Effects of participation vs. observation of a simulation experience on testing outcomes: implications for logistical planning for a school of nursing.

The simulation program within our nursing curriculum covers a wide array of content areas and has been rated very highly by students and faculty. Due to this success, requests for increased simulation experiences have grown dramatically. The challenge lies, however, in logistically accommodating large student groups in finite periods of time. To overcome these constraints, an alternative plan was devised where half of the students actively participate in the simulation while their cohort observes. Both groups participate in the debriefing process. Findings revealed no significant differences (p=.97) between the simulation and observational groups on scoring of the test items related to this content (n=92). Over 70% reported the simulation experience as enjoyable, well-organized, clarified issues, increased knowledge and prepared them to work in a hospital. These findings indicate that the use of this alternate plan was effective for student learning and could therefore be incorporated into the simulation program design.

Use of an emergency preparedness disaster simulation with undergraduate nursing students.

This is a report of an educational strategy to prepare nursing students to respond to disasters. The strategy includes an emergency preparedness disaster simulation (EPDS) implemented in a school of nursing simulation lab using patient simulators, task trainer mannequins, and live actors. The EPDS immerses student groups into a "tornado ravaged assisted-living facility" where the principles of emergency preparedness can be employed. A total of 90 B.S.N. students participated in the EPDS in the final semester of their senior year. Student post-simulation survey responses were overwhelmingly positive, with mean scores of 4.65 (on a 5-point Likert scale) reported for the EPDS "increasing understanding of emergency preparedness" and "well organized." Mean scores were over 4.40 for "scenario believability, increasing knowledge base, increasing confidence in working in teams, ability to handle emergency preparedness situations and to work more effectively in hospital or clinic." The lowest mean score of 4.04 was for "prompting realistic expectations." Owing to the effectiveness of this educational strategy, the EPDS has been incorporated into the undergraduate curriculum.

Design and implementation of an interdisciplinary pediatric mock code for undergraduate and graduate nursing students.

Higher patient acuity and shortage of healthcare professionals have led to an expansion in the role and responsibilities for nurses, and ultimately, nursing students. Nursing faculty are challenged to develop strategies based on core competencies to obtain optimal practice within this complex system. Use of patient simulators is an effective strategy as it allows for deliberate practice of skills and standardized exposure to limited scenarios. The rarity of pediatric codes and opportunities for students to interact in teams led faculty to develop an interdisciplinary pediatric mock code simulation. Senior baccalaureate students function as members of a pediatric code team with emergency nurse practitioner students as code team leaders. Student preparation included Web-based information and an interactive class on code skills and team communication during a sentinel event. The scenario incorporated team roles and family-centered care. The debriefing session reinforced the evidence and reviewed quality improvement and safety through error identification and patient consequences. A total of 43 BSN students and 12 emergency nurse practitioner students participated. The simulation was rated very highly for realism, enjoyment, concept clarification in debriefing, increasing knowledge base, ability to function in the clinical setting, and increasing confidence in caring for a critically ill infant.