Academic journal article Nursing Education Perspectives

Clinical Teaching by SIMULATION: Lessons Learned from a Complex Patient Care Scenario

Academic journal article Nursing Education Perspectives

Clinical Teaching by SIMULATION: Lessons Learned from a Complex Patient Care Scenario

Article excerpt


A simulated learning experience designed to teach nursing students about cardiac arrhythmias and nursing intervention for patients experiencing a cardiac dysfunction was developed and implemented. Key to the simulation was the use of the SimMan(TM) human patient simulator, a technologically advanced simulator that can be programmed to have realistic and individualized responses to health care scenarios. Fifty-five students participated in the simulation experience. Although the overall experience was judged to be a success, it was not without its pitfalls. This article reports on the process of developing and implementing the laboratory experience, and lessons learned along the way.

Keywords Human Patient Simulator * Nursing Education * Clinical Teaching * Simulation

THE NATIONAL LEAGUE FOR NURSING, in collaboration with the Laerdal Corporation, is completing a three-year, multi-site, national study designed to explore, implement, and evaluate the use of simulation in nursing education. Eight participating schools of nursing served as collaborators on the overall research goals of the study. In addition, each school had the opportunity to test or implement selected components of the project to provide further insight into the usefulness of simulation in nursing education.

* The College of Nursing and Health Professions at the University of Southern Maine (USM) elected to study the simulation development and implementation process and measure student satisfaction as an outcome. This was done within the larger objective of testing the research instruments that were used at all eight sites in the second phase of the study.

Background Nursing is a practice profession in which the beginning nursing student is required to learn numerous psychomotor skills. During the course of their education, students are expected to acquire knowledge, incorporate critical thinking and psychomotor skills, develop self-confidence in their abilities, and then transfer this knowledge to the clinical setting where they have the opportunity to care for patients. The majority of nursing programs in the United States have a learning resource center (LRC) or clinical skills lab (1) where students have the opportunity to learn and practice these techniques prior to entering the clinical arena. Using learning resources and tools in the LRC, students are able to take theoretical concepts and bridge them, in a safe and supportive learning environment, to the experience of clinical patient care (2-5).

Technology has always played an important role in the LRC. Whether by use of filmstrips or audio-recorded breath sounds, to more modern manikins and computerbased instruction, technology has brought the sights and sounds of the patient experience to life for nursing students. The latest development is the use of simulation and realistic patient simulators.

Simulations range from the very simple to the extremely complex. A simple simulation might be a case study written by a faculty member that serves as the basis for role play and discussion. An interactive session using a static manikin to insert an IV into an IV arm is another version of a simulation. Current technology allows for critical care scenarios complete with cardiac and respiratory arrest on a computerized patient simulator. Cost usually rises in proportion to the complexity of the simulation device.

The usefulness of simulation to teach skills to students in a variety of professions and trades has been well documented. Nursing is no exception in using this technology (6). Research has demonstrated that certain outcomes are more readily achieved when simulation is used for student learning. For example, it has been shown that students retain knowledge learned from a simulation for a longer period of time compared to when the same skill is taught in a traditional way (7). Skill acquisition has been shown to be quicker (8) and learners have been shown to be more satisfied (9,10). …

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