Clinical Simulation in Nursing - Articles in Press

Interdepartmental Simulation Collaboration in Academia: Exploring Partnerships With Other Disciplines - Corrected Proof

Janet Willhaus — 2010-09-07

Abstract: Multidisciplinary collaboration provides opportunities for growth in any simulation program. Simulation coordinators pursuing excellence may find unlikely partners among health care and non–health care professionals. Non-nursing collaborations can offer students, faculty, and simulation coordinators fresh views about simulation in an interdisciplinary climate. Examples of cooperative work with instructors and researchers in radiology, sports medicine, and criminal justice studies are described. Sports medicine students participated in scenarios involving a school-aged child with a spontaneous pneumothorax, a coach who was having a stroke, a pregnant yoga instructor experiencing an asthma attack, and a football player who had been momentarily unconscious after a tackle. Nursing students were asked to participate in criminal justice scenarios because of their understanding of simulation principles.

A Review of Simulation-Based Interprofessional Education - Corrected Proof

Chao Zhang, Sarah Thompson, Connie Miller — 2010-09-01

Abstract: Simulation is fast becoming an integral part of health professional education, including interprofessional education (IPE). There are numerous reports of positive student reactions to this innovative teaching strategy. However, there remains a need for evidence of positive learning outcomes from studies using methodological rigor and validated evaluation strategies. The purpose of this literature review and synthesis is to examine research studies of simulation-based interprofessional education (IPE), with a focus on study design and evaluation strategies. A literature search was conducted using CINAHL, MEDLINE, and PsycINFO for the years 1999–2009. A total of 25 studies met the established inclusion criteria, namely, (a) both simulation and IPE were reported, (b) research study results were presented, and (c) quantitative assessment and /or outcome measures were reported. Although positive effects of simulation-based IPE were revealed, a wide range of educational interventions used outcome measures that were investigator-developed questionnaires lacking psychometric testing. Given these findings, the authors suggest that the use of an evaluation framework that defines outcomes and a quality improvement model to structure a disciplined approach to designing and testing an intervention could provide the scientific foundation for measuring effectiveness of simulation-based IPE.

Interprofessional Simulation: An Effective Training Experience for Health Care Professionals Working in Community Hospitals - Corrected Proof

Dawn Prentice, Karyn Taplay, Elizabeth Horsley, Sue Payeur-Grenier, Dan Belford — 2010-08-30

Abstract: Background: This descriptive study measured the effectiveness of and participants' satisfaction with an interprofessional simulation education workshop as a teaching strategy for health care professionals.Method: Health care professionals completed a 1-day clinical simulation workshop on interprofessional collaboration, after which they had the opportunity to fill out 4 evaluative instruments.Results: One hundred sixty-three participants completed the questionnaires. The majority were registered nurses (73.6%). Subscale scores were calculated for 3 of the instruments, with the mean ranging from 3.99 to 4.61 out of a possible maximum rating of 5. Content analyses of the participants' comments resulted in 6 themes: (a) simulation as a learning experience, (b) the learning environment, (c) interprofessional collaboration learning continuum, (d) cohesiveness, (e) adapting to change, and (f) improved patient outcomes.Conclusions: Simulation was highly rated as an effective teaching strategy for interprofessional collaboration. Staff expressed satisfaction with simulation as a teaching strategy.

PartoPantsTM: The High-Fidelity, Low-Tech Birth Simulator - Corrected Proof

Susanna Rose Cohen, Leslie Cragin, Mike Rizk, Allen Hanberg, Dilys M Walker — 2010-07-26

Abstract: The purpose of this project was to create an inexpensive, universally accessible low-tech birth simulator for use in high-fidelity obstetric simulation learning. We adapted a pair of scrub pants to have a birth canal, perineum, urethra, rectum, symphysis pubis, and hemorrhage mechanism. PartoPants™ have been used in the United States and in Mexico for obstetrical emergency training, including eclampsia, hemorrhage, shoulder dystocia, breech birth, prolapsed cord, labor triage, and normal birth. PartoPants™ serve as a low-cost, low-tech birth simulator alternative that has been used successfully in high-fidelity obstetrical simulations.

Creating and Implementing Pediatric Simulation Experiences for Licensed Practical Nursing Students - Corrected Proof

Patricia Dunphy Suplee, Susan M. Solecki — 2010-07-21

Abstract: The phenomenon of decreasing opportunities for hands-on clinical experiences for undergraduate nursing students, especially in the field of pediatrics, has led academic administrators to focus on nontraditional alternatives. Over the past decade, faculty members have been engaged in the use of simulation environments that include manikins and standardized patients to provide students with enhanced learning opportunities. Simulated experiences can be used to fulfill clinical course learning objectives and can also be used as a method of evaluating students' clinical competence. As part of a Pennsylvania Workforce grant, a simulation workshop that focused on pediatric assessment, therapeutic communication, physical exam, and medication calculation and administration was designed and implemented for licensed practical nursing students. Evaluation methods of the workshop included written student evaluations, verbal faculty responses, and verbal responses from the human standardized patients, all of which were extremely positive. This pilot project contributes to the growing body of knowledge about simulation's ability to enhance nursing clinical experiences.

A Discussion of High-Stakes Testing: An Extension of a 2009 INACSL Conference Roundtable - Corrected Proof

2010-07-21

Abstract: This article was prompted by an extended discussion in 2009, on the International Nursing Association for Clinical Simulation and Learning (INACSL) Listserv, about the use of simulation for high-stakes testing. That discussion led to a roundtable at the 2009 INACSL conference in St. Louis. This article comes from notes taken at that roundtable and further-developed thoughts of the lead discussants. Many of their conclusions were echoed in the recent Carnegie report on nursing education.

Transformational Leadership: Instituting a Nursing Simulation Program - Corrected Proof

2010-07-21

Abstract: The demands of the health care environment, the need for clinical placements, the changes in health care delivery, and the high volume of nursing students all have created a need for innovative pedagogies, such as the use of high-fidelity simulation. Although many faculty recognize the value of teaching and learning through high-fidelity simulation, implementing a program of simulation within a curriculum is a challenging process. This article describes how the principles of transformational leadership were used to guide the development and integration of a simulation program into the curriculum.

Tech-Know-Logy: Using Multimodal Simulation Strategies to Bring Data Management and Patient Care Technologies to Life - Corrected Proof

Allen D. Hanberg, Connie Madden — 2010-05-21

Abstract: The purpose of this project was to thread patient care technology and informatics competency into immersive patient care learning experiences for undergraduate nursing. By integrating the academic overlay of a simulated electronic health record system with other simulation modalities, the University of Utah established comprehensive and dynamic learning experiences. These scenarios were introduced into first-semester courses of a baccalaureate nursing program. This multimodal method of simulation delivery resulted in immersive experiences providing meaningful context for students to learn while applying information management competencies to patient care. Many challenges remain in preparing nursing graduates to enter the workforce with the necessary informatics and patient care technology competencies. The process described here provides educators with a valuable pedagogical alternative for teaching these skills regardless of the electronic health record system employed at their academic institution.

Merging Problem-Based Learning and Simulation as an Innovative Pedagogy in Nurse Education - Corrected Proof

Siobhan Murphy, Irene Hartigan, Nuala Walshe, Angela V. Flynn, Sinéad O'Brien — 2010-05-21

Abstract: Current curriculum models rely heavily on conventional teacher-centered approaches to student learning. Recent literature challenges educators to implement student-centered learning approaches. Health care complexities that confront the future of nursing education, combined with the demands of technologically literate students, challenge educators to be responsive and proactive to advance student-centered learning. Undertaking a scholarly approach to teaching and learning is in keeping with the concept of integrative learning. This article discusses the merger of two active-learning strategies, problem-based learning and simulation, on the basis of a review of recent literature, as well as the scholarly approach undertaken to develop an innovative teaching–learning strategy. Last, it recommends potential pedagogical advantages of combining these strategies in nurse education. This discussion article presents the rationale for merging two well-known teaching strategies for a baccalaureate nursing program at University College Cork, Ireland.

Comparison of Selected Teaching Strategies Incorporating Simulation and Student Outcomes - Corrected Proof

2010-05-17

Abstract: Background: Teaching strategies need to engage learners and focus on active learning. The nursing faculty shortage challenges us to prepare competent students. Simulation has been suggested as an appropriate teaching strategy.Method: The basic experimental posttest-only design of this study evaluated effects of three teaching strategies on the outcomes of performance and retention performance of intervention activities, student satisfaction and self-confidence, and educational practice preferences.Results: Students' scores were significantly higher in retention performance than in first performance. There was a significant interaction effect for time and teaching strategy. Nursing education needs to focus on use of high-fidelity simulation as a teaching strategy.

Nursing Students: Untapped Resource for Running Computerized Patient Simulators - Corrected Proof

Starla Aragon, Amy Kotter, Patricia K. Ravert, Suzan E. Kardong-Edgren — 2010-05-17

Abstract: High-fidelity simulation (HFS) is sweeping the nation as a legitimate and exciting new resource for nursing educators. As with most new technologies, HFS is not without its difficulties. It can be a costly program to run and may also cause anxiety among the faculty required for implementation. There is a simple solution to help increase the ease of its implementation: using student workers. This article discusses how using students to help run the simulations can not only reduce overall cost and anxiety associated with this new technology but also increase learning among those participating in HFS.

The Effects of Simulated Clinical Experiences on Anxiety: Nursing Students' Perspectives - Corrected Proof

Teresa Gore, Caralise W. Hunt, Francine Parker, Kimberly H. Raines — 2010-05-17

Abstract: Background: Beginning baccalaureate nursing students (BSNs) are known to be apprehensive the first time they are required to provide patient care within a hospital setting. This study assesses the effect of simulation as an initial clinical experience on nursing students' anxiety levels.Method: Junior-level BSN students enrolled in the fundamentals and health assessment courses at a southeastern university were assigned randomly to two groups: preclinical simulation experience (intervention) and no simulation experience prior to human patient contact. Anxiety levels were compared between the groups. The intervention was a mock hospital unit simulation in the learning resource center, which allowed each student to care for a simulated patient for 4 hours. A patient problem was incorporated into each scenario. The outcome measure was the Spielberger State-Trait Anxiety Inventory.Results: The experimental group's anxiety scores were significantly lower (p = .01) than the control group's scores (11.0 ± 2.8 vs. 13 ± 3.4).Conclusion: These findings demonstrate the value of a simulation experience to reduce anxiety levels among junior-level nursing students.

Use of the Standardized Patient to Clarify Interdisciplinary Team Roles - Corrected Proof

Gerrie V. Barnett, Lynn Hollister, Susan Hall — 2010-04-05

Abstract: Background: The University of Utah began an interdisciplinary experience for students of the health sciences professions in order to improve communication and experience teamwork.Process: Students from different health professions interviewed standardized patients then worked in teams to develop a care plan.Results: Students' evaluations of the experience were positive. Students felt more at ease in their communications with other disciplines after the experience. They saw the value of teamwork in giving optimal patient care.Conclusions: Interdisciplinary team experiences, such as the one described here, are valuable tools for exposure to the healthcare teamwork needed to improve patient outcomes.

Patient Simulator for Teaching Heart and Lung Assessment Skills to Advanced Practice Nursing Students - Corrected Proof

Jennifer Tiffen, Susan Corbridge, Bernadette Cuasay Shen, Patrick Robinson — 2010-03-12

Abstract: Background: Patient simulators are becoming an integral component in the education of nurses because they provide a unique opportunity to practice skills without the anxiety and pressure of a real clinical experience. However, there is a lack of evidence supporting the effectiveness of simulation among advanced practice nursing students.Objective: This study's objective is to determine whether the use of an intermediate-fidelity manikin simulator could affect student confidence, knowledge, and satisfaction with physical assessment skills.Method: Advanced practice nursing students were randomly assigned to receive either a 1-hour simulator session and the usual teaching and learning strategy of didactic lecture and laboratory practice or only the usual teaching and learning strategy. Following the Nursing Education Simulation Framework, the outcomes of confidence, knowledge, and satisfaction were measured.Results and Conclusions: Students in the simulation group had significantly greater (t(26) = −2.068, p < .05) knowledge of heart and lung assessment following the simulator experience; however, there was no difference in confidence between the 2 groups. Students with fewer years of experience had greater changes in their confidence levels. The current study adds to the growing body of evidence that suggests patient simulation positively affects learning outcomes in advanced practice nurse education.

Using Simulation to Teach Prelicensure Nursing Students to Minimize Patient Risk and Harm - Corrected Proof

Gregory A. DeBourgh, Susan K. Prion — 2010-02-17

Abstract: Background: The Agency for Healthcare Research and Quality estimates 98,000 deaths occur each year as a result of medical errors, and preventable medical errors are increasing each year. Managing complex health care environments to ensure safe, quality patient care outcomes is an important nursing contribution. Experienced nurses are able to predict patient risk and harm based on experience and knowledge and to act to recognize and respond to this risk. First-year prelicensure nursing students have not yet developed this knowledge and skill or a clear sense of their accountability in the nurse role as primary advocate for patient safety.Method: A quasi-experimental, pre–post test study of 285 students enrolled in a prelicensure clinical nursing course was conducted to describe results of an innovative simulation learning experience with standardized patients that is focused on preventing patient falls, a dramatic example of a patient outcome that is sensitive to nursing care.Results and conclusions: Results of the simulation learning experience suggest this instructional modality provides students with knowledge and skill gains and challenges them with memorable experiential learning that they can apply to clinical practice.

Integration of Simulation Across the Undergraduate Curriculum: Student and Faculty Perspectives - Corrected Proof

Valerie Michele Howard, Nadine Englert, Kirstyn Kameg, Katherine Perozzi — 2009-12-28

Abstract: Background: High-fidelity human simulation provides an innovative teaching method for nursing students. Faculty members face challenges related to the integration of this method of teaching within a curriculum.Method: The purpose of this study was to implement and integrate the use of high-fidelity human simulation as a teaching and active learning strategy throughout the undergraduate nursing curriculum and evaluate the student and faculty perceptions related to this instructional technology. Kolb's experiential learning theory and Jeffries's Nursing Education Simulation Framework provided the framework for this research project. Creative methods for implementation of simulation in various courses are described. A mixed-methods (survey and focus group) research design was used to measure student and faculty perceptions of this process. Following the simulation experience, students (N = 151) completed the simulation evaluation survey, and faculty (N = 6) participated in focus groups to provide insight into the experience.Results/Conclusions: Student responses related to the experience were overwhelmingly positive, and while faculty agreed that the use of simulation was beneficial to the achievement of learning objectives, many challenges related to the use of the technology were experienced. This study supports the use of simulation in an undergraduate nursing curriculum and offers suggestions for faculty faced with implementing simulation.

A Collaborative Project to Influence Nursing Faculty Interest in Simulation - Corrected Proof

2009-11-20

Background: Despite its popularity, many nurse educators are reluctant or unprepared to use manikin-based simulation in their teaching. The purposes of this article are to describe a state-wide collaborative project to help baccalaureate and associate degree program faculty develop and utilize manikin-based simulations in online and face-to-face nursing courses and to share assessment findings regarding the effectiveness of the project in influencing faculty interest in simulation.Method: Faculty completed a simulation interest and usefulness survey at the start and end of the project year.Results/conclusions: Trends of increased comfort in creating and using simulation in courses were observed and all faculty teams reported developing simulations. Challenges and suggested solutions for maintaining faculty interest and engagement in learning new teaching pedagogies are discussed.