The Advantages of Including Clinical Simulation in Nursing Education - Research Paper Example

?The Advantages of Including Clinical Simulation in Nursing Education The great philosopher, Aristotle, once said, “What we have to learn to do, we learn by doing”. This quote has become the motto of many people especially those involved in Education. Although most people have been raised to learn things by listening to a teacher’s lecture, observing others or doing pencil and paper tasks to record learning, experiencing learning first-hand is still the best learning approach. This way, the individual is fully engaged in something that he might otherwise just read about or watch someone else doing. However, in most situations, people are just asked to “watch and learn” and be expected to automatically imbibe what is being taught. Somehow, for most people, this is not enough, especially for those in jobs that would require actual practice before they apply what they have learned. Nursing is one example of a career that would need much practical experience before implementation as a career. Since nurses are entrusted with the lives of their patients, having no clue as to what to do with them in actual practice, no matter if they are just new in their profession, is no excuse. It would be a risky and unprofessional thing to do. Lacking practical experience, nursing students cannot just rely on their theoretical knowledge gained from school. New Training Technique One new development in nursing education is the use of clinical simulation. This is a teaching methodology that provides students with learning experiences closely resembling real-life circumstances that they are likely to encounter in their professional practice. “Simulated clinical experience requires immersing students in a representative patient-care scenario, a setting that mimics the actual environment with sufficient realism to allow learners to suspend disbelief” (Waxsman:29). Faced with a simulated environment, they gain familiarity with situations that they will most probably encounter in their future profession. They get to see the real equipment to be used, the set up in a clinical environment, and get an idea of how it feels like to be in a clinic, hospital room or operating room. In this method, student nurses get the opportunity to use a lifelike high-fidelity manikin which is interactive and realistic (Jeffries: 56). Different scenarios that nurses are likely to encounter with their patients are played out during simulation sessions that would summon their skills and knowledge. The manikin would serve as a sample patient that the nurses can attend to depending on the symptoms presented. High and low-fidelity manikins as well as skill and task trainers, virtual reality trainers, computer-based simulators and scenarios and even standardized patients comprise the simulation education package (Jeffries: 60). In clinical simulation, they get exposed to various scenarios and are supposed to apply what they have learned in a safe and controlled environment that will not risk the safety and life of any patient. This is very much different from the traditional teaching methods that nursing students have been accustomed to such as lectures, discussions, role-play and laboratory practice, as these may no longer be effective (Waxman:30). What is currently being promoted in education is the adherence to constructivist pedagogical approaches wherein more active, experiential learning strategies reflect real world practices. Parker & Myrick (42) contend that clinical simulation has constructivist pedagogical underpinnings fostering interpretive, generative learning which is suited to the promotion of transformative learning. Through the use of clinically- simulated scenarios, students engage in concrete experiences likely to be done in their future practice. The Process of Clinical Simulation Human patient simulation (HPS) is the technology behind clinical simulation in nursing education. Bearnson and Wiker (422) explain that a human-like manikin designed with human-like responses and function is controlled by a computer by the instructor. This method gives students opportunities to practice nursing interventions like the administration of medicine, catheterization or oxygen therapy. The instructor decides which scenarios to use and controls the manikin to present symptoms mimicking patients’ illnesses via the interactive physiological systems namely the cardiovascular, respiratory and neurological systems (Parker & Myrick:46). The sophisticated technology allows the manikin to speak, breathe, perspire and exhibit human-like manifestations of life (Medical Education Technologies, Inc.). The simulation environment also replicates a hospital room to make the clinical experience more realistic (Yeager et al:328). During the simulation, the instructor merely watches intently and does not intervene while the student goes through with the scenario. He may check if the student is applying everything she has learned from the courses. After the simulation session, a debriefing session is conducted wherein an evaluation of the simulation is discussed. Both instructor and students share their feedback on what transpired and the decisions made within the session (Parker & Myrick:52). The instructor advises the students on their performance in the simulation, focusing on the weaknesses they displayed and how these can be strengthened as well as highlighting the points where they were successful so that these may be reinforced. This encourages reflective practice. It means the practitioner makes a deliberate and conscious attempt to act and reflect upon a situation and how it should be handled in the future (Loughran:33). Clinical simulation trains student nurses in the areas of patient safety, priority setting, leadership and delegation, communication, patient teaching and cultural diversity (Waxman:40). It offers a wide variety of scenarios from effective communication with patients to ensuring medical safety to medical procedures and other clinical practices (Waxman:41). Some Critiques About Clinical Simulation Clinical simulation’s innovative techniques in training future nurses may be warmly welcomed by most educators, however, they should also be open to some downsides. Chen (13) claims that clinical simulation does not represent all aspects of real clinical experience because they are just prototypes of actual situations. The cases that the students work on are contrived and simplified by the facilitators so that they meet the goals set for them. The whole picture only comes together when they are faced with real situations that are not edited or planned out. Students still need to keep an open mind that there must still be something missing in the scenario and should be able to reflect on what those details or possibilities are so that they cover most bases. Clinical Simulation from the Nursing Students’ Perspective It is understandable that initial experiences in clinical simulation may be intimidating. Being in an “almost real” environment that requires them to display their knowledge and use their skills while being aware that they are being watched by their instructor may hinder them from acting naturally. Their confidence may waver and they may feel overwhelmed, but they need to experience such feelings because real situations may affect them the same way. According to the study of Bambini, Washburn and Perkins (21), nursing student participants expressed appreciation for clinical simulation. They claimed that they learned the importance of communication with patients and their families. Secondly, they admitted that the clinical simulation experience raised their confidence in their psychomotor skills and patient interactions. Finally, they reported learning the importance of clinical judgment. They learned how to prioritize assessment skills, point persons who can intervene, and identification of symptoms and physical assessment findings. After being accustomed to clinical simulation, student nurses should be able to build up their confidence in being true healers. Exposure to a variety of scenarios that they may possibly encounter in their future practice strengthens their knowledge and skills and most importantly how they will discern in the right way and use both in specific situations. Nursing Education Clinical simulation is not yet included in the curriculum of most nursing colleges and universities due to its cost. However, most nurse educators believe that it will be highly beneficial in training high quality nurses in the future. The Bay Area Simulation Collaborative (BASC) is an organization of schools and hospitals that train health workers using clinical simulation. Waxman (39) reports that the organization assigns more than 600 nurse educators in schools and hospitals within the San Francisco Bay Area. It aims to promote the innovative technique as crucial to the development of nursing students’ critical thinking skills, interpersonal skills and medical skills. Conclusion Evolution into something better should be strived for by everyone. The nursing profession is no exception. The introduction of clinical simulation in nursing education is a breakthrough in teaching-learning strategies that could greatly help nursing students become better professionals someday. This would mean that they will be able to deliver a higher quality of service to their patients, meaning more people will benefit from it. However, no matter how sophisticated teaching-learning techniques could go, learning from it is still dependent on the learner’s attitude and perseverance. Thus, it is crucial to first develop nursing students’ dedication and commitment to their vocation. This should be a lifelong goal. Works Cited Bambini, D., Washburn, J. & Perkins, R., Outcomes of Clinical Simulation for Novice Nursing Students: Communication, Confidence, Clinical Judgment, Nursing Education Research, Vol. 30, No. 2. ,2009. Print. Bearnson, C.S., & Wiker, K.M. Human patient simulators: A new face in baccalaureate nursing education at Brigham Young University. Journal of Nursing Education, 44 (2005): 421-425. Print. Chen, R.P., Moral imagination in simulation-based communication skills training, Nursing Ethics Vol.18, No.1, 2011. Print. Jeffries, P.R. (Ed). Simulation in nursing education: From conceptualization to evaluation. New York: National League for Nursing. 2007. Print. Loughran, J.J. Developing reflective practice: learning about teaching and learning through modeling. Routledge.1996. Print. Medical Education Technologies, Inc. HPS: Human patient simulator. Retrieved from http://www.meti.com/ downloads/HPSCF.pdf. 2004. Web. Parker, B. & Myrick, F. Transformative Learning as a Context for Human Patient Simulation, Journal of Nursing Education, Vol. 49, No. 6, 2010. Print. Waxman, K.T. The Development of Evidence-Based Clinical Simulation Scenarios: Guidelines for Nurse Educators, Journal of Nursing Education, Vol. 49, No. 1, 2010. Print. Yeager, K.A., Halamek, L.P., Coyle, M., Murphy, A., Anderson, J., Boyle, K., et al. High-fidelity simulation-based training in neonatal nursing. Advances in Neonatal Care, 4, (2004): 326-331. Print. Read More