NURSING NOTES – Advances in Simulation Technology Improve Learning


The words “nursing school” can invoke mental images of textbooks, lecture halls, heavily highlighted class notes, late night study sessions and shiny new stethoscopes. An integral part of the modern nursing classroom, however, is the use of simulation technology to teach nursing skills.

No longer static anatomy models or whole-body mannequins, simulation technology has developed into a suite of high tech tools including virtual software and human patient simulators. After acceptance from the National Council of State Boards of Nursing and top-tier research backing up its potential to positively impact patient outcomes, simulation technology is being incorporated into nursing classrooms across the country. Nurse educators are striving to adopt strategies that incorporate simulation technology into their curriculum, better preparing their students for their first day on the floor.   

One such school is the University of South Alabama (USA) in Mobile, Ala. Mike Jacobs, DNS, RN, director of the USA Simulation Program, noted that the program is interdisciplinary and serves the educational needs of students from the College of Nursing, as well as the College of Allied Health and the College of Medicine. More than 35,000 students study in the simulation labs at USA each year. According to Jacobs, simulation technology provides many benefits for the modern nursing student.

“Simulation provides the opportunity for both undergraduate and graduate students to actively engage in high-risk clinical scenarios where students may not be ready to respond to in an actual clinical setting,” he said. “This allows students to be more than observers as they learn the necessary skills to safely, competently and confidently succeed in the nursing role.”

Simulation also enables students to develop important skills in an environment that does not risk patient safety. For nurse practitioner students, Jacobs said simulation training gives students the opportunity to learn key skills such as suturing, central line placement, chest tube insertion, paracentesis or abscess drainage – before even beginning clinical rotations.

“These hands-on experiences mimic an actual clinical environment where students can learn in a low-stress, low-risk setting with an opportunity to evaluate performance and correct deficits through repetition,” he said.

Although USA uses virtual technology, such as i-Human Patients, and high-fidelity models, a study published in The Online Journal of Issues of Nursing  provides a breakdown of the large variety of simulation methodologies, including high- and low- fidelity mannequins, virtual environments, and unfolding video case simulations.

According to Jacobs’ colleague at USA, Pam Johnson, DNP, RN, simulation technology is just one example of how nursing education has changed to reflect evolving nursing practices. New learning strategies have impacted the way educators like Johnson and Jacobs approach nursing education as a whole.

“We have seen a tremendous shift toward learning strategies that center toward the individual student,” she said. “These new strategies focus on interprofessional education using a team-based approach in the classroom and simulation labs. The role of the educator is changing from being a ‘pure’ teacher to being a facilitator of deeper learning, including the development of critical decision making skills.”

For example, during lessons in the USA lab, the faculty divides students into small, interprofessional teams and gives an introduction to a clinical scenario or skill. After the lesson, the faculty monitors and interacts with the students, providing coaching and feedback to promote mastery of the scenario or skill.

Although technology is deeply rooted in the USA curriculum, it did take time and effort from the faculty. According to Jacobs, using simulation technology often increases the preparation time for faculty, since they have to spend time before the lesson creating scenarios, but that tradeoff is greater student engagement. Johnson noted that the biggest challenge toward incorporating simulation technology into the USA curriculum was gaining faculty buy-in. In the beginning, many faculty members were intimidated by the technology associated with the simulation tools.

“To overcome this, our motto became ‘Keep It Simple,’” she said. “As faculty started to become successful with simple simulation scenarios, we began to build in more complexities for richer cases and student learning opportunities.”

In addition, the USA Simulation Program hired and trained faculty and staff to assist college faculty with scenario development and running the simulators. This permitted college faculty to focus on the facilitation and evaluation of student learning.

Although nursing education tools have evolved in the years since Johnson and Jacobs started, some elements have remained consistent. They both agree that even though teaching tools may change, the biggest reward of nursing education remains the same: watching the “rapid growth of knowledge and passion for the nursing profession in our students.”

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