Simulation as a Teaching Strategy
Introduction
An event or situation that is prepared to bear a resemblance to clinical practice as closely as possible is called simulation. Areas that can be taught by the use of simulation include technology, theory, assessment, various skills and pharmacology. Simulation enables learners to operate in a setting that is closely looks like the real clinical situation. This is unlike a classroom environment or an examination requiring the use of a pen and a paper. There are various types of simulation that can be used in nursing education.
One type is the high fidelity simulations, which enable learners to react to various situational changes provided by the simulation. The use of standardized patients is another type of simulation that can be employed for clinical evaluation. Objective Structured Clinical Examination is yet another type of simulation for clinical evaluation. Simulation was acknowledged as an effective teaching strategy as early as the late 1970s. Over the past decade, this strategy has been gaining acquiescence as a valuable learning instrument for health care students because it effectively prepares students to provide safe and adept care for their patients.
Discussion
The essence of incorporating simulation into nursing education is grounded on the fact that it is not possible to accomplish sufficient clinical learning in the clinical field alone. The use of simulation has achieved great success in both formal and clinical education (Emerson, 2007). For many decades, simulation has also been employed in various fields other than healthcare for instance, transportation, aviation, behavioral and social sciences and nuclear power industries. These fields use simulation to promote risk-free practice, to evaluate critical thinking skills and to teach various concepts. The first types of simulators in healthcare were referred to as the stagnant models for example body parts made of rubber. These simulator types are still utilized in teaching basic skills like inserting intravenous and urinary catheters (Rauen, 2004).
Technological advancement has made acquisition of more intricate skills through simulation feasible. For instance, learners can gain the mastery of operating a monitor through the use of interactive simulators linked to hemodynamic monitors and showing patient’s data without being attached to the real patient. Simulation allows nurses to learn troubleshooting, timing as well as the general purpose and technicalities of a pump without putting a patient’s life at risk. Modern technology integrates simulators that are computer-based and that support applications of CD-ROM. Response to questions and selection of therapies are examples of ways through which learners advance through a clinical situation (Spinello & Fischbach, 2008).
Simulation as a teaching strategy enables learners to acquire skills that can effectively prepare new nurses. It allows learners to be exposed to a wide spectrum of experiences ranging from basic integral nursing skills to scenarios that are more complex. Typical simulation activities entail working as a health care team member. The instructor gives feedback and redirection to students in a controlled setting. Simulation does not put a patient’s life at risk. Due to the various benefits associated with the use of simulation as an instructional strategy, current competency testing for health professionals employs the strategy (Sanford, 2010).
Literature contains various examples of simulation utilized in the process of teaching-learning for health care programs’ emergent care skills, especially in medical school. A good example is a program at Michigan University where there was exposure of medical students to learning settings that were formed to coach them on how to care for patients who were acutely ill (Bradshaw & Lowenstein, 2010). High-fidelity human patient simulation was utilized in Melbourne, Australia to enable learners to gain skills required to nurse patients going through a medical crisis, like hemorrhagic shock. Other information sources give a description of computer-aided stimulation that is used to help students to obtain and maintain the expertise required for advanced cardiac life support. Clinical simulations are used to assist new students in development of decision-making and problem-solving skills at GriffithUniversity in Brisbane, Australia (Sanford, 2010).
Following the recognition of great interest in the use of simulation and simulation products in nursing education resource centers, some of which are extremely costly, the Laerdal Corporation and the National League for Nursing, collaboratively sponsored a countrywide multisite, multimethod study aimed at developing test models through the use of simulation to promote nursing education. Additional roles of the project are contributing to the sophistication of the body of knowledge associated with the use of simulation in nursing education and forming a cadre of nursing staff that can employ simulations to promote student learning (Spinello, 2008).
A skilled nursing professional has to demonstrate competence across three main domains. These domains are the affective, psychomotor and the cognitive domains. Traditionally, simulation use in clinical labs laid emphasis on development of psychomotor skills aimed at preparing beginning students for clinical practice. However, the merits associated with the use of simulation as a teaching strategy have often been reported in cognitive and affective domains. Despite the fact that there are few quantitative evaluations of simulation in literature to data, it is extremely easy to find subjective and anecdotal examples (Rauen, 2004).
Under the affective domain, students with prior experience in simulation instruction need more opportunities to learn using the strategy. Students getting ready to take part in a simulation report a feeling of performance anxiety but appreciate the fact that the learning experience promotes their actual patients’ safety (Sanford, 2010). Under the cognitive domain, simulation as an instructional strategy enables acquisition of skills needed for sound clinical judgment and critical thinking. In the psychomotor domain, simulation gives students an opportunity to practice in a controlled and safe environment as they advance through the nursing curriculum (Emerson, 2007).
An example of a situation where simulation strategy can be applied is a health care setting based on the use of computer-based community simulation presenting a disease outbreak such as tuberculosis. In this setting, learners would find the simulation to be potentially captivating and interesting. Community simulation offers an effective educational setting which enables students to apply various skills in the actual problem context. Designing such a program enables students to attain low mean perceived cognitive learning scores. An interesting juxtaposition to the final exam scores is provided by the self-reported cognitive learning scores.
The utilization of computer-aided simulation in teaching concepts relating to community health may be successful’ given the various demerits associated with traditional simulation strategy. Students taking part in computer-based simulations often report high examination scores in the fields of intervention planning and needs assessment. Simulation provides a learning environment that facilitates group dynamics and teamwork (Spinello, 2008).
There are several advantages of using simulation as a teaching-learning strategy. Some of the advantages are the capability of experiencing a crisis situation prior to its occurrence in the clinical environment; the predictability of being able to create situations which may never occur in any other means, artificially; and the capability of evaluating and reflecting on the activities in an arena that is non-threatening (Nehring & Lashley, 2010).
There are also some disadvantages associated with the use of simulation. These are inadequate evidence-based research and supporting theories regarding simulation; and the fact that simulation is time-consuming with regard to creation of scenarios, lab setting and role plays planning of instructors, who are already overwhelmed. It is therefore clear that the area of simulation is in need of further research especially they high-fidelity type of simulation (Nehring, 2010). Further research will prevent simulators from becoming costly bed occupants in the nursing laboratories.
Summary
A wide range of technologies for simulation are common in the instruction and the continuing training of nurses and other health specialists. Simulation technologies enable instructors to develop professional and useful strategies needed instilling clinical and decision-making skills to distinct groups of learners in simulated patient situations that are complex. Simulation strategy connects learners in active learning, which can be a major challenge for students signed up for various study programs. A review of literature indicates that simulation is an effective strategy that enables students to attain the expertise needed in handling critical patient situations. Devotion on the part of both learners and instructors is required for successful use of simulation.
References
Bradshaw, M. J., & Lowenstein, A. J. (2010). Innovative Teaching Strategies in Nursing and Related Health Professions. Jones & Bartlett Learning
Emerson, R. J. (2007). Nursing education in the clinical setting. Elsevier Health Sciences
Nehring, W. M., & Lashley, F. R. (2010). High-fidelity patient simulation in nursing education. Jones & Bartlett Learning
Rauen, C. A. (2004). Simulation as a Teaching Strategy for Nursing Education and Orientation in Cardiac Surgery. Critical Care Nurse, 24: 46-51
Sanford, P. G. (2010). Simulation in Nursing Education: A Review of the Research.The Qualitative Report, 15(4)
Spinello, E. F., & Fischbach, R. (2008). Using a Web-Based Simulation as a Problem-Based Learning Experience: Perceived and Actual Performance of Undergraduate
Public Health Students. Public Health Rep., 123(Suppl 2)
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