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Nurses are expected to possess leadership skills and employers demand new graduates demonstrate leadership skills such as professional behaviors, critical thinking, conflict management, prioritization, delegation, and excellent communication skills. However, few senior nursing students express confidence in their own leadership skills. Simulation can be a confidence building approach to develop leadership skills. To determine if a simulation activity can develop students’ leadership skills, small groups of students responded to multiple simulated patients. Following a change-of-shift report, four students, functioning as nurses, and a fifth student, acting as charge nurse, cared for four human patient simulators that represented typical acute care patients requiring simultaneous care. The patient care scenarios were designed with a change in patient status or a need for the student to make a decision during the scenario. Students evaluated the activity by writing a narrative of their leadership experience. Faculty members assessed students’ demonstration of quality improvement guidelines, agency policies, risk management principles, ethical principles, legal guidelines, prioritization, delegation, and communication. The faculty determined that the activity was effective in developing leadership behaviors based on feedback from students and faculty who participated in the activity.. Using simulators to develop leadership skills with a group of peers and evaluated by faculty may benefit nursing students to prepare for clinical decision-making. Assessment of student performance during carefully crafted scenarios may identify the necessary knowledge, skills, and attitudes for professional behaviors, prioritizing, delegating, and excellent communication skills required by nurses in today’s healthcare environment. Abstract Objectives Course leaders selected scenarios and prepared a sequence of activities to include the care of four typical medical, obstetric, and pediatric patients. Two of the four required a phone call to the MD. Three of the four experienced a sudden change of condition that required nursing intervention. One of the four developed a life threatening change requiring new orders from the MD. Preparation Implementing the Scenario Student’s Perceptions References Cooper, S., Kinsman,L., McConnell-Henry T., Endacott, R. & Schools, J. (2010). Managing the deteriorating patient in a simulated environment: Nursing students' knowledge, skill and situation awareness. Journal of Clinical Nursing, 19, 2309-2318. Kaddoura, M. A. (2010). New graduate nurses’ perceptions of the effects of clinical simulation on their critical thinking, learning, and confidence. The Journal of Continuing Education in Nursing, 41(11), 506-516. Kaplan, B., & Ura, D. (2010). Use of multiple patient simulators to enhance prioritizing and delegating skills for senior nursing students. Journal of Nursing Education, 49(7), 371-377. Radovich, P., Palaganas, J., Kiemeney, J., Strother, B., Bruneau, B., & Hamilton, L. (2011). Enhancing leadership orientation through simulation. Critical Care Nurse, 31 (5), 58-63. Schaefer, J. J., Vanderbilt,A., Cason, C.L., Bauman, E.B., Glavin, R.J., Lee, F.W., & Navedo, D.D. (2011). Instructional design and pedagogy science in healthcare simulation. Simulation in Healthcare, Supplement 6 (7), s30-38. Contact Margaret Kroposki, PhD, RN University of Phoenix Online mkro18@email.phoenix.edu mkroposki@att.net At the conclusion of this presentation, the participant will 1.State how nurse educators can teach leadership skills leadership skills in a simulation lab using multiple simulators. 2.State how nursing students perceive their experience with multiple simulators enhanced their confidence in the development of leadership skills such as professional behaviors, prioritizing, delegation, and communication. Faculty charge nurse gave the student charge nurse a separate report. The student changer nurse assigned other students as staff members to the four different simulated patients. Student staff nurses entered the patient area and began assessment of assigned patient. All patients were stable for about 10 minutes. Students could consult a bedside chart that included an order sheet, any standard protocols for that patient’s condition, and the phone number of attending physician who was played by the faculty monitoring the scenario. The student charge nurse made rounds and responded to student staff nurse concerns. Faculty monitored the scenario, changed the patient’s condition, used a microphone to verbalize for the patient, played part of MD when called by nurse, and gave orders to respond to patient’s change of condition. Technology included one-way window, video and audio capture, and real time audio to allow student to interact with patient. A lab manager solved technical issues. Night shift nurse (faculty) gave a short report to student staff nurses. The report was realistic in that not all information was reported. Student staff nurses were expected to request pertinent information. Students brought their own stethoscope, pen, paper, penlight, and cell phone to use to call for lab results or the physician if necessary. The course leader oriented and assigned faculty to four simultaneous scenarios, two charge nurse (faculty) and one outgoing night shift nurse (faculty). The four scenario faculty played the roles of patient, monitor, and physician. Faculty and students used cell phones to assist with communication. Debriefing included a short individual evaluation, a group discussion, and a written narrative response to the statement: “Reflect on how the simulation experience helped you understand or apply concepts of leadership and management such as conflict management, delegation, communication, prioritization, quality improvement, and risk management.” In Students’ (n=67) Own Words “I think that the simulation allowed me to help improve my communication skills with other staff.” (21) “I feel it allows you to know when to delegate tasks and when to actually take action yourself.” (17) “It allowed all of us to come together as a team and prioritize the situation that was happening.” (10) “The fast paced environment and multiple simulations also cause one to focus on conflict management skills.” (4) “Safety is and should always be a priority but seems to have been put on the back burner during our scenario.” (1) I appreciate the realism which brought to my attention where to focus my attention for improvement (QI). (1) Margaret Kroposki, PhD, RN; Debbie Lyles, PhD, RN; Ann Stuck, MSN, RN University of Phoenix and Greenville Technical College Leadership Behaviors Development Using Multiple Human Patient Simulators