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).
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).
Very interesting post concerning Simulated learning. I've always wondered when and if simulated learning/teaching could ever catch on enough to be piloted but never in a nursing field. I believe there are some professions you would steer clear of simulated learning/teaching while others would suit the profile. In your opinion, what do you think about it in the sense of using it supplementary and CAN it stand by itself and be successful? I wonder if there's a "lower cost method" of simulation you can incorporate to see the advantages and hurdles you will have with the implementation? Just a thought..
ReplyDeleteI enjoyed reading your post. I am only familiar with simulation as it is used in a gaming sense, so it was interesting to hear your thoughts about the use of simulated learning in the nursing profession.
ReplyDeleteI do agree with you that being able to practice techniques without the fear of harming the patient is one of the biggest perks of using simulated learning in the medical field. I also think that you make a good point when you say that it is a mistake to let simulated learning take the place face-to-face interaction and practicing techniques with real patients.
I wonder how many other professions would benefit from the use of simulated learning. Would pre-service teachers be better prepared to handle difficult students and parents if they participated in a simulation of that type of situation? I don't know if anyone in the education profession would go for that, but I think it would be an interesting use of simulated learning.
Andy: There is a lower cost method known as task trainers -- but they only focus on repetation of a skill in a stagnant situation. Thus a very behaviorist approach -- which is good for skill development, but not for developing or assessing the ability to think on your feet (so to speak). Thanks for your comment.
ReplyDeleteMonica:
ReplyDeleteHi-Fi Simulation has a long history of use in the Aviation industry. Pilots in simulator practice controlling the aircraft in bad weather conditions, engine failure, etc.
What makes you think the people in education would not "go for" the use of simulation in the management of difficult student situations?
Thanks for your insights. -
Deborah,
ReplyDeleteVery interesting post, I believe that when learning occurs in a realistic environment related to work, learning is retained and reproduced more effectively. Have you had the opportunity to use a simulation in your class? If so, as your curriculum progresses are your learner demonstrating an increased in knowledge and skill base on the domains of nursing?