Advance Level Nursing Education and Use of Simulation
Use of Simulator In Nursing Education
Simulation experiences represent an important component of clinical education, serving as a valuable augmentation to direct and indirect care within healthcare settings. Laboratory and simulation experiences provide an effective, safe environment for learning and demonstrating competencies. However, care experiences with current individuals or groups continue to be the most important component of clinical education.
A landmark study conducted by the National Council of State Boards of Nursing concluded that for pre-licensure students “substituting high-quality simulation experiences for up to half of traditional clinical hours produces comparable end of program educational outcomes” (Hayden et al. , 2014, p. 53). Simulation cannot substitute for all direct care practice experiences in any one sphere or for any one age group.
Also, simulation learning experiences should align with best practice standards such as those developed by the International Nursing Association for Clinical Simulation and Learning (INACSL) or the Society for Simulation in Healthcare (SSH). The use of simulation in the curriculum as a replacement of direct patient clinical/practice hours or experiences is also determined by requirements of regulatory entities (ie, licensing and accrediting bodies).
Practice Synthesis Experience/Immersion
Development of competency attainment is facilitated through use of focused and sustained practice experiences. Immersion experiences provide the learner with the opportunity to integrate the Level 1 sub-competencies. Entry level professional nursing programs (pre-and post licensure) must develop immersion or synthesis experiences that allow students to integrate learning and gain experience that facilitates transition into practice.
Such experiences provide opportunities to enact principles of the nursing discipline and for building clinical reasoning, management of care, and assessment of clinical outcomes.
These opportunities increase the student's self-confidence, professional identity, and sense of belonging within the profession. Immersion experiences also allow students to integrate previous learning and demonstrate competencies in more complex situations and contexts.
Immersion experiences may afford the student an opportunity to focus on a population of interest and clinical role. The immersion experience may occur towards the end of the program as a culminating synthesis experience; and/or there may be one or more immersion experiences at various points in a summary. The key is to provide for a concentrated practice experience that approximates professional practice expectations (Fowler et al., 2018; Tratnack et al., 2011).
Advanced Level Nursing Education
Nursing programs preparing nurses to advance their education beyond entry level professional nursing practice will incorporate advanced-level nursing education (Level 2) sub-competencies: Advanced-level nursing education programs (degree granting and advanced nursing practice post-graduate certificate programs) intentionally build on Level 1 sub-competencies.
Although Level 2 sub-competencies have been written with doctoral education in mind, the actual differentiator for the degree attained does not lie within the sub-competencies themselves, but rather the degree/program requirements-such as the DNP project (described below), role/ specialty requirements, and other requirements set by the faculty and institution.
While it is not expected that every sub competency and concept will be applied in every course, sub-competencies are not to be isolated in one or two courses and then disregarded for the rest of the program.
Advanced level nursing education programs prepares for practice in an advanced nursing practice specialty (informatics, administration/practice leadership, public health/population health, health policy) or an advanced practice nursing role (certified graduate nurse practitioner, certified nurse midwife, certified clinical nurse specialist, certified registered nurse anesthetist).
Advanced level nursing education programs focus on providing specialty knowledge for graduates to enact specific advanced practice nursing roles or assume advanced nursing specialty practice within the healthcare system.
For this reason, specialty competencies, defined by nationally recognized specialty organizations, represent a major component of advanced level nursing education programs. Specialty competencies complement and build upon the Level 2 sub competencies.
All graduates of an advanced nursing education program are prepared and eligible for national, advanced nursing practice specialty certification or advanced nursing practice role certification when available. It is noteworthy that specialties evolve over time and new specialties may emerge.
All DNP programs (post-baccalaureate and post-master's) demonstrate that graduates attain and integrate Level 2 sub-competencies and competencies for at least one advanced nursing practice specialty or advanced nursing practice role.
Individuals should seek to advance disciplinary expertise in a chosen nursing specialty or advanced nursing practice role. This expertise is critical to advancing the profession, to expand the influence of the profession for the transformation of health care, and to ensure an informed disciplinary perspective for teaching in the discipline.
Advancing education in nursing with the emphasis on teaching and learning alone does not fulfill the achievement of disciplinary expertise. Excellence as an educator is achieved by the collective enterprise for faculty teaching and learning afforded by institutions and applied to discipline-specific teaching.
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