Simulation Method In Nursing Education and Their Use
What Is Simulation Methods
Simulation is a trial-and-error method of teaching whereby an artificial experience is created that engages the learner in an activity that reflects real-life conditions but without the risk-taking consequences of an actual situation. Simulation is a highly innovative teaching method to teach health professionals about the complex world of health care in their respective disciplines in an effective, efficient, safe, and high-quality fashion.
As Gaba (2004) explains, “Simulation is a technique, not a technology, to replace or amplify real experiences with guided experiences that replicate substantial aspects of the real world in a fully interactive manner” (p. 12).
Over the past 25 years, but especially in the last few years, interest in simulation has grown rapidly as a way to hone the knowledge and practice skills of the healthcare workforce for the ultimate purpose of improving patient safety, patient care outcomes, and teamwork ( Beaubien & Baker, 2004; Chiniara et al., 2013; Gaba, 2004).
No longer seen as a technological toy for learning basic skills, simulation is now used to teach critical thinking and high level decision making skills and to serve as a feedback tool for an assessment cycle of repeated performance, clinical practice, and improvement (Bluestone et al., 2013; Gaba, 2009; Kaufman & Ireland, 2016).
It is also a means to foster collaborative interdisciplinary education to improve teamwork, communication, and role evaluation among the various healthcare disciplines (Dillon, Noble, & Kaplan, 2009).
To some extent, overlap exists between the methods of gaming, simulation, and role play, in that all three instructional approaches require learners to engage in experiential learning (Allery, 2004). Simulation allows participants to make decisions in a safe and controlled environment, witness the consequences, and evaluate the effectiveness of their actions (Corbridge et al., 2008; DeYoung, 2014).
Usefulness of Simulation Method
A follow up discussion with learners after use of these experiential methods is important to facilitate their analysis of the experience. Simulation should always be followed by a debriefing session that includes a discussion of events that happened during the experience, the decisions made, the actions taken, the consequences of the choices, the possible alternatives, and suggestions for improvement in skill performance.
Simulations provide the opportunity for antic ipatory learning (Allery, 2004: Childs & Sepples, 2006; Jeffries, 2005).When planning a simulation, it is most effective if the educator makes the learning experience resemble real life as much as possible but in a nonthreatening way.
The activity should challenge the decision-making ability of the learner by imposing time constraints, providing realistic levels of tension, and using actual equipment or other important features of the environment in which the specific skill will be performed.
For example, a scenario could be developed to help parents prevent sudden infant death syndrome (SIDS) by working through a situation in which a monitor signals respiratory difficulty in their baby. As another example, a staff nurse along with other staff team members might be expected to make a rapid assessment and intervene with accuracy, coordination, and speed in caring for a chest trauma victim in a simulated emergency room setting.
Such simulations are created to determine whether the learner has the necessary skills to perform the activity correctly.
Types of Simulation Method In Nursing Education
Many types of simulations are possible, including the following (Beaubien & Baker, 2004; Childs & Sepples, 2006; Epstein, 2007; Gaba, 2004; Jeffries, 2005, 2013; Turner, 2007; Yoo & Yoo, 2003):
1.Written simulations may use case studies about real or fictitious situations, with the learner being asked to respond to these scenarios. Staff nurses, for example, might be asked to describe how they would handle a personnel communication problem on a unit or manage a physiologically complex patient in the critical care environment.
2.Clinical simulations can be set up to replicate complex care situations, such as a mock cardiac arrest. An experienced nurse can serve as a buddy or a coach for the inexperienced nurse who is running the code. This simulation allows the novice to practice these skills in a nonthreatening situation with immediate feedback.
Participants in such simulations have reported that these sessions helped them validate their thinking and allowed for ongoing thinking out loud in formulating questions they might otherwise not have asked.
3.Model simulations are frequently used to teach a variety of audiences. An effective and economical method to teach certain non-invasive skills is to ask a peer, educator, or trained individual to act as a patient. Standardized patients-people trained to act as patients were found to be a more effective method of simulation to teach fundamentals to nursing students than were lectures and laboratory practice with a model.
4.An innovative technology is high-fidelity whole-body patient simulators, such as Sim Man, that reproduce in a sophisticated, lifelike manner the cardiovascular, respiratory, urinary, and neurological systems.
The more sophisticated models (SimMan 3G) are able to respond to selected drugs; mimic heart, lung, and bowel sounds; and give oximeter and vital sign readings in response to a variety of interventions. However, widespread use within clinical settings remains limited by the high cost of this technology.
5.Computer simulations are used in learning laboratories to mimic situations whereby information and feedback are given to learners in helping them develop decision-making skills.
6.The learning laboratory is a commonplace teaching environment for nursing students on college campuses and has been used in the last 15 years to update the skills of nurses reentering the workforce.
Nevertheless, these simulated experiences are not yet widely available to train patients or family providers in self care skills because of lack of space and the high cost of simulators. In the future, simulation with high-tech, portable equipment could revolutionize client education.
7.Simulated experiences for the learner should be followed with actual experiences as soon as possible. Simulation is never the same as the real thing to prepare the learner. Therefore, the learner will need help with the transfer of skills acquired in a simulated experience to the actual situation.
Virtual reality technology, which is emerging in healthcare education and practice settings, has the potential to narrow the distance even more between simulation and real life for the education of patients, nursing students, and staff (Cook et al., 2011; Gaba, 2009 ; Jenson & Forsyth, 2012; Kaphingst et al., 2009).
8.Simulation can be made more cost effective by reuse of supplies and the interdisciplinary sharing of simulation equipment. Given the shortage of healthcare faculty, the diminishing number of clinical sites available for practice teaching, and the growing knowledge base and skills needed to produce competent and confident care providers, simulation offers a cost effective approach to student teaching, staff orientation, and continuing staff development (Jeffries, 2005, 2013).
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