Simulation in Nursing
Simulation has been used in Nursing education for the past 15 years (Waxman, 2010). Simulations are used to enhance educational objectives and outcomes through hands on approach in a safe environment. According to the National League for Nursing, simulations are defined as “activities that mimic the reality of a clinical environment and are designed to demonstrate procedures, decision-making, and critical thinking through techniques such as role playing and the use of devices such as interactive videos or mannequins” (2011).
Simulations are completed in a specially designed setting usually called the Simulation Lab where learning occurs in a controlled environment. Faculty have the ability to ‘make things happen’ and can guide learners to the desired learning outcomes and objectives. Simulations are usually completed using prewritten clinical scenarios geared to the experience level of the learner (Waxman, 2010). Pre written scenarios are used to create an evidence-based situation that enables the student to encounter as close to real life experience as possible. Although each scenario begins a scripted way, each scenario can take a different form depending on what interventions are planned for and implemented by the students. Therefore, no two experiences will be the same.
Simulations are intended to enhance the clinical education experience. They are designed to be a compliment to the clinical and classroom experiences. You will find that concepts covered in both clinical and class as well as concepts from your previous blocks will be used in each clinical scenario. The intent is to build each semester in the Simulation Lab and enhance your clinical reasoning and judgment as you progress towards graduation.
Increase in Simulation Use
Although simulation has been in existence for quite some time, it has gained significant attention and use over the past 5 years as current trends in healthcare are emerging. A significant national nursing shortage has resulted in a surge of interest by those wanting to enter the profession (Lasater, 2007). Although this is met with welcome arms for our communities, it does present challenges to educating nurses. There are not enough clinical agencies to support the exponential growth of students and nursing programs.
In addition, health care reimbursement efforts to reduce acute care admissions and lengths of stay can produce inconsistent clinical experiences (Lasater, 2007). With the use of simulation, clinical experiences can be replicated on college campuses and laboratory settings.
Simulation is not intended to replace clinical entirely although the number of hours spent in the Simulation Labs will grow as you progress through MaricopaNursing at Phoenix College. Please know that while you are in the Simulation Lab, you are performing in a clinical experience and are expected to perform as you would in the acute care clinical setting. Please read further on Simulation Guidelines for information on student performance.
In addition, health care reimbursement efforts to reduce acute care admissions and lengths of stay can produce inconsistent clinical experiences (Lasater, 2007). With the use of simulation, clinical experiences can be replicated on college campuses and laboratory settings.
Simulation is not intended to replace clinical entirely although the number of hours spent in the Simulation Labs will grow as you progress through MaricopaNursing at Phoenix College. Please know that while you are in the Simulation Lab, you are performing in a clinical experience and are expected to perform as you would in the acute care clinical setting. Please read further on Simulation Guidelines for information on student performance.
Realism in Simulation
In the Simulation Lab we have several types of patients that can perform a variety of functions. In your Simulation Center tour, you will be introduced to patients that can talk, breathe, have palpable pulses, heart, lung and bowel sounds and be hooked to monitoring equipment. Although the patients look like mannequins who cannot do the things your patient in a hospital can do, we can make our patients do and say almost anything. It is important that you as the student 'buy-in' to the experience and tell yourself this is a real situation. You will gain the most from the experience if you treat it as you would a live clinical patient and not just a game, or pretend.
Your patient in the Simulation Center may have wounds, drainage, blood for IV insertion or venipuncture, chest tubes, NG tubes, Foley catheters and much, much more. We have gone to great lengths to create a situation that is as close to the real thing as you can get. On the same note, you will get the interactions of a real nursing unit. You will have supplies that need to be gathered, a Unit Secretary, a Physician, Pharmacy, and Laboratory Services.
Benefits of Simulation
We use simulation in nursing education for a variety of evidence based reasons. Research has shown that simulation-based training can improve student learning, and therefore patient care (National League for Nursing, 2011). It is an opportunity to practice what you have learned in lecture and lab in a safe, controlled environment that enables us to recreate real life situations. Furthermore, we can make things happen. We have the ability to create situations that cannot be seen in the clinical area…or you could wait forever to see!
We also use simulation as a means of evaluation in a non-punitive environment. A non-punitive environment is one of learning where unsafe practices can be learned from without detrimental effects on a patient. This does not mean that performing grossly unsafe actions, without regard to basic principles of safety, will not go without documentation, warning or in the rare cases, probation. What this does mean is that if you perform unsafely, no patient will be harmed.
We also use simulation as a means of evaluation in a non-punitive environment. A non-punitive environment is one of learning where unsafe practices can be learned from without detrimental effects on a patient. This does not mean that performing grossly unsafe actions, without regard to basic principles of safety, will not go without documentation, warning or in the rare cases, probation. What this does mean is that if you perform unsafely, no patient will be harmed.
Additional Benefits of Simulation
- Students can practice safely, competently and confidently
- Integration of knowledge, skills & attitudes
- Gaps in learning can be filled
- Development of critical thinking/clinical judgement
- Development of self reflection
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Phoenix College and the Maricopa Community Colleges are EEO/AA institutions.