Simulation in the Undergraduate Nursing Curriculum at Queen’s University Belfast: Clinical Skills, OSCE, ILS, High Fidelity Simulation

Why is simulation important?

The HPS Represents Advanced Technology, ‘mimics’ a Real Patient” & adds Authenticity Interacts with the student Patient’s condition can improve or deteriorate with interventions as the scenario progresses

Putting Simulation into Action Five students worked together on each scenario, two participated and three observed. Students were given the scenario by a lecturer as a ward handover report and had twenty minutes to carry out the appropriate nursing interventions. Nurse teachers took the role of qualified nurse or relative as necessary during the scenario

Simulated Learning Cycle Clinical scenario Assessment & Diagnostic Skills Nursing Interventions Debriefing & Reflection Self Assessment Future Action

Theme 1: The ‘Reality’ of the Simulation Once the simulation session began students forgot that they were working on a simulated patient and responded to the situation as if it were ‘real’. This response was integral in all other themes.

Theme 2: The Benefits of Active Learning Students stated that the HPS experience provided a much better learning opportunity than a text book, indicating that they perceived a huge difference between seeing and doing. Students were clear of the need to visualise a situation in order for learning to occur.

Theme 3: The Opportunity to Experience working as an Autonomous Practitioner The experience enabled students to recognise the importance of a sound knowledge base to effective clinical judgement and decision making. Students benefited from the opportunity to work independently and the experience enabled them to realise that effective care depended on good team work.

Theme 4:The Importance of Theory to Practice Students commented that the case scenarios exposed individual and collective knowledge deficit. This is summarised by one student who stated: “…the lack of knowledge was made clear…..I had notes and books but I had not read and absorbed the information. You can cram for examinations but when you are faced with a problem you have to be able to apply theory to practice.” The simulated case scenarios also affirmed the importance of students asking questions during clinical placement as a means of extending their knowledge base.

Theme 5 The Benefits of Working in a Safe Environment “ “An excellent day, the scenarios were so real, it was like a real patient” “I found the simulation practice enjoyable and interesting. I feel it helped to highlight areas where I need further development in my skills and also showed my strengths” “I feel that this opportunity has urged me to think about the care we deliver as nurses and the importance of teamwork. It was a very worthwhile day” “The theory is being taught, therefore, it is great to put us into such a real life scenario to deal with and help us understand our strengths and weaknesses. This experience will improve the quality of care we provide for our patients when we are on placement and as newly qualified nurses”

Enhancing the Learners’ Experience

Recommendations It is imperative that nurse educators help prepare students for the reality of the clinical environment where cases are increasingly complex. Using the HPS as an educational tool, can assist with the transition from student to a trained member of the health service would appear to offer some solution to this problem The HPS encourages students to think critically and analytically and allows the lecturer to vary the clinical scenarios in response to changes in the health service. The scenarios can be used to facilitate teamwork and to monitor how the student reacts in challenging situations. Debriefing is a forum for reflection and debate of the issues arising from the scenarios. The scenarios introduce students to situations they will experience as a qualified nurses within the safe simulated clinical environment.