1. SIMULATED LEARNING EXPERIENCE IN A FIRST YEAR NURSING COURSE: LESSONS LEARNED Lisa Keenan-Lindsay RN, MN Professor of Nursing Seneca College

2. OBJECTIVES  To review the application of the use of simulated learning experience (SLE) within education.  To discuss the goals of SLE in a first year maternal newborn nursing course.  To explore the learning that takes place in SLE as well as the challenges.

3. WHAT IS SIMULATION LEARNING EXPERIENCE (SLE)  SLE provides a realistic re-enactment of clinical situations in which the student is able to step into a role in a non-threatening learning environment (Schoening, Sittner, & Todd, 2006)  Can be used to learn a variety of skills through different modalities …High fidelity …Medium fidelity …Low fidelity …Task trainer http://www.ocean.edu/academics/programs_of_study/nursing/virtual.htm

4. WHY USE SLE?  Incorporates active engagement, shared responsibility for learning and reflection  “Learn by doing”  Fosters development of clinical and critical thinking skills to enhance patient care in safe environment  Allows student to make mistakes and learn from the consequences without harming patient  Increases confidence (and decreases anxiety related to new skills)  Enjoyable for students  Can incorporate many skills into scenarios

5. FIRST YEAR NURSING COURSE  Curriculum shift  Older Adult OR Maternal Newborn  Clinical course: 8 students  Learning objective for course  To provide care to a patient in each clinical area  Simulation lab experience  Fall 2011: 2 weeks = 20 hours  Winter 2012: 1 week = 5 hours + classroom simulation

6. SLE: LAB  Student Preparation  Introduction  Scenario: Realistic  Time-outs  Debrief  Written reflection

7. DEBRIEF  “facilitated or guided reflection in the cycle of experiential learning” Fanning & Gaba (2007)  Primary place of learning  Reflect on and discuss their actions and those of others …Self-evaluation by students is best …Can improve student’s evaluation skills …Need to give objective evaluation

8. DEBRIEF  Need instructors with expertise in area and experience with simulation  Research needed: what is better – individual or team debriefing  Video-taping  If time permits may run through scenario again with new learning http://maasd.edublogs.org/2010/01/17/creating-an-environment- which-meets-student-learning-needs /

9. STUDENT REFLECTION  “turning experience into learning” (Ness et al, 2010) …Were able to realize that they focused more on tasks than on developing relationships with patients …Recognize that SLE provides valuable practice that can benefit their clinical competence and skills …Application of nursing theory to clinical practice …Incorporated knowledge from other courses …Valued other members of group http://www.sde.ct.gov/sde/cwp/view.asp?a=2609&q=320242

10. LEARNING: OUR EXPERIENCE  Assessments & health teaching  Communication with patients and families  Skills were transferable to other areas of nursing  Incorporated knowledge from other courses  Hands-on learning environment can be more valuable than didactic education (work well together)  Increases students confidence & enthusiasm  Team work  Critical thinking: Aha moments! http://changizi.wordpress.com/2010/09/09/why-we-have-aha-moments /

11. LEARNING  SLE will never replace clinical experience but can give students opportunities to experience different areas  Students learn and retain skills better when learn in environment of emotion, laughter and social experiences  Students enjoyed experience  Student anxiety  Great teaching experience  Provided consistency in marking for part-time clinical teachers http://jamesbrauer.com/you-do-realize-its-about-learning- right/student-learning /

12. STUDENT EVALUATION OF EXPERIENCE  “great way to apply theory to practice”  Felt information could be applied to other clinical situations  Realized how biases affected how they give care  “will now be able to incorporate family into care I provide”  “able to take your time and make mistakes”  Equipment made everything feel “real”  If it wasn’t for sim lab I would never really know how to build a therapeutic relationship with a patient in the hospital  Felt less “ripped off”  Feedback was useful

13. CLASSROOM SIMULATION  Learning: eliminated didactic class time (showing rather than telling)  Students needed to come prepared  Many students did not want to be nurse  Need buy-in from teachers in class – takes away class time  Teachers need to feel comfortable with equipment

14. CHALLENGES  Cost of simulators  Cost of trained faculty (resource intensive)  Teachers need training in use of simulator, debriefing as well as clinical expertise  Ideal if have lab that resembles clinical environment

15. NEXT STEPS  Collaborative, inter-professional opportunities  Students want more simulation experiences  Research: are the students able to take this new learning into other clinical areas  Move into classroom and possibly 1 st semester skills lab class http://gratitudeplanet.com/2011/01/28/there-is-always-the-next-step /

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