How to prepare students to act in unexpected situations is a challenge for educators in high risk practice based professions. Understanding nursing care needs and developing the professional judgment needed to provide safe care don’t happen in a single moment or through the discrete event of hearing, reading or watching. Responding to a complex phenomenon requires learning opportunities that are cumulative, integrative and multifaceted. In the teaching of health professions curriculum, high fidelity simulation has emerged as a possible solution.
Simulation allows events to occur simultaneously and the nurse learns to identify relationships essential and common to safe and effective practice in a setting. Unlike a classroom setting, simulation allows learners to function in an environment similar to the clinical setting and to think on their feet and to “act as the nurse” without the constraints of potential harm to the patient or liability issues. Simulation allows the integration of technical skills with the knowledge and the application of professional judgment foundational to safe and effective nursing care. Simulations are optimized for learning. With the use of simulation, the educational experience is determined by the needs of the learner and not the needs of the patient. Learners have permission to fail and to learn from the negative consequences of the failure to recognize and act. This isn’t feasible in the clinical setting. The use of simulation removes the potential of risk to the patient and lets learners experience the outcomes of their actions or inactions in the clinical setting.
One disadvantage often cited in discussions about the use of simulated learning experiences is the cost. While simulation may be more costly and time-intensive than the ad hoc clinical experiences available in the practice setting, the lack of risk to patient well-being, lack of liability and ability to explore the impact of failure to act may outweigh the financial investment in the simulator and development time. A second limitation is when educators use simulation as a replacement activity. Some setting have tried to use simulation in place of direct patient care experiences, and the outcome has been less than satisfactory
This technology has potential benefits to society as nurse competence and safe patient care outweigh the cost associated with the use of simulated nursing situations as learning opportunities.
Here is a video demonstrating the use of simulation in a nursing laboratory setting: Video and a link to an article abstract: Article Abstract
These photos are from a community based project, using high-fidelity simulation that we are developing for parents preparing for their infant's discharge from the NICU (neonatal intensive care unit).