Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Practising on Plastic People: Can I Really Care?

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Practising on Plastic People: Can I Really Care?

Article excerpt


A nurse cradling a child who is receiving treatment for asthma. A nurse holding the hand of a frail diabetic patient and encouraging him during the discharge process. A nurse's empathetic expression for a frightened teenager facing emergency surgery. (Cohen, 2007)

This image of the nurse, as Cohen (2007), points out, is positive, as is the constant high public ranking of nurses as honest, despite contrasting misleading stereotypes or lack of acknowledgement of the professional role itself. Central to this positive image is a perception of the nurse's interpersonal skills, specifically the qualities of caring and empathy. How might changes in contemporary nurse education, in particular the use of new instructional resources such as high-fidelity Human Patient Simulation Mannequins' (HPSMs), impact on the development of these skills?

The use of HPSMs is increasingly common in nursing education as an adjunct to clinical practice both in Australia and internationally. Although ethnically limited, high-fidelity mannequins are available in a range of patient ages from newborn to adult (Laerdal, 2014). While low-fidelity mannequins have limited functions and are essentially static human-shaped task trainers, high-fidelity mannequins can be programmed to mimic vital signs of acute conditions and respond physiologically to treatment (Laerdal, 2014). More recently, with augmented reality additions, high-fidelity mannequins are designed to approximate real personalities rather than to function simply as plastic dummies used to increase nursing skills (Swamy et al., 2014). University websites often describe the high-fidelity simulation experience as one that combines learning to recognise clinical symptoms with generation of feelings of empathy for the mannequin: This SimMan's name is Samaritan. Our patient simulators have names to increase our empathy for their 'humanness' (SMU, 2015). Companies creating high-fidelity mannequins for nursing are aiming to deploy augmented reality techniques to mimic empathy.

While anatomical models have been used in nursing since the 1800s (Nehring & Lashley, 2009), the increased use of simulated-based learning environments ( Issenberg, 2006) is so significant that it has been described as a paradigm shift (Nehring, 2008). Theories and experiments are now regarded as outmoded while 'simulation has emerged as the third leg in the stool of science and education' (Nehring, 2008, p. 64).

This is an important development in nursing education; yet, there is little critical analysis of its rationale or its efficacy in developing nursing skills, including interpersonal communication skills. In order to explore the impact of the use of HPSMs specifically on the development on empathy in students, this paper looks at both communication theory and data from focus groups conducted with final-year Bachelor of Nursing students in an Australian university.

Simulated learning environments

It is important to remember that simulation is a technique and not a technology (Gaba, 2004). A range of simulation techniques have been deployed in nursing education to enhance clinical skills and to approximate empathy, ranging from the Geriatric Medication Game (GMG) to auditory hallucination simulation and poverty simulation techniques (Chen, Kiersma, Yehle, & Plake, 2014). However, limited information is available on the impact of HPSMs on student empathy (Chen et al., 2015). The importance of simulated learning environments in nurse education in Australia was recognised when in 2008 the Council of Australian Governments (COAG) commissioned a study of certain workforce issues and 'the necessary and complementary reforms to education and training' (Health Workforce Australia, 2010, p. 2). The second phase of the project focused on the suitability of simulated environments to replace clinical placements. The resulting report -'Simulated Learning Environments in Nursing Curricula'-employed Crookes et al. …

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