Written by: Sheri Howard, Ph.D., RN, CHSE
Fidelity in simulation is key for a successful transition from nursing education to clinical practice. Watching students grow and learn using simulation-based learning to develop critical thinking skills, decision-making skills, and have those “light bulb moments" is one of the most rewarding parts of being a nurse educator.
Simulation-based learning in nursing education
Simulation-based learning occurs in a safe environment where structured activities, that represent actual or potential situations, facilitate learners’ development of knowledge, skills, and attitudes. Simulation is being used in nursing education more than ever before and is an attempt at replicating reality to help students practice and learn in a safe environment. In healthcare education, simulation tries to replicate some of the essential aspects of a clinical situation so that the situation may be more readily understood and managed when it occurs in clinical practice. Bridging the gap between didactic (classroom) and clinical areas (practice) are needed for students to develop the knowledge, skills, and attitudes needed to succeed in the clinical arena.
Nurse educators are struggling to meet the dynamic needs of a complex health care system that is seeing patients with extremely high acuity. Simulation-based education strategies can be applied to structure learning experiences to any area a student needs improvement or needs to develop competency. The struggle with recreating these experiences can be with realism and fidelity in a simulation. The simulation must be realistic, and therefore more believable, in order for the students to learn.
Four qualifiers for simulation in clinical training
The National Council of State Boards of Nursing released the results of a landmark study in 2014. The study identified four qualifiers, that when used, indicated that up to 50% of the traditional clinical time could be successfully replaced with simulation. Fidelity and realism are a large part of ensuring that high-quality simulation is being used in nursing education.
1 - The use of International Nursing Association for Clinical Simulation and Learning (INACSL) standards for best practices
2 - Trained simulation faculty
3 - High quality simulation
4 - Rigorous structured reflective debriefing.
What is fidelity in simulation?
Fidelity refers to how closely a simulation imitates or amplifies, reality. Miller (1990) indicated that action, or what a person does, is built upon their knowledge, competence, and performance. As a student increases knowledge, competence, performance and action, the level of fidelity is increased in a simulation experience. The higher the fidelity, the more a student does and therefore the more opportunities there are for learning.