Nursing students' nonverbal reactions to malodor in wound care simulation

Abstract

Background: wound care is an essential competency which nursing students are expected to acquire. To foster students' competency, nurse educators use high fidelity simulation to expose nursing students to various wound characteristics. Problem: little is known about how nursing students react to simulated wound characteristics. Malodor is a wound characteristic which can be particularly difficult for nursing students to manage. To facilitate students' developing skills in managing malodor, nurse educators have designed high fidelity simulations including olfactory realism. However, there is a gap in nursing knowledge about nursing students' reactions to malodor in simulation. Aim of the study: the aim of this project was to describe how nursing students reacted to malodor in video recordings of wound care simulation. Methodology: the project was an observational study using qualitative descriptive methodology to describe nursing students' nonverbal reactions to malodor in simulation. A coding scheme using the Facial Action Coding System (FACS) was drawn from the literature and revised with nonverbal behavior codes which emerged during data analysis. Based on feedback from two expert observers/raters, three coding schemes were developed and tested using NVivo software. Findings: content analysis of participants' nonverbal reactions to malodor revealed three themes of reactions: noticing, confirming, and focusing. Additionally, nonverbal reactions embedded in the three themes seemed to cluster into two patterns of behaviors: physical reactions and psychosocial reactions. Two of the coding schemes exhibited inter-rater agreement values of 82%.