1. Using Simulation to Prepare Nursing Students Dawn M. Garrett, Ph.D. (c), RN & Lisa Proctor, BSN, RN Western Kentucky University School of Nursing

2. An Old Chinese Proverb States “I hear, I forget;“I hear, I forget; I see, I remember; I do, I understand!”

3. Ask Yourself? Do I want to be on the pilot’s first flight?Do I want to be on the pilot’s first flight? Would I like to be the surgeon’s first case?Would I like to be the surgeon’s first case? In an emergency, would I be comfortable knowing the nurse had never taken care of a client with my condition?In an emergency, would I be comfortable knowing the nurse had never taken care of a client with my condition? Will I trust my money to an inexperienced broker?Will I trust my money to an inexperienced broker? Would I send my child to a therapist/counselor who had just graduated and begun practicing?Would I send my child to a therapist/counselor who had just graduated and begun practicing?

4. Question How do you get experience in an applied discipline or profession without…. …getting your experience on the job??

5. Simulation Defined “A near representation of an actual life event” (Billings & Halstead, 1998)“A near representation of an actual life event” (Billings & Halstead, 1998) “An event or situation made to resemble clinical practice as closely as possible”“An event or situation made to resemble clinical practice as closely as possible” (Jefferies, 2007)

6. Simulation Roots Simulation has been used in in many disciplines for decadesSimulation has been used in in many disciplines for decades Used by multiple disciplines/professions as a risk free training mechanismUsed by multiple disciplines/professions as a risk free training mechanism Stimulates critical thinkingStimulates critical thinking

7. Uses of Simulation In Various Disciplines Teach TheoryTeach Theory Assess Progress Toward Course ObjectivesAssess Progress Toward Course Objectives Integration of Technology in the Classroom and Clinical SettingIntegration of Technology in the Classroom and Clinical Setting Development of Reasoning Skills/Critical ThinkingDevelopment of Reasoning Skills/Critical Thinking

8. History of Simulation in Healthcare Education Used for 40 + years in many healthcare disciplinesUsed for 40 + years in many healthcare disciplines Typically low tech simulations using stagnant modelsTypically low tech simulations using stagnant models Last 10 years we have seen a dramatic increase in high fidelity simulation equipmentLast 10 years we have seen a dramatic increase in high fidelity simulation equipment

9. National Council of State Boards of Nursing Definition of Simulation “Simulations are activities that mimic the reality of a clinical environment and are designed to demonstrate procedures, decision-making and critical thinking through techniques such as role- playing and the use of devices such as interactive mannequins.”“Simulations are activities that mimic the reality of a clinical environment and are designed to demonstrate procedures, decision-making and critical thinking through techniques such as role- playing and the use of devices such as interactive mannequins.” (NCSBN, 2004)

10. Types of Simulation Low techLow tech –Case studies –Role playing High techHigh tech –Gaming software –Virtual Excursion/Virtual Reality Software –Human patient simulators Resusci-Annie (low fidelity)Resusci-Annie (low fidelity) Vital Sim (medium fidelity)Vital Sim (medium fidelity) Sim Man (high fidelity)Sim Man (high fidelity)

11. Key Elements of a Simulation ObjectivesObjectives FidelityFidelity Problem-SolvingProblem-Solving Student SupportStudent Support ReflectionReflection

12. Why Are We Using More Simulations in Nursing? Simulation offers alternativesSimulation offers alternatives –Allows teaching multiple objectives –Brings learning alive –Increases student confidence leading to competence –Eases strain on clinical sites –Risk free training Not a substitute for, but a complement to, supervised clinical practiceNot a substitute for, but a complement to, supervised clinical practice

13. High Fidelity Simulations in the ADN Program Simulation DesignSimulation Design Objectives must be developed by the instructor Objectives must be developed by the instructor Supplies and set-up for the chosen experience Supplies and set-up for the chosen experience Coordinate the experience to the curriculum currently being taught in the classroom Coordinate the experience to the curriculum currently being taught in the classroom Develop experiences that correlate to the clinical expertise of the student participantsDevelop experiences that correlate to the clinical expertise of the student participants Debriefing session after the experience Debriefing session after the experience

14. High fidelity simulations currently used in the ADN programsHigh fidelity simulations currently used in the ADN programs BSN use of simulationBSN use of simulation

15. Sim WoMan (aka-Molly Green)

16. Conducting the Patient Assessment

17. Planning Care

18. Preparing to Intervene

19. We Saved Molly Green!!

20. Advantages Patient safety is not threatened Patient safety is not threatened The instructor controls the clinical situation The instructor controls the clinical situation Mistakes can be madeMistakes can be made Learning is interactive and includes immediate feedbackLearning is interactive and includes immediate feedback Delegation, leadership and communication skills can be developedDelegation, leadership and communication skills can be developed Psychomotor skills can be taught and appliedPsychomotor skills can be taught and applied

21. Disadvantages Cost of high-fidelity simulators can range from $20,000 to $200,000 depending on the features Cost of high-fidelity simulators can range from $20,000 to $200,000 depending on the features Reliability and maintenance of the simulator Reliability and maintenance of the simulator Required technical support for the simulator Required technical support for the simulator Physical space requirements Physical space requirements To enhance learning, only small groups of learners can be accommodated in each sessionTo enhance learning, only small groups of learners can be accommodated in each session Both faculty and learners can experience performance anxiety Both faculty and learners can experience performance anxiety

22. Benefits For StudentsFor Students Risk free training Risk free training Brings learning alive Brings learning alive Increases confidence leading to competence Increases confidence leading to competence Friendly environment for learning Friendly environment for learning For Faculty Risk free training Lessens the number of clinical sites required for training Allows teaching of multiple objectives

23. If you make people think they're thinking, they'll love you; But if you really make them think, they'll hate you.If you make people think they're thinking, they'll love you; But if you really make them think, they'll hate you. –Don Marquis US humorist (1878 - 1937) Don MarquisDon Marquis

24. Pitfalls/Lessons Learned The faculty member sets the tone for the experience The faculty member sets the tone for the experience Debriefing is often overlooked, but can be the greatest teaching experience for both the student and the instructor Debriefing is often overlooked, but can be the greatest teaching experience for both the student and the instructor Assign roles to the students-this ensures that everyone gets an opportunity to fully participate Assign roles to the students-this ensures that everyone gets an opportunity to fully participate

25. Education's purpose is to replace an empty mind with an open one.Education's purpose is to replace an empty mind with an open one. –Malcolm Forbes, in Forbes Magazine US art collector, author, & publisher (1919 - 1990) Malcolm ForbesMalcolm Forbes

26. Time to Share How are you using simulations in your courses?How are you using simulations in your courses?