SIMULATED LEARNING
EXPERIENCE IN A FIRST YEAR
NURSING COURSE:
LESSONS LEARNED
Lisa Keenan-Lindsay RN, MN
Professor of Nursing Seneca College
WHAT IS SIMULATION LEARNING
EXPERIENCE (SLE)

SLE provides a realistic re-enactment of clinical
situations in which the student is able to step into
a role in a non-threatening learning environment
(Schoening, Sittner, & Todd, 2006)

Can be used to learn a variety of skills through
different modalities
…
High fidelity
… Medium fidelity
…
Low fidelity
http://www.ocean.edu/academics/programs_of_study/nursing/virtual.htm
WHY USE SLE?

Incorporates active engagement, shared
responsibility for learning and reflection

Fosters development of clinical and critical
thinking skills to enhance patient care in safe
environment

Allows student to make mistakes and learn from
the consequences without harming patient

Increases confidence (and decreases anxiety
related to new skills)

Can incorporate many skills into scenarios
FIRST YEAR NURSING COURSE

Clinical course: 8 students

Curriculum shift


Learning objective for course



Older Adult OR Maternal Newborn
To provide care to a patient in each clinical area
Simulation lab experience

Fall 2011: 2 weeks = 20 hours

Winter 2012: 1 week = 5 hours
Classroom experience

Incorporated some scenarios into theory class
SLE EXPERIENCE: LAB

Student Preparation

Introduction

Scenario: Realistic

Time-outs

Debrief

Written reflection
DEBRIEF

“facilitated or guided reflection in the cycle of
experiential learning” Fanning & Gaba (2007)

Primary place of learning

Reflect on and discuss their actions and those of
others
…
Self-evaluation by students is best
…
Can improve student’s evaluation skills
…
Need to give objective evaluation
DEBRIEF

Need instructors with expertise in area and
experience with simulation

Research needed: what is better – individual or
team debriefing

Video-taping

If time permits may run through scenario again
with new learning
http://maasd.edublogs.org/2010/01/17/creating-an-environmentwhich-meets-student-learning-needs/
STUDENT REFLECTION

“turning experience into learning” (Ness et al, 2010)
…
Were able to realize that they focused more on tasks than
on developing relationships with patients
…
Students want more experiences like this
…
Recognize that SLE provides valuable practice that can
benefit their clinical competence and skills
…
Application of nursing theory to clinical practice
…
Incorporated knowledge from other courses
http://www.sde.ct.gov/sde/cwp/view.asp?a=2609&q=320242
LEARNING: OUR EXPERIENCE

Assessments & Health teaching

Communication with patients and families

Skills were transferable to other areas of nursing

Incorporated knowledge from other courses

Hands-on learning environment can be more
valuable than didactic education (work well
together)

Increases students confidence & enthusiasm

Team work

Critical thinking: Aha moments!
http://changizi.wordpress.com/2010/09/09/why-we-have-aha-moments/
LEARNING

SLE will never replace clinical experience but can
give students opportunities to experience different
areas

Students learn and retain skills better when learn
in environment of emotion, laughter and social
experiences

Students enjoyed experience

Student anxiety

Great teaching experience

Provided consistency

in marking for part-time clinical teachers
http://jamesbrauer.com/you-do-realize-its-about-learningright/student-learning/
STUDENT FEEDBACK

“great way to apply theory to practice”

Felt information could be applied to other clinical situations

Realized how biases affected how they give care

“will now be able to incorporate family into care I provide”

“able to take your time and make mistakes”

Equipment made everything feel “real”

If it wasn’t for sim lab I would never really know how to build a
therapeutic relationship with a patient in the hospital

Felt less “ripped off”

Feedback was useful
CHALLENGES

Cost of simulators

Cost of trained faculty (resource intensive)

Teachers need training in use of simulator as well
as debriefing

Ideal if have lab that resembles clinical
environment
CLASSROOM SIMULATION

Learning: eliminated didactic class time (showing
rather than telling)

Students needed to come prepared

Many students did not want to be nurse

Need buy-in from teachers in class – takes away
class time

Teachers need to feel comfortable with equipment

http://www.hhs.gov/ash/initiatives/hai/training/
NEXT STEPS

Collaborative, inter-professional opportunities

Students want more simulation experiences

Research: are the students able to take this new
learning into other clinical areas

Move into classroom and possibly 1st semester
skills lab class
http://gratitudeplanet.com/2011/01/28/there-is-always-the-next-step/
http://esriaustralia.wordpress.com/tag/cloud/