week 5 discussions answers

Simulations are designed to enhance the nursing students knowledge, skills, and competencies within a life-like environment. Successful SIM programs have many characteristics. Clear objectives and learning outcomes that align with the curriculum provide for learning with appropriate goals (Issenberg et al, 2020). Well designed scenarios that replicate real life clinical situations that allow nursing students to apply their knowledge and skills in a safe environment as well as a supportive learning environment that promotes active participation and feedback (Hayden et al., 2014). Essential elements of curriculum are identified based upon the learning objectives of the course. Simulation promotes learning from the classroom and into the clinical setting by providing opportunities for repeated practice and reinforcement which increases the students retention and transfer of knowledge and skills (Doolen & Hoffman, 2018)

Doolen, J & Hoffman, L. (2018). Teaching communication skills using simulation in a nursing program. Journal of Nursing Education and Practice. 8(8), 43-50.

Issenberg, S., McGaghie, W., Petrusa, E., Lee, Gordon, D., & Scalese, R. (2020). Features and uses of high-fidelity medical simulations that lead to effective learning: A BEME systematic review. Medical Teacher, 42(1), 32-40

Hayden, J., Smiley, R., Alexander, M., Kardong-Edren, S., & Jeffries, P. (2014). The NCSBN national simulation study: a longitudinal, randomized, controlled study replacing clinical hours with simulation in prelicensure nursing education. Journal of Nursing Regulation, 5(2), 2-64. 

To differentiate the outcomes of a successful or unsuccessful SIM program, there are a few things to look at and evaluate. Some of these include but are not limited to the student’s reaction to the activity, their learning, and the change in their behavior as a result of the simulation (Keating, 2015). Another way would be the long term effect of the teaching based on how the students act once they are out on the field, but that would need to be evaluated at a later time. Initial and constant evaluations must be done to ensure that the simulation matches what is experienced/seen in the clinical setting. This can easily be done by nurses who still work at the bedside to ensure that practices are up to date and relevant. In turn, learning in the classroom can lead to what is taught in the simulation setting. Keeping everything integrated and tied are the best way to make sure that students are getting the best possible education. 

Reference Keating, S. B. (2015). Curriculum development and evaluation in nursing (3rd ed.). Springer Publishing Company.

Benner's model of learning is a progressive process in which the individual moves from novice to expert in stages. Faculty can design simulation scenarios that draw on previously learned coursework and clinical experiences by ensuring that the scenarios include topics, skills and abilities that the students have already learned (Boese, T., et al., (2018). There are several strategies that faculty can employ to promote student knowledge, skills and abilities. Faculty can provide deliberate practice opportunities that students can use to hone their skills and develop competence (Boese et al, 2018). Faculty can also provide effective feedback during or after the simulation to reinforce positive behaviors as well as correct errors as well as debriefing sessions to allow students to reflect on their experiences, identify areas of strength and weaknesses for developing a plan of improvement (Liaw, et al, 2018). Practice makes perfect! 

Boese, T., Curren, M., & Schmidt, B. (2018). Simulation in nursing education - global reflections on practice. Clinical Simulation in Nursing, 15, 1-5. doi: 10.1016/j.ecns.2017.10.006

Liaw, S., Koh, J., Tan, S., Chua, W., & Zhou, W. (2018). The impact of simulation-based learning on nursing students' self-efficacy and confidence: a systematic review. Nurse Education Today, 69, 230-243. doi: 10.1016/j.nedt.2018.06.017

Since Benner’s model moves from novice to expert, I believe that the simulation labs can match with the students’ growth in education (Keating, 2015). For example, med surg courses are broken down into intro, intermediate and advanced med surg classes. I would model these to add to the simulation. For example, in intro, it may start with a simple head to toe assessment, with very little involved medically as they are still new. In intermediate, it can involve more medical issues that include identifying signs and symptoms of disease processes they are learning in theory such as diabetes or kidney issues. For advanced, there could be rapid responses or code blues to challenge what they have learned thus far as well as assess their critical thinking skills. This would encompass so much of what they learned and and challenge their abilities before taking on their new role of bedside nurses. 

Reference Keating, S. B. (2015). Curriculum development and evaluation in nursing (3rd ed.). Springer Publishing Company.