Where Are We Now? A Follow-up Survey on Regulation of Simulation Use in United States Prelicensure Nursing Programs.

Background: Approval of simulation in substitution of traditional clinical hours increased in nursing programs during the COVID-19 pandemic, yet these temporary and inconsistent between states. Variability and a return to "pre-pandemic" limits on simulation use amplify questions about consistency of learner outcomes. Methods: Boards of Nursing (BONs) of the United States and District of Columbia (DC) were queried to verify accuracy of simulation regulations posted on the International Nursing Association for Clinical Simulation and Learning (INACSL) regulatory map and to identify factors contributing to regulatory changes. Results: Approximately half of respondents indicated information posted on the INACSL regulatory map is accurate for their state. Almost 30% of respondents indicated information is not accurate. Some states could not confirm accuracy of simulation regulations posted. Conclusions: Many nursing programs expanded the use of simulation during the COVID-19 pandemic. Reverting to "prepandemic" limited simulation use presents a missed opportunity to advance nursing education and align simulation regulation with the growing body of evidence supporting its outcomes.

Fellow Designations of Interest to Nurse Leaders.

Achieving fellow designation is commonly a career goal for nurse leaders. The path to achievement can be confusing, and once a goal is set, choosing the right designation is important. This column outlines the background of fellow designation, clarifies differences between fellow designation and other career advancement options, and presents ideas for consideration by nurse leaders as they pursue career advancement through fellow designation.

The Importance and Impact of Nurse Leader Engagement With State Nursing Workforce Centers: Lessons From the COVID-19 Pandemic.

The COVID-19 pandemic caused unparalleled morbidity and mortality across the globe. Health care agencies, public health departments, and academic institutions experienced widespread disruption to usual operations. These events had an adverse impact on the nursing workforce. Nurse leaders in California rallied to identify and remediate the effects of COVID-19 on the nursing workforce. This article describes the strategy and interventions. Nurse leaders should invest resources in state workforce centers to ensure the health and supply of a strong nursing workforce.

The Scope of Hospital-Based Simulation.

BACKGROUND: Healthcare simulation has expanded dramatically; however, little is known about the scope of simulation in acute care hospitals. METHODS: A descriptive, cross-sectional online survey was used. Participants included nurse executives from acute care hospitals in California. RESULTS: Most organizations (96%) used simulation primarily for education, 37% used simulation for health system integration and systems testing, 30% used it for error investigation, 15% used it for research, and 15% used it for patient/family education. CONCLUSIONS: Organizations have a substantial opportunity to increase the scope of simulation beyond education to include systems integration, clinical systems testing, and other translational simulation activities. This targeted focus on patient safety and quality will allow hospitals to improve financial performance and maximize scarce resources.

Exploring Faculty Perceptions about Simulation Training: Influence on Career, Confidence, Knowledge and Skill Acquisition and Competence.

Even with insufficient evidence in the literature regarding the impact of faculty development with simulation education, faculty development is critical to building a successful simulation program. Despite simulation being ubiquitous in nursing education across the United States (US), there is little investigation of the impact of the education and training on job satisfaction, skill development and overall confidence when using simulation to teach nursing students. The purpose of this qualitative study was to investigate how has simulation education and training has influenced faculty career fulfillment, acquisition of knowledge, overall self-confidence and competence? Themes that emerged included the following: competency, professional role change, role acquisition, course learner needs, course impact, skill development, and overall ability and confidence. The study results confirmed that a gap exists where faculty without formal education may not be aware of their lack of competence and what training they need to be effective in facilitating clinical simulation.

Simulation as a Nursing Education Disrupter.

Simulation as an evidence-based pedagogy began emerging at a time when many constraints were being imposed on clinical experiences for nursing students. As research illuminated the advantages of simulation and standards were developed, educators began to recognize the limitations of the clinical setting, such as the inability to provide experiences in teamwork and delegation, and a focus on tasks. Simulations are crafted to provide an experience that matches content that is being taught in class, and debriefing techniques guide learners in a reflective process that promotes the development of clinical reasoning and judgment. The National Council of State Boards of Nursing study concluded that simulation could be substituted for 50% of clinical hours. Simulation-exposed gaps in the curriculum and its pedagogical principles are now extending to adaptations of its use in the classroom and in clinical postconferences. They are also shaping teacher-student conversations in the office and the hallways. Use of simulation for assessment is beginning to evolve. In a little more than 10 years, it has started a revolution that will continue to have a major impact on all aspects of nursing education in the future.

The evolution of a statewide network: the Bay Area Simulation Collaborative.

The Bay Area Simulation Collaborative (BASC), established in 2007, is a group of more than 100 schools of nursing and hospitals, totaling more than 600 faculty and hospital educators, from both service and academia in the ten counties that comprise the San Francisco Bay Area. The California Institute for Nursing & Health Care leads the BASC, which was funded through a grant from the Gordon and Betty Moore Foundation. This 3-year project was designed to train and educate nursing faculty and hospital educators in the concepts of simulation. It was also designed to develop clinical simulation scenarios for use within the BASC. Finally, the project implemented a research and evaluation agenda to demonstrate that simulation makes a positive difference in the critical thinking skills of nursing students. This article will describe the evolution, purpose, and goals of the BASC and how the initial investment has been leveraged to create addition regional collaboratives in the state and ultimately, the California Simulation Alliance.

The doctor of nursing practice degree: my journey.

The Doctor of Nursing Practice (DNP) degree is a new terminal degree for nursing. This article reviews the essentials of the DNP degree as published by the American Association of Colleges of Nursing and describes the author's personal journey toward completion of the DNP degree in December 2008.

The development of evidence-based clinical simulation scenarios: guidelines for nurse educators.

Clinical simulation has been recognized as a teaching method using learning exercises that closely mimic real-life situations. The development of evidence-based clinical simulation scenarios and guidelines for nurses is an important step in redesigning nursing education. These scenarios are created for students to learn in a safe environment. Simulated clinical experience requires immersing students in a representative patient-care scenario, a setting that mimics the actual environment with sufficient realism to allow learners to suspend disbelief. The purpose of this article is to discuss the Bay Area Simulation Collaborative's development of guidelines for effective evidence-based scenarios for use in hospitals and nursing schools. Six scholarly articles were reviewed and evaluated to determine whether evidence-based guidelines for scenario development exist and whether consensus in the literature regarding best practice is evident.

Marketing your skills outside the hospital walls.

As patient care shifts from acute care to outpatient and community home health care, nurses need to repackage their skills. A personal skill assessment on an ongoing basis helps nurses plan for the future.