Role Play and Patient Simulation and Their Advantages, Disadvantages or Issues As Outcome Evaluation Strategy In Nursing Evaluation

Outcome Evaluation Strategy In Nursing Evaluation and Role Play and Patient Simulation & Their Advantages, Disadvantages or Issues

What is Patient Simulation and Role Play? Its Use for Outcome Evaluation In Nursing Education, Advantages and Issues as Outcome Evaluation Strategy In Nursing Education.

What is Role Play as Outcome Evaluation Strategy In Nursing Education

    In role play, the learner portrays a specific individual and is generally given much freedom to act out that role spontaneously. Role play is particularly appropriate for objectives related to developing interpersonal relationships with patients, peers, and other health care providers (Oermann & Gaberson , 2014). The role-playing process provides a live sample of human behavior that serves as a vehicle for students to:

(1) explore feelings

(2) gain insight into their abilities, values, and perceptions

(3) develop their problem-solving skills and attitudes

(4) explore subject matter in different ways

    The time for role play can vary according to the time available and the complexity of the role-play situation. The student is informed of the concept or role to be performed and given time to be creative in his or her presentation. The content, and not the performance ability, should be assessed. 

    The content and process can be assessed for use of communication techniques. Role reversal is used in situations in which the purpose is to change attitudes. This facilitates an understanding of opposing beliefs. At the end of the role play, the student observers analyze what occurred, what feelings were generated, what insights were gained, why things happened as they did, and how the situation is related to reality.

Advantages of Role Play as Outcome Evaluation Strategy In Nursing Education

    Situations can be structured or prepared as open-ended responses. After students critique the role play, the process can be repeated. Role play provides the opportunity for students to practice peer review. This technique actively involves the students and fosters creativity.

Disadvantages of Role Play as Outcome Evaluation Strategy In Nursing Education

    Role play can be awkward for the faculty and students if it is not practiced before the time of assessment or evaluation. Immediate feedback is difficult to provide when many groups are performing at the same time.

Issues of Role Play as Outcome Evaluation Strategy In Nursing Education

    Using role play as a teaching mode before its use in evaluation assists students and faculty to become familiar with the techniques and materials. Everything that could happen cannot be anticipated. Students need to be informed in advance about the use of this technique for assessment. It may take time and experience to build comfort with this technique.

What Is Patient Simulation? Its Use for Outcome Evaluation In Nursing Education

    Simulation is the creation of a representation or model of a real-life situation. In nursing, simulations are used to provide a safe practice environment for student learning, assessment, and evaluation (Jeffries, 2012). The continuum of simulation ranges from role playing to high-fidelity, computer-supported simulation that uses the most up-to-date mannequins and computer-driven equipment to closely replicate real life situations. 

    Use of standardized patients (individuals who are trained to act as patients) is another form of role playing used to evaluate student performance in simulations. Faced with limited clinical resources, both standardized patients and high-fidelity simulations are being widely adopted in nursing education programs. 

    The National Council of State Boards of Nursing study on simulation has demonstrated that undergraduate students can experience up to 50% of clinical instruction via simulation (Hayden, Smiley, Alexander, Kardong Edgren, & Jeffries, 2014), and when used as clinical instruction , faculty also need to consider the most appropriate way to assess and evaluate clinical learning outcomes and determine when simulation is best used for assessment including feedback for improvement or for evaluation and grading.

Advantages of Patient Simulation In Nursing Education as Outcome Evaluation Strategy

    Standardized patient and low-fidelity and high fidelity simulation provide safe environments to assess and evaluate skills that are essential for quality nursing practice. Low-fidelity simulations can allow the opportunity for students to practice psychomotor skills in a more authentic environment. 

    For example, instead of setting up individual stations where students validate their ability to perform procedures, a more authentic simulation involves new orders on a given patient that requires performance of the skills in the context of patient care. The combination of video recording with simulation provides opportunities for debriefing with students.

    Faculty must carefully consider whether these situations are appropriate for evaluation, or are best used to help students learn. In addition to assessing individual skill performance and demonstration of higher order thinking skills, simulations allow for assessment of team and interprofessional interaction. 

    High fidelity simulations have been used with students of various disciplines to improve communications and teamwork across disciplines. Students and faculty alike find the simulated patient care environment interesting and stimulating. Again, faculty must be thoughtful in their decision to use simulations for grading and evaluation in these situations.

Disadvantages of Patient Simulation In Nursing Education as Outcome Evaluation Strategy

    The main disadvantage of using high-fidelity simulations for evaluation is the time and expense involved. While equipment cost is decreasing, it remains rather high for the initial purchase. Another disadvantage is that simulations can only accommodate a small number of active participants at a given time. Similarly, disadvantages of using standardized patients include the training required, the expense involved, and increased faculty workload for evaluation. 

Issues of Patient Simulation In Nursing Education as Outcome Evaluation Strategy

    Major issues related to using simulation as an evaluation strategy include but are not limited to selection of scenarios, opportunity for practice prior to evaluation, maintenance of equipment, faculty education and training, personnel needs, and efficient scheduling of students. The format of the scenario for evaluation should match the format used for practice. There is a need for ample opportunity for student practice prior to evaluation. 

    This assists the students to become more comfortable with the simulated environment before they receive a grade (even if it is satisfactory or unsatisfactory). Creating reliable and valid instruments for evaluation and ensuring interrater reliability for their use is another issue. How to efficiently schedule students for evaluation must be addressed as simulations only accommodate a small number of active participants. 

    It is necessary to work out the mechanics of scheduling students whether simulations are used as a teaching, assessment, or evaluation strategy. If collaborative partnerships have been developed between practice and academia for shared simulation equipment and space, then scheduling issues may be more complicated.