Nursing clinical simulation

Students engaged in simulated hands-on experience. (Photo by Anna Zhu)
 

Lecturer:
Hui Chen

Faculty:
Science

Project:
The use of simulation as a novel experiential learning module in science education 

Keywords:
simulation, experiential teaching, graduate attributes

      

Simulations are common in health care education but their use in undergraduate Science is relatively new. Dr Hui Chen and her team are paving the way, introducing simulation scenarios to their Science students. 

What the project is about 

Dr Chen's project is building on the success of a recent collaboration between Health and Science that produced two simulation scenarios for a second year Science subject, Human Pathophysiology. In the developed simulation scenarios, students interact with manikins and their peers, providing a more authentic link to clinical settings than traditional, paper-based methods. In response to the success of the simulation sceanrio in second year the project is developing and piloting additional simulation scenarios for first and second year subjects. 

Why the project is being introduced

Physiology and Pathophysiology in the Faculty of Science traditionally work with paper-based case studies and whilst these cases are built around a scenario that is authentic, they lack context relating to the clinical setting. Introducing simulation scenarios to first year students in human anatomy and physiology helps support:
 

  • their transition from high school to university
  • their cultural diversity
  • their engagement within a scientific context
  • their orientation toward practice

This hands-on approach provides students with opportunities to experience and exercise both theoretical and practical skills.

Dr Chen hopes that the simulation classes provide the students with a better understanding of the discipline in human physiology and a smoother transition into second year physiology-based subjects.
 

Beyond second year subjects, simulation as contextualised learning develops students' graduate attributes such as team work and communication (with group members and with the ‘patient’), leadership skills, problem solving and decision making. All of which are not easily achieved with a paper-based case study approach.

How the project is being implemented

The process of Dr Chen’s project is as follows:
 

In Autumn semester:

  • Developing a scenario to trial as a pilot in the first year subject Human Physiology. Students are able to study changes in physiological parameters (heart rate, blood pressure, respiratory rate, body temperature etc.) due to a non-diseased state e.g. intoxication or drug overdose after a night out clubbing with friends

In Spring semester:

  • Constructing a new simulation scenario in the second year subject Human Pathophysiology, and improving the existing two scenarios in Human Pathophysiology by incorporating basic medical procedures, such as intravenous infusion, multiple stix test, etc.
  • Demonstrators guiding students through the process of history inquiry, symptom analysis, laboratory examination, diagnosis and treatment
  • Workshoping the demonstrators’ training prior to each simulation session
  • Developing an assessment task (e.g. case report) based on one simulator scenario in Human Pathophysiology to examine:
    -  Leadership, teamwork and collaboration, as marks can be assigned according to individuals’ contribution, e.g. based on a scale of active participation/roles in the team
    -  The understanding of discipline knowledge, as to whether the correct diagnosis, examination, and treatment is given
  • Debriefing session after each simulation session, and a formal evaluation sheet completed to aid future planning.
  • Data of attrition rates and grades will be collected and analysed to compare students’ experience of simulation sessions and traditional practical classes

Challenges and considerations

Initial feedback in 2012 from students who performed some simple medical examinations on the manikins and fellow students, showed that students better understood the process, the underlying knowledge and the realistic setting of the exercise.
 

However in the implementation of Dr Chen's 2013 project, passive observation dominated the students' learning time during class. Further modification are being implemented to develop learning activities where students work as a team in response to the sceanrios with faciliation by the demonstrators supporting active engagement.
 

 

Exploring further

Parr, M.B. & Sweeney, N.M. (2006). Use of human patient simulation in an undergraduate critical care course. San Diego State University.
Read...


Delving even deeper

Lasater, K. (2007). Clinical judgment development: Using simulation to create an assessment rubric. Journal of Nursing Education.
Read...
Lasater, K. (2007). High fidelity simulation and the development of clinical judgment: Students' experiences. Journal of Nursing Education.
Read...