
Results
The majority of the results shows that the simulation improves, in a way significantly more important than the clinical course, the acquisition of skills and knowledge, as well as the feeling of self-efficacy in drug administration. On the other hand, the assessment of the level of stress linked to drug administration and the professional attitude evaluated during the OSCE were not significantly more improved by the simulation than by the training alone (stress: p-value = 0.8269, professional attitude = 0.9857).
Conclusions
For the students in the experimental group, the simulation showed a positive impact on the skills, knowledge and feeling of self-efficacy associated with drug administration. Changes and continuation of the study would make it possible to go further in the generalization of results, in the evaluation of learning outcomes, and to attest to their sustainability.