Transcript Simulated Learning Experience in a First Year Nursing Course

SIMULATED LEARNING
EXPERIENCE IN A FIRST YEAR
NURSING COURSE:
LESSONS LEARNED
Lisa Keenan-Lindsay RN, MN
Professor of Nursing Seneca College
WHAT IS SIMULATION LEARNING
EXPERIENCE (SLE)
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SLE provides a realistic re-enactment of clinical
situations in which the student is able to step into
a role in a non-threatening learning environment
(Schoening, Sittner, & Todd, 2006)

Can be used to learn a variety of skills through
different modalities
…
High fidelity
… Medium fidelity
…
Low fidelity
http://www.ocean.edu/academics/programs_of_study/nursing/virtual.htm
WHY USE SLE?

Incorporates active engagement, shared
responsibility for learning and reflection
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Fosters development of clinical and critical
thinking skills to enhance patient care in safe
environment
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Allows student to make mistakes and learn from
the consequences without harming patient

Increases confidence (and decreases anxiety
related to new skills)
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Can incorporate many skills into scenarios
FIRST YEAR NURSING COURSE
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Clinical course: 8 students
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Curriculum shift

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Learning objective for course
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
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Older Adult OR Maternal Newborn
To provide care to a patient in each clinical area
Simulation lab experience
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Fall 2011: 2 weeks = 20 hours
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Winter 2012: 1 week = 5 hours
Classroom experience
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Incorporated some scenarios into theory class
SLE EXPERIENCE: LAB
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Student Preparation
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Introduction
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Scenario: Realistic
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Time-outs
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Debrief
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Written reflection
DEBRIEF
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“facilitated or guided reflection in the cycle of
experiential learning” Fanning & Gaba (2007)
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Primary place of learning
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Reflect on and discuss their actions and those of
others
…
Self-evaluation by students is best
…
Can improve student’s evaluation skills
…
Need to give objective evaluation
DEBRIEF

Need instructors with expertise in area and
experience with simulation

Research needed: what is better – individual or
team debriefing

Video-taping

If time permits may run through scenario again
with new learning
http://maasd.edublogs.org/2010/01/17/creating-an-environmentwhich-meets-student-learning-needs/
STUDENT REFLECTION

“turning experience into learning” (Ness et al, 2010)
…
Were able to realize that they focused more on tasks than
on developing relationships with patients
…
Students want more experiences like this
…
Recognize that SLE provides valuable practice that can
benefit their clinical competence and skills
…
Application of nursing theory to clinical practice
…
Incorporated knowledge from other courses
http://www.sde.ct.gov/sde/cwp/view.asp?a=2609&q=320242
LEARNING: OUR EXPERIENCE
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Assessments & Health teaching
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Communication with patients and families
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Skills were transferable to other areas of nursing
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Incorporated knowledge from other courses
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Hands-on learning environment can be more
valuable than didactic education (work well
together)
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Increases students confidence & enthusiasm
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Team work

Critical thinking: Aha moments!
http://changizi.wordpress.com/2010/09/09/why-we-have-aha-moments/
LEARNING
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SLE will never replace clinical experience but can
give students opportunities to experience different
areas
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Students learn and retain skills better when learn
in environment of emotion, laughter and social
experiences

Students enjoyed experience
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Student anxiety
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Great teaching experience
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Provided consistency
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in marking for part-time clinical teachers
http://jamesbrauer.com/you-do-realize-its-about-learningright/student-learning/
STUDENT FEEDBACK
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“great way to apply theory to practice”
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Felt information could be applied to other clinical situations
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Realized how biases affected how they give care
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“will now be able to incorporate family into care I provide”
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“able to take your time and make mistakes”
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Equipment made everything feel “real”
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If it wasn’t for sim lab I would never really know how to build a
therapeutic relationship with a patient in the hospital
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Felt less “ripped off”
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Feedback was useful
CHALLENGES
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Cost of simulators
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Cost of trained faculty (resource intensive)
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Teachers need training in use of simulator as well
as debriefing
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Ideal if have lab that resembles clinical
environment
CLASSROOM SIMULATION
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Learning: eliminated didactic class time (showing
rather than telling)

Students needed to come prepared

Many students did not want to be nurse

Need buy-in from teachers in class – takes away
class time

Teachers need to feel comfortable with equipment
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http://www.hhs.gov/ash/initiatives/hai/training/
NEXT STEPS
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Collaborative, inter-professional opportunities
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Students want more simulation experiences
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Research: are the students able to take this new
learning into other clinical areas
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Move into classroom and possibly 1st semester
skills lab class
http://gratitudeplanet.com/2011/01/28/there-is-always-the-next-step/
http://esriaustralia.wordpress.com/tag/cloud/