Using Simulations in Nursing Education - Research Paper Example

? Using Simulations in Nursing Education Research Paper user [Pick the Using simulation in the field of health care, Obstetrics has been considered as extremely helpful tool in the learning process for the related students. The using of simulations in the learning phase trains the students effectively to cope up with the challenges of the practical field. This paper investigates the importance of simulations in the field of Obstetrics and analyzes different studies carried out to understand the impact of simulation and its benefits. Introduction Simulation is regarded as the cardinal and effective tool in learning any subject or course in the modern education system these days. Nursing is not an exception as there are numerous aspects of the study in nursing which cannot be grasped by the students without practical knowledge. Simulation has been used in the nursing domain and health care sector for a long time but there is a need to elevate the frequency and quality of simulation based techniques in nursing in order to completely exploit the benefits (Jun et al., 1999). The three main learning theories which are known as cognitive, social, and constructivist explain the detailed processes through which the learners gain in depth knowledge about any topic while using simulations. This paper will discuss the evidence based depictions generally in health care and then an emphasized study with specific relation to field of Obstetrics, which will explain the effectiveness and importance of using the simulations in nursing education and its positive impact on the patient outcomes. Literature Review The importunate need of the simulation in nursing domain surfaced in late 20th century when the resources were depleting for the health care sector and time restrictions were augmenting. There were loop holes in the skills of the trained nurses which were experienced in the practical fields and the patient outcomes were going through drastic results. According to a report published by Institute of Medicine (IOM) named “Err Is Human,” almost 45,000 to 98,000 patients die each year in the United States as a result of human errors which are somehow caused by the loop holes in the education of nursing. After the horrific results of this report, IOM called an emergency meeting of the health sector gurus which passed as resolution with consensus that the human error ratio is because of the weak educational system and the nurses are needed to be equipped with emergency case scenarios and in depth knowledge of different kind of diseases. Simulation provides the best space for the students to learn and practice the medical theories without a fear of harming the patient. Simulation also provides a massive opportunity for the students to test their skills and periodic repetitions of the practical methodological studies. The apprenticeship training processes can be easily performed and the instructors can effectively transmit the changing health patterns to the students by practically showing them the simulations. The sensitivity factors often acts as a major hindrance in the learning process for the nurses (Rutherford-Hemming, 2012). The operative vaginal delivery with forceps and vacuum devices are also being deployed at large in the medical domain of Obstetrics. The neonatal risks are accompanied with the use of vacuum cups, but they are far more efficient in the delivery procedures and are used by a great number of Obstetricians. In the same way some other sectors of Obstetrics such as needle usage amniocentesis and fetal blood sampling requires a great deal of practice and such cases are not available for the nursing students for practice on hands. Some medics foresaw the importance of simulation in the field of Obstetrics and issues order to embed the low-fidelity models for amniocentesis in the learning and training procedures (Cass et al., 2011). The results were optimal, and patient outcomes were affected in a very positive way after the training and on hands experience of the students on these simulators. The results showed a comparison between the didactic and practical learning experiences. The doctors observed that the improvement is depicted at all trainee levels, and even the students with the least experience have performed very well. The productivity level of the students and learning ease was significantly improved. Importance of Simulation In the field of Obstetrics, the deployment of simulation has also shown the alluring and magnificent improvements so far. The field of Obstetrics is of sensitive nature which cannot sustain any kind of human errors. The medical and nursing students often find less hand on experiences because the instructors cannot allow the people who do not have any experience in this field to operate directly on the human. The statistics show that in the United States, only 33% of senior obstetricians use vaginal breach deliveries because this process requires a great deal of competence of experiences before. A slight human error can cause detrimental effects on the lives of the woman and child. In order to deplete the chances of injuries to babies, obstetrical birth simulators were introduced that were to enhance the training facilities of the nurses and doctors in order to equip them with the skills to cope up with the unforeseen conditions while vaginal breach deliveries. The results were very appreciating as 8 out of 12 deliveries were safe and sound after the introduction of the simulations in the training process. The nurses, staff and students were very comfortable because of the fact that they got a chance to interact with the circumstances which they experience in the real life vaginal breach surgeries and deliveries. High fidelity simulators like Gaumard’s No-elleS575 maternal and neonatal birth simulator with new born HAL are really productive in the learning of the skills regarding Obstetrics. Similarly, In a comprehensive study carried out by Jude, Gilbert, and Magrane, the results showed that the students who used simulation in the learning processes showed high level of confidence and skills in the practical field as compared to the students who did not deploy the simulators in their practical learning (Daniel & Simpson, 2009). The modern world nursing education is becoming more and more demanding because of increasing time constraints and the amount of subject that is way beyond the grasp of students of nursing. The National League for Nursing also proposed that simulation should be embedded as the primary part in the learning process of nursing and all the course content which require even a minimal type of practical experiments should deploy simulation as this will not only boost the self-confidence of the students, the detrimental effects on the patients will also be minimized. . According to a study, students remember 90% of what they do and only 10% of what they learn. This shows the importance in simulation based techniques in medical and nursing education which constitutes excess of practical experiments and interaction with the human body. There was a study in order to calculate the effectiveness of the simulation in nursing education. The second year medical students were included in the study and the study domain was the heart diseases in which cardiac output, heart rate, and systemic vascular resistance in response to volatile anesthetics were studied and the importance of simulation in the course was introduced. The results were amazing and appreciating as 95% of the students said that the simulations are effecting the time and learning process of the course optimally and in a positive way. Similarly 83% of the students said that this method of learning is far much better than the didactic lectures (Okuda et al., 2009). Significance of simulation based learning in domain of Obstetrics The field of Obstetrics has to inculcate the use of simulations because there a lot of sensitive cases in the practical terms which cannot be passed by the nurses which do not have the experience. Similarly there was another comprehensive and retrospective study by Draycott in the domain of shoulder dystocia which is very rare in Obstetrics treatment process but can cause a lot of damage to the patients and the nurse must be aware of the standards operating procedure in case of this problem and the details involved in the treatment. The results showed that if the simulation is used in the learning and treatment process the injury is minimized up to a level of 9.3% to 2.3 %.(Okuda et al., 2009). The simulators in the teaching ultrasound-guided amniocentesis, determining fetal station, managing shoulder dystocia, managing obstetric Emergencies and trauma are being deployed at a very high rate these days. These all processes are very difficult to manage because the delivery cases are many times emergency based (Ennen & Satin, 2010). Use of simulation is primarily effective and useful in the cases which are rare to happen in the human beings and there is a very less chance for the students to learn anything practically. If the students are not trained with in hands experiences then there is an enhanced possibility of human error in case of the practical experiences (Gaba, 2004). Study 1 Shoulder dystocia is one of the rare types of problems that occur in the human beings. There was a study to evaluate the effectiveness of the using simulation in the Shoulder dystocia cases. The results were stupendous and commendable (Benedetti, 2009). In a 40 minute shoulder dystocia management, there was a significant improvement at the end of session in the treatment proceedings. Before the training 42.9% participants successfully achieved the simulated delivery whereas after the training. Training was done on high-fidelity mannequin that helped the participants to retain the efficient results up to a longer period of time. There was a sustaining rate of  6 (84%) and 12 months (85%) after training. After the use of simulation in the delivery systems and training, the results were depicting a great improvement. When the delivery systems were not using the simulations in an efficient way the success rate was 72% whereas after the training the success rate rose to 94%. This population survey shows how efficient can be the simulation based learning and the effects on the patient outcomes are great. The simulation techniques are more helpful in the cases which are rare in the medical field (Ennen & Satin, 2010). Results The results showed that with the use of simulation the rate of neonatal injury at birth time for example brachial plexus injury and bony fracture in different treatment processes and cases of shoulder dystocia decreased from 9.3% before the introduction of simulation to 2.3% after the introduction of simulation in the learning process. This shows a clear and high magnitude improvement in the results and how the use of simulation can affect the patient outcome in positive ways and can deplete the human life losses and damages (Ennen & Satin, 2010). . Study 2 In another comprehensive study to evaluate the effectiveness of the use of simulation in Obstetrics was carried out in which four emergency cases were studied with the help of advanced mannequins’ simulators. The patient population consisted of around 88 midwives and 60 residents. Checklists were maintained and all the sessions were recorded in order to compare and contrast the results to perceive the true benefits of simulations in the treatment process. During a specific time period, the 88 midwives went through a course based on simulation, which was maintained in order to facilitate them with emergency conditions and how to cope up with some difficult situations in the practical scenarios. Most major problems in the labor deliveries and other procedures were identified to be transporting the bleeding patient to the operating room which was around eighty two percent, untrained with the use of prostaglandin to reverse uterineatony 82%, poor cardiopulmonary resuscitation (CPR) techniques which were calculated to be 80%, improper documentation of shoulder dystocia which was around eighty percent delayed provision of blood related products to reverse consumption coagulopathies like DIC 66%, and unjustified avoidance of episiotomy in some obstetric complications like in shoulder dystocia and breech extraction thirty two percent (Maslovitz et al., 2007). Results In order to evaluate the results, 18 participants were selected for the latest after six months of the training and their performance was improved as compared to the score before the training with a ratio of (79.4.3 Versus 705.3). Similarly, the a group of doctors from the United Kingdom developed a simulation based course for providing on hands experiences for the nurses and trainees in order to cope up with the challenges in the obstetric emergencies. The results depicted a great improvement in handling the obstetric emergency management. These results from different population studies show that the introduction of simulation based techniques in the learning processes enhance the reliability of the emergency handing and the nurses can easily go through the difficult problems in any scenario (Maslovitz et al., 2007). Conclusion and Recommendations The importunate significance of using simulation in study and training of obstetric treatments is emphasizing the need of expansion of this technique in all other branches of medicine in order to minimize the probabilities of human error in the treatment of patients (Birch et al., 2007). The simulation based learning processes must be deployed in diverse range of domain in order to refine the quality of health care facilities. The student must be encouraged to use the practical means and simulation based tools so that they can resolve the unforeseen circumstances in the practice. The nursing institution must adhere to the simulation standards and design the course contents in the alignment of practical demands of the medical field (Jeffries, 2008). References Benedetti, T. J. (2009). Shoulder dystocia. Protocols for High-Risk Pregnancies, Fourth Edition, 565-569 Birch, L., Jones, N., Doyle, P., Green, P., McLaughlin, A., Champney, C., & ... Taylor, K. (2007). Obstetric skills drills: evaluation of teaching methods. Nurse Education Today, 27(8), 915-922. Cass, G. S., Crofts, J. F., & Draycott, T. J. (2011). The Use of Simulation to Teach Clinical Skills in Obstetrics. Seminars In Perinatology, 35(2), 68-73. doi:http://dx.doi.org/10.1053/j.semperi.2011.01.005 Ennen, C. S., & Satin, A. J. (2010). Training and assessment in obstetrics: the role of simulation. Best Practice & Research Clinical Obstetrics & Gynaecology, 24(6), 747-758 Gaba, D. M. (2004). The future vision of simulation in health care. Quality and Safety in Health Care, 13(suppl 1), i2-i10. Jeffries, P. R. (2008). Quick Reads: Getting in STEP with Simulations: Simulations Take Educator Preparation. Nursing Education Perspectives, 29(2), 70-73. Jun, J. B., Jacobson, S. H., & Swisher, J. R. (1999). Application of discrete-event simulation in health care clinics: A survey. Journal of the operational research society, 50(2), 109-123. Maslovitz, S., Barkai, G., Lessing, J., Ziv, A., & Many, A. (2007). Recurrent obstetric management mistakes identified by simulation. Obstetrics And Gynecology, 109(6), 1295-1300 Okuda, Y., Bryson, E. O., DeMaria Jr, S., Jacobson, L., Quinones, J., Shen, B., & Levine, A. I. (2009). The utility of simulation in medical education: what is the evidence? Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine, 76(4), 330-343. Rutherford-Hemming, T. (2012). Simulation methodology in nursing education and adult learning theory. Adult Learning, 23(3), 129-137. Daniel, L., & Simpson E. K. (2009). Integrating team training strategies into obstetrical emergency simulation training. Journal for Healthcare Quality, 31(5), 38-42. Read More