Lab Simulation: Safe, High-Quality Patient Care

My chosen practicum will be teaching in the skills/simulation lab at NCMC. This paper will outline how the experience will enhance my knowledge and develop skills necessary to fulfill the role of nurse educator. The goals, objectives, and timeline will be discussed in this paper. The project that will be developed during the practicum experience will be a debriefing philosophy and evaluation tool to assess student learning with emphasis on critical thinking skills.

A human patient simulator is a life-like, anatomically correct, computer driven mannequin with physiologic responses that mimic real patients. Education in simulated learning environments (SLEs) has grown rapidly across health care professions. A randomized controlled trial has investigated whether SLEs can, in part, substitute for traditional clinical education finally provided evidence that clinical education in an SLE can in part (25%) replace clinical time with real patients without compromising students' attainment of the professional competencies required to practice (Watson et al., 2012). An increase in recognition of medical errors has dictated the need to improve education by allowing students and clinicians to learn in an environment

However, researchers failed to indicate any possible bias that might have affected the credibility of their findings. Sample selection includes students from the same class taking the same course at the time of the study, but researchers did not consider individual experiences of participants. There is a possibility that student may have prior experience working in clinical settings in a position such as nurses’ aide before enrolling in nursing school. Such experience might have influenced the clinical judgment of the student, and the progress researchers identified in the reflective journal of such student may have been influenced by the prior experience and not necessary the structured simulation involved in the study. Despite this possibility, findings from the study still contribute evidence adequate for enhancement of nursing practice; Nurse educators will benefit from the result of this study because it will enable them to include simulation in nursing curriculum and help prelicensure nursing students develop clinical judgment before entering the

Simulation is rapidly becoming a significantly learning methodology in healthcare education. Primarily, the changes seen within the nurse educator's role as a result of simulation use is the unique characteristics of learning to create a bridging experience between the classroom and actual patient care and, more importantly, helps learners develop advanced clinical reasoning skills. Furthermore, learner active engagement is a critical requirement for effective learning during simulation and debriefing, which tasks educators to design simulation learning environments that foster learner active engagement (Fisher, 2016). An example of bridging the gap from classroom to clinical practice is using various low fidelity simulation practice and situations

Increased use of high-fidelity resources led to further incorporation and study of outcomes associated with its use. Educators have found that using simulation benefits students with superior learning opportunities through exposure to high-risk scenarios not always accomplished in live clinical settings, an environment to explore patient care errors without causing actual patient harm, and an opportunity for direct observation of student actions and reflection on thinking process (Adamson, 2015). As a proven

The use of simulation in nursing education is not a new teaching method. In fact, the Provincial Archives of Alberta has a photo in its records, circa 1920, of nursing students attending a lecture, seated around a hospital bed with a manikin tucked under a sheet (Provincial Archives of Alberta, PA3403, accessed Nov. 25, 2015). This may not resemble modern high-fidelity human-patient simulators, however, the strategy of nursing students learning and practicing skills on a manikin prior to executing those skills on a human patient, is a common and historical tradition in nursing education (Jeffries, 2007; Nehring & Lashley,

This course will meet weekly on Monday’s from 8-10:00 AM. Clinical time will be held on Wednesday or Thursday each week according to the clinical rotation the student is randomly placed into. Each week you will complete various combinations of online assignments, in and out of class interactive activities, readings, etc. Instructional approaches to be used may include lecture, discussion, demonstration, media resources, simulation, team-based learning, case studies, clinical assignments, and post clinical

Nursing simulation, a progressive method of education and utilized by nursing programs, improve patient outcomes through giving students opportunities to practice and learn new nursing skills in non-threatening environments. The use of simulation experiences origins stems from the military and airline industries. Nevertheless, since that time, many academic interest groups, including medical and nursing education have adopted this educational method. Furthermore, it is anticipated that simulation experiences will allow students the opportunities they need to practice skill sets that will lead to the improvement of the patient’s condition. Additionally, an evaluation of the nursing simulation also serves an important role in determining the effectiveness of the activity in meeting the objectives of various nursing curricula. Completing and recording the outcomes of a methodical evaluation, such as a rubric, is foundational to the enhancement of both the procedure and results (Robinson & Dearmon, 2013). This capstone project specifically focuses on the development, implementation, and evaluation of a rubric for nursing simulation scenarios conducted by baccalaureate level nursing students at Western Kentucky University.

The Institute of Medicine’s landmark report, Crossing the Quality Chasm, emphasized the need for new health professions educational models as “essential in preparing the healthcare workforce of the future to provide evidence based care, to work collaboratively on multidisciplinary teams, and to manage complex patient-clinician relationship” (Presti). Another report also examined the nursing workforce’s ability to meet the demands of the modern healthcare system (Presti). A conclusion of the study indicated “the ways in which nurses were educated during the 20th century are no longer adequate for dealing with the realities of healthcare in the 21st century” and “nursing curriculum needs to be reexamined, updated, and adaptive enough to change with patients’ changing needs…” (Presti). The new goal is to further engage students to be active learners and critical thinkers by means of the flipped classroom. This method offers a more self-determined learning experience that strengthens students’, especially nurses, practice-based learning and promotes learning through personal experience, with the “learner being central to the process” (Presti). Such experiences include the use of virtual simulation and volunteer patients, which provide students with the time and setting to practice interview techniques and apply learned concepts in a simulated setting (Presti). Also,

Simulation technology can be described as the reproduction of a real life clinical situation used enhancing nurse learning and help resolving patient safety issues. There are “several types of simulation that are used in healthcare education” (Nelson&Staggers, 2014, p 455). This includes interactive computer programs and human patient simulators. Each of these different simulators allow for nurses to practice critical thinking, clinical judgment, communication, teamwork skills, learn and or brush up on clinical nursing

Nursing schools are now using more and more simulation technology within their curriculum. As stated in The Journal of Nursing Education, “such laboratory makes it possible for students to practice in a safe environment, without risk to patients, and acquire a level of knowledge and practice that readies them for the actual clinical environment” (Bellack, 2004). By doing this, it not only decreases the number of practice hours that the students would need but it also assist in the supervision that is needed in a clinical health care setting. With these new simulated clinical settings, nursing students would not have to waste as much time as they have done in the past in regards to orienting to multiple different facilities/clinical sites that usually have lengthy orientations and different policy and procedures and electronic health records to learn. This would ultimately give the students more time to focus on learning nursing information. Likewise, game-based learning is becoming very popular lately. It offers all the benefits of a simulated environment but also has the ability for students to learn about more complex situations or scenarios that cannot always be established in a simulated environment. According to author Sadaf Murad “Gaming fosters critical thinking, decision-making skills in students and prepares them to become a better nurse in practical settings” (Murad,

Do students experience the simulated patient situation as relevant for their self-confidence and performance in clinical practice?

Simulation in nursing education provides various active, student-centered learning strategies which lead to a strong pedagogical approach that provides an increase in several student learning outcomes (Lubbers & Rossman, 2017). Simulation has been connected to multiple outcome variables including self-efficacy, critical thinking, clinical judgment, collaboration, communication, and self-confidence (Nehring & Lashley, 2010; Jeffries, 2005). It is difficult to determine which of these variables has a leading impact on the others. Is it that simulation leads to improved critical thinking, leading to increased self-confidence? Or that simulation leads to increased self-confidence, therefore allowing students to show increased critical thinking and clinical judgement? While a clear identification of which comes first, is not easily determined, the purpose of this article is to explore the relationship specifically between simulation

This evidence-based project focused on the creation of a rubric for simulation experiences in the baccalaureate program at WKU. First, to become familiar with the different uses of simulation and its evaluation within the nursing realm, completion of a comprehensive review of the literature occurred. Hence, the search included the use of Google Scholar, PubMed, and EBSCOhost databases to aid with the search of pertinent literature. Identifying keywords selected for the search were nursing simulation, nursing simulation evaluation, and nursing simulation rubrics. Published articles chosen for review fell between 2010 and 2015.

This evidence based project focused on the creation of a rubric for simulation experiences in the baccalaureate program at WKU. To become familiar with the different uses of simulation and its evaluation within the nursing realm, completion of a comprehensive review of the literature occurred. Hence, the search included the use of Google Scholar, PubMed, and EBSCOhost databases to aid with the search of pertinent literature. Identifying keywords selected for the search were nursing simulation, nursing simulation evaluation, and nursing simulation rubrics. Published articles chosen for review fell between the years of 2010 and 2015.