Cultural Norms of Clinical Simulation in Undergraduate Nursing Education

Simulated practice of clinical skills has occurred in skills laboratories for generations, and there is strong evidence to support high-fidelity clinical simulation as an effective tool for learning performance-based skills. What are less known are the processes within clinical simulation environments that facilitate the learning of socially bound and integrated components of nursing practice. Our purpose in this study was to ethnographically describe the situated learning within a simulation laboratory for baccalaureate nursing students within the western United States. We gathered and analyzed data from observations of simulation sessions as well as interviews with students and faculty to produce a rich contextualization of the relationships, beliefs, practices, environmental factors, and theoretical underpinnings encoded in cultural norms of the students’ situated practice within simulation. Our findings add to the evidence linking learning in simulation to the development of broad practice-based skills and clinical reasoning for undergraduate nursing students

The effectiveness of debriefing in simulation-based learning for health professionals: A systematic review

© the authors 2012. Background: Simulation is defined as a technique used to replace or amplify real experiences with guided experiences that evoke or replace substantial aspects of the real world in a fully interactive manner. The use of simulation for educational purposes began decades ago with the use of low-fidelity simulations and has evolved at an unprecedented pace. Debriefing is considered by many to be an integral and critical part of the simulation process. However, different debriefing approaches have developed with little objective evidence of their effectiveness. Objectives: The aim of this review was to identify, appraise and synthesise the best available evidence for the effectiveness of debriefing as it relates to simulation-based learning for health professionals

The Use of Mock Code Training in Improving Resuscitation Response

The American Heart Association\u27s Get With the Guidelines (GWTG) has established measures for how quickly a resuscitation team is to respond in a cardiac arrest with performance of cardiopulmonary resuscitation (CPR) and defibrillation. Two of the core measures for GWTG require initiation of CPR within 1 minute of cardiac arrest and defibrillation within 2 minutes in at least 85% of cases. The problem of interest in this Doctor of Nursing Practice (DNP) project was that the facility had not been able to reach 85% on these 2 measures. The purpose of this project was to achieve nursing response times for CPR and defibrillation to meet the core measures. Using the logic model, the project leader implemented mock code training over an 8-week period on the medical-surgical units. The study design for this project was a nonexperimental, retrospective chart review. Compliance data were obtained from the American Heart Association\u27s GWTG database for the facility before and after implementation of mock code training. The results included a review of 10 cardiac arrest cases that occurred after implementation of training. There was 100% compliance with initiation of first compression within 1 minute of cardiac arrest. However, of 2 cases that required defibrillation, only 1 received the shock within 2 minutes. Quantitative descriptive analysis used percentages and a runs chart to compare response times prior to training with response times after training. The chart showed improvement in the area of first compression in meeting the goal of 85% compliance. As a result, the facility will continue to implement mock code training on a routine basis in its effort to improve patient outcomes, including survival and quality of life

Use of a Standardized Tracheostomy Patient Simulation to Evaluate Student Clinical Communication Skills

Simulation is a valid pedagogical tool used to teach students, observe student clinical skills, and to assess clinical competencies. During the COVID-19 pandemic, a lack of medical speech-language pathology placements required graduate programs to re-examine clinical training. Simulation has proven useful in providing an alternative and safe learning modality. Standardized patients, which are one simulation modality, provide increased standardization and higher fidelity than medical manikins. This is particularly true in the context of both student learning and demonstration of clinical communication skills (CCS) within a simulated learning environment where the simulated patient can interact authentically with the student clinician. CCS are important because they can lead to better treatment outcomes and strengthen the therapeutic alliance. The purpose of this study was to evaluate the evidence for a CCS training in the context of a speaking valve trial with a standardized tracheostomy patient. Results showed that students are demonstrating emerging skills or have already developed CCS in this context. Student questionnaire ratings suggest that this simulation was helpful to their learning as it provided a safe environment for them to practice valuable clinical skills. Simulation appears to be a viable modality to use when training CSD students to improve their CCS

My heart is racing! Psychophysiological dynamics of skilled racecar drivers

Our purpose was to test the multi-action plan (MAP) model assumptions in which athletes’ psychophysiological patterns differ among optimal and suboptimal performance experiences. Nine professional drivers competing in premier race categories (e.g., Formula 3, Porsche GT3 Cup Challenge) completed the study. Data collection involved monitoring the drivers’ perceived hedonic tone, accuracy on core components of action, posture, skin temperature, respiration rate, and heart rate responses during a 40-lap simulated race. Time marks, gathered at three standardized sectors, served as the performance variable. The A1GP racing simulator (Allinsport, Modena) established a realistic race platform. Specifically, the Barcelona track was chosen due to its inherently difficult nature characterized by intermittent deceleration points. Idiosyncratic analyses showed large individual differences in the drivers’ psychophysiological profile, as well as distinct patterns in regards to optimal and suboptimal performance experiences. Limitations and future research avenues are discussed. Action (e.g., attentional control) and emotion (e.g., biofeedback training) centered applied sport psychology implications are advanced

Simulation and Curriculum Integration: Does Simulation Improve Clinical Competence

Background: While simulation is a widely used pedagogy in nursing education, there is inconsistent evidence regarding its effectiveness in demonstrating positive learning outcomes. Therefore, further research is needed to establish the effectiveness of simulation in developing clinical competence, and the incorporation of this pedagogy into nursing curricula. Purpose: To explore how the integration of high-fidelity simulation into nursing curricula influences learning outcomes. More specifically, to examine differences in clinical competence as measured by the outcomes: knowledge, skills, critical thinking, and clinical judgment in nursing fundamental students taught using high-fidelity simulation versus traditional instructional methods. Design: A two-group time series experimental design was used to evaluate the impact of traditional or high fidelity simulation instructional methods on improving clinical competence at three time points. Findings: The results reveal significant improvements in knowledge, skills, and clinical judgment over time. However, instructional method did not have a significant effect on these learning outcomes. There was a significant interaction between time and instructional method on improving critical thinking, as both groups demonstrated significant improvements from pre to post intervention. The traditional group showed a significant decline in critical thinking ability 3 weeks post intervention, while the simulation group remained unchanged. Conclusions: The findings of this study support the inclusion of high-fidelity simulation into nursing curricula to facilitate improvements in clinical competence. This study provides evidence that high-fidelity simulation is a better approach than traditional instruction in developing critical thinking, and is analogous to traditional instruction in improving all other domains of clinical competence

Large-scale training simulators for industry and academia

How should industrial large-scale simulators be used in academia? Which aspects of industrial training can benefit engineering education? This article demonstrates the use of industrial large-scale simulators for educational and training purposes for both academia and industry. The didactic models of the simulator courses are described and the learning results are evaluated for two case examples using the same industrial oil and gas process simulator. The differences and similarities of the didactic models of the courses are explored and the further possibilities for collaboration between academia and industry are outlined