John J. Duffy DNP, RN, CHSE, Assistant Professor, Director of Nursing Resource Center, Department of Nursing, Temple University
With the advances in technology, healthcare education has embraced the use of simulation to provide experiential learning to students. Simulation is a learning andragogy, which provides patient-centered clinical scenarios that challenge healthcare-professional learners to critically think in a safe patient care replication. The clinical challenges present in each case must be appropriately leveled to the learner and reinforce developing critical thinking skills. These clinical scenarios can expose learners to common or rare clinical patient care events. It is commonly agreed that hospital clinical rotations make a very significant contribution to the clinical education of novice practitioners, but clinical placements are limited and highly competitive. Additionally, there is no way for educators to assure that students are exposed to similar important clinical benchmarks.
With recent innovations in technology, simulation centers can replicate a realistic patient encounter that clinically challenges a team of learners at a hospital bedside, outpatient clinic or at home care or community environment. To create these clinical challenges, the simulation uses technologically advanced human patient simulators (manikin) or can hire a standardized patient(actor) to play the role of the patient. The manikins available today can replicate a complete human physiological system, such as cardiovascular, neurological, respiratory, gastrointestinal and urinary. These remarkable teaching tools allow learners to practice full head to toe assessment, as well as practice skilled-based interventions. Unlike traditional clinical rotations, instruction in a simulation center can be standardized to meet program objectives. Transference of skills learned in the simulation center will prepare the learners to face interprofessional clinical situations in their future practice environment.
Simulation can provide interprofessional groups of students with the opportunity to practice clinical skills, identify patient safety issues, incorporate content knowledge, practice interprofessional communication, and apply physical assessment skills. Working in a team in real-time at the patient’s bedside to address a clinical challenge helps develop the team’s situational awareness, team engagement, clinical judgment, and critical thinking in a realistic but non-threatening environment. It further provides a mechanism to ensure a standardized clinical education for all students.
Teaching with simulation improves patient outcomes by integrating simulation-based teaching in a meaningful and deliberate manner throughout the nursing curriculum, with consideration of the individual, family, community and population-level factors that impact the delivery of quality, compassionate, holistic and effective nursing care. The overall aim of simulation is to provide a state-of-the-art simulation-based learning environment for education, technology, and research that will advance student learning to provide quality patient care. Learners will use evidence-based deliberate practice scenarios in a safe environment to develop and improve their critical psychomotor skills, clinical judgment, peer feedback and effective teamwork skills. Learners will increase their empathy, professional communication and cultural competence.
Filming simulations have very powerful learning benefits. A graduate student will be challenged to interact and examine a standardized patient in a high-fidelity examination simulation suite. These standardized patient encounters will be filmed for later viewing. At the time of the encounter, the course faculty will be in an adjoining viewing room, taking notes to debrief with the learner directly following the patient encounter. The filmed event can be reviewed at that time or posted to the student’s course board for later viewing (Reflective Learning), allowing the learners to see themselves in the moment.