Scenario Based Clinical Learning In Nursing Education

Use of Scenario Based Clinical Example in Nursing 

Clinical Scenarios Definition,Clinical Scenario In Nursing Education,Application of Scenario Based Evidence In Nursing Education,Outcomes In Nursing Education.

Clinical Scenarios Definition

    The term scenario is derived from the Latin word scenario, indicating a place for building a stage; "scaena" is the term for the stage itself. A scenario is a collage of events or series of actions that unfold during a performance. Clinical scenarios in nursing address relevant events that occur in the actual execution of health care. During the last decade, a theoretical model and guidelines have emerged to steer the advancement of inter active student learning scenarios in nursing education and clinical practice.

Clinical Scenario In Nursing Education

    Clinical scenario applications have been used by the aeronautic, automotive, military, and other industries to develop the best defensive tactics for the prevention of error and promotion of safety. Scenarios are a component of the broader category of simulation education that incorporates low- and high-fidelity manikins, skill and task trainers, virtual reality trainers, and computer-based simulators. The scenario requires a model or laboratory that represents the real-world clinical process. Simulation characterizes the operation of the model or activities that mimic the clinical reality (Jefferies, 2005). 

    A scenario is the enacted performance creating opportunity for a high level of realistic interactivity for students to learn and develop confidence. A specification of the details of the enactment and the order of the activities is required. Written materials are prepared for the faculty and a separate script is designed for the student. An important aspect of the clinical scenarios is the debriefing segment, which includes reflection on the experience, the student's performance, and what was learned (Schneider Sarver, Senczakowicz, & Slovensky, 2010).

Application of Scenario Based Evidence In Nursing Education

    Scenarios have been written to address essential domains of nursing practice including technical and functional training, problem solving decision making, and team based competencies (Schneider Sarver et al, 2010). They are increasingly used in nursing education throughout the United States and internationally. Both prelicensure and advanced clinical skills require active listening, effective communication, knowledge, and competence appropriate to the individual's education and experience. The scenario must match the specific level of the undergraduate student while advancing in various degrees of complexity. 

    Both simple vignettes and complex scenarios were rated by students as beneficial in helping them to set priorities, develop critical thinking, acquire assessment skills, and gain an awareness of the nurse's role (Guhde, 2011). Scenarios used in graduate programs, particularly the post-scenario reflection, have been identified as an effective teaching method for graduate faculty and a positive learning experience for graduate students (Einion, 2013; Velok & Smedley, 2014).

    Simulation scenarios have been incorporated into the employment setting for licensed providers to learn new techniques and maintain and strengthen skills that are necessary for events that rarely occur. Clinical scenarios are a mechanism for integrating individual skills into complex operational capabilities. Clinical scenarios are designed to develop and enhance team interaction, giving students the opportunity to improve communication, decision making, and team discipline (Liaw et al., 2014). Although simulation scenarios can be traced back to several decades, current designs are more realistic and congruent with the complexity nurses encounter in the workplace. 

    Clinical scenarios provide students with a means to safely understand the potential for failure while gathering the necessary data to make critical decisions in real-time replication. Jefferies (2005) identified six critical areas as essential components for clinical scenarios: objectives, planning, fidelity, complexity. cues, and debriefing Continued efforts in simulation scenario education produced theoretical frameworks for generating scenarios (Jeffries & Rogers, 2009). Sixteen studies from the United States and the United Kingdom have used frameworks in undergraduate and graduate curricula to design and evaluate respective simulation scenarios. 

    Students reported that participation in clinical scenarios provided more opportunity for problem solving and that the experience positively affected critical thinking. Analysis of the student outcomes demonstrated improvement in patient safety competencies, higher levels of student satisfaction with the learning method, and increased confidence regarding clinical skills (LaFond & Van Hulle Vincent, 2013)Waxman (2010) introduced an evidence-based practice (EBP) template for constructing clinical scenarios as a means to promote effective learning. 

    The template was derived from EBP data to advance clinical reasoning skills. Key elements of the template include techniques to measure learning and validation criteria for written scenarios. Data from the Simulated Professional Learning Environment (SIMPLE) provided further evidence of the value of clinical scenarios for baccalaureate students. The students believed that they were better prepared for transitioning to the workplace as a result of the clinical scenario experience (Liaw et al., 2014). 

    The health care environment is continually changing, thus challenging educators to provide a safe platform for learning while preparing graduates to apply clinical reasoning skills in the actual setting Clinical scenarios prepare the learner to quickly organize data derived from multiple sources, process the data, and identify priority needs. Evaluation, reflection, and feedback provide the learner with the opportunity to safely advance in proficiency.

Outcomes In Nursing Education

    Multisite trials with large sample sizes have been called for to thoroughly evaluate the effect of simulation scenarios on prelicensure students (Shinnick, Woo, & Mentes, 2011), Jeffries et al. (2011) reported on the effectiveness of a highly complex simulation based cardiovascular assessment curriculum for advanced practice nurses (APN). There was participation from four university-based nursing programs distributed across the United States, with a small number of participants from each institution. 

    Logistic challenges, human resources, and cost have posed obstacles to conducting more multi site complex trials and well-constructed clinical scenarios have emerged primarily in the medical surgical practice areas. Future effort should include the development of maternal infant and child scenarios that address childbearing and parenting Substantial validation of the effectiveness and cost-effective improvement of student learning and patient outcomes will provide valuable information for broadening the use of clinical scenarios in nursing education.