Teena Milligan

Salisbury University Teaching and Learning Conference,

Simulated patient care experiences are becoming an increasingly important teaching/learning strategy in nursing education programs for several reasons. First, they provide a safe learning environment where students can learn from their mistakes. Second, they are highly controlled, assuring that all students can engage in the same experiences without the unpredictability that is seen in a “live” clinical environment and the variability that is inherent in working with human beings, even those with the same medical condition. Third, simulations can be video-recorded for review and reflection by learners and their faculty which has been shown to improve student insight and ability to connect theory with clinical practice. Fourth, simulations in a replicated clinical environment, help reduce student anxiety and lead to improved performance when moving into a “live” setting. Simulations can be low, medium, or high fidelity. Low fidelity simulations are those conducted with plastic manikins who are unable to exhibit any human physiologic functions and do not speak whereas high fidelity simulations use sophisticated computerized manikins who can manifest nearly all aspects of human physiology and are able to speak. This presentation will report preliminary findings of research investigating the use of low and high fidelity simulation experiences in NURS 311 Care of Adults 1, the first required clinical course in the undergraduate nursing curriculum, in preparing students for “live” patient care experiences. More specifically, we sought to understand how simulation experiences influenced student perceived self-confidence, knowledge about how to care for a patient with a particular condition, and satisfaction with learning using this pedagogy. Ninety-two students completed the experience over a two-week period. Pre- and post-experience data on perceptions of self-confidence and satisfaction with learning through simulations and changes in knowledge as measured by a 10-item inventory will be presented. Implications for use of simulation pedagogy will be discussed.

Salisbury University Teaching and Learning Conference,

“Behavioral simulations can simulate real life by presenting players with relevant information, choice options and realistic choice consequences” (Cohen et al., 2018). During the fall of 2020, the NURS 450 course: Best Practices in Nursing and Nursing Education, was held in a synchronous virtual modality. In order to keep the 23 students engaged, innovative teaching strategies were utilized each week. One particular method was the use of simulations where both instructors acted out three case studies and incorporated both therapeutic and non-therapeutic communication techniques. The students then guessed the techniques by writing them on a whiteboard or piece of paper and holding it up at the same time at the conclusion of each case. The instructors then asked the students with the correct responses to explain. This class was an enjoyable experience for all involved and spawned a more thorough and complex simulation activity during the fall of 2021. Now in-person for class once more, the 25 students were placed in groups of five and provided one case study with two therapeutic and two non-therapeutic communication techniques. The students took turns acting out each case, one playing the nurse and one the patient, and the remaining students had to guess which techniques were being utilized. A student facilitator was designated in each group to assist with the discussion. These simulations contributed to the students’ further knowledge of concepts while providing a creative and unique opportunity for learning.

2023 Nursing Education Research Conference, Washington, D.C.

The American Nurses Association (2021) and Association of Colleges of Nursing (2021) have identified interprofessional communication and collaboration as essential leadership competencies for professional nurses, however, nursing students may not have opportunities to develop skills working within interprofessional teams in real clinical situations. Simulation immerses students in experiential learning, and it is an effective teaching strategy that promotes team-based, collaborative practice (Ganheim et al., 2018). Standardized patients (SPs) are individuals specially trained to act as patients, family, or other healthcare professionals, and they are used in simulation to replicate complex clinical scenarios providing a greater sense of realism (Wilcox et al., 2017). Studies utilizing SPs have validated their worth in improving nursing and other health professions students’ confidence communicating and collaborating in teams (Ganheim et al., 2018; Wilcox et al., 2017). As students routinely identify the need for increased face-to-face collaborative experiences, nurse educators must identify effective teaching strategies to develop undergraduate students’ leadership competencies in interprofessional communication and collaboration, and the use of standardized patient experiences (SPEs) can be an effective pedagogical strategy to provide such an opportunity (Ganheim et al., 2018).<br><br>A web-based toolkit with an integrated SPE was developed for undergraduate baccalaureate nursing students to address interprofessional collaboration (IPC) in an end-of-life scenario. While IPC was the primary focus of the toolkit, effective team communication was essential to this experience. The toolkit included online modules with learning objectives, pre- and post-simulation activities to encourage critique and refinement of new skills, a video vignette utilizing SPs, and a face-to-face SPE with debrief. This innovative toolkit incorporated a variety of activities to better prepare and engage students during the experience. All students completed an evaluation of the toolkit activities and SPE for the purpose of process improvement.<br><br>When piloted with second-degree senior nursing students in fall 2018, feedback was extremely positive, and students and faculty identified the benefits of using the toolkit earlier in the curriculum. The toolkit was concurrently utilized the following semester with traditional degree seeking seniors and second semester juniors. Feedback again supported this curricular change with recommendations to include students from other healthcare programs. In spring 2020, respiratory therapy students were integrated into the experience with junior nursing students. Due to the pandemic, students participated in the SPE virtually. Despite the abrupt format change, students in both programs identified the benefits of working cooperatively. The toolkit is now utilized every spring semester with all junior nursing and respiratory therapy students, and as of 2022, all SPEs were transitioned back in-person. A future aim is to integrate students from social work into the experience.<br>Utilizing an IPC toolkit with an integrated SPE is an effective teaching strategy to promote interprofessional learning among undergraduate nursing and respiratory therapy students. The toolkit provides students the opportunity to develop essential leadership competencies of interprofessional communication and collaboration in a safe learning environment, and both nursing and respiratory therapy students are gaining irreplaceable hands-on experience necessary for future, team-based practice.