Undergraduate
Nursing &
Clinical
Simulation
Karen Edgecombe, CPIT
Undergraduate Simulation in NZ
Nursing Council of NZ
All students have access to
simulation learning resources in
order to prepare them appropriately
for clinical experiences to ensure the
safety of health consumers,
students and staff
BN Programme
– Feb/July intakes
• 135 students (approx)
Year One
Focus on Building Knowledge and Skills
– Bioscience
– Communication
– Nursing Knowledge
Clinical Experience
– Aged Care Sector
Simulation
– Skill focused
• Nursing skills – starts simple
• 2013 change to curricula and focusing on small group simulation
activities, with lecturer rotating through with one group
Year Two
2A: Mental Health
• Debriefing, de-escalation
• Skills focus: injection techniques
• Area for expansion in simulation
2B: Acute Care – Med/Surg
• 5 weeks theory
• Simulations each week
– Sim Man utilisation
Simulation gets students ready for
practice
Objectives – what we try to teach
• Professionalism
• Assessment skills
• Communication skills
– with the patient
– with the whanua/family
– with health professionals
• Appropriate, safe nursing management
• Documentation
Professionalism
• Attitude
• Appearance
• Clear identity
Systematic, organised approach
to assessment
•
•
•
•
Incorporating frameworks
ABCDE rapid assessment
PQRSTU
Focused assessment of specific system
– e.g. respiratory, musculoskeletal
• Initial Assessment
• Comprehensive Assessment
Students need to know what to do
in an…
Teamwork
Meet the
Patient
Communication
Tool
•
Recognising changes in a
patient
Close attention to vital signs &
observations
-Watching trends
• Report to a senior RN or doctor
Nursing Management
• On-going monitoring vital signs &
observations
• Positioning
• Medication administration
But…. not the real world
In the real world…documentation
Paper work
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Patient notes
Neuro obs
Neurovascular obs
Fluid balance
QM0004
Falls risk
Bristol stool chart
Lab results
But wait, always more!
Computer updates
Debriefing
Peer
Observatio
n
Tool
Debriefin
g
What students say
‘I don’t know anything’ ….
‘It makes more sense’
‘I didn’t know he was going to breathe.’ ‘He talks!’
‘I think we should call the doctor!’
‘You want me to do all that again?!’
‘I didn’t have time for the paper work’
‘Everything changed so suddenly.’
‘I didn’t know what to do’
‘now I see why how frameworks work.’
What is going well
We do have some humour and fun.
We are meeting different learning styles.
http://www.kon.org/urc/v9/hunter.html
We see beginning critical thinking skills.
We build confidence and competence.
What else could we be doing
Expand scenario library.
Video taping.
__ ____________
Year Three
3A: Family & Community Health
• Paediatric CPR
3B: Transition to RN Practice
• Simulation: Deteriorating patient
• Small group rotations, lecturer follows through
with debriefing
What we know…
Simulation and the Nursing Student
• Literature supports the use of simulation as an
accepted teaching and learning strategy
– Anecdotal & research based
– Recognise that students ‘report’ feelings of
increased confidence & knowledge post simulation
(Blum & Borglund, 2010; Cant & Cooper, 2010; Hovancsek & Jeffries, 2009)
– What are the BEST teaching &
learning strategies that lead to this point?
Simulation & the Nursing Lecturer
• Recognise that the nursing student is electronically
‘savvy’
– Maybe more so than the nursing lecturer!
– E-books, Web-based games, cell-phone technology
– Have a greater understanding and reliance on technology
• Although they may love the technology, they can still be pretty naive about it!
• Use of simulation as a teaching & learning strategy
to assist in scaffolding knowledge (Levett-Jones & Gersbach, 2011)
– Improving clinical decision making
• Recognise that clinical areas are
increasingly technology driven