“Tell me and I forget. Teach me and I remember. Involve me and I learn.” –Benjamin Franklin
BY KELLY FOLTZ-RAMOS, PHD, RN, FNP-BC, CHSE, RHIA | JULY 17, 2018
In nursing education, simulation usually involves high technology patient simulators, standardized patients or a combination of both. High-tech patient simulators are programmable life-like manikins that can breathe, talk and bleed. These simulators provide the opportunity for students to do full assessments of vital signs, start IV lines, run fluids, administer medications, insert foley catheters, do chest compressions and cardiac defibrillation, and many other functions.
Standardized patients are trained actors who play the part of the patient in scenarios where these other functions are not essential, but where communication is key. With advances in technology, it is becoming a trend to use trained actors in combination with add-on simulated body parts to provide more functionality. For example, MamaNatalie®, a product from Laerdal Medical, is a birthing simulator worn by a standardized patient to simulate childbirth and childbirth-related complications.
When nursing students go to clinical, we cannot guarantee what scenarios they will encounter. During their nursing education, it would be ideal for every student to have an opportunity to participate in a rapid response, a cardiac arrest, a birth, a death, etc. However, this is not guaranteed. In simulation, instructors can guarantee that the students will participate in designated scenarios to ensure they have experienced these low frequency, high-risk events and are better prepared to handle them when encountered in the clinical setting.
When students experience events in the simulation lab, they are the decision makers driving the scenario. In the clinical setting, they would most likely be in the back seat watching a clinical instructor or preceptor manage the patient. Simulation allows for students to utilize critical thinking and clinical decision-making skills to navigate the simulation scenario. In a supportive environment, simulation can help students to exercise their thinking and judgment skills and improve their self-confidence.
Students often cite simulation as the place where they “put it all together.” In class, they learn about how to care for patients. In the simulation lab, they put everything they learn to work. The lab is where it all starts to make sense.
The bulk of learning in simulation does not occur during the simulation scenario itself, but rather in the debriefing following the scenario. Simulation facilitators bring the students through the scenario, allowing for that vital self-reflection. By debriefing with good judgment, the facilitator helps the students understand what they did well and how they could have performed differently to improve patient outcomes. The debriefing session should also include a review of what students learned in simulation and how it can be used in the clinical setting.
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