title: Multisite Single-Blinded Randomized Control Study of Transfer and Retention of Knowledge and Skill Between Nurses Using Simulation and Online Self-Study Module.
abstract: BACKGROUND
  Obstetric (OB) nurses must be proficient in performing a basic neurologic examination to assess and detect changes in a patients' neurologic status. This study aimed to compare knowledge and skill acquisition for a basic neurologic examination between OB nurses who participated in simulation and those who participated in an online self-study module. Short- and long-term knowledge retention and skill transfer between groups were evaluated.
  
  
  METHODS
  Nurses were randomized to either simulation or online self-study module and assessed by direct observation and completion of a standardized instrument by the observer at 3 time points: baseline (time 1), within 7 days of baseline in the clinical setting (time 2), and at 2 months (time 3) using a validated12-item Neurologic Knowledge Assessment and a 14-item performance skill checklist.
  
  
  RESULTS
  Among OB nurses, those in the simulation group demonstrated higher levels in both short-term (time 2) [mean (SD), 67.6 (20.2) vs. 29.6 (19.0); P < 0.001] and long-term (time 3) [mean (SD), 46.1 (17.6) vs. 27.5 (15.9); P < 0.001] skill performance compared with nurses in the online self-study module. Nurses in the simulation and online self-study module groups had similar mean levels on Neurologic Knowledge Assessment scores at time 2 (P = 0.86) and time 3 (P = 0.59), but these mean scores were not significant.
  
  
  CONCLUSIONS
  The greater transfer of skills by nurses who received simulation education is an important finding because few studies have addressed this level of translation with practicing nurses. There was a lack of differences in short- and long-term knowledge acquisition between nurses in the simulation and online self-study module groups. More research is needed to determine the timing of simulation-based education repetition over time to aid in knowledge and skills retention.
authors.affiliation: From the Adjunct Faculty, Case Western Reserve University, Frances Payne Bolton School of Nursing (T.R.-H.), Multidisciplinary Simulation Center (L.S.), Cleveland Clinic (N.C.K., D.L.G., M.F., C.M.H.), Cleveland, OH.
authors.forename: Tonya
authors.initials: T
authors.lastname: Rutherford-Hemming
authors.forename: Nichole C
authors.initials: NC
authors.lastname: Kelsey
authors.forename: Deanna L
authors.initials: DL
authors.lastname: Grenig
authors.forename: Michelle
authors.initials: M
authors.lastname: Feliciano
authors.forename: Leslie
authors.initials: L
authors.lastname: Simko
authors.forename: Christina M
authors.initials: CM
authors.lastname: Henrich
mesh_terms: D000328:Adult; D057189:Checklist; D002983:Clinical Competence; D006801:Humans; D008875:Middle Aged; D009773:Obstetric Nursing / Q000193:education*; D012153:Retention, Psychology; D000066908:Simulation Training; D016037:Single-Blind Method