S IMULATION : A TEACHING STRATEGY Mayumi Anthony Cheryl Muffley

O VERVIEW OF S IMULATION Definition: A method of instruction whereby an artificial or hypothetical experience that engages the learner in an activity reflecting real-life conditions but without the risk-taking consequences of an actual situation is created (Bastable, 2008, p. 635). Description: Participants make decisions in a safe environment, witness the consequences, and evaluate the effectiveness of their actions.

A PPLICATION OF E DUCATIONAL T HEORIES Social Learning Theory Self-efficacy or social change occurs through modeling and reinforcement learning. Educator designs a simulation to teach a skill, pattern, or role play, and then designs additional simulations where the target behavior is reinforced. Simulation provides planned stimuli organized in a way so as to give the participant opportunity to respond. Experiential Learning Theory Educator designs simulation to match a student’s needs and preferences for learning. Students are assigned to participate in a simulation activity that matches their learning style.

A PPLICATION OF S IMULATION TO TEACHING SITUATIONS Assessment Skills Assessment of and early intervention for patients with acutely deteriorating conditions Improved proficiency in advanced life support following simulation training compared to clinical experience alone (Wayne et al., 2005) Hospital resuscitation teams trained in advanced life support using simulation can improve patient outcomes following cardiac arrest (Moretti et al., 2007) Pharmacological concepts Drug recognition unit allows simulator to respond physiologically (Rauen, 2004) Ex. Simulated morphine injection causes pupil size of mannequin to change and the respiratory rate, heart rate, and blood pressure to decrease Instructor can pause simulation to review assessments, detect problems, or discuss treatment

A PPLICATION OF S IMULATION TO TEACHING SITUATIONS ( CONT.) Basic and Advanced Cardiac Life Support Techniques Developing and demonstrating critical thinking skills Scenarios require students to use classroom knowledge, incorporate assessment skills, and create and implement a plan Students are given an opportunity to witness the outcome and evaluate their plan and make appropriate changes if necessary With the use of simulation, students can implement the entire nursing process and are required to think critically

U SES OF SIMULATION : A PPROPRIATE SETTINGS Aviation Transportation Nuclear Power Industry Social and Behavioral Sciences

U SES OF SIMULATION : A PPROPRIATE SETTINGS IN NURSING Undergraduate Graduate Hospitals: Nursing Orientation

A DVANTAGES OF S IMULATION Enjoyable, motivating activity Element of reality is compatible with principles of constructivism Enhances appreciation of the more subtle aspects of concept/principle Promotes critical thinking Allows student to practice reality in a safe setting

L IMITATIONS OF S IMULATION Preparation time Cost can be an issue Assessment is more complex than some traditional teaching methods

W AYS TO A DAPT S IMULATION Time The arc of the activity can be adjusted. Content Some simulations offer content more appropriate to specific ages, trainings, and professions. Expectations Not all students appreciate the subtleties of a concept as well as others. Rubrics can be developed to help the educator determine the level of success.

E VALUATION OF THE E FFECTIVENESS OF S IMULATION Educators must monitor the process to ensure that students both understand the process and are benefiting from it. Helpful to develop rubric as a guide Follow up activities may be helpful to establish a measure of comprehension. Some prepackaged simulations include assessment suggestions.

E VALUATION OF THE E FFECTIVENESS OF S IMULATION ( CONT.) Does this simulation offer an appropriate measure of realism for my group of students? Are the desired instructional outcomes well defined? Is the level of ambiguity manageable for this group? Does the student demonstrate an understanding of his/her role? Are problem solving techniques in evidence? Is cooperation between participants in evidence? Has the student been able to resolve the issue satisfactorily? Does the student provide meaningful answers to probing questions? Will follow-up activities be necessary? The following are some questions that educators may ask themselves to assess the simulation and its apparent success:

C ONCLUSION Simulation is a vehicle for translating classroom knowledge into a safe learning environment (Leigh, 2008). Simulation allows learners to function in an environment that is as close as possible to an actual clinical situation and provides them an opportunity to “think on their feet, not in their seat” (Rauen, 2004). Simulation promotes the use of critical and evaluative thinking.

C ONCLUSION ( CONT.) The main benefits of simulation can be summarized as: experimentation in limited time, reduced analytical requirements, easily demonstrated models. The main limitations are: simulation cannot give accurate results when the input data are inaccurate, simulation cannot provide easy answers to complex questions, simulation cannot solve problems by itself. Success is usually determined by the facility and commitment of the participants. Follow up activities may be helpful to establish a measure of comprehension.

R EFERENCES Bastable, S. B. (2008). Nurse as educator (3 ed.). Sudbury, Massachusetts: Jones and Bartlett. Cameron, B. (2010). The Effectiveness of simulation in a hybrid and online networking course. Tech Trends, 47 (5), Retrieved from Leigh, G. T. (2008). High-fidelity patient simulation and nursing students’ self-efficacy: A review of the literature. International Journal of Nursing Education Scholarship, 5 (1). Moretti, M. A., Cesar, L. M., Nusbacher, A., Kern, K. B., Timerman, S., & Ramires, J. A. (2007). Advanced cardiac life support training improves long-term survival from in-hospital cardiac arrest. Resuscitation, 72, Rauen, C. (2004). Simulation as a teaching strategy for nursing education and orientation in cardiac surgery. Critical Care Nurse, 24 (3), 46 – 51. Saskatoon Public Schools. (2010, March 17). Instructional strategies online. Retrieved from Wayne, D. B., Butter, J., Siddall, V. J., Fudala, M. J., Lindquist, L. A., & Feinglass, J. (2005). Simulation-based training of internal medicine residents in advanced cardiac life support protocols: A randomized trial. Teaching and Learning in Medicine, 17 (3),