The impact of virtual simulation on the recognition and response to the rapidly deteriorating patient among undergraduate nursing students.

A major patient safety challenge is recognition and response to deteriorating patients since early warning signs are often not detected in a timely manner. Nursing students typically learn the skills for early identification through clinical placement, but clinical placements are not guaranteed to provide exposure to deteriorating patients. Nursing students require practice with emergency scenarios to develop their competency and confidence to act in this area. This study aimed to explore the impact of a virtual simulation intervention on the recognition and response to the rapidly deteriorating patient among undergraduate nursing students. A mixed methods study involving a quasi-experimental pre/post design and focus groups. The participants were third or final year undergraduate nursing students from five university sites across four countries (Canada, England, Scotland and Australia, n = 88). Students were randomly assigned to a treatment or control group. The treatment group received a virtual simulation intervention and participated in a focus group. The virtual simulation intervention had a significant effect on improving nursing student knowledge and clinical self-efficacy in the recognition and response to the rapidly deteriorating patient. Students reported that the virtual simulations decreased anxiety, helped them prioritize, filled gaps in their learning, and encouraged autonomous learning within a safe 'low risk' environment. Virtual simulation is an effective strategy for improving knowledge and confidence in recognizing and responding to the rapidly deteriorating patient among undergraduate nursing students.

P Stands for Pivot: Pivoting Face-to-Face Practicum to Virtual Simulation during the Pandemic.

Virtual simulation has been widely used to temporarily replace face-to-face clinical practicum experiences in nursing education in response to the global COVID-19 pandemic. While more traditional clinical settings were prioritized and made available only to senior students, the use of virtual simulation provided an opportunity to safely pivot from the usual placement to a comparable practical learning modality to maintain clinical competence during unprecedented public health restrictions and mitigation strategies. Like many others across the globe, nursing students in a Canadian university continued their nursing education predominantly using virtual simulation for an entire academic year to avoid catastrophic delays in entering the workforce and to ultimately protect the health service delivery needs throughout the oncoming waves of the pandemic. The purpose of the paper is to describe guiding principles established in a School of Nursing as a means to responsibly and ethically adopt a replacement of traditional clinical practicum experiences with virtual simulation. The principles for incorporating virtual simulation included the need to achieve and maintain a high level of quality of learning experiences, a fluid delivery articulated in phases, and a financial commitment by the learning institution. As the global pandemic may see a fourth wave, the use of virtual simulation will continue to present a major change for clinical practicum and establishing principles for the use of virtual simulation has demonstrated to be an integral part of safe pandemic response and post-pandemic recovery.

Shaping clinical imagination as new graduate nurses in maternal-child simulation.

BACKGROUND: Combined with traditional placement, simulation has been used as an experiential learning opportunity to integrate theory and practice in maternal-child nursing. METHOD: van Manen's phenomenology of practice uncovered the lived experience of new graduate nurses adopting maternal-child simulation in their practice. Narrative methods included a three-phased approach to phenomenological interviews to capture the new graduate's entry into practice. RESULTS: Thematic analysis revealed four main themes: acting like a nurse, forming a clinical imagination, embodying the role of the novice nurse, and embracing in-situ simulation. DISCUSSION: The essence of being a nurse required immersion into the ethics of caring and creation of an optimal simulation debriefing using a skilled and thoughtful approach to trigger imaginative thinking. While an inventory of simulation in nursing education was deemed necessary to understand the current blend of traditional placement and simulation in practice education, the new graduate nurses in the study looked for specialty training, and exposure to advanced roles in the simulation experiences. CONCLUSION: An integrated traditional placement with the use of simulation fostered clinical imagination where the new graduate nurse visualized and embodied the role of the novice nurse. Future research is required to describe the impact of simulation on practice readiness.