Simulation gains traction, credibility with nursing

Executives need to support learning via simulation.

Nursing students, educators and trainers, no longer satisfied with cumbersome textbooks and standard lectures, acknowledge the power of direct clinical experience in building skills, knowledge and competence. Unfortunately, scheduling these clinical experiences isn’t always possible. Healthcare facilities may not have the resources or staff to accommodate the clinical training needs of nursing students and educators. And while clinical settings like hospitals offer reality and immediacy, they may not be able to deliver the experience needed for nurses to assimilate knowledge and master skills and competencies needed in the world of nursing practice.    

Perhaps that is why so many healthcare educators, trainers, managers and executives have turned to simulation as a vehicle to help professionals acquire new knowledge and skills, address clinical practice errors and prepare for varied care scenarios — from natural disasters like hurricanes and highway pile-ups, to home healthcare and rehabilitation. The trick is knowing if, how, when and where to use simulation experiences.

Fortunately, the jury on the use of simulation in nursing is no longer out. We now have evidence to indicate how and how much nursing education programs can substitute simulation for real-world clinical experience. We also have a clear picture of how simulation influences nurses’ knowledge, skills and critical thinking thanks to the National Council of State Boards of Nursing’s multi-site, longitudinal study of simulation use in pre-licensure nursing programs throughout the country, released in July.

The Journal of Nursing Regulation reported the results of the study that explores the extent to which simulation can be substituted for the more traditional clinical experience. Researchers wanted to know how simulations introduced within pre-licensure nursing programs influence the knowledge, skills and competence of nursing students. Study participants, nursing students from 10 U.S. universities and colleges, were placed in one of three groups: 10 percent or less simulation, 25 percent simulation and 50 percent simulation. The study, which used Elsevier’s Simulation Learning System among other simulation products, measured graduate nurses’ competence and preparedness as throughout their nursing courses and as they completed nursing licensure exams and transitioned to nursing practice.

The results of the study support simulation as a useful tool in building knowledge, skills and competence among nurses. Clinical nursing courses with up to half of traditional clinical hours replaced by simulation were just as effective as courses that integrated fewer hours in simulation in preparing nursing students for practice, showing simulation can reliably replace a bulk of a nurse-in-training's clinical experience hours.

Healthcare professionals can use simulations to:

  • Practice within specialties like pediatrics where clinical experiences are sometimes limited
  • Develop skills in situations where students might not have access to sufficient experience in a clinical environment, such as urinary catheter insertion
  • Supplement simulations with added instruction and commentary
  • Participate in knowledge and skill development free from the distractions of clinical practice  

The study provides substantial evidence that up to 50 percent simulation can be effectively substituted for traditional clinical experience in all pre-licensure core nursing courses under conditions comparable to those described in the study. The study also reveals that nurses and other healthcare professionals can learn, refine and evaluate skills in a simulation-based learning environment before moving on to more complex and risky clinical settings.

Because the study suggests simulation-based training to be a feasible substitute for clinical experience, executives should consider the following before deciding to implement a simulation-based training program:

  • Simulation leadership is needed for ongoing education. Advise healthcare professionals on how simulation could help enhance enterprise-wide quality, safety, efficiency, cost management and outcomes as they stay updated on latest practices and treatments through ongoing professional education and training.

  • Explore the possibilities of simulations. Organizations can use simulations to help train nurses and other professionals on basic skills. But they also can tap simulations to address systemic failures, crises or medical errors. Through simulations, nurses and other professionals can more easily grasp root causes and develop plans for future action in a safe environment where they can refine critical thinking skills without the pressure of a true life or death situation. Equally important, organizations can mobilize simulations to prepare for likely and unlikely events, including hurricanes, floods, tornadoes, explosions, fires, car accidents or epidemics – opportunities that might be infrequent and dangerous in real life.

  • Exchange simulation resources and insights. Healthcare organizations can learn much from sharing the simulation experiences and insights of hospitals, health systems, academic medical centers associations and educational institutions. Just as important is sharing investment in highly realistic, but costly simulation mannequins. Especially critical is simulation software, which liberates educators and trainers from the difficult and time-consuming process of simulation design.

  • Think ahead to the future. Think in terms of what simulation offers today, as well as what it could offer as healthcare arrives at the gateway to 2020. The Mayo Clinic Multidisciplinary Simulation Center offers surgical suites where educators can teach techniques and simulate emergencies. Educators, who typically stand behind a control booth, are able to record, review and comment on a health team’s responses, followed by recommendations to practice or repeat the experience.

However, nurse educators and trainers need to offer simulations under the best possible conditions. That, in turn, calls for the application of simulation best practices and ongoing investment in simulation training. Before embarking on a simulation program, nursing educators should evaluate available options and consider best practices:

  • Goals: How will or could simulations contribute to achieving enterprise-wide clinical, operational and financial goals? How could simulations facilitate the move toward interdisciplinary care coordination and coordination across the continuum?
  • Planning: Does the organization have an adequate plan for integrating simulations with other education, training and learning opportunities? Does the plan cover all clinical disciplines or is it restricted to nursing?
  • Obstacles: Which barriers could prevent the organization from moving ahead with simulations? How can the organization remove or minimize these barriers?
  • Funding: Does the organization have adequate resources to purchase and upgrade new and emerging simulation technologies? Could the organization develop funding and sharing partnerships to improve access to simulation hardware and software?
  • Implementation: How should the organization introduce and implement simulation? What are the best approaches for simulation education training, promotion and buy-in?
  • Evaluation: By which metrics will the organization evaluate the impact and influence of simulations? How will the organization capture and report results on acquired knowledge and skill?
  • Innovation: Through which systems and processes should the organization introduce and integrate new simulation insights and technologies?  

Simulations have a bright future in clinical practice with implications for operational and business practice. Healthcare leaders can foster innovation through simulation by supporting ongoing research, education, training and partnerships with multiple healthcare decision makers and influencers.  

 

Susan Sportsman, RN, PhD, ANEF, FAAN is the director of the Academic Consulting Group, an innovative service of Elsevier. Sportsman is also currently the co-chair of the Texas Team Advancing Health Through Nursing Education Committee and an author and co-principal investigator of the Academic Progression in Nursing Grant awarded to the Texas Team by the Robert Wood Johnson Foundation. She was selected as a Fellow in the National League for Nursing Academy of Nurse Educators in 2011 and the American Academy of Nursing in 2012. 

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Whitepapers

Featured Webinars