Nursing simulations have become increasingly more sophisticated and typically involves three parts: 1) preparation work (self-study or a classroom lecture), 2) the simulation itself, and, 3) a debriefing session. In the debriefing, students review their own performance and consider how nursing theory is actually applied to nursing practice, then receive feedback from an instructor.
A body of research shows that simulation is an effective teaching method and can contribute both to better patient outcomes and a culture of safety among nursing staff.
Students participate in simulation scenarios on everything from clinical topics like congestive heart failure and asthma, to professional concepts such as communication and nursing leadership.
Various studies have demonstrated that nurses participating in simulation activities improve skills in areas like recognizing a deteriorating patient, triaging emergency patients more accurately, managing stroke patients, working collaboratively, and more.
The first step in developing a simulation exercise is determining the overall purpose and goals of the training, as well as to consider the desired methodology or technique of simulation. Dimensions to consider include:
- purpose and aims of the simulation activity
- unit of participation
- experience level of participants
- healthcare domain in which the simulation will be applied
- healthcare discipline of personnel who will participate
- type of knowledge, skills, attitudes, or behavior to be addressed
- age of the patient being simulated
- technology applicable or required
- site of simulation participation
- extent of direct participation
- feedback method.
Simulation activities can take on many shapes and sizes. Low tech simulation might involve, for example, practicing injections on an orange, as well as role playing, static mannequins, or task trainers, such as a model “arm” designed for practicing IV insertion.
Hi Tech Simulators
The future of nursing education may be in the area known as high-fidelity simulation: the use of computerized mannequins that exhibit a wide range of patient conditions. Virtual reality settings also allow students, via computer screen, to develop non-technical or interpersonal skills. They can practice briefing colleagues during patient handoffs or teaching diabetes self-management strategies to a patient.
Hi-fidelity simulation labs can be quite sophisticated. They might include a mock hospital room, exam room, critical care room, operating theater, birthing suite, or even a senior citizen’s apartment for home health training purposes.
Computerized mannequin “patients” can range in age from neonate to adult, and can be assigned names and medical histories, along with anatomically correct features like a pulse, specific pupil responses, a voice, and even spurting blood. They respond to the “care” provided by students and to “medications” given, for example with blood pressure changes or convulsions.
Real medical equipment like IV pumps and crash carts add to the reality of the simulation lab. Often, instructors can remain hidden behind one-way mirrors to evaluate student performance. These high-fidelity simulation labs are an effective way for nurses to practice the skills needed to manage complex high-acuity patients, drill for emergency preparedness, or practice teamwork and collaboration with other providers.
With more innovation in nursing education comes a higher level of knowledge and competence in nursing practice. Develop a simulation program that has specific training and improvement goals.
Have you participated in a simulation exercise? Was it high- or low-tech? How did it better prepare you for real-life patient scenarios?