Nursing Education and Standardized, In
Situ, Virtual Simulations and Digital Platforms, Purpose of Simulations

Standardized
Patients Technique for Clinical Learning Environment In Nursing Education, In
Situ Simulations Technique for Clinical Learning Environment In
Nursing Education, Virtual
Simulations and Digital Platforms Technique for Clinical Learning
Environment In Nursing Education, Purpose
of Simulations For Clinical Learning Environment In Nursing
Education, Simulations as
Experiential Technique for Clinical Learning Environment In Nursing
Education.

Standardized Patients Technique for Clinical Learning Environment In Nursing Education

    Standardized patients are live
actors trained to portray the role of a patient according to a script or
clinical scenarios written by the faculty. The actors become the patients,
demonstrating clinical symptoms and responses of real patients. 

    A variation of
the standardized patient instructional strategy is the use of these types of
simulations to evaluate physical assessment skills, history taking,
communication techniques, patient teaching, and types of psychomotor skills or
objective structured clinical examination (OSCE).

In Situ Simulations Technique for Clinical Learning Environment In Nursing Education

    In situ simulation is a type of
simulation that involves training performed in a real-life setting where
patient care is commonly provided (Dismukes, Gaba, & Howard, 2006). The aim
of this type of simulation is to achieve high fidelity (realism) by performing
the simulations in actual clinical settings, blending and providing both a
clinical and learning environment. 

  Typically, simulation-based experiential
learning focuses on interdisciplinary professional teams. Practicing
professionals are well versed in their particular field, possess a fair amount
of experience, and prefer their learning to be problem-centered and meaningful
to their professional lives. 

   Adults learn best when they can immediately apply
what they have learned. Traditional teaching methods (eg, a teacher imparts
facts to the student in a unidirectional model) are not particularly effective
in adult learning because it is important for adults to make sense of what they
experience or observe.

Virtual Simulations and Digital Platforms Technique for Clinical Learning Environment In Nursing Education

    Simulations can also take place in
virtual environments. Increasing development in virtual patient simulation is
evolving and allows the learner to interact with the patient and the virtual
environment where the patient is responsive to interventions through a digital
media platform. 

    An example of this platform is Second Life, a virtual world
accessible by the Internet that enables its users to interact with each other
through avatars. In this simulated world, users can explore, meet other users,
socialize, participate in individual or group activities, and create services
for one another or travel throughout the world. 

    The software is a
three-dimensional modeling tool that attempts to depict reality for the users.
Second Life is used as a platform for education by many institutions, such as
colleges, universities, libraries, and government entities. There are other platforms whereby software
programs replicate clinical practice and respond to learner interactions; some
provide written feedback to the learner with suggestions and evidence as
feedback. 

   Simulation through game-based learning can be performed independently
or moderated and this type of simulation helps prepare students for the
clinical setting and allows the learner to make decisions and interact with a
patient with real-time response in a safe learning environment. 

    Cook (2012)
designed and evaluated a virtual world simulation for family nurse practitioner
students and also created a primary care pediatric simulation for use by family
nurse practitioner students in Second Life. Seefeldt et al. (2012) used Second
Life to allow pharmacy, nursing, physical therapy, occupational therapy, and
physician assistant students to interact around a mock patient case. 

    The pilot
study examined the feasibility of using Second Life as a means to foster
interprofessional education (IPE). Students overall found the platform useful;
However, there were technical difficulties in using the platform and students
lacked the necessary knowledge and skills to use the platform. 

    Farra, Miller,
Timm, and Schafer (2013) found out that virtual environments can be used as a
learning strategy for nursing students to practice and hone their disaster
response and management skills. The study found that students were able to
retain the knowledge after the simulation and there was an overall positive
response to the use of the virtual platform.

Purpose of Simulations For Clinical Learning Environment In Nursing Education

    Clinical simulations in nursing
education can be used for many purposes, for example, as a teaching strategy or
for assessment and evaluation, or as an avenue to encourage IPE. 

    However, one
of the most important reasons that educators use simulations is to provide
experiential learning for the student. Students can be immersed in a simulation
where they can actually portray the primary nurse, a newly employed nurse in
orientation, or whatever role within the scope of nursing practice the learner
is assigned.

Simulations as Experiential Technique for Clinical Learning Environment In Nursing Education

    The use of simulation corresponds
with a shift from an emphasis on teaching to an emphasis on learning (Dunn,
2004; Jeffries, 2005) in which the faculty facilitate learning by encouraging
students to discover, or construct, knowledge and meaning. Kolb (1984) and
others ( Sewchuck , 2005; Svinicki & Dixon, 1987) suggest that the
experiential learning cycle is a continuous process in which knowledge is
created by transforming experience. 

    Individuals have a concrete experience,
they reflect on that experience (reflective observation), they derive meaning
(abstract conceptualization) from the experience, and they try out or apply
(active experimentation) the meaning they’ve created, thus continuing the cycle
with another concrete experience. 

    When making a shift in approach from a focus
on teaching to a focus on learning, goals of the educational programs serve as
the framework for the development of specific learning activities. For example,
both nursing students and novice nurses entering professional practice find it
difficult to transfer theoretical knowledge into clinical practice. 

    The use of
simulation allows students to experience the application of theory in a safe
environment where mistakes can be made without risk to patients. The use of
highly realistic and complex simulation may not always be an appropriate
educational approach. In some situations, beginning students can use
low-fidelity simulation to work on attainment of foundational skills, including
effective communication with patients, psychomotor skill performance, and basic
assessment techniques. 

    With task trainers or standard manikins, students can
practice procedural skills and caregiving in a safe environment that allows
them to make mistakes, learn from those mistakes, and develop confidence in
their ability to approach and communicate with patients in the clinical
setting. 

   In addition, students benefit from the opportunity to work with
technologically sophisticated equipment such as clinical information systems
and hemodynamic monitoring systems in the educational setting before
encountering such equipment in the clinical setting.    

    Advanced practice nursing
students benefit from high fidelity simulations that are complex, realistic,
and interactively challenging experiences that support them in developing and
practicing leadership abilities, teamwork, and decision-making skills. 

    With
patient simulators, for example, students can practice complex assessment
skills in their area of clinical practice. Faculty can create scenarios and
program equipment to simulate serious clinical situations such as respiratory
arrest or aberrant cardiac rhythms that may require an emergent response.
Simulations are also appropriate to prepare psychiatric nursing practitioners. 

    As students respond to these more complex situations, they demonstrate their
abilities to establish priorities, make decisions, take appropriate action, and
work successfully as part of a team (Reese, Jeffries, & Engum, 2010).
Within the simulated environment, advanced students also can demonstrate
application of learning because they are no longer merely acquiring knowledge
and skills. 

    Students learn from the simulated practice without the need for
faculty stepping in to correct and control the situation. High-fidelity
simulation affords all students the opportunity to experience a baseline set of
clinical scenarios, including those that are uncommon or rare, and to practice
skill sets repeatedly until they develop a routine and process for safe patient
care (Reising & Hensel, 2014) .