Academic journal article Nursing Education Perspectives

IMPLEMENTING a High-Fidelity Simulation Program in a Community College Setting

Academic journal article Nursing Education Perspectives

IMPLEMENTING a High-Fidelity Simulation Program in a Community College Setting

Article excerpt


Despite their relatively high cost, there is heightened interest by faculty in undergraduate nursing programs to implement high-fidelity simulation (HFS) programs. High-fidelity simulators are appealing because they allow students to experience high-risk, low-volume patient problems in a realistic setting. The decision to purchase a simulator is the first step in the process of implementing and maintaining an HFS lab. Knowledge, technical skill, commitment, and considerable time are needed to develop a successful program. The process, as experienced by one community college nursing program, is described.

Key Words Associate Degree Nursing Education - Human Patient Simulator - High-Fidelity Simulation - Implementing Technology

MANY NURSING EDUCATION PROGRAMS ARE CONSIDERING THE PURCHASE OF A HIGH-FIDELITY SIMULATOR. The reasons are many: an increasingly complex health care environment; pressure from employers for new nurse graduates to practice independently; dissatisfaction with the outcomes of traditional teaching strategies; and a student population accustomed to using technology to learn (1,2). * The decision to purchase a high-fidelity simulator (HFS) is only the first step in the process of implementing and maintaining an HFS lab. This article describes the process as experienced by one community college nursing program.

Review of the Literature "Simulation is a replication of the essential aspects of reality so that the reality can be better understood, controlled and practiced" (3, p. 90). Simulation can be detailed, closely mimicking reality, or it can consist of some components of reality (4). Traditionally, nurse educators have used the term simulation to include a variety of experiential learning techniques including games, case studies, role playing, skills practice using models or mannequins, multimedia presentations, and computer-assisted instruction (3-6).

The use of simulation for training novice practitioners has increased in recent years and is supported by the Institute of Medicine in its 1999 report on human error in health care (7). Simulation allows students to make mistakes while developing essential skills without fear of embarrassment or the threat to patient safety present in real clinical situations (5,8). Currently, the nursing education literature focuses on two categories of simulation tools: two-dimensional tools, also known as computer-based simulation, and three-dimensional tools, which include task/skill trainers and full-scale, computer-integrated simulation models.

Fidelity, a term commonly used in descriptions of simulation products, refers to the precision of reproduction of real life. A highfidelity device closely resembles real life, whereas a low-fidelity device is less real. Low-fidelity simulators, frequently referred to as task or skill trainers, are considered useful for introducing and practicing psychomotor skills but lack the realism to ensure that students will be able to transfer skills to real life (9). Examples include catheter insertion models and medication injection pads.

HFS technology overcomes the barriers to learning posed by other teaching methods because it allows active learning, in a realistic clinical setting, without a threat to patient safety (10). High-fidelity simulators, frequently called human patient simulators (HPS), are computerized mannequins that allow psychomotor skill practice and the observation of physiological responses to physical and pharmacological interventions via preprogrammed pathways. They can present specific and unique patient situations consistently to all students with opportunities to correct and discuss errors as they happen (11).

USES OF HIGH-FIDELITY SIMULATION IN NURSING EDUCATION Despite use in anesthesia training since 1969, HFS is a relatively recent phenomenon in nursing education (12). The most frequently cited reason for the growing desire to use simulation as a teaching strategy is the heightened interest in patient safety. …

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