Using International Nursing Association for Clinical Simulation and Learning Standards to Evaluate the Rigor of High-Fidelity Simulation Learning Experiences

In situ simulation training strengthened bachelor of nursing students' experienced learning and development process- a qualitative study

BACKGROUND

In advanced clinical learning labs on campus, high-fidelity simulation has become an essential educational approach in the Bachelor of Nursing Education programme. However, simulation while in clinical placement, in situ, is rarely used in Bachelor of Nursing Education. The aim of the present study was to explore how in situ simulation training at a surgical hospital ward, according to Bachelor of Nursing students, influenced their learning and development process.

METHODS

A qualitative descriptive study was conducted. Data were collected through individual interviews with a sample of 21 s-year Bachelor of Nursing students who completed 40 in situ simulations during their eight-week clinical placement at a Norwegian University Hospital. Data were analysed using inductive content analysis.

RESULTS

The data analysis generated six subcategories constituting two descriptive categories: building professional confidence and internalising nursing knowledge. Although the students found in situ simulation stressful and uncomfortable for being assessed by student peers, the teacher and preceptor, the process of managing clinical situations in simulation helped build professional confidence. What the students had learned in the simulation was directly transferable to real clinical situations because they were in the hospital setting. The simulation sessions enabled them to connect theoretical knowledge and clinical skills. They could test their skills in a safe environment, performing procedures that made them aware of how their knowledge could be used in real life.

CONCLUSION

According to the Bachelor of Nursing students' own experiences, in situ simulation supported the students' learning process, connected theory and practice and contributed to developing confidence in the performance of clinical skills. Including simulation in clinical practice could prove to be an effective way of teaching and learning clinical skills in nursing regarding resources and learning outcomes.

Determining current approaches to the evaluation of the quality of healthcare simulation-based education provision: a scoping review

Background: With an increase in simulation being used in healthcare education, there is a need to ensure the quality of simulation-based education is high. This scoping review was conducted to answer the question: What are the current approaches to the evaluation of the quality of health-care simulation-based education provision? Methods: Databases PubMed, Cochrane, ERIC, CINAHL and Medline were searched in March 2023 to retrieve peer-reviewed healthcare research and review articles written in the English language within the last 20 years. All data were extracted from six studies, themed and presented in the main text and in tabular form. Results: Two scoping reviews, one systematic review and three research articles were included. Three main themes were found: adherence to existing design frameworks, lack of validation of these frameworks and lack of evaluation frameworks, and a proposed evaluation framework. Many of the excluded articles focussed on gaining participant feedback to evaluate simulation activities, rather than evaluating the quality of the design and implementation of the simulation. Conclusions: Benchmarking of current United Kingdom (UK) healthcare simulation against UK and international simulation standards is required to increase its quality, therefore, an agreed UK template framework to evaluate simulation packages is recommended.

Impact of Simulation on Undergraduate Student Outcomes

BACKGROUND

Clinical reasoning is a cognitive and metacognitive process that is essential for positive patient outcomes. Simulation experiences provide situations and reflection where students can build clinical reasoning.

PURPOSE

This study examined the impact of a higher number of simulation experiences on undergraduate student outcomes.

METHODS

A retrospective comparison study examined differences between group grade point average, Assessment Technologies Institute (ATI) predictor, and National Council Licensure Examination (NCLEX) scores ( P < .05). A sample of 395 students was included in data analysis.

RESULTS

No differences were noted in grade point average or NCLEX pass rates. However, students who completed a simulation elective had significantly higher ATI predictor scores. Cohen's d (0.39) approached a medium effect size.

CONCLUSIONS

Incorporating higher levels of in-person simulation through creative delivery models can improve student outcomes. Simulations may enhance students' clinical reasoning skills.

Form for planning and elaborating high fidelity simulation scenarios: A validation study

Every human being has the right to safe, dignified and harm-free care in health institutions. High fidelity simulation has been used in teaching for the training and continuing education of health professionals to promote quality, safe and humanized patient care. Elaborating scenarios is an important phase to provide a simulation-based experience, and is relevant in the teaching-learning process. The objective of this study was to validate the content and applicability of the High Fidelity Simulation Scenario Planning and Development Form and its Operational Manual. The form could be used to development of scenarios to medicine, nursing, physiotherapy and as well as other specialties in the healthcare. This was a methodological validation study of the form and its manual content by experts in simulation and its feasibility, conducted in two phases: Phase 1: eight experts were selected using the “snowball” sampling technique to validate the content measured by the content validity index; Phase 2 (test): the form and its operational manual validated by the experts were made available to 28 participants in order to elaborate scenarios for the feasibility assessment and participation in the focus group. All items in the form and in the operational manual reached a content validity index above 0.80. The total content validity index was 0.98. The evaluation of the usability of the instruments carried out by the participants reached a percentage above 96.43% in all alternatives except for the item “It was easy to use the form to build your scenario” (75%). Eight participants were present in the focus group. Focus group discussions were categorized into completeness, practicality and usefulness according to comments and suggestions. The form and its operational manual proved to be valid instruments.

P Stands for Pivot: Pivoting Face-to-Face Practicum to Virtual Simulation during the Pandemic

Virtual simulation has been widely used to temporarily replace face-to-face clinical practicum experiences in nursing education in response to the global COVID-19 pandemic. While more traditional clinical settings were prioritized and made available only to senior students, the use of virtual simulation provided an opportunity to safely pivot from the usual placement to a comparable practical learning modality to maintain clinical competence during unprecedented public health restrictions and mitigation strategies. Like many others across the globe, nursing students in a Canadian university continued their nursing education predominantly using virtual simulation for an entire academic year to avoid catastrophic delays in entering the workforce and to ultimately protect the health service delivery needs throughout the oncoming waves of the pandemic. The purpose of the paper is to describe guiding principles established in a School of Nursing as a means to responsibly and ethically adopt a replacement of traditional clinical practicum experiences with virtual simulation. The principles for incorporating virtual simulation included the need to achieve and maintain a high level of quality of learning experiences, a fluid delivery articulated in phases, and a financial commitment by the learning institution. As the global pandemic may see a fourth wave, the use of virtual simulation will continue to present a major change for clinical practicum and establishing principles for the use of virtual simulation has demonstrated to be an integral part of safe pandemic response and post-pandemic recovery.