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“Simulation is a technique, not a technology, to replace or amplify real experiences with guided experiences, often immersive in nature, that evoke or replicate substantial aspects of the real

world in a fully interactive fashion” (Gaba, 2007, p. 126).

The simulation team

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Canadore College/ Nipissing University

“On the other side of learning”

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The literature reveals

Nurses entering specialty areas sooner than in previous years are assuming roles which require them to respond to complex health challenges in maternal child nursing.

50.1% of nurses are between ages of 40-59 and 12.3% are over the age of 60 in Canada (Canadian Institute for Health Information, 2014)

“Nurses care for patients with multifaceted issues; in the best interest of these patients, nurse often must consider a variety of conflicting and complex factors in choosing the best course of action” (Lasater, 2007, p. 496).

Specialized units are smaller and difficult to secure due to fewer staff to supervise, increasing student enrollment, competition for placement, restrictions on group size (Smith, Spadoni & Proper, 2013).

The practicum in pediatric and perinatal units is a short rotation, with often few patients, observation-only learning experiences for nursing and medical students often leaving the maternal child specialties with inconsistent learning experiences (Luctkar-Flude et al., 2013; Jeffries, Bambini, Hensel, Moorman & Washburn, 2009).

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Review of the literature Simulation is a growing strategy to provide a range of experiences in

which students may not be exposed in a clinical practice setting (Lasater, Johnson, Ravert & Rink, 2014).

Replicas of the human torso, fabric dolls have been used in medical education and midwifery since the 17th century (Jeffries et al., 2009).

Simulation ranges in fidelity and realism from task trainers, to mannequins, multi-media computer systems, role playing and standardized patients (McGaghie, Issenberg, Barsuk, & Wayne, 2014; Jeffries et al., 2009).

Simulation provides the opportunity to incorporate the affective, cognitive and psychomotor domains of learning into nursing practice (Kardong-Edgren, Adamson & Fitzgerald, 2010).

Learning in the affective domain is inclusive of the values, attitudes and beliefs consistent with the professional standards of practice in nursing (Kardong-Edgren et al., 2010).

Year 4 lab & clinical practicum

Academic schedule includes:

3 hours of lab/week

12 hours of clinical/week x 12 weeks

2 days of simulation per student

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Pediatric scenarios

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Labs

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Maternal Child simulation lab in Year 4

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Debriefing Strategies

Debriefing: 2 stage

First: at the bedside Second: while reviewing the video

Sequence 9: again I cannot get it to run

Art and value of debriefing

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In summary Simulations: NCLEX preparation

Competency based learning

Reflects knowledge-base and theory of each year of study

Presented to the students as a safe learning environment and confidentiality of learners is ensured

All activities have planned reflection/ debriefing

Students submit assignments relating to their experiences

Preparation is essential to help develop skills required in clinical practice

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ReferencesAttanasio, L.B., McPherson, M.E., & Kozhimannil, K.B. (2014). Positive childbirth experiences in US

hospitals: A mixed methods analysis. Maternal Child Health Journal 18 (5), 1280–1290. doi:

10.1007/s10995-013-1363-1

Benner, P., Tanner, C.A., & Chesla, C.A. (1996). Expertise in nursing practice : Caring, clinical judgment,

and ethics. New York: Springer.

Canadian Institute for Health Information. (2014) Regulated Nurses, 2013. Ottawa, ON. Retreived from

https://secure.cihi.ca/free_products/Nursing-Workforce-2013_EN.pdf.

Creswell, J. (2012). Educational research: Planning, conducting and evaluating quantitative and

qualitative research. New Jersey: Pearson Education Inc.

Creswell, J. W., Klassen, A. C., Plano Clark, V. L., & Smith, K. C. (2011). Best practices for mixed

methods research in the health sciences. Bethesda: National Institutes of Health. Retrieved from

http://obssr.od.nih.gov/mixed_methods_research/pdf/Best_Practices_for_Mixed_Methods_Resear

ch_acknowledgement.pdf.

ReferencesDenzin, N.K., & Lincoln, Y.S. (2011). The Sage handbook of qualitative research (4th ed.). Thousand

Oaks, CA: Sage.

DePoy, E., & Gitlin, L.N. (2011) Introduction to research: Understanding and applying multiple

strategies (4th ed). St.Louis, MI: Elsevier Mosby.

Fenske, C. L., Harris, M. A., Aebersold, M. L., & Hartman, L. S. (2013). Perception versus reality: A

comparative study of the clinical judgment skills of nurses during a simulated activity. Journal

of Continuing Education in Nursing, 44(9), 399-405. doi:10.3928/00220124-20130701-67.

Gaba, D. M. (2007). The future vision of simulation in healthcare. Simulation in Healthcare: Journal

of the Society for Simulation in Healthcare, 2(2), 126-135.

doi:10.1097/01.SIH.0000258411.38212.32.

Jeffries, P. R., Bambini, D., Hensel, D., Moorman, M., & Washburn, J. (2009). Constructing

maternal-child learning experiences using clinical simulations. Journal of Obstetric,

Gynecologic, & Neonatal Nursing, 38(5), 613-623. doi:10.1111/j.1552-6909.2009.01060.

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ReferencesJohnson, B., Onwuegbuzie, A., & Turner,L. (2007) Toward a definition of mixed methods research.

Journal of Mixed Methods Research, 1 (2), 112-133. doi: 10.1177/1558689806298224.

Kardong-Edgren, S., Adamson, K.A., & Fitzgerald, C. (2010). A review of currently published

evaluation instruments for human patient simulation. Clinical Simulation in Nursing, 6 (1), 25-

35. doi: 10.1016/j.ecns.2009.08.004.

Lasater, K. (2007a). Clinical judgment development: using simulation to create an assessment

rubric. Journal of Nursing Education, 46 (11), 496-503. Retrieved from PubMed

PMID:17580739.

Lasater, K. (2007b). High-fidelity simulation and the development of clinical judgment: Students’

experiences. Journal of Nursing Education, 46 (6), 269-276. Retrieved from

http://www.oclbcp.org/Documents/Simulation%20articles/lassiter.pdf.

Lasater, K., Johnson, E. A., Ravert, P., & Rink, D. (2014). Role modeling clinical judgment for an

unfolding older adult simulation. The Journal of Nursing Education, 53(5), 257-264.

doi:10.3928/01484834-20140414-01.

ReferencesLuctkar-Flude, M., Baker, C., Medves, J., Tsai, E., Rivard, L., Goyer, M.C., & Krause, A. (2013).

Evaluating an interprofessional pediatrics educational module using simulation. Clinical

Simulation in Nursing, 9(5), 163-169. doi:10.106/j.ecns.2011.11.008.

McGaghie, W. C., Issenberg, S. B., Barsuk, J. H., & Wayne, D. B. (2014). A critical review of

simulation-based mastery learning with translational outcomes. Medical Education, 48(4),

375-385. doi:10.1111/medu.12391.

Nevin, M., Neill, F., & Mulkerrins, J. (2014). Preparing the nursing student for internship in a pre-

registration nursing program: Developing a problem based approach with the use of high

fidelity simulation equipment. Nurse Education in Practice, 14(2), 154-159.

doi:10.1016/j.nepr.2013.07.008

Reynolds, A., Ayres-de-Campos, D., & Lobo, M. (2011). Self-perceived impact of simulation-based

training on the management of real-life obstetrical emergencies. European Journal of

Obstetrics & Gynecology and Reproductive Biology,159 (1), 72-76. doi:

10.106/j.ejogrb.2011.07.022.

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ReferencesSmith, P. M., Spadoni, M. M., & Proper, V. M. (2013). National survey of clinical placement settings

across Canada for nursing and other healthcare professions--who's using what? Nurse

Education Today, 33(11), 1329-1336. doi:10.1016/j.nedt.2013.02.011

Society for Simulation in Healthcare. (2014). About simulation. Retrieved from

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