High-Fidelity Simulation in Nursing Education, Research Paper Example

After graduation, many nurses feel ill-prepared for their transition into a fast paced clinical environment. Even before then, nursing students are frequently concerned about their ability to convert their knowledge into practice. To bridge the gap between classroom knowledge and hands-on patient involvement, it may be useful to implement simulation throughout the nursing education. Simulation will allow students to reinforce the information that they learned and practice it until they are confident that they will be able to complete these tasks in real life. Although hand-on patient experience is ideal, allowing nursing students to have excessive interactions with patients during their undergraduate education is expensive, timely, and will not boost students’ feelings of self-efficacy. A useful model to adapt for clinical simulation is the high-fidelity simulation system. This model will allow nursing students to practice on virtual patients and reinforce their knowledge acquired during lectures. Many previous studies have shown that virtual learning is a useful way to increase grades and enhance understanding; therefore the high-fidelity simulation system should be adapted as a part of the nursing education structure.

A recent article entitled “Theoretical Framing of High-Fidelity Simulation With Carper’s Fundamental Patterns of Knowing in Nursing” discusses the experience that many nursing programs have had as a result of integrating high-fidelity simulation into their curriculum (McGovern et al, 2012). High-fidelity simulation takes advantage of “manikins” that are designed to represent real people and have accurate anatomy and human-like function. Supporters of the use of high-fidelity simulation in the nursing classroom believe this is an effective way of educating nurses because the instructor will be able to manipulate the manikin to represent various health problems. Since the students must work together to both diagnose and suggest treatments for the manikin, high-fidelity simulation fosters teamwork and allows instructor input throughout the experience. Furthermore, it is safer for students to work on manikins than real patients; they will be able to utilize their own problem solving abilities to a greater extent in this situation, because a real life is not at stake. Instead of an instructor guiding students to avoid errors, as would be necessary in the case of a real patient, the students will be allowed to make mistakes which will reinforce the learning process.

This paper discusses a specific type of simulation that uses “Carper’s Patterns of Knowing”, which utilizes the concepts of empirics, esthetic, personal knowing, and ethics. While the author acknowledges that Carper’s Patterns are a useful way of beginning to use this technology, it is far from perfect. Rather, the authors hope that future clinicians and engineers will work together to build upon this model to develop an even greater simulation for clinical learning. It is likely that this type of high-fidelity simulation model will be useful to the nursing education throughout its various stages. For example, in classroom lectures in which students are learning facts about the human body and how it operates, the lecturer would be able to refer to the manikin to visually demonstrate many of the processes that are being discussed. This will allow the students to draw a greater connection between what they are learning and how it actually relates to human health; if this occurs, the nursing students will be more likely to remember detailed information when it becomes necessary during clinical practice.

A second article, entitled “Simulation in an Undergraduate Nursing Curriculum: Implementation and Impact Evaluation” discusses how to effectively implement a simulation program in nursing schools and how to evaluate the efficacy of this model (Schlairet, 2011). While the usefulness of utilizing simulation in the classroom seems apparent, it is necessary to first test this model and determine whether it allows nursing students to have an equal to or greater learning experience than using just patients as a method of teaching. The two factors that this study used to determine efficacy of the high-fidelity simulation system in the nursing classroom included implementation evaluation and impact evaluation, which were the evaluation of activities accomplished and the program objectives and outcomes that were met, respectively. The study found that the simulation exercises were advantageous, because a majority of the students surveyed reported that they enjoyed having the opportunity to work with their peers and that they were actively learning. In addition, in the comment section of the survey, student’s showed that they learned characteristics about patient practice that couldn’t be learned in lecture; for example, this exercise allowed one student to understand that using a high degree of body language is necessary for assisting patients who either don’t speak English well or don’t speak the language at all. Overall, students found that it was more useful for them to go through steps of certain procedures using a simulation system rather than just hearing about them and discussing them in class.

Ultimately, this article demonstrates that implementation of the high-fidelity simulation system will result in nurses that are better prepared for the world outside of school. It allows them to become more confident with the methods and techniques learned and they will be less likely to become hesitant when they first need to try them out on a real patient. Furthermore, the simulations will allow the students to connect with their patients more easily; because they have already worked through several patient scenarios, real life situations will be less likely to take them by surprise.

Like the previous study, “High-Fidelity Patient Simulation in Nursing Education: An Integrative Review” aims to determine the efficacy of high-fidelity patient simulation throughout the nursing education process; however, it does so by conducting a systematic review of all journal articles published on the topic since 1998 (Weaver, 2011). While the study found that this simulation system assists the students in terms of knowledge, value, realism, and learner satisfaction, the studies were unable to determine the effects of the system on characteristics such as confidence, knowledge transfer, and stress. Despite this, it is arguable that success in the first set of characteristics will lead to success in the second set; if nursing students have more knowledge, they will be more likely to be able to transfer this knowledge into clinical practice. If these situations seem more realistic than traditional lecture based education, they will be more confident in real life situations and suffer from less stress as a direct consequence of their increased experience. Overall, it is difficult to directly measure these characteristics in nursing students due to their subjectivity; however, it is arguable that if the students believe that high-fidelity simulation is helping enhance their education, they should be implemented in every nursing education institution without question. After all, the goal of these institutions should be to have quality nurses at the time of graduation; the implementation of this simulation model will allow them to achieve this goal more readily.

While the prior articles discussed generally have positive views about the utilization of high-fidelity simulation in the nursing classroom, “Challenges in High Fidelity Simulation: Risk Sensitization and Outcome Measurement” argues that it’s nearly impossible to measure whether this model is effective for nursing education and provides explanations of disadvantages of using the system (Onello et al., 2013). The authors believe that the two major risks involved in implementing this model are the dangers of risk sensitization and the need for some kind of a standardized framework. Ultimately, they conclude that the current high-fidelity simulation model needs to be expanded upon to include the element of longitudinal care and patient response and that best practices need to be identified for the use of this equipment.

Although it isn’t surprising that high-fidelity simulation has opponents, Onello and Regan provide useful insight into the needs for this system to evolve further. Even proponents of the high-fidelity simulation system don’t believe that it’s perfect; however, the system that is currently being used is the best available and using this one is better than the alternative of keeping nursing education primarily lecture based. Better nurses will develop as a result of this hands-on experience; while it would be beneficial to add longitudinal care to this experience, it is not currently available. However, it is likely that technology companies are currently working on a new model for high-fidelity simulation that will include this component in the near future.

While many people are passionate about the implementation of simulation in the nursing classroom, it is important to consider whether low-fidelity simulation is equivalent to high-fidelity simulation; this is an important question to consider because low-fidelity simulation is associated with lower costs. A 2009 article entitled “Implementation of Active Learning Pedagogy Comparing Low-Fidelity Simulation Versus High-Fidelity Simulation in Pediatric Nursing Education” attempts to reconcile this issue (Butler et al., 2009). Low-fidelity simulation is defined by use of static manikins and is traditionally used in the nursing classroom while high-fidelity simulation emulates a real patient more realistically. While the students surveyed believe both the high-fidelity and low-fidelity simulation was useful to their learning experience, students felt that the high-fidelity simulation allowed them to have a better experience because of its ability to foster teamwork in the problem solving process, active learning, and diversification of learning. While low-fidelity simulation shouldn’t be completely removed from the classroom, it’s important to note that teamwork is an important part of nursing and that only high-fidelity simulation can offer this experience.

In conclusion, high-fidelity simulation should be offered to nursing students as an opportunity for hands-on experience. This is the only method that has been shown statistically to bridge the gap between the classroom experience and the clinical setting. Nursing students who use this method report to have a decreased level of stress, increased knowledge and understanding of the subject area, actively learn, and have the opportunity to work as a member of a team to solve problems. Since it is risky, expensive, and timely to allow nursing students to consistently work with real patients, high fidelity simulation is the best alternative to improve the quality of nurses that nursing schools produce.

References

Butler KW, Veltre DE, Brady D. (2009). Clinical Simulation in Nursing. Retrieved from http://www.nursingsimulation.org/article/S1876-1399(09)00142-X/abstract

McGovern B, Lapum J, Clune L, Schindel M, Lori. (2012). Theoretical Framing of High-Fidelity Simulation With Carper’s Fundamental Patterns of Knowing in Nursing. Journal of Nursing Education. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23244195

Onello R, Regan M. (2013). Challenges in High Fidelity Simulation: Risk Sensitization and Outcome Measurement. The Online Journal of Issues in Nursing. Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No3-Sept-2013/Articles-Previous-Topics/Challenges-in-High-Fidelity-Simulation.html

Schlairet MC. (2011). Simulation in an Undergraduate Nursing Curriculum: Implementation and Impact Evaluation. Journal of Nursing Education. Retrieved from http://ts.isil.westga.edu/loginurl=http://search.proquest.com/docview/894328842?accountid=15017

Weaver A. (2011). High-Fidelity Patient Simulation in Nursing Education: An Integrative Review. Nursing Education Perspectives. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21473481