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Erin Davis Wilmington University
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Definition: A technique used to artificially replicate specific components of reality to achieve a desired goal. (Dunn, 2004) In Health Care: A teaching method used to educate practitioners and provide real life experiences without putting patients at risk. (Cannon-Diehl, 2009)
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1 st Documented Simulation: World War II (1940s) Flight simulators were used to train pilots and are currently still used today for simulation of take off, landing, loss of power, engine and system failures, and emergency operations. Simulators used vs. actual flight due to expense and hazard of practicing flight procedures in the air. (Ward-Smith, 2008) 1 st Health Care Simulation: Resusci © Anne & Harvey (1960s) Anne used for CPR training Harvey used for cardiology assessment and treatment training (Jeffries, 2007)
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Social Learning Theory Key concepts related to learning through simulation: Learning by imitating role models Learning through doing or rehearsal Cognitive processing by the learner is internalized and reflected by self-regulation and control Learner is central (Active participant) Socialization and interaction contributes to the learning process (Bastable, 2008)
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Low Fidelity Low Fidelity Case studies Role play Partial Task Trainers Partial Task Trainers Low technology mannequin Sophisticated Technology Sophisticated Technology Computer-based simulation Clinical scenario High Fidelity High Fidelity Realistic patient simulator Highly interactive Fidelity How close to reality the simulation experience approaches. (Jeffries, 2007)
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Team Training Multidisciplinary team management of critical events Case scenario provided and team manages crisis using simulation through effective communication, leadership, planning and distribution of actions to reach the outcome. (Dunn, 2004) Debriefing and reflection can be used to enhance learning and critique performance, providing immediate feedback to the learner Psychomotor, cognitive, and affective components (Cannon-Diehl, 2009)
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Nursing/Medical School Education Provides novice students with the ability to practice real life scenarios and complex situations. Helps develop decision making and critical thinking skills in a non-threatening environment. (Sportsman et al., 2009) New equipment or procedure training Provides education to the learner by hands-on experience. Practice on new equipment or performing a new procedure via simulation replicates reality without placing patients at risk for harm. (Cannon-Diehl, 2009)
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Depending upon portability of simulation equipment, equipment may be transportable to desired location for learning. Setting Examples: Simulation laboratory Classroom Clinical area
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Simulation experiences should be designed to meet learning objectives and be adapted to each specific teaching session to satisfy the those objectives. If undesirable outcomes are experienced, the educator should: Evaluate the simulation, focusing on why the objectives were not achieved. Modify the experience or simulation model in order to achieve the objectives and provide a positive learning experience to the learners. (Jeffries, 2007)
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PROS Real Life Scenarios Active Learner Involvement Non- threatening Environment True to life experience provides a higher level of learning. (Ward-Smith, 2008) Challenges decision making by mimicking tension of situations, time constraints, and using actual equipment for learning. (Bastable, 2008) Enhances psychomotor skill development (Bastable, 2008) Stimulates deeper cognition and high level problem-solving (Cannon-Diehl, 2009) Increases retention of knowledge ( Jeffries, 2007) Performance anxiety can be minimized. (Jeffries, 2007) Learn from mistakes to improve skill when performed on a real patient (Jeffries, 2007) Increases self-confidence (Jeffries, 2007)
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C ost (Can be very expensive) O peration (Labor intensive & may need an expert to manage equipment) N ot readily available (Needs to be well planned out and available as a method for teaching; Not all places have simulation related to the other cons listed.) S pace (Designated space for equipment not always available) (Bastable, 2008) & (Jeffries, 2007)
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Measures the effectiveness of the simulation by verifying that specific learning outcomes/objectives have or have not been satisfied. Written – simulation equipment, instructor, or team member evaluation; Test Verbal – performance critique and immediate feedback; Learner debriefing (cannon-Diehl, 2009) Return demonstration – performance/competency assessed by demonstrating what was learned from the teaching session (Jeffries, 2007)
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Bastable, S. B. (2008). Nurse as educator: Principles of teaching and learning for nursing practice. 3 rd Ed. Boston: Jones & Bartlett. Cannon-Diehl, M. R. (2009). Simulation in healthcare and nursing: State of the science. Critical Care Nursing Quarterly, 32(2), 128-136. Dunn, W. F. (2004). Simulators in critical care and beyond. Des Plaines, IL: Society of Critical Care Medicine. Jeffries, P. R. (2007). Simulation in nursing education: From conceptualization to evaluation. New York: National League for Nursing. Sportsman, S., Bolton, C., Bradshaw, P., Close, D., Lee, M., Townley, N. & Watson, M. N. (2009, February). A regional simulation center partnership: Collaboration to improve staff and student competency. The Journal of Continuing Education in Nursing, 40(2), 67-73. Ward-Smith, P. (2008, December). The effect of simulation learning as a quality initiative. Urologic Nursing, 28(6), 471-473.
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