title: The effects of using high-fidelity simulators and standardized patients on the thorax, lung, and cardiac examination skills of undergraduate nursing students.
abstract: BACKGROUND
  Existing research literature indicates that the use of various simulation techniques in the training of physical examination skills develops students' cognitive and psychomotor abilities in a realistic learning environment while improving patient safety.
  
  
  OBJECTIVE
  The study aimed to compare the effects of the use of a high-fidelity simulator and standardized patients on the knowledge and skills of students conducting thorax-lungs and cardiac examinations, and to explore the students' views and learning experiences.
  
  
  METHODS
  A mixed-method explanatory sequential design.
  
  
  METHODS
  The study was conducted in the Simulation Laboratory of a Nursing School, the Training Center at the Faculty of Medicine, and in the inpatient clinics of the Education and Research Hospital.
  
  
  METHODS
  Fifty-two fourth-year nursing students.
  
  
  METHODS
  Students were randomly assigned to Group I and Group II. The students in Group 1 attended the thorax-lungs and cardiac examination training using a high-fidelity simulator, while the students in Group 2 using standardized patients. After the training sessions, all students practiced their skills on real patients in the clinical setting under the supervision of the investigator.
  
  
  RESULTS
  Knowledge and performance scores of all students increased following the simulation activities; however, the students that worked with standardized patients achieved significantly higher knowledge scores than those that worked with the high-fidelity simulator; however, there was no significant difference in performance scores between the groups. The mean performance scores of students on real patients were significantly higher compared to the post-simulation assessment scores (p<0.001).
  
  
  CONCLUSIONS
  Results of this study revealed that use of standardized patients was more effective than the use of a high-fidelity simulator in increasing the knowledge scores of students on thorax-lungs and cardiac examinations; however, practice on real patients increased performance scores of all students without any significant difference in two groups.
authors.affiliation: Yildirim Beyazit University, Faculty of Health Sciences, Department of Nursing, 06800 Ankara, Turkey. Electronic address: hilaldemircan@gmail.com.
authors.forename: Hilal
authors.initials: H
authors.lastname: Tuzer
authors.affiliation: Hacettepe University, Department of Fundamentals of Nursing, 06100 Ankara, Turkey. Electronic address: leylad@hacettepe.edu.tr.
authors.forename: Leyla
authors.initials: L
authors.lastname: Dinc
authors.affiliation: Hacettepe University, Faculty of Medicine, Department of Medical Education and Informatics, 06100 Ankara, Turkey. Electronic address: melcin@hacettepe.edu.tr.
authors.forename: Melih
authors.initials: M
authors.lastname: Elcin
mesh_terms: D000328:Adult; D002983:Clinical Competence; D004506:Education, Nursing / Q000379:methods*; D004521:Educational Measurement; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006321:Heart; D000070856:High Fidelity Simulation Training / Q000379:methods*; D006801:Humans; D008168:Lung; D008297:Male; D016544:Patient Simulation; D010808:Physical Examination / Q000379:methods*; D018794:Problem-Based Learning / Q000379:methods*; D013909:Thorax; D055815:Young Adult
keywords: High-fidelity simulator; Nursing education; Physical assessment; Simulation; Standardized patient