HealthJanuary 15, 2017

Up to 50% of clinical hours can be replaced by simulations

Simulation has a proven history of training military personnel and aviators, and in the past 20 years, has become prevalent in the education field, as well. Nursing simulations for students training to be the nurses help bring real-life scenarios into the classroom, allowing students to hone their clinical reasoning skills and boost their confidence when they officially enter the nursing workforce.

With the proliferation of nursing simulation scenarios in the classroom, context-rich experiential learning can take place isa safe environment, thereby augmenting or replacing altogether traditional learning experiences.

In fact, the National Council of State Boards of Nursing (NCSBN) published an award-winning and groundbreaking study that found that up to half of traditional clinical hours in pre-licensure nursing programs can safely be replaced by high-quality patient scenarios for students in the form of nursing simulations. With clinical opportunities limited, more and more programs are looking to manikin-based and virtual simulations to supplement clinical instruction – and it’s paying off.

The Study

“The NCSBN National Simulation Study: A Longitudinal, Randomized, Controlled Study Replacing Clinical Hours with Simulation in Prelicensure Nursing Education,” began in the fall of 2011 with incoming nursing students from 10 prelicensure programs across the U.S.

The study focused specifically on these questions:

  1. Are there differences in clinical competency among graduating nursing students in the three study groups?
  2. Are there differences in knowledge among graduating nursing students in the three study groups?
  3. Are there perceived differences in how well learning needs are met in the clinical and simulation environments among the three study groups?
  4. Are there differences in clinical competency among the three study groups in each of the core clinical courses?

These students were followed through to graduation in May 201, at which time they were assessed on both clinical competency and nursing knowledge. Additionally, graduates provided ratings on how well their perceived learning needs were met.

Study participants were also followed into their first six months of clinical practice. The study found that there were no meaningful differences between the groups in critical thinking, clinical competency and overall readiness for practice as rated by managers at six weeks, three months and six months after working in a clinical position.

The results concluded that simulations for nursing education could be used in up to half of traditional clinical hours experiences under conditions comparable to those described in the simulations for nursing study.

Based on the results of the NCSBN study, The National League of Nursing says “simulation provides a rich learning opportunity, and can be used as a substitute for traditional clinical experiences … with qualifications.” They are:

  • Simulation experiences should be facilitated by an adequate number of dedicated simulation faculty with training and expertise in nursing simulations.
  • Debriefing should be theory based and facilitated by a qualified educator who has received specific education in debriefing techniques. Debriefing facilitators should have their competence regularly assessed.
  • All aspects of simulation experiences should be guided by the Standards of Best Practice Simulation (INACLS, 2013)

The effects on nursing education

  1. An increasing number of educators are using simulations for nursing students. This method provides rich nursing scenarios replicating actual clinical situations. Simulations for nursing education also provide the ability to standardize clinical experiences in an environment of unpredictable and often inconsistent clinical learning opportunities.
  2. Nursing programs are requesting permission from boards to allow simulations for nursing education. Since nursing boards have received requests to allow simulation to substitute for clinical hours, the NCSBN study now provides evidence to guide boards of nursing on recommendations for the use of these simulation for clinical education.
  3. Standards of Best Practice have been published to guide the use of nursing education simulations. Standards of Best Practice, published by The International Nursing Association for Clinical Simulation and Learning (2013), as referenced above, echo the qualifying conditions of the NCSBN study.Standard V states that nursing simulation facilitators are key to participant learning and should have specific simulation education. Standard VI says that debriefing is the most important part of a simulation for nursing education experience and should be guided by a facilitator who is competent in the process of debriefing.

Simulations for nursing education available on the market

Co-developed with Laerdal Medical, vSim for Nursing simulates real nursing simulation scenarios and allows students to interact with patients in a safe online environment that’s available anytime, anywhere. vSim for Nursing helps students develop clinical reasoning skills, competence, and confidence by providing:

An interactive, online simulation experience

  • Students gain patient-centered practice using realistic clinical nursing simulation scenarios
  • Nursing simulation game-like experience appeals to today’s learners

Curriculum integration nursing simulation resources

  • Suggested readings
  • Pre-and post-simulation quizzes
  • Documentation assignments that can be used with Lippincott DocuCare
  • Guided reflection questions to gauge student understanding and support improved competence through remediation

Real-time feedback

  • Individual actions during the nursing education simulation are recorded, resulting in a personalized feedback log to help each student identify strengths or areas of needed improvement
  • Nursing simulation Instructors can access individual and class results from debrief logs, pre- and post-simulation quizzes
  • SmartSense links integrated throughout the nursing simulation scenario and curriculum provide additional learning opportunities through evidence-based, point-of-care content

Want to learn more about how to implement vSim for nursing in your program? Our FREE implementation guide provides strategies for use of vSim, offering faculty ideas on how to integrate vSim into existing curricula and offers ways to develop and/or enhance current teaching strategies.

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