SIMULATED LEARNING EXPERIENCE IN A FIRST

YEAR NURSING COURSE: LESSONS LEARNED

Lisa Keenan-Lindsay RN, MN

Professor of Nursing Seneca College

OBJECTIVES

To review the application of the use of simulated learning experience (SLE) within education.

To discuss the goals of SLE in a first year maternal newborn nursing course.

To explore the learning that takes place in SLE as well as the challenges.

WHAT IS SIMULATION LEARNING EXPERIENCE (SLE)

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

… Task trainer

http://www.ocean.edu/academics/programs_of_study/nursing/virtual.htm

WHY USE SLE?

Incorporates active engagement, shared responsibility for learning and reflection

“Learn by doing” Fosters development of clinical and critical

thinking skills to enhance patient care in safe environment

Allows student to make mistakes and learn from the consequences without harming patient

Increases confidence (and decreases anxiety related to new skills)

Enjoyable for students Can incorporate many skills into scenarios

FIRST YEAR NURSING COURSE

Curriculum shift

Older Adult OR Maternal Newborn

Clinical course: 8 students

Learning objective for course

To provide care to a patient in each clinical area

Simulation lab experience

Fall 2011: 2 weeks = 20 hours

Winter 2012: 1 week = 5 hours + classroom simulation

SLE: LAB

Student Preparation

Introduction

Scenario: Realistic

Time-outs

Debrief

Written reflection

DEBRIEF

“facilitated or guided reflection in the cycle of experiential learning” Fanning & Gaba (2007)

Primary place of learning

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-

environment-which-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

… 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

… Valued other members of group

http://www.sde.ct.gov/sde/cwp/view.asp?a=2609&q=320242

LEARNING: OUR EXPERIENCE

Assessments & health teaching

Communication with patients and families

Skills were transferable to other areas of nursing

Incorporated knowledge from other courses

Hands-on learning environment can be more valuable than didactic education (work well together)

Increases students confidence & enthusiasm

Team work

Critical thinking: Aha moments!

http://changizi.wordpress.com/2010/09/09/why-we-have-aha-

moments/

LEARNING

SLE will never replace clinical experience but can give students opportunities to experience different areas

Students learn and retain skills better when learn in environment of emotion, laughter and social experiences

Students enjoyed experience

Student anxiety

Great teaching experience

Provided consistency in marking for part-time clinical teachers

http://jamesbrauer.com/you-do-realize-its-about-learning-

right/student-learning/

STUDENT EVALUATION OF EXPERIENCE

“great way to apply theory to practice”

Felt information could be applied to other clinical situations

Realized how biases affected how they give care

“will now be able to incorporate family into care I provide”

“able to take your time and make mistakes”

Equipment made everything feel “real”

If it wasn’t for sim lab I would never really know how to build a therapeutic relationship with a patient in the hospital

Felt less “ripped off”

Feedback was useful

CLASSROOM SIMULATION

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

CHALLENGES

Cost of simulators

Cost of trained faculty (resource intensive)

Teachers need training in use of simulator, debriefing as well as clinical expertise

Ideal if have lab that resembles clinical environment

NEXT STEPS

Collaborative, inter-professional opportunities

Students want more simulation experiences

Research: are the students able to take this new learning into other clinical areas

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/