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

Using Simulation and Critical Thinking in Speech-Language Pathology: A University Case Study

Abstract Education is changing. Virtual learning is now a common occurrence. Along with this change, more and more virtual learning tools are being used in the educational setting. The American Speech-Language-Hearing Association (ASHA) has recognized this change and has modified certification standards to include clinical simulation experiences in graduate speech-language training programs. Along with this modification, critical thinking skills are an expected goal, not only in face-to-face experiences, but also in simulation experiences. Educators need to meet this expectation to ensure that future speech-language pathologists are fully prepared to make sound decisions within the clinical setting. Educators may benefit from the following suggestions in regards to the use of critical thinking skills within a clinical simulation experience

Improving medication practices for persons with intellectual and developmental disability: Educating direct support staff using simulation, debriefing, and reflection

Direct support professionals (DSP) are increasingly active in medication administration for people with intellectual and developmental disabilities (IDD), thus supplementing nursing and family caretakers. Providing workplace training of DSPs is often the duty of nursing personnel. This article presents empirical data and design suggestions for including simulations, debriefing, and written reflective practice during in-service training for DSPs in order to improve DSPs’ skills and confidence related to medication administration. Quantitative study results demonstrate that DSPs acknowledge that their skill-level and confidence rose significantly after hands-on simulations. The skill- level effect was statistically significant for general medication management -4.5 (p <0.001) and gastrointestinal medication management -4.4 (p < 0.001). Qualitative findings show a deep desire by DSPs to not just be “pill poppers” but to understand the medical processes, causalities, and consequences of their medication administration. On the basis of our results, the authors make recommendations regarding how to combine DSP workplace simulations and debriefing with written reflective practice in DSP continuing education

Exploring the Integration of Disability Awareness into Tertiary Teaching and Learning Activities

A desire to have every student attending our University be aware of, and reflect on, disability in their studies and future careers, initiated our project to explore how to enhance disability awareness within all our University’s papers. In this project we systematically reviewed pertinent literature and ran an action research workshop for staff. Strategies to enhance disability awareness identified in the literature and workshop were presented and verified at an interactive conference presentation. Embedding disability awareness into curricula is challenging; staff considered themselves powerless to bring about change in their departments, but thought that one way to do so would be by modelling inclusive behaviour and by introducing subtle inclusive practices into papers taught. The identified strategies may be of use to others contemplating similar curricular modifications

Advances in Teaching & Learning Day Abstracts 2005

Proceedings of the Advances in Teaching & Learning Day Regional Conference held at The University of Texas Health Science Center at Houston in 2005

What do faculties specializing in brain and neural sciences think about, and how do they approach, brain-friendly teaching-learning in Iran?

Objective: to investigate the perspectives and experiences of the faculties specializing in brain and neural sciences regarding brain-friendly teaching-learning in Iran. Methods: 17 faculties from 5 universities were selected by purposive sampling (2018). In-depth semi-structured interviews with directed content analysis were used. Results: 31 sub-subcategories, 10 subcategories, and 4 categories were formed according to the “General teaching model”. “Mentorship” was a newly added category. Conclusions: A neuro-educational approach that consider the roles of the learner’s brain uniqueness, executive function facilitation, and the valence system are important to learning. Such learning can be facilitated through cognitive load considerations, repetition, deep questioning, visualization, feedback, and reflection. The contextualized, problem-oriented, social, multi-sensory, experiential, spaced learning, and brain-friendly evaluation must be considered. Mentorship is important for coaching and emotional facilitation

High fidelity full sized human patient simulation manikins: Effects on decision making skills of nursing students

Background: The continued use of high fidelity full sized human patient simulation manikins (HF-HPSMs) for developing decision making skills of nursing students has led to growing research focusing its value on student learning and decision making skills. Methods: In October 2012, a cross-sectional survey using the 24-item Nurse Decision-Making Instrument was used to explore the decision making process of 232 pre-registration nursing students (age 22.0 + 5.4; 83.2% female) in Singapore. Results: The independent samples t-tests demonstrated three significant predictive indicators. These indicators include: prior experience in high fidelity simulation based on pre-enrolled nursing course (t = 70.6, p = .001), actual hands-on practice (t = 69.66, p &lt; .005) and active participation in debrief (t = 70.11, p &lt; .005). A complete experience based on role-playing followed by active discussion in debrief was a significant contributor to the decision making process (t = 73.6667, p &lt; .005). However, the regression model indicated active participation in debrief as a significant variable which explained its development (t = 12.633, p &lt; .005). Conclusions: This study demonstrated the usefulness of active participation in simulation learning for an analytic- intuitive approach to decision making, however active participation in debrief was a more important influencing element than role-playing. In situations where resources are limited for students to experience hands-on role-playing, peer reviewing and feedback on others’ experiences could benefit students, just as much. However, further study is warranted to determine the development of HF-HPSMs as a pedagogic tool for enhancing the decision making process of nursing students

Simulation on sensory impairment in older adults:nursing education

Sensory impairments are identified as the most common chronic and disabling conditions of later life impacting significantly on the quality of life and safety of older adults. Hospitals and care environments can present significant challenges to older adults with sensory impairments to negotiate. Therefore, it is important to raise awareness on sensory and cognitive impairments with all healthcare professionals and nurses in particular, both to help develop an empathetic awareness on the impact of impairment and to minimize risk of adverse events. This article reports on a pedagogical innovation on the development and use of a simulation resource primarily on sensory impairments in older adults with first year nursing students within an undergraduate nursing programme in a Scottish university. The article also reports on students' reflections on their experience of participating in this simulation

Development of a programme to facilitate interprofessional simulation-based training for final year undergraduate healthcare students

Original report can be found at: http://www.health.heacademy.ac.uk/publications/miniproject/alinier260109.pdfIntroduction: Students have few opportunities to practise alongside students from other disciplines. Simulation offers an ideal context to provide them with concrete experience in a safe and controlled environment. This project was about the development of a programme to facilitate interprofessional scenario-based simulation training for final year undergraduate healthcare students and explored whether simulation improved trainees’ knowledge of other healthcare discipline’s roles and skills. Methods: A multidisciplinary academic project team was created and trained for the development and facilitation of this project. The team worked on the development of appropriate multiprofessional scenarios and a strategy to recruit the final year students on a volunteer basis to the project. By the end of the project 95 students were involved in small groups to one of fifteen 3-hour interprofessional simulation sessions. Staff role played the relatives, doctor on call, and patient when it was more appropriate than using a patient simulator (Laerdal SimMan/SimBaby) in the simulated community setting and paediatric or adult emergency department. Each session had 3 to 4 of the following disciplines represented (Adult/Children/Learning Disability Nursing, Paramedic, Radiography, Physiotherapy) and each student observed and took part in one long and relevant high-fidelity scenario. Half the students were randomly selected to fill in a 40-item questionnaire testing their knowledge of other disciplines before the simulation (control group) and the others after (experimental group). Students were assessed on the questions relating to the disciplines represented in their session. Results: By the end of the project 95 questionnaires were collected of which 45 were control group students (Questionnaire before simulation) and 50 experimental group students (Questionnaire after simulation). Both groups were comparable in terms of gender, discipline and age representation. Participants were: Adult nurses (n=46), Children’s nurses (n=4), Learning Disability nurses (n=7), Nurses, Paramedics (n=8), Radiographers (n=20), Physiotherapists (n=8). 15 sessions were run with an average of around 7 participants and at least 3 disciplines represented. The knowledge test results about the disciplines represented was significantly different between the control and experimental groups (Control 73.80%, 95% CI 70.95-76.65; and Experimental 78.81%, 95% CI 75.76-81.87, p=0.02). In addition, there were sometimes reliable differences between the groups in their view of multidisciplinary training; confidence about working as part of a multidisciplinary team was 3.33 (SD=0.80, Control) and 3.79 (SD=0.90, Experimental), p=0.011; their anticipation that working as part of a multidisciplinary team would make them feel anxious was 2.67 (SD=1.17, Control) and 2.25 (SD=1.04, Experimental), p=0.073; their perception of their knowledge of what other healthcare professionals can or cannot do was 3.00 (SD=0.91, Control) and 3.35 (SD=0.93, Experimental), p=0.066; their view that learning with other healthcare students before qualification will improve their relationship after qualification was 3.93 (SD=1.14, Control) and 4.33 (SD=0.81, Experimental), p=0.055; their opinion about interprofessional learning helping them to become better team workers before qualification was 3.96 (SD=1.24, Control) and 4.42 (SD=0.77, Experimental), p=0.036. Conclusions: Although the difference is relatively small (~5%), the results demonstrate that students gained confidence and knowledge about the skills and role of other disciplines involved in their session. Through simulation, the positivism of students about different aspects of learning or working with other healthcare disciplines has significantly improved. Students gained knowledge of other disciplines simply by being given the opportunity to take part in a multiprofessional scenario and observe another one. The results of the test and their reported perception about multidisciplinary team working suggest that they are better prepared to enter the healthcare workforce. Discussions during the debriefings highlighted the fact that multidisciplinary training is important. The main challenges identified have been the voluntary student attendance and timetabling issues forcing us to run the session late in the day due to the number of disciplines involved in each session and their different placement rota. The aim is now to timetable formally this session within their curriculum. Introducing simulation in the undergraduate curriculum should facilitate its implementation as Continuing Professional Development once these students become qualified healthcare professionals