This study validated the use of simulation as a method of effectively transfer learning into competencies, building teamwork and basic organizational skills. Limitations to this study is the small sample size, evaluation tool, and no evaluation of participants experiences of past simulation exposure. The literature review stated that the use of up to fifty percent as a clinical experience had no impact on NCLEX-RN past rates. Therefore this study could be used by educators as evidence for future training to ensure competencies of APRN.
Forneris, Neal, Tiffany, Kuehn, & Meyer, 2015, replicated the Dieifurest’s findings using a structured debriefing model to enhance reasoning scores in pre-licensed nursing programs. Only a few studies have been performed to measure debriefing techniques. Dreifuerst, 2012, model of Debriefing for Meaningful Learning (DML) required six components to aid the facilitator in a guided debriefing. The debriefing is an active process that engages, explores, explains, elaborates, evaluates, and improves learner’s thinking. The DML was structured to enhance clinical reasoning skills.
This multi-sight study asked two questions. Does the DML model of debriefing increase the development of clinical reasoning skills compared to the traditional unstructured methods of debriefing? Second, the students’ perception of a quality debriefing. Clinical reasoning was measured using the Health Science Reasoning Test (HSRT), and the Debriefing Assessment for
This simulation experience allowed me to practice my focused assessment skills, delegation of tasks, prioritization on of tasks, interdisciplinary communication skills, and skills that I have not been able to participate in such as blood administration. I learned that my strengths are patient education, delegation, noticing changes in patient condition, and working as a member of a team. I need to improve my speed of completing tasks, my confidence, and my process of working through new skills.
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
-Simulation allows individuals to “learn, practice, and repeat procedures as often as necessary in order to correct mistakes, fine-tune their sills and optimize clinical outcomes” (Patow, 2005). This results in improved skills without harm to the real patients and improved self-confidence in clinical practice.
Cant, R. P., & Cooper, S. J. (2011). The benefits of debriefing as formative feedback in nurse education. Australian Journal of Advanced Nursing, 29(1), 37-47.
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.
I have experienced being a part of simulation labs during my clinical rotation on pediatrics. The pediatrician, residents, medical students, nurses, nursing students and anyone else were welcome to attend and encouraged to take part. This is an example of teamwork building as the students have an opportunity to learn each other’s roles and practice communication under the supervision of practiced doctors and nurses, who can provide valuable
Critical thinking and clinical judgment are important skills that professional nurses use in every day clinical setting. In 2012, a mix method qualitative study by Dr. Jeanne Mann was done to evaluate the effectiveness of educational strategy to develop clinical judgment skills in nursing students. In this study, the population was identified as volunteered Level II baccalaureate nursing students from a Midwest nursing program. The variables identified in this article are the relation between critical thinking and clinical judgment. The title of the article clearly indicated the focus of the study and created an interest in reading the research due to nurses utilize their ability to critical think and
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.
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
Clinical reasoning can be defined as, ‘the process by which nurses (and other clinicians) collect cues, process the information, come to an understanding of a patient’s problem or situation, plan and implement interventions, evaluate outcomes and reflect on and learn from the process’ (Levett-Jones & Hoffman 2013, p.4). It requires health professionals to be able to think critically and ensures better engagement and results for the patient (Tanner 2006, p.209). The Quality in Australian Healthcare Study (Wilson 1995, p.460) discovered that ‘cognitive failure’ resulted in approximately 57% of unfavourable clinical events involving the failure to produce and act correctly on clinical information. It also recognises that often nurse’s preconceptions and assumptions can greatly affect patient care and by going through such a process, one can take into account the holistic nature of the patient and provide the best, most appropriate care.
Clinical reasoning is concerned with relationships and has concern for those they are caring for (Benner et al., 2008). It is a term used synonymously with decision making and clinical judgement (Simmons, 2010).
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.
Nursing practice requires both critical thinking and clinical reasoning. Critical thinking is the process of deliberate higher level thinking to define a patient’s problem, examine the evidence-based practice in caring for the patient’s, and make options in the delivery of optimal care. Critical thinking involves the demarcation of statements of fact, judgment, and opinion. The progression of critical thinking requires the nurse to think imaginatively, use reflection, and engage in logical thinking (Alfaro-LeFevre, 2013). Critical thinking is a vital skill needed for the recognition of patient’s
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.