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How Can Nurses Leverage Simulation Technology for Patients and Family Education?

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Nursing education involves a practice-oriented curriculum in which emphasis is placed on both theoretical knowledge and psychomotor skills. In skill-based education, where learning through practice occupies a central role, it is important to ensure the integration of theoretical knowledge into practice

In this context, simulations represent an innovative teaching method that stimulates a number of senses at the same time among learners. Simulation is a method which can be designed to reflect real-life conditions, and which provides the opportunity to work in contexts that are closer and more representative of real settings. Depending on the clinical situation or scenario; the simulation method will involve a student or a group of students performing a number of patient care activities on a manikin, player or standardized patient.

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The alarming rise in morbidity and mortality among hospitalized patients throughout the United States heightens concerns about professional competency. Nurses and other health care professionals are under increased scrutiny to provide safe, effective care. Likewise, nursing education programs are faced with increased pressure to produce graduates who are capable of providing safe patient care. Toward that end, nursing education programs develop curricula, hire qualified faculty, and select learning experiences for students in an effort to train and graduate competent, effective nurses. The instructional strategies utilized in both didactic and clinical components of nursing education courses are highly influential in determining critical thinking and clinical decisionmaking ability as well as in developing the psychomotor skill performance of new graduates

Of course, it is unrealistic to think that graduates of nursing education programs have received all the training they need when they depart the doors of academia. Orientation programs for new graduates and continuing education for nurses are essential tools to help practitioners improve their knowledge, skills, and expertise so that quality patient care is provided and outcomes are optimized while errors are minimized. Ongoing evaluation of nursing competence is necessary to promote patient safety. Nursing education has long utilized simulation in some form to teach principles and skills of nursing care. Models of anatomic parts, whole body mannequins, and various computer-based learning programs have provided educators with training tools for students seeking to become professional nurses. Current interest in simulation as a clinical teaching tool has largely been fueled by development of the human patient simulator.

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Simulation-based learning occurs in a safe environment where structured activities, that represent actual or potential situations, facilitate learners’ development of knowledge, skills, and attitudes (Meakim, et.al, 2013). Simulation is being used in nursing education more than ever before and is an attempt at replicating reality to help students practice and learn in a safe environment. In healthcare education, simulation tries to replicate some of the essential aspects of a clinical situation so that the situation may be more readily understood and managed when it occurs in clinical practice. Bridging the gap between didactic (classroom) and clinical areas (practice) are needed for students to develop the knowledge, skills, and attitudes needed to succeed in the clinical arena

Nurse educators are struggling to meet the dynamic needs of a complex health care system that is seeing patients with extremely high acuity. Simulation-based education strategies can be applied to structure learning experiences to any area a student needs improvement or needs to develop competency. The struggle with recreating these experiences can be with realism and fidelity in a simulation. The simulation must be realistic, and therefore more believable, in order for the students to learn. The National Council of State Boards of Nursing released the results of a landmark study in 2014. The study identified four qualifiers, that when used, indicated that up to 50% of the traditional clinical time could be successfully replaced with simulation (Kardong-Edgen & Jeffries, 2014). Fidelity and realism are a large part of ensuring that high-quality simulation is being used in nursing education.

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Given these points, simulation could also be used to ensure annual competencies (as described in the unfolding case exemplar) or to remediate poor performing employees. In addition to its usefulness in nursing education, simulation provides a suitable methodology for deliberately performing skills necessary to be an effective practicing nurse

Many of these simulations can be done without a costly, high fidelity mannequin. One must only consider the overall purpose of the simulation and be creative.

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Meakim, Boese, Decker, Franklin, Gloe, Lioce, Sando, Borum (2013) Standards of Best Practice: Simulation Standard I: Terminology. Clinical Simulation in Nursing. doi: 10.1016/j.ecns.2013.04.001

Dieckmann, P., Gaba, D., Rall, D., (2007). Deepening the theoretical foundations of patient simulation as social practice. Simulation in Healthcare 2 (3) 10.1097/SIH.0b013e3180f637f5

Hayden, J., Smiley, R., Alexander, M., Kardong- Edgren, S., & Jeffries, P.R. (2014). The NCSBN national simulation study: Replacing clinical hours with simulation in pre-licensure nursing education. Journal of Nursing Regulation, 5 (2), 61-64.doi:10.1016/S21558256 (15)303355

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