Impact of Peer Observation on Learning Outcomes in Simulated Clinical Learning Experiences

Comparison of traditional teaching methods with simulation in nursing education research fails to inform educators on how to best design, structure and implement simulation experiences to improve student learning outcomes. The prevalence of this technology in nursing education makes it essential to understand how to use simulation efficiently and effectively. The purpose of this study was to determine if a simulation instructional design that uses peer observation impacts student learning outcomes. Nursing students enrolled in an adult medical-surgical course were randomly assigned to either an experimental condition (peer observation) or a control condition (no peer observation). Raters evaluated small groups of approximately three students participating in a simulated clinical learning experience using the Creighton Simulation Evaluation Instrument™. The findings from this study indicate that peer observation had a positive impact on student learning outcomes in simulated clinical learning experiences. Specifically, overall learning outcomes measured by the Total Score for the C-SEI™ were statistically higher for the experimental condition than for the control condition following the initial instance of peer observation. When the findings for this study were examined for the control condition against the combined experimental conditions, it was noted that the learning outcomes for the Total Score for the C-SEI™ as well as two of the categories of learning (i.e. Assessment and Technical Skills) were significantly higher for the peer observation experimental conditions than for the no peer observation control condition. Also, there was a sequential additive, or cumulative, effect on learning outcomes for successive groups for Technical Skills. There are indications, however, that the sequential additive, or cumulative, effect on learning outcomes may be more pervasive because the mean rank and median scores for the Total Score for the C-SEI™ increased for each successive peer observation experimental condition. Though the results were not statistically significant, each successive peer observation experimental condition scored better on the Total Score for the C-SEI™ resulting in a large effect size, which suggests that some measure of a sequential additive, or cumulative, effect may have occurred overall across all categories. Well-designed simulation experiences have the potential to impact nursing practice and patient outcomes.