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Getting Organized: Simulation in Nursing Education

Developments in simulation are enhancing the capability of educator creative thinking and collaborative problem solving through access to multimodal interactions. Design of simulation in nursing education involves initial planning with foresight. The educator looks to review the intended simulation learning objectives and ensures that learning outcomes align nicely with the module, course, program, or clinical staff development progression. To start, the fidelity is selected, and then the setting, necessary simulators, props, diagnostic technology, and documentation modes are integrated. Consideration is given to the type of simulator to be used, along with the application mode and correlating groundwork, such as how the voice will be performed. If medication, nutrition, intravenous therapy, and respiratory support are essential to the simulation, the educator will also plan for access to these supports.

Once the general direction is organized, the nurse educator begins preparing the details of the scenario. This includes a description of the patient, which may involve the patient’s legal name, preferred name, date of birth, pronouns, height, weight, allergies, gender identity, sexual orientation, religion, culture, language, immunizations, treatment team members, presenting illness/chief complaint, medical history, psychosocial history, surgical history, primary medical/psychiatric diagnoses, nursing diagnoses, occupational data, assistive devices, and support system, among others. The scenario will likely include the patient’s admission date (hospitalized patients) and the date and time of the current interaction, along with patient care records, such as medication administration records, orders, and so forth. Each simulation is uniquely considered; therefore what is discussed here may be included, omitted, or built upon as designed and relevant.

As the simulation intention comes along, roles are established. Learners are typically assigned roles with correlating guidelines for engagement. Common roles include the primary nurse, secondary nurse, unlicensed assistive personnel, support member (such as family or friend), observer, and recorder. Sometimes, other roles may include students or staff outside of the nursing program or specialty as well, such as from allied health sciences, theater, or other disciplines, to help create authentic environments. The educator checks with all learners to ensure that they are prepared prior to the start of the simulation and that each participant understands their role. Planning for success not only includes theory and the practical application of skills, but also the identification of barriers to learning and to providing care that is respectful of, and responsive to, individualized needs. Upon evaluation, the student’s performance ability is not the focus; rather, the substance is assessed. The educator really should stress this focus ahead of the simulation, so that undue pressure is not placed. We also suggest that resources such as evidence-based practice guidelines, teaching tools, and guest speakers are gathered and arranged beforehand, so that come debriefing time, all supports are ready and available.

Purposeful student planning is very important! The nurse educator ensures that supplemental materials necessary for success are dispersed to the learners ahead of the simulation with sufficient time for review. If videos or readings are suggested, the educator shares this direction, while also creating space to orient to the technology and expectations with ample support for questions and concerns. We need to remember that the goals here are based on practice, along with forming new understandings and associations to the material, so that all are encouraged to learn in environments that embrace their current place in development and encourage them forward.

By remaining up-to-date with modern trends in simulation, nurse educators develop timely and pertinent experiences that support growth surrounding current working conditions. As nurse educators, we can utilize open access resources for advancing competency to educate with, and about, technology. While we remain accountable to the evolving needs of our profession, including technological innovations in simulation, we bring about authentic experiential scenarios in nursing education.