Standardized, In Situ, Virtual Simulations and Digital Platforms, Purpose of Simulations In Nursing Education

Nursing Education and Standardized, In Situ, Virtual Simulations and Digital Platforms, Purpose of Simulations

Standardized Patients Technique for Clinical Learning Environment In Nursing Education, In Situ Simulations Technique for Clinical Learning Environment In Nursing Education, Virtual Simulations and Digital Platforms Technique for Clinical Learning Environment In Nursing Education, Purpose of Simulations For Clinical Learning Environment In Nursing Education, Simulations as Experiential Technique for Clinical Learning Environment In Nursing Education.

Standardized Patients Technique for Clinical Learning Environment In Nursing Education

    Standardized patients are live actors trained to portray the role of a patient according to a script or clinical scenarios written by the faculty. The actors become the patients, demonstrating clinical symptoms and responses of real patients. 

    A variation of the standardized patient instructional strategy is the use of these types of simulations to evaluate physical assessment skills, history taking, communication techniques, patient teaching, and types of psychomotor skills or objective structured clinical examination (OSCE).

In Situ Simulations Technique for Clinical Learning Environment In Nursing Education

    In situ simulation is a type of simulation that involves training performed in a real-life setting where patient care is commonly provided (Dismukes, Gaba, & Howard, 2006). The aim of this type of simulation is to achieve high fidelity (realism) by performing the simulations in actual clinical settings, blending and providing both a clinical and learning environment. 

  Typically, simulation-based experiential learning focuses on interdisciplinary professional teams. Practicing professionals are well versed in their particular field, possess a fair amount of experience, and prefer their learning to be problem-centered and meaningful to their professional lives. 

   Adults learn best when they can immediately apply what they have learned. Traditional teaching methods (eg, a teacher imparts facts to the student in a unidirectional model) are not particularly effective in adult learning because it is important for adults to make sense of what they experience or observe.

Virtual Simulations and Digital Platforms Technique for Clinical Learning Environment In Nursing Education

    Simulations can also take place in virtual environments. Increasing development in virtual patient simulation is evolving and allows the learner to interact with the patient and the virtual environment where the patient is responsive to interventions through a digital media platform. 

    An example of this platform is Second Life, a virtual world accessible by the Internet that enables its users to interact with each other through avatars. In this simulated world, users can explore, meet other users, socialize, participate in individual or group activities, and create services for one another or travel throughout the world. 

    The software is a three-dimensional modeling tool that attempts to depict reality for the users. Second Life is used as a platform for education by many institutions, such as colleges, universities, libraries, and government entities. There are other platforms whereby software programs replicate clinical practice and respond to learner interactions; some provide written feedback to the learner with suggestions and evidence as feedback. 

   Simulation through game-based learning can be performed independently or moderated and this type of simulation helps prepare students for the clinical setting and allows the learner to make decisions and interact with a patient with real-time response in a safe learning environment. 

    Cook (2012) designed and evaluated a virtual world simulation for family nurse practitioner students and also created a primary care pediatric simulation for use by family nurse practitioner students in Second Life. Seefeldt et al. (2012) used Second Life to allow pharmacy, nursing, physical therapy, occupational therapy, and physician assistant students to interact around a mock patient case. 

    The pilot study examined the feasibility of using Second Life as a means to foster interprofessional education (IPE). Students overall found the platform useful; However, there were technical difficulties in using the platform and students lacked the necessary knowledge and skills to use the platform. 

    Farra, Miller, Timm, and Schafer (2013) found out that virtual environments can be used as a learning strategy for nursing students to practice and hone their disaster response and management skills. The study found that students were able to retain the knowledge after the simulation and there was an overall positive response to the use of the virtual platform.

Purpose of Simulations For Clinical Learning Environment In Nursing Education

    Clinical simulations in nursing education can be used for many purposes, for example, as a teaching strategy or for assessment and evaluation, or as an avenue to encourage IPE. 

    However, one of the most important reasons that educators use simulations is to provide experiential learning for the student. Students can be immersed in a simulation where they can actually portray the primary nurse, a newly employed nurse in orientation, or whatever role within the scope of nursing practice the learner is assigned.

Simulations as Experiential Technique for Clinical Learning Environment In Nursing Education

    The use of simulation corresponds with a shift from an emphasis on teaching to an emphasis on learning (Dunn, 2004; Jeffries, 2005) in which the faculty facilitate learning by encouraging students to discover, or construct, knowledge and meaning. Kolb (1984) and others ( Sewchuck , 2005; Svinicki & Dixon, 1987) suggest that the experiential learning cycle is a continuous process in which knowledge is created by transforming experience. 

    Individuals have a concrete experience, they reflect on that experience (reflective observation), they derive meaning (abstract conceptualization) from the experience, and they try out or apply (active experimentation) the meaning they've created, thus continuing the cycle with another concrete experience. 

    When making a shift in approach from a focus on teaching to a focus on learning, goals of the educational programs serve as the framework for the development of specific learning activities. For example, both nursing students and novice nurses entering professional practice find it difficult to transfer theoretical knowledge into clinical practice. 

    The use of simulation allows students to experience the application of theory in a safe environment where mistakes can be made without risk to patients. The use of highly realistic and complex simulation may not always be an appropriate educational approach. In some situations, beginning students can use low-fidelity simulation to work on attainment of foundational skills, including effective communication with patients, psychomotor skill performance, and basic assessment techniques. 

    With task trainers or standard manikins, students can practice procedural skills and caregiving in a safe environment that allows them to make mistakes, learn from those mistakes, and develop confidence in their ability to approach and communicate with patients in the clinical setting. 

   In addition, students benefit from the opportunity to work with technologically sophisticated equipment such as clinical information systems and hemodynamic monitoring systems in the educational setting before encountering such equipment in the clinical setting.    

    Advanced practice nursing students benefit from high fidelity simulations that are complex, realistic, and interactively challenging experiences that support them in developing and practicing leadership abilities, teamwork, and decision-making skills. 

    With patient simulators, for example, students can practice complex assessment skills in their area of clinical practice. Faculty can create scenarios and program equipment to simulate serious clinical situations such as respiratory arrest or aberrant cardiac rhythms that may require an emergent response. Simulations are also appropriate to prepare psychiatric nursing practitioners. 

    As students respond to these more complex situations, they demonstrate their abilities to establish priorities, make decisions, take appropriate action, and work successfully as part of a team (Reese, Jeffries, & Engum, 2010). Within the simulated environment, advanced students also can demonstrate application of learning because they are no longer merely acquiring knowledge and skills. 

    Students learn from the simulated practice without the need for faculty stepping in to correct and control the situation. High-fidelity simulation affords all students the opportunity to experience a baseline set of clinical scenarios, including those that are uncommon or rare, and to practice skill sets repeatedly until they develop a routine and process for safe patient care (Reising & Hensel, 2014) .