Running head: SIMULATION CENTERS IMPROVE CARE 1
Katie Armstrong, BSN, RN, CEN
Liberty University
SIMULATION CENTERS IMPROVE CARE 2
Simulation has started to become a standard of education for nurses over the last few
years. But simulation has already been a learning and education component of healthcare for
decades (Burchum, et al., 2016). Hands on learning is a necessary tool within the healthcare
setting. The ability to create and develop muscle memory to perform skills is paramount in
higher quality care. Being able to practice skill on in simulation setting helps better the delivery
of patient care without putting people at risk by practicing on humans. There are many different
types of simulation. Virtual simulation is a way to educate where videos are used to help
remember information. There is also written case studies, standardized patients, partial task
trainers, and patient simulators of different intensity (Burchum, et al., 2016). Nursing
informatics has been apart of medical simulations since it started. Without the informatics part it
wouldn’t be the advancement of technology that it is today.
Hands on simulation using mannequins, has become the best way for many members of
the healthcare team to learn and practice medicine. In a study completed by The Journal of
American College of Radiology they looked at hands on training versus computer-based training.
The study showed that in a testing environment the hands-on learners received a higher grade
than those who only did computer-based training (Wang, et al., 2017). The higher grade then
turned into a higher level of understanding and patient care delivery. There are mannequins being
used in simulation that are as close to life like as you can get. They can blink, have tears and
other body fluids expelled, have heart, lung and bowel sounds. The are controlled by a computer
and that computer is run by a person. They can alter the patient’s vital signs and even cause the
mannequin to speak in some models. Another type of simulation that has been very beneficial to
the nursing community is the ability to simulate medication administration and injections. It can
be a very overwhelming task to give a person an injection for the first time. Its one thing for a
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fellow nurse or instructor to explain to you what it feels like when you puncture a patient’s skin
for the first time. But, doing these skills for yourself for the first time is often done with more
confidence and skill knowledge after they have been done in a controlled simulation center.
The presented problem for this paper is than an organization is interested in the addition
of a simulation center to enhance interdisciplinary competency skills and fill a need for local
nursing education programs. Simulation has been known to aide in learning in individual career
fields specially nursing, but also with the whole interdisciplinary team. In controlled simulation
centers an environment for learning is created. The more educated healthcare providers are the
better care they will provide. In a study performed by The American Journal of Surgery, they
looked at the communication of staff members in a Trauma team during high stress situations.
Within a simulation center they were able to run 16 different scenarios to evaluate the
communication of all members of the team. The outcome showed that they needed a standard
way of communication to improve the flow of a trauma situation and improve the overall
outcomes of patients (Jung, et al., 2018). Patient safety should always be the first goal hospitals
are trying to achieve. Informatics plays a huge part in simulation centers across the nation.
Healthcare is best delivered when it is backed by a team approach. Being a successful
healthcare team encompasses multiple qualities that are needed from everyone of the team.
Simulation is a strategy to assist team members with effective communication and promote
collaboration with other professionals (Burchum, et al., 2016). A good team member is respectful
in a group situation. This meaning, that each member values the others input. This also mean that
when there is a code blue or high stress situation all team members know who the leader is and
what their own role is. Team work needs good communication. Being able to properly
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communicate with fellow team members provides a trusting and clear relationship. Words are
powerful and team members need to know when and how to use them.
Informatics is imbedded within out healthcare systems across the United States and the
world even. From the electronic health record to communicating with providers from where you
want, technology is more apart of out healthcare system now more than ever. It would only make
sense that if we are needing to work in an environment that’s is embedded with informatics, then
we should be teaching our new and upcoming healthcare providers with informatics in mind.
Simulation has recently been cited by the National Council of State Boards of Nursing (NCSBN)
as an effective replacement for up to half of the recommended clinical hours in prelicensure
nursing education if quality simulation is used (Cohen, et al., 2016). As our healthcare system
makes huge changes with the inclusion of informatics and forward thinking by including
simulation in nursing and healthcare education, this is proving successful in simulation centers.
Patient safety as mentioned before should be the goal of all healthcare providers from
doctors to nurses, to the members of the radiology departments. All individuals that work within
the healthcare system need to remember they are there to give the best care to the patients that
present. Having a simulation center added into a medical facility, for the staff to use would
improve the staff’s confidence, education level and team cohesion. This isn’t the perfect answer
as nothing is in the world as we know it, but it has been shown in some areas of study to improve
the care delivered and over the patient safety. Although there is growing interest in the adoption
of clinical simulation within educational programs, there is a gap in empirical research to
identify valid and reliable tools for evaluating simulation effectiveness, especially in translating
knowledge and skills from simulation experiences to actual clinical practice; research is needed
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(Burchum, et al., 2016). More research needs to be conducted, but there have been many positive
outcomes within many different nursing schools and hospitals.
For the implementation of a new simulation center the learning theory fits best. This
theory looks at how people learn. As the planning starts or the simulation center, there needs to
be an evaluation completed to see how the members who will use the simulation center will learn
best. One of the biggest reasons for a simulation center in a medical center would be to educate
the staff and improve patient outcomes. Not only could they be getting to learn new skill, but
they could sharpen the skills they already have. The learning theory attempts to determine how
people learn and to identify the factors that influence that process. It has been defined that
learning is defined as an increase in knowledge, a change in attitude or values, or the
development of new skills, and several different learning theories have been developed
(Burchum, et al., 2016).
At the heart of any simulation center could be informatics nurse who understands the ins
and outs off the equipment. You could almost argue that any simulation center is only as good as
its informatics nurse. Now many simulation centers are operated by different facilitators but it’s
important the person who is operating or running the simulation center be properly educated.
Although the existence of health informatics as both a discipline and as a profession is well
accepted, it is interesting to note there is currently no consensus or generally accepted name and
standard definition for this profession (Burchum, et al., 2016). There would need to be a nurse
informaticist. Even if that individual doesn’t work directly with in the simulation center, they
would be a big asset to the outcomes of using the simulation center. They could evaluate and take
in data related to improvements through the facility. There are many different definitions of
informatics and different titles for those working in the informatics arena. But in a summary, they
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are going to take information of knowledge, communication and different areas of nursing to
better the practice. That meaning that those in informatics are vital to a simulation center because
they can evaluate its impact on the nursing field and total healthcare system.
Implementation of a simulation center would take work and certain criteria must be met
to have the expected outcome for the medical staff using it. There needs to be staff or student buy
in depending on the location and utilization of the simulation center. In order to develop a
thriving simulation center, the staff members at the organization need to be on board with having
a simulation center. In the development process there needs to be an authentic and sounds
education plan. The members of the development team need to have the necessary education to
prepare the lesson plans or scenarios, simulation equipment, environment and evaluation ideas.
In a multi-plot study listed in Nurse Education Today, four separate sites were used to
develop and evaluate simulation for new graduate nurses. In the research many new graduates’
nurses state that there is a break between their nursing theory they learned in school and the
actual application of the nursing practice. Simulation centers can bridge that gap. In the
development of a simulation center certain concepts should be applied to each scenario,
interpersonal skills, decision making, coping in crisis, and reporting (Jung, D. et al., 2017).
Within each scenario should be included a list of the skills or steps that should be performed.
Policies should be developed and ensure that there is high fidelity in the criteria and development
of the simulation center.
The way that adults learn needs to be included into the way the simulation center is put
into place. Characteristics of adult learners are that they are self-directed, want to be involved in
planning and evaluating their learning experience, use past experiences to build new learning,
need to understand the reason for learning, want immediate application of knowledge to solve
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problems, and are more invested when the learning is associated with a new role (Burchum, et
al., 2016). A focus must be made to evaluate the best way that the simulation center would be
used. Depending on the organization using the simulation center what types of simulation will be
given. In a recent research they are starting to utilize simulation centers in different hospitals to
educate patients and their family members. Simulation centers have great potential to impact the
healthcare system for medial staff but also for the patients receiving our care. By educating
patients and their family members on proper care that empowers them to take control of their
own care and decrease self-injury and neglect from lack of education.
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References
Burchum, J. R., Rosenthal, L. D., Jones, B. O., Neumiller, J. J., & Lehne, R. A. (2016). Lehnes
pharmacology for nursing care. St. Louis, MO: Elsevier/Saunders.
Cohen, B. S., & Boni, R. (2016). Holistic Nursing Simulation: A Concept Analysis. Journal of
Holistic Nursing, 36(1), 68-78. doi:10.1177/0898010116678325
Jung, D., Lee, S. H., Kang, S. J., & Kim, J. (2017). Corrigendum to “Development and
evaluation of a clinical simulation for new graduate nurses: A multi-site pilot study”
[Nurse Educ. Today 49 (February 2017) 84–89]. Nurse Education Today, 52, 124.
doi:10.1016/j.nedt.2017.03.001
Jung, H. S., Warner-Hillard, C., Thompson, R., Haines, K., Moungey, B., Legare, A., . . .
Sullivan, S. (2018). Why saying what you mean matters: An analysis of trauma team
communication. The American Journal of Surgery, 215(2), 250-254.
doi:10.1016/j.amjsurg.2017.11.008
Wang, C. L., Chinnugounder, S., Hippe, D. S., Zaidi, S., Omalley, R. B., Bhargava, P., & Bush,
W. H. (2017). Comparative Effectiveness of Hands-on Versus Computer Simulation–
Based Training for Contrast Media Reactions and Teamwork Skills. Journal of the
American College of Radiology, 14(1). doi:10.1016/j.jacr.2016.07.013
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