Inacsl standards presentation

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  • Special thanks to the INACSL Board of Directors 2009-2011 for developing initial standards draft
  • Terminology has not been standardized until this point.
  • Clinical Scenario:
    The plan of an expected and potential course of events for a simulated clinical experience.
    -provides the context for the simulation and can vary in length and complexity, depending on the objectives.
  • This model shows the progression from psychomotor skills to clinical judgment
  • Sharing of Information can:
    Interfere with learning outcomes
    Bias an individual’s performance
    Alter perception of a safe learning environment (psychological safety)
    Modify group dynamics
    Negatively alter the future participants’ learning experience
    This standard offers the opportunity for similar learning experiences to all participants.
    Upholding professional integrity promotes a safe learning environment where:
    Formative assessment and/or summative evaluation can occur.
    Simulation participants will consider their performance and the performance of others as confidential interactions.
    Violation of professional integrity may be viewed as an honor code/ethical violation, eliciting similar consequences.
  • Upholding Professional Integrity Promotes a Safe Learning Environment where:
    Formative assessment and/or summative evaluation can occur
    Participants consider performances confidential interactions. Performances include self and others in the simulation
    Violation of professional integrity may be viewed as an honor code or ethical violation and may elicit consequences invoked by honor code or ethical issues
    Facilitator must address these:
    Ensure a safe learning environment
    Ensure steps are taken to protect the content of the scenario & simulation
    Provide clear direction to the participants: expectations of the simulation environment, learning or testing
    Demonstrate professional & ethical behavior
    Role model constructive feedback during simulation and debriefing
    Monitor for unprofessional participant behavior during simulation and take steps to abate it
  • Objectives should be:
    Achievable within an appropriate time frame
    Incorporate evidence-based practice
    Address domains of learning
    Appropriate to the participant ‘s level of learning and congruent with overall program outcomes
    See Standard I: Terminology for Nursing Skill Development and Clinical Judgment Model
  • Multiple methods should be used to meet the participant objectives and expected outcomes
  • Level of Facilitation:
    Facilitator Prompting
    Partial Facilitator Prompting
    No Facilitator Prompting
  • The facilitator assists the participants with identifying actions that could have been changed to promote better patient outcomes and how the actions could have been changed to meet the learning objectives, if these objectives are not met
  • Clearly communicate and ensure understanding of objectives, goals, and expected outcomes
    Create a safe learning environment
    Promote maintenance of fidelity in the simulated environment
    Recognize and use appropriate facilitation method(s)
    Identify & evaluate individual and group performance as it relates to the acquisition of knowledge, skills, appropriate attitudes & behaviors
    Demonstrate professional and ethical behaviors
    Foster enthusiasm & support for simulation as a learning modality
    Establish methods for obtaining meaningful feedback from participants, observers, & other facilitators/instructors re: effectiveness of facilitator
    Demonstrate role modeling when assuming a role in the simulation
  • Reflection: assimilation of knowledge, skills, and attitudes (KSAs) with pre-existing knowledge and can lead to new interpretations by the learner
    Reflective thinking does not happen automatically, but it can be taught; it requires time, active involvement in realistic experience, and guidance by an effective trainer/facilitator (coach).
    Learning without guidance could lead to the learner repeating mistakes, focusing only on the negative, or developing fixations
  • Debriefing and reflection are essential determinants of professional development at all levels and are linked to professional nurse competencies
    Encourage reflective learning:
    Provides an opportunity to discuss the process, outcome, and application of scenario to clinical practice
    Enables the facilitator to review relevant teaching points
    Promotes reflective thinking
    The debriefing should be facilitated by an individual who has observed the simulated experience; based on a structured framework for debriefing; based on standard III, in a safe learning environment
  • Formative Assessment
    Assessment wherein the facilitator’s focus is on the participant’s progress towards goal attainment.
    Summative Evaluation
    Evaluation occurring at the end of a learning period where participants are provided feedback about their achievement of outcome criteria.
  • The participant outcomes should include, but are not limited to:
    Safe patient care and/or decision-making abilities
    Skill performance
    Critical thinking/reasoning
    Knowledge level of the participant
    In addition, self-confidence & satisfaction with the experience can be assessed
    When these domains interact in the context of a novel simulation experience, problem-solving and analytical skills can be evaluated in terms of the achievement of identified outcomes.
  • Simulation used for assessment and high-stakes evaluation:
    Be explained to the participant prior to the start
    Conducted in a familiar environment on previously tested evidence-based content
    Be standardized in format and in scoring method
    Use appropriate fidelity level
    Be accompanied by specific participant objectives
    Use pre-established guidelines for responses/prompting if any
    Have predetermined parameters for terminating the scenario
    Include the participant’s self-assessment of performance as part of the evaluation.

Transcript

  • 1. The International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice: Simulation 2011 Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 2. Presenters and Disclosures Laura Gonzalez PhD, ARNP, CNE  INACSL Chair of Education Assistant Professor of Nursing, University of Central Florida  Disclosure: Pearson Faculty Consultant & Contributor  Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 3. Mission and Vision Statements The Mission of INACSL is to promote research and disseminate evidence based practice standards for clinical simulation methodologies and learning environments The Vision Statement: Nursing’s portal to the world of clinical simulation pedagogy and learning environments Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 4. Development of Standards 2 Years Survey to INACSL Membership Committee Draft Peer Review Final Draft Publication – Summer 2011 Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 5. Special Thanks to the 2009-2011 INACSL BOD           Teri Boese, MSN, RN Jimmie Borum, MSN, RN Janis Childs, PhD, RN Sharon Decker, PhD, RN, ANEF Jana Faragher, ND, CNS, RN Cheryl Feken, MSN, RN Teresa Gore, DNP, APRN Nicole Harder, PhD, MPA, RN Beverly Hewett, PhD, RN Valerie Howard, EdD, RN Pearson Faculty Development March 23, 2012 Fort Lauderdale         Kim Leighton, PhD, CNE, RN Colleen Meakim, MSN, RN Meg Meccariello, MS, RN Patricia Ravert, PhD, RN, CNE, ANEF Leland (Rocky) Rockstraw, PhD, RN Carol Sando, PhD, CNE, RN Renee Schnieder, MSN, RN Marianne Schubert, MSN-Ed, CEN, MICP, RN
  • 6. Special Thanks Standards Committee 2010-2011 for their continued work on revisions and peer-review process Jana Faragher, ND, CNS, RN-Chair  Sharon Decker, PhD, RN, ANEF  Teri Boese, MSN, RN  Carol Sando, PhD, RN, CNE  Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 7. Standards of Best Practice 1. Terminology 2. Professional Integrity of Participant 3. Participant Objectives 4. Facilitation Methods 5. Simulation Facilitator 6. The Debriefing Process 7. Evaluation of Expected Outcomes INACSL Board of Directors, (August, 2011). Standards of best practice: Simulation. Clinical Simulation in Nursing, 7(4 Supplement). S1-S20. Available at http://www.nursingsimulation.org/issues?issue_key=S1876-1399(11)X0005-1 Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 8. Standard One: Terminology Statement: Consistent terminology provides guidance, clear communication, and reflects shared values in simulation experiences, research, and publications. Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 9. Rationale Standardized terminology: Enhances understanding and communication among planners, participants and others involved in simulation experiences  Promotes consistency in the development, implementation, evaluation and publication of or about simulated clinical experiences or research studies for use in education and practice  Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 10. Nursing Skill Development & Judgment Model Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 11. Standard Two: Professional Integrity of Participants Statement: The simulation learning and testing environment will be one of clear expectations for the attitudes and behavior of each participant and an area where mutual respect is supported. Professional integrity related to confidentiality of the performances, scenario content, and participant experience is expected to be upheld during a simulation experience. These performances in simulation experience may be live, recorded, and/or virtual. Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 12. Rationale Failure of the participants to maintain professional integrity related to simulation and lack of respect or professionalism could undermine the benefits of this pedagogy Sharing of confidential information of any kind before, during or after the simulation experience can alter the experience Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 13. Outcomes This standard offers the opportunity for similar learning experiences to all participants Upholding professional integrity promotes a safe learning environment To achieve the desired outcomes, the facilitator must address key areas during the simulation Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 14. Standard Three: Participant Objectives Statement: The simulation experience should focus on the participant objectives and experience level. Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 15. Rationale Participant objectives are the guiding tools for simulation and essential to achieve the outcomes Identification of appropriate scenario, fidelity, instructor prompting/facilitating, and environment is crucial for best experiences and meeting the participant objectives Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 16. Outcomes The focus of simulation is on the outcome to be achieved and on participant learning-Know your participants Should facilitate the development of clinical judgment in order to deliver high quality and safe nursing care that is holistic and includes cultural awareness Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 17. Standard Four: Facilitation Methods Statement: Multiple methods of facilitation are available, and use of a specific method is dependent upon the learning needs of the participant(s) and the expected outcomes. Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 18. Rationale Facilitation methodology should vary because participants bring cultural and individual differences that affect their knowledge, skills, attitudes (KSAs), and behavior Facilitation assists the learner to meet the objectives by incorporating learner’s needs and experience into the planning and implementation of a simulated clinical experience Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 19. Outcomes Facilitation revolves around engaging participants within the scenario by assisting them to meet the objectives of the clinical scenario Effective facilitation requires using the facilitation method and personnel/faculty indicated by participant objectives and expected outcomes Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 20. Standard Five: Simulation Facilitator Statement: A proficient facilitator is required to manage the complexity of all aspects of simulation. Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 21. Rationale The facilitator is the key to participant learning:  guides and supports participants to understand and achieve the objectives  Engages the participants to search for evidence-based practice solutions to develop participant’s skill development and clinical judgment  Adjusts simulations to meet objectives based on participant’s actions or lack of actions  Leads the participants in identifying the positive actions and changes Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 22. Outcomes Facilitator promotes and assists with achieving the desired outcomes of a simulated experience by utilizing various methods Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 23. Standard Six: The Debriefing Process Statement: All simulated experiences should include a planned debriefing session aimed toward promoting reflective thinking. Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 24. Rationale Learning is dependent upon the integration of experience and reflection Reflection is the conscious consideration of the meaning and implication of an action The skills of the debriefer are important to ensure the best possible learning Learners report the debriefing session is the most important component of a simulated learning experience Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 25. Outcomes The integration of the process of debriefing into simulation:  Enhances learning  Heightens self-confidence for the learner  Increases understanding  Promotes knowledge transfer  Identifies best practices  Promotes safe, quality patient care  Promotes life-long learning Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 26. Outcomes (Continued) To achieve the desired outcomes, the effective debriefing process should:  Be facilitated by individual competent in debriefing that observed the simulation  Use evidence-based debriefing methodologies  Be based on a structured framework for debriefing  Be based on objectives, the learners, & the outcomes  Be conducted in an environment that supports confidentiality, trust, open communication, self-analysis & reflection Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 27. Standard Seven: Evaluation of Expected Outcomes Statement: This standard addresses summative evaluation as opposed to formative assessment. Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 28. Rationale Simulation is an acceptable method of evaluating the three domains of learning:  Cognitive (knowledge)  Affective (attitude)  Psychomotor (skills) Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 29. Outcomes The participant’s achievement of expected outcomes of a simulation experience should be based on valid and reliable instrumentation, tools, and methodologies in the evaluation process To achieve valid and reliable evaluation results, the simulation used for the purpose of assessment and particularly high-stakes evaluation must follow certain aspects. Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 30. Resources  International Nursing Association for Clinical Simulation and Learning (INACSL): http://www.inacsl.org/INACSL_2010/  Society for Simulation in Healthcare (SSH): http://www.ssih.org/SSIH/ssih/Home/  Simulation Innovation Resource Center (SIRC) http://sirc.nln.org/  METI: Human Patient Simulation Network (HPSN) http://www.hspn.com/  Laerdal: Simulation User Network (SUN) http://simulation.laerdal.com/ Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 31. Evaluation Tools  Kardong-Edgren, S., Adamson, K. A., & Fitzgerald, C. (2010, January). A review of currently published evaluation instruments for human patient simulation. Clinical Simulation in Nursing, VOL(6), e25-e35. doi:10.1016/j.ecns.2009.08.004  METI Simulation Effectiveness Tool and Educational Material  http://www.meti.com/mymeti/education_main.html  NLN and Laerdal Simulation Study Evaluation Tools  http://www.nln.org/research/toolsandinstruments.htm  Other tools are available Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 32. What Can I Do With the Standards? Curricular Integration Evidence Based Practice in Education Administrative Support Faculty Buy-In Research Opportunities Funding Opportunities Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 33. INACSL Conference 11th Annual International Nursing Simulation/Learning Resource Centers Conference: Saddle up for Simulation: Rope in the Best Ideas Pre-conference: June 20, 2012 Conference: June 21 -23 2012 San Antonio Marriott Rivercenter Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 34. How to Obtain Standards of Best Practice: Simulation Initial publication of the Supplement to Clinical Simulation in Nursing was made possible by an educational grant from METI Will be printed and mailed to current members of INACSL Available through the official journal of INACSL: Clinical Simulation in Nursing http://www.nursingsimulation.org/ Journal access is just one benefit of membership in INACSL Pearson Faculty Development March 23, 2012 Fort Lauderdale
  • 35. Conclusion Thank you for attending this presentation Question and Answer Session Pearson Faculty Development March 23, 2012 Fort Lauderdale