Simulation And Caring Of A Critically Ill Patient

How has advancing technology impacted students’ critical thinking and clinical reasoning abilities? In order to find an answer or at least some background knowledge to help answer this question, I reviewed two journal articles. Montenery (2013) aimed to determine how millennial nursing students perceived the effects of technology on attention, knowledge, critical thinking, and overall satisfaction. Vyas (2011) discusses providing more hands on clinical practice through the use of human patient simulation. Though some believe technology is producing a decline in critical thinking and analysis, technology can positively impact critical thinking abilities because students positively rate virtual learning and simulation experiences, prefer computerized testing, and are exposed to complex patient cases through simulation that require clinical judgment.

For the next simulation, I am hoping that I have improved my critical thinking skills in nursing to effectively perform whatever role I will have. Moreover, since simulations are actual situations in real life clinical settings that are being played out by the students, I will research on applicable evidenced based nursing intervention and applied it during the simulation. Applying this type of intervention during the simulation will reinforce my knowledge of effective nursing intervention and will enable me to acquire a more meaningful experience that could be applied in actual clinical setting. I will also try my very best to find out what possible equipment will be used in carrying out nursing care for a given clinical

Nursing simulation, a progressive method of education and utilized by nursing programs, improves patient outcomes by giving students opportunities to practice and learn new nursing skills in non-threatening environments. The use of simulation experiences origins hold root in the military and airline industries. Nevertheless, since that time, many academic interest groups, including medical and nursing education have adopted this educational method. Furthermore, anticipated is the idea 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, recording, and studying the outcomes of a methodical evaluation, such as a rubric, are foundational to the enhancement of both the procedure and results (Robinson & Dearmon, 2013). This capstone project specifically concentrates on the development, implementation, and evaluation of a rubric for nursing simulation scenarios conducted by baccalaureate level nursing students at WKU.

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

(Weinberg, Auerbach, & Shah, 2009) This may prove especially important as the assessment and care of critically ill children is particularly stressful for providers. Debriefing after the simulation experience also provides a time for reflection. Concepts taught in lecture become more tangible as a result of their application during the simulation. Simulation has the potential to enhance pediatric nursing education, improve patient safety and provide additional experiences when clinical sites are limited. The student has an opportunity to build and practice a pediatric skill set. (Bultas, 2011)

Simulation is one kind of reflective tool that widely use in nursing education. National League for Nursing (NLN) described that simulation was a teaching technique that encouraged students to use and apply their theoretical knowledge in clinical scenarios (2015). NLN (2015) also mentioned that “simulation engages learners with diverse perspectives to reflect and reframe the understanding of practice, bringing thinking and doing together” (p. 4). Jones (2009) showed the similar view that reflective simulation was a critical learning process via practiced-based scenario activity that enhanced students to learn and to practice skills before they faced real situations. However, not all processes of simulation use reflection, it is just debriefing process.

Mock Hospital simulation was the focus of the Clinical Nurse Educator Teaching project. The duration of the project span over a four-week period to meet the 22.5 hours required for the project. The simulation dates were determined in advanced for the Nursing Leadership and Management in Professional Nursing course. The preceptor and student determined dates for participating in the simulation and other deliverable activities to meet the requirements for the project. The activities to meet the project requirements were to participate in meetings to plan for the Mock Hospital simulation, to write learning objectives for the simulation, to develop an evaluation tool and debriefing questions, to participate in the Mock Hospital, and to lead debrief sessions after completion of the simulation.

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.

Looking at a past study done before the team began their own study they found that junior nursing student (second year bachelor students) and other level of nursing students using the simulation method of teaching had improvements in their critical thinking, clinical performance, and improved conceptualization of clinical nursing. This team modeled their study

Throughout this course, I received exposure to valuable lessons that I can use in my clinical practice of patient care. One experience generated the greatest impact in my ability to provide safe, high-quality patient care – lab simulation. Lab simulation stands as a technique that “allows the educator to control the learning environment through scheduling of practice, providing feedback, and minimizing or introducing environmental distractions” (Durham & Alden, 2008, p. 222). Simulation is a technique used to prepare students for real experiences in clinical practice; simulation stands as an opportunity for students to provide nursing care in a simulated, safe environment. From personal experience, I can claim that lab simulation positively impacted me in various mannerisms – increased my confidence, assisted in my stress management skills, improved my care management of a patient, transferred my skills learned in the simulation to the clinical setting, improved my communication skills, and enhanced my critical thinking abilities.

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 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

Bandura, Jeffrey, and Gajdos reported that high self-efficacy in one situation tends to generalize to other situations, in which an individual may have perceived himself or herself as having personal inadequacy during a previous experience. Perhaps generalization is one reason why nurse educators have adopted self-efficacy as an outcome of simulation education. Broadly, nurse educators have an inherent interest in seeing simulation outcomes transfer to other situations of clinical nursing practice. The active learning component of simulation fits naturally with Bandura's social cognitive theory (Franklin & Lee, 2014). Hence, active learning of simulation leads to mastery of learning new skills such as tracheostomy care, suctioning, and handling of mechanical ventilators safely and efficiently. Nurse educators who extend Bandura's framework to simulation relate increases in self-efficacy to simulation features, including hands-on practice, immediate feedback, peer modeling, and repeated practice in a psychologically safe environment (Franklin et

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.

Research shows that novice nurses find it difficult to handle patient situation properly in the event that their condition rapidly deteriorate. Barbara Aronson (PhD, RN, and CNE) and her colleague Barbara Glynn (DNP, RN-BC) conducted the research. The title of the article was clearly stated and it focused on the effectiveness of a role- modeling intervention on student nurse simulation competency. The researchers used quasi -experimental studies to conduct a pre-test and post-test study to evaluate whether student been exposed to the role- modeling intervention simulation competency will be able to handle patient conditions better than student not exposed to that intervention. The study was been