Background: Effective discharge teaching (DT) in pediatric emergency departments (EDs) supports safe continuity of care at home. Inadequate DT contributes to adverse home events and hospital readmissions. However, pre-licensure nurses often lack structured DT training. Hands-on, controlled simulation (SIM) activities can help promote knowledge and skills to close practice gaps.
Purpose/Specific Aims: This quality improvement (QI) project implemented an explicit DT curriculum to improve student DT competencies. Specific aims were to: (a) design evidence-based DT-specific curricular changes to existing high-fidelity SIM protocols for a pediatric ED asthma scenario; (b) develop an in vivo faculty-rated observation measure assessing SIM participants' DT practice competencies; and (c) measure competency improvement.
Methods: Junior Bachelor of Science in Nursing (BSN) students in a pediatric nursing simulation course were divided into two groups: baseline (n = 19) performing SIM scenario without explicit DT training; intervention (n = 19) receiving explicit DT training for the SIM. Mann-Whitney U test compared overall competency; Fisher's exact tests examined individual competencies and performance distribution.
Results: The intervention group demonstrated significantly higher competency (M = 81.6%, Mdn = 100%) compared to baseline (M = 28.4%, Mdn = 33.3%), p < .001, r = 0.83. Two of six competencies reached significance after Bonferroni correction, with two additional competencies significant at the uncorrected threshold. Performance distribution shifted from 31.6% of baseline students scoring 0% to 63.2% of intervention students achieving 100% mastery.
Conclusion: A structured DT curriculum integrated with simulation substantially improved student competency, offering a sustainable model aligning education with practice requirements.
