Simulation-Based Learning

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.

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)

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

The SIM lab can help in teaching nurses and faculty in practicing tracheostomy care without any harm to the patient. Human patient simulators are sophisticated computer mannequins that can be programmed to exhibit signs and symptom and replicate real patients. The mannequins can have pulses, chest, heart and bowel sounds. All the SIM lab equipment can be hooked up to a hi-tech computer and audio-visual aids. Groups of students and faculty can get to role-play a broad range of different scenarios, with a lab co-coordinator observing, running and intervening in the situation

Aviation first trains their pilots on simulators and case studies before allowing pilots to fly the plane by themselves. This development was created after World War II to reduce pilot error (Gibson & Singh, 2003). Aviation makes it very hard to allow their pilots to make mistakes, especially since those mistakes include potential deaths. I believe healthcare should follow the footsteps of the aviation industry. Practitioners should practice and continue to practice even throughout their careers to ensure that new techniques and skills are learned and old ones are sharpened. As the world continues to advance, so do the use of technology and different methods when implementing care. Gibson and Singh (2003) mentioned the use of “dummy medicine”. Practitioners and nurses can now practice on simulated patients and act out real life situations so that they are better prepared to handle these situations on the field. This will reduce the likelihood of medical errors or mistakes from occurring and safeguard patients from these events. Cadavers, simulated patients, three dimensional (3D) realities, and even case studies can help all healthcare providers to learn, train, and sharpen their skills so that the mistakes will be made during the training rather than on an actual patient. Even though someone may train on a simulator, does not mean they are skilled and competent to care for a living human

The research question addressed by the article titled, “The Effect of Unit-Based Simulation on Nurses’ Identification of Deteriorating Patients” by Disher et al., are: 1. What is the effect of using unit-based, high-fidelity simulation as an educational tool on RNs’ knowledge levels in handling acute respiratory deteriorating patients on step-down cardiovascular units in a community hospital? 2. What is the effect of using unit-based, high-fidelity simulation as an educational tool on RNs’ self-confidence levels in handling acute respiratory deteriorating patients on step-down cardiovascular units in a community hospital? (Disher et al., 2014)

Thanks for the links Nilson, I agree that medical technology is being incorporated in almost any area of the healthcare system. Currently within my simulation lab we use simulation mannequins for blood pressure, breath sound, labor contractions and everything else that a real human being can do. I enjoy teaching with the mannequins when the students are in the first semester, however after a few months have past I typically encourage them to work with each other. I find that the students master the skills better on a real person then a simulation mannequins

The utilization of HFS in nursing simulation is widely supported by several nursing governing bodies, leaders in nursing education and nursing education literature. Implications for nurse education relate to educators recognizing HFS as an effective student-centered learning and teaching strategy. By incorporating HFS into nursing curriculum, educators give students ample opportunities to develop and practice skills as well as using their prior knowledge in a safe environment without

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.

I believe each student possesses the aptitude for fishing, but likely isn’t going to be an instant success reading instructions in a book. Education has come a long way, and no longer is memorization and recitation considered best practice. Consequently, it is important for the educator to provide students with diverse methods to learn and demonstrate competency. Technology is altering the face of education, making opportunities for active learning easier than ever before. Teaching a new skill might involve watching a video, discussing course content in an electronic forum with other learners across the globe or even participating in simulated learning experiences.

The integration of high-fidelity simulation as a teaching strategy is considered to enhance the profession of nursing. “With high-fidelity simulation, educators can replicate many patient situations, and students can develop and practice their nursing skills (cognitive, motor, and critical thinking) in an environment that does not endanger patients” (Hayden, et. all 2014).  After an informed letter approved by the IRB of the Academic Institution, American Sentinel University.

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

Cardiac nursing classes should be taught using today’s technology for the student’s to best absorb the material. The class should involve lecture, and additional learning should take place in a learning lab. The learning lab would ideally include a mannequin that would be helpful in teaching the students the anatomy of the heart, the sounds of the heart and correct placement of the stethoscope as the students practice the assessment of the heart. The mannequin could also potentially be used to simulate real life situations. The use of simulation activities has been helpful in promoting critical thinking and clinical judgement skills in the students (Berndt et al., 2015). The learning lab should also include videos that demonstrate the blood flow through the heart. In addition the learning lab should include computer games, and or quizzes that would help the student review the material. Another resource that may help in the learning process is the interactive whiteboard. The interactive whiteboard could be used for class discussions, and or could be used to manipulate other resources for learning materials (Mastrian, McGonigle, Mahan, & Bixler, 2011).Although traditional lectures are used today’s students learn best with the use of interactive learning