The use of simulation for skills assessment and

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Mary Ann Cordeau PhD, RN
From participating in this presentation the
participant should be able to:
Define assessment and validation as they relate
to clinical simulation
Link evaluation to simulation learning outcomes
Describe the process of designing a scenario
which incorporates skills validation
Skills assessment – evaluating student
performance
Validation – confirming student’s ability
Formative – learners provided feedback and
reflect on performance, experience shapes
learning
Summative – end of learning period measures
how learners met objectives
How does evaluation link to:
Learning (knowledge) (objective) - learner is
evaluated
Current knowledge
Knowledge gained
Skill performance (objective) learner is
evaluated
Learner satisfaction (subjective) learner
evaluates simulation, instructor
Clinical reasoning (objective and subjective)
learner is evaluated
Self-confidence (subjective) learner evaluates)
Cognitive skill – Critical thinking, Clinical
Reasoning
Psychomotor skill – vital signs
Affective skill – how does student relate to
patient?
Ability to maintain a safe environment
Patient care situation which incorporates
affective, cognitive, and psychomotor skills
Didactic content- alternative testing
How do students work in group
Should be appropriate for level of student
Should reflect the purpose of the clinical simulation experience
Learning Outcomes for Caring for a Client with Ischemic Stroke
Identify client developmental, physical, and environmental factors that may
lead to accidents or injury
Implement nursing interventions for a client with impaired physical mobility
related to an Ischemic Stroke
Implement nursing interventions to prevent the transmission of infection
Demonstrate therapeutic communication when caring for client
Implement critical thinking when assessing laboratory values in relation to
medication administration
Administer medications using the five rights of medication administration
Provide necessary teaching related to illness management (stroke, diabetes,
hypertension)
Self-evaluate care provided
Will depend on level of student (novice)
Major cognitive skill(s) - Assessment
Knowledge of illness management of a client with ischemic stroke/impaired
mobility (independent reading)
Knowledge of illness management of a client with Insulin Dependent
Diabetes Melitus (independent reading)
Knowledge of illness management of a client with Hypertension
(independent reading)
Knowledge of vital signs and laboratory values related to medication
administration (independent reading, drug guide)
Therapeutic Communication skills (view communication video, pre-hospital
skills lab)
Knowledge of client teaching (NU 310 Learning Theories), independent
reading
Major psychomotor skill(s)
Basic assessment
Vital sign assessment
Medication administration (Subcutaneous Injection) - Validation
What skills are appropriate for the scenario
When will skill be taught – students should not
be expected to be validated on a skill that they
have not learned and practiced
Determine how much time it will take for
scenario – needed for scheduling
Determine the needed realism with equipment
Provide orientation to scenario
Write the scenario
Pilot before running with entire class
How much information about patient will
student be given prior to experience
Depends on learning outcomes
Depends on level of student (novice)
How many practice opportunities will student
have?
Depends on previous experience with clinical
simulation
Opportunities to practice skills
Effect will grade have on progression
No grade
Letter grade
Number grade
% of a course grade
Pass/Needs Improvement
Number of opportunities for meeting outcomes
All instructors should use same standards to evaluate students
Evaluating learner performance in clinical simulation is like
evaluating learner performance in clinical practice; it is both
objective and subjective
Validating psychomotor skills has less subjectivity
Critical care scenarios should be very objective
Evaluating therapeutic communication scenarios will be
subjective and objective
Evaluating longer scenarios that incorporate critical
thinking/clinical reasoning and psychomotor skills will be both
objective and subjective
Establish criteria for a grade of Pass
On how many interventions can a student receive a N or NI
and receive a grade of Pass?
Are there critical interventions that must be completed?
What if student notes errors/omissions during self
evaluation and not during scenario?
Is safety the most important factor in passing?
Can student state what they learned?
Can student state what they would do differently?
Does student note areas that need more study/practice
Rubric should reflect learning outcomes
Rubric should reflect level of student
Rubric should be user friendly
Rubric should have space for objective and
subjective evaluation data
Pilot
Revise as necessary
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