Final Discussion Board on Simulation Article and a Reflection

The interest population for the study comprises all graduate nurses working in a large health facility in the city. In the clinical environment, nurses ensure continuity of patient care and are involved in various emergency responses. Therefore, it is important that nurses have adequate primary emergency response skills to enhance their clinical competence in managing the needs of patients. This study will assess whether the use of high-fidelity simulators compared to low-fidelity simulators result in graduate nurses with better non-technical skills during emergencies. The researcher will choose a representative sample of graduate nurses from the population to participate in the study. Based on the study’s inclusion criteria, the sample will comprise only male or female graduate nurses working in various wards of the health facility. Notably, the study will exclude all registered nurses at the health facility. The overall sample will comprise 40 graduate nurses. However, power analysis with G*Power indicates that the study should use a sample of 128 graduate nurses.

The meeting was scheduled during a time I would be out of time so I could not be there in person, but I was able call in to listen and contribute to the meeting. Prior to the meeting my preceptor shared an article about a similar simulation. Kilgore, Goodwin, and Harding (2013) discussed the primary focus of the simulation they conducted was to provide constructive feedback to the students to improve their skills in communication, delegation, conflict resolution, priority setting, clinical reasoning, and psychomotor skills. The meeting consisted of several faculty that had initiated and planned the upcoming simulation, and many of the same concepts outlined in the article would be addressed in the scenarios developed. The bulk of the meeting consisted of reviewing the potential patients for the simulation, which included names, diagnosis, complaints, and expected outcomes for the scenarios. Some changes had to be made for one of the previously

Simulation labs and clinical placements are effective for practicing skills and building hands-on dexterity, habits, rhythms, and confidence. Not every facet of nursing education prepares student nurses with this kind of learning; originally an, most commonly clinical hours spent in simulation labs were integrated strictly into BSN programs, eliciting the statement made by Taylor (2008) that ADN programs have had to expand their curricula and offer students more content (p.613). According to Go’s (2012) dissertation on High Fidelity Patient Simulation (HFPS), simulation labs are advantageous because they give student nurses a venue for instruction while working in a clinical setting (p. 34). HFPS promotes and validates the clinical judgment competency of nursing students; it offers opportunities for feedback, debriefing, and guided reflection; it increases the student's ability to synthesize knowledge and insight, forming the bridge between theory and practice (Go, 2012, p. 34). However, hours spent in standard clinical settings are often inadequate in preparing

The use of simulation allows students to experience hypothetical clinical scenarios without threat of harm to patients. One of the objectives of running the simulation is to allow to experience and learn from various scenarios that they will likely encounter on the nursing floor and provide an opportunity to apply theory into practice. Prior to this simulation, we were introduced to several literature covering concepts on nursing responsibilities when floating, impaired nursing, diversion of medication, reasonable suspicion, and the AACN standards for establishing and sustaining healthy work environments. Such concepts help the nurse to practice her profession safely and transform into a leader that can initiate and influence change towards the success of an organization.

Since nursing is an ever-evolving profession, the faculty's RAM model can be integrated into the SIM lab to help transition nursing faculty to ensure safe and effective tracheostomy care to patients. Further, rubrics can be used as a tool in SIM lab to help validate progression in learning from simple to more complex care concepts (Moughrabi & Wallace, 2015). When the faculty understands the concept of theory and applies it to practice, their training can bring their newly acquired skills into clinical practice. Therefore, Roy's model would work for my DNP project because the staff transitions can be made more effective through the use of simulations so that faculty can be comfortable to respond to any given emergency situation by adapting to any

The simulation environment offers a safe place for students to practice critical scenarios and gain confidence in proscribed settings (Decker, Sportsman, Puetz, & Billings, 2008). Simulation helps faculty to facilitate learning which meets one of the NLN’s core competencies. Simulation also enhances communication through emerging leadership and delegation skills, and builds teamwork through goal and priority setting (Dillon, Noble, & Kaplan, 2009). Therefore, according to Lasater (2007) simulation is highly effective as an adjunct teaching strategy in clinical practice.

the potential ethical consequences and recommendations of including currently popular virtual/computer-based simulation as a medical educational tool for formal nurse- and physician- education programs.

For years nurses have gained experience in the medical field through clinical rounds at hospitals and doctors offices. Learning has always taken place first through textbooks and then through personal experience during required clinical time. These methods have proven effective but include limitations to the amount of exposure a student can gain before entering the workforce. A new way of learning is on the rise with the use of High Fidelity Simulations (HFS) or the Sim Man. HFS is a computerized life size manikin that simulates real human responses to treatment. This new technology allows students to practice rare procedures or treat common diagnoses.

Since the capstone project started early on beginning of the Doctor of Nursing Practice (DNP) program, I was able to discuss and work personally with Dr. Spicer as my practice mentor in selecting the appropriate topic for my project. Dr. Spicer was very involved in choosing my second option for new capstone project # 1 related to simulation lab and faculty teaching and learning. The patient simulation laboratory (SIM lab) uses state-of-the-art equipment that provides students and faculty with the opportunity to tackle real-life scenarios in a safe and supported environment. Further, I learned that active learning involves the faculty through participation and investment in exploring content knowledge in all phases of the learning process. It requires educational activities that provide faculty with the opportunity to engage actively in courses and respond to the learning situation.

My answers were not decisive which reflect my weak critical thinking skill. For example, when it comes to medication administration, in instances where things are not clear, it should always be referred to the doctor which in this case I belatedly remembered. Nurses should also make sure that they knew how to use all the equipment that is used in the nursing care. In a medical emergency situation, every second counts. In the simulation, epinephrine administration was delayed since the nurse did not know how to use the automatic injection. Over-all the simulation had a significant impact to my learning process.

Smith, L. G., & Gallo, K. (2015). Building a Culture of Patient Safety Through Simulation: An Interprofessional Learning Model. New York: Springer Publishing

The intent of clinical simulations is to provide a safe environment for students to practice and implement skills. This is a way in which to help prepare the student for the hospital setting. Enhanced confidence, clinical judgment, knowledge, and competence are factors that come from these situations. I gained further knowledge, but I did not experience the other skills during simulation. During the postpartum-hemorrhage and birthing simulation, I purposefully picked the scenarios that I felt most comfortable with. That entailed being the spouse of the woman in labor, the nursing assistant, and the patient’s family member. When embodying those roles, I felt at ease, because I was not the fixation; I was not the one in charge of the situation. During the preeclampsia simulation, I was “dubbed” the staff nurse. I was definitely out of my comfort zone. I was in the second group, and this allowed me to observe the first group. I learned and made alterations from the first group’s performance. Observing the first group helped, but my performance was poor. I made several mistakes and was embarrassed by the end result. I did not do well with the assessments, answering the patient’s questions appropriately, and when calling the doctor, I was not fully prepared. Despite all the mistakes and feelings of embarrassment, I learned. I am very thankful for the awareness of what things went wrong. With further practice and

Simulation has been recognized as one of the standard teaching strategies in nursing education and it also enables learning and evaluation of patient care (NLN, 2015). Simulation not only promotes active learning but also

Hospitals are working towards a more team-based training. The last couple years most of my training has been in a simulation lab. I feel it improves communication, teamwork, reinforces skills and new practices. Hands-on simulation experience allows healthcare workers to get messy, make mistakes and sharpen problem-solving skills — with no risk to patients. As nurses, we collaborate with each other on a daily basis but we are trained and tested individually on our skills, theory, and practical situations. As healthcare evolves, stimulation labs should be part of all healthcare works training and testing, that way everyone is better prepared to handle real time events.

There have been multiple studies on the importance of simulation use in nursing education, both in school and as new graduates in the work force. Simulation occurs throughout nursing specialties and comes in various formats, with varying models that educators have to choose from. The fidelity of the simulations (high, medium, low) and the use of standardized patients will be consider in the following review.