Nursing Education and Advances in Simulation Learning

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Once used primarily in defense, aviation and military training, simulations are becoming an invaluable component of health care education.

Learning in the digital age

A simulation-based approach to learning has proven to be highly effective across industries because it allows students to develop crucial skills without risk. One field that has benefited considerably from simulation learning is the aviation industry. As the Federal Aviation Administration (FAA) explained, commercial pilots will invariably complete their training in a simulator. The most sophisticated simulation learning platform for pilots currently available is the full flight simulator, the FAA reported. These simulators offer trainee pilots an immersive experience: A faux cockpit designed to replicate a certain kind of aircraft, complete with motion and visuals, enables pilots to feel as though they are in the air, allowing them to refine their flying skills and practice correct responses to any number of scenarios, such as emergency protocol in the event of engine failure or fire.

Given that simulation learning has proven so effective in the aviation industry, it is no surprise that that this interactive approach has been adopted in other industries — notably the health care sector. Simulation is employed in the education of nurses and physicians.

Simulation learning in health care

Simulation programs are especially helpful in the nursing field, as they provide opportunities for nurses to perfect techniques without endangering the safety of patients. According to the National League for Nursing (NLN), simulation as a teaching method also is effective because it allows students to develop skills through practice in a context that mirrors real-life conditions.

The NLN was instrumental in championing simulation learning as a viable educational strategy. It began with a groundbreaking study in 2003, which culminated in the NLN/Jeffries Simulation Framework. This framework is an essential tool and resource that scholars and nurse educators use to guide simulation pedagogy. Furthermore, in 2007, the NLN launched a comprehensive website for nurse educators and students eager to learn more about simulation — The Simulation Innovation and Resource Center (SIRC).

Types of simulation learning

As a study published in the Online Journal of Issues in Nursing (OJIN) explained, simulation learning strategies can vary widely and typically are employed when educating student nurses. Examples of common simulation approaches in the nursing field include the following:

  • Virtual platforms, such as a video games or computer programs (also called mid-fidelity simulation).
  • Task-trainer programs that allow users to practice important skills.
  • Computerized manikins that can be used to create scenarios that feel authentic (also known as high-fidelity simulation).
  • Role-play either with other team members or using non-computerized manikins.

The study also noted that simulation can be used to educate practicing nurses. Researchers argued that simulation can be implemented when a nursing team struggles with communication among its members or when productivity and professionalism is on the decline. In such scenarios, simulation exercises are an effective way for nurses to not only revise and refine basic nursing skills but also to improve communication within their team through collaboration.

The study further proposed that simulation learning can be implemented as a means to assess candidates for nursing roles and then again throughout the orientation process.

The effect on patient outcomes

Ultimately, simulation is becoming increasingly common in nursing education. Several studies across various sectors of nursing care have shown that simulation leads to better patient care and higher rates of treatment success:

  • A 2012 obstetrics study examined the impact of a simulation program designed to educate nurses in labor and delivery. Study authors found that a year and a half after implementing the simulation program, patients felt safer and outcomes improved.
  • A 2013 research project examined the efficacy of a simulation program for pediatric emergency teams in hospitals. The initiative involved practicing medical staff, who on a rotational basis received simulation experience in how to more effectively recognize and treat deteriorating patients with critical illnesses. Researchers found that the training was highly effective at enabling the emergency team to more quickly recognize and respond to deteriorating patients, improving outcomes. The research found that the emergency response team was responsible for an overall reduction in patient mortality rates.
  • A 2015 study, published in the Journal of Nursing Education (JNE) suggested that use of human simulation in nursing education benefits cognitive and clinical skill acquisition — two things that no doubt lead to improved patient outcomes.

The proven efficacy of simulation training undergirds a core principle of online education at Bradley University: the use of technology and multimedia to enhance learning. “At Bradley University, we utilize digital avatars,” says Rachel Borton, director of the online Family Nurse Practitioner program, “which is something specific to our nursing programs that helps with health assessment and getting students comfortable with performing techniques and skills that are necessary before getting out in the field to practice with preceptors.”


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