simulated learning experience in a first year nursing course: lessons learned lisa keenan-lindsay...
TRANSCRIPT
SIMULATED LEARNING EXPERIENCE IN A FIRST
YEAR NURSING COURSE: LESSONS LEARNED
Lisa Keenan-Lindsay RN, MN
Professor of Nursing Seneca College
OBJECTIVES
To review the application of the use of simulated learning experience (SLE) within education.
To discuss the goals of SLE in a first year maternal newborn nursing course.
To explore the learning that takes place in SLE as well as the challenges.
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
… Task trainer
http://www.ocean.edu/academics/programs_of_study/nursing/virtual.htm
WHY USE SLE?
Incorporates active engagement, shared responsibility for learning and reflection
“Learn by doing” 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)
Enjoyable for students Can incorporate many skills into scenarios
FIRST YEAR NURSING COURSE
Curriculum shift
Older Adult OR Maternal Newborn
Clinical course: 8 students
Learning objective for course
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 simulation
SLE: 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-
environment-which-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
… 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
… Valued other members of group
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-learning-
right/student-learning/
STUDENT EVALUATION OF EXPERIENCE
“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
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
CHALLENGES
Cost of simulators
Cost of trained faculty (resource intensive)
Teachers need training in use of simulator, debriefing as well as clinical expertise
Ideal if have lab that resembles clinical environment
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/