When Mannequins Bleed: Clinical Simulation Transforms Nursing
Simulation is both a nursing education strategy and a tool to evaluate nurses' knowledge and competence. Simulation delivers technology-based experiential learning, putting the focus on evidence and outcomes rather than process and instruction. At a time when faculty shortages plague nursing education, simulation prepares new and existing nurses for the changing healthcare workplace, while ensuring the safety and well-being of patients and families.
Looking to the Leaders
Among those institutions in the vanguard of simulation is the University of Michigan School of Nursing, which recently launched a clinical learning center with six simulation rooms featuring high fidelity mannequins.
Nurses learn by trial-and-error as they perform procedures like drug administration or suctioning secretions from the trachea. Instructors who sit behind a bank of screens and two-way mirrors introduce physiological responses in high-tech mannequins. After participating in simulations, students take part in debriefing sessions with dedicated simulation faculty.
Simulation programs have proliferated thanks to the leadership of entities like the Regional RISE Center of Robert Morris University, which was launched in 2009 as an educational resource and center of excellence for simulation training and research.
Equally important is the International Nursing Association for Clinical Simulation and Learning, which works toward "advancing the science of healthcare simulation," and the National Council of State Boards of Nursing (NCSBN), which conducted a national study of simulation in nursing that resulted in the development of national simulation guidelines.
Expanding Choices and Benefits
Nursing faculty and students now have an expanded array of simulation technologies to choose from, including computer-based simulations, virtual/standardized and human patient simulations. Research acknowledges the drawbacks of simulation, including lack of realism, limited human interaction and incomplete patient symptoms. However, research and practical experience also point to a myriad of benefits for patients and nurses:
- Simulation improves nurses' confidence and competence in numerous nursing competencies.
- Simulation eases nurses' transition to new work environments.
- Simulation could help reduce the rate of C-section deliveries by preparing for birthing emergencies through a mobile simulation lab.
- NCSBN's national simulation study confirmed that faculty is able to substitute up to 50% simulation for traditional clinical experiences in all core nursing courses. Moreover, substituting simulation for clinical experience seems to have no impact on NCLEX pass rates.
Forward to the Future
Simulation has a bright future as educators determine how to integrate classroom learning, simulation and clinical experience for transfer application to the real-world of care delivery. For example, virtual reality delivered in the context of nurse-friendly games will enable nurses to practice complex medical procedures, like catheter insertions, multiple times and at their own pace.
Nursing students at Boise State University already see virtual reality as a fun, competitive way to learn. They find it is better able to deliver real-time feedback, especially when compared to medical mannequins, which faculty perceive as less cost effective, considering their price tag of between $15,000 and $64,000.
The compelling aspect of virtual reality is its ability to transport learners into environments they wouldn't otherwise access, according to the New Media Consortium in its 2016 Horizon Report. The bottom line: Virtual reality will have a profound impact on nursing education, offering faculty and students fresh opportunities to interact with course content in three-dimensional learning environments.
Nurses can master simulation by taking advantage of multiple programs. The Regional RISE Center of Robert Morris University offers a certificate program in simulation instruction and management, along with courses in TeamSTEPPS. Meanwhile, the International Nursing Association for Clinical Simulation and Learning fosters learning through its best practice standards, webinars, journal and online resource library.
Nursing schools, colleges and universities increasingly offer programs in simulation development, learning, management and research. Consider the following options:
Drexel University College of Nursing and Health Professions offers a certificate in simulation, while Johns Hopkins School of Nursing is committed to "bridging the gap between academe and clinical practice" via education, research and inter-professional training.
The UCLA Simulation Center offers courses in clinical nursing and team training, as well as a nursing simulation lab within the UCLA School of Nursing. Simulation centers like those sponsored by UCLA and Harvard offer simulation experiences for nurses and other clinicians.
Similar programs are available through the University of Texas at El Paso School of Nursing, St. David's School of Nursing at Texas State University, and the University of Virginia's School of Nursing Clinical Simulation Center.
If you're not ready for a complete academic program, check out nursing simulation conferences like those offered by the International Nursing Association for Clinical Simulation and Learning, Society for Simulation in Healthcare and Boise State University.
Simulation has a bright future in nursing education. As nursing evolves, simulation will evolve as an education and training tool and strategy too. For now, simulation remains a highly effective teaching and learning method that improves outcomes and reinforces a culture of safety among nursing staff.