2025 Theses Doctoral

Effect of High-Fidelity Manikin Versus Standardized Patient on Cultural Humility and Cultural Self-Efficacy Among Second- and Fourth-Year Baccalaureate Nursing Students

Chahal, Aisha

Due to increasing diversity and shifting demographics nationally, many professional organizations have called upon nursing education to prepare future generations of nurses to provide culturally appropriate care to diverse patient populations. It is crucial to use evidence-based pedagogical strategies to teach nursing students to tailor care to meet the diverse needs of patients.

Simulation has been widely used in nursing education as an effective pedagogical strategy. A study was undertaken to explore the differences between using a high-fidelity manikin versus a standardized patient in simulation on cultural humility and cultural self-efficacy in second- and fourth-year baccalaureate nursing students. Second-year (n = 39) and fourth-year (n = 58) students were equally distributed into two groups. The intervention group participated in a simulation using a standardized patient and the comparison group used a high-fidelity manikin. Mean scores on the Cultural Humility Scale (Foronda, 2020) were used to measure cultural humility, and mean scores on the Cultural Self-Efficacy Scale (Bernal & Froman, 1987) were used to measure cultural self-efficacy.

A researcher-developed 5-item demographic survey was used to collect demographic information from participants. The simulation sessions were conducted over 7 weeks from the end of February to mid-April in the spring semester of 2024. Students participated in the simulation session as a clinical group of 4-9 students on their assigned clinical day. Participants completed a pretest before the simulation, posttest 1 immediately after the simulation, and posttest 2 at the end of the semester in May. The pretest and posttests consisted of the Cultural Humility Scale, the Cultural Self-Efficacy Scale, and the demographics survey.

Data analysis revealed that although there was a statistically significant improvement in cultural humility and cultural self-efficacy immediately and over time after the simulation for both groups, there was no statistically significant difference between high-fidelity manikin simulation or SP simulation on either cultural humility, F(1,95) = 1.26, p = .27, ηp2 = .002, or cultural self-efficacy, F(1,95) = .11, p = .74, ηp2 = .001. Also, there were no differences in cultural humility or cultural self-efficacy based on the year of enrollment before or after the simulation. As no difference was found between using a manikin and using a standardized patient, nursing programs have a choice of using either approach based on the feasibility, cost, and available resources. Future research should include replications of this study as well as comparisons of other teaching modalities in simulation to increase cultural humility and cultural self-efficacy.

Keywords: Cultural humility, cultural self-efficacy, nursing education, nursing students, clinical simulation, cultural humility scale, and cultural self-efficacy scale.