This document discusses the use of simulation in nursing informatics education. It describes how simulated electronic health records (EHRs) can be incorporated into nursing education to allow students to actively use informatics in a realistic learning context. There are two main approaches: EHRs created specifically for simulation or using a real EHR system from a healthcare facility or vendor. The document outlines challenges and opportunities to further integrate informatics tools into education to better prepare nursing students.

1. Chapter 21
Simulation in
Nursing
Informatics
Education

2. Objectives
• Describe the role of simulation in nursing
informatics education
• Differentiate between the types of simulated
electronic health records available for use
• Identify the limitations of using a live clinical
information system for educational purposes

3. Introduction
• You complete your documentation in the
patient’s electronic health record (EHR) and
the simulation scenario ends and the
debriefing begins.
• The instructor provides feedback on not only
actions taken within the simulation scenario,
but also on the use of the EHR as an important
resource for patient information and
documentation.

4. Nursing Informatics Competencies in
Nursing Education
• What best practices exist so that students
become prepared in informatics?
• 50-60% of respondents said that informatics was
integrated throughout the curriculum and that
experience with nursing informatics was provided
during clinical rotations.
• With emerging technologies in nursing and health
care education, the use of simulation to allow
students to actively use informatics in an
authentic and realistic learning context is one
potential approach.

5. A Case for Simulation
• Simulators encompass a broad range of devices including,
but not limited to:
– partial task trainers, such as an IV insertion arm
– screen based simulations, including simulated EHR’s
– simulated environments replicating a realistic patient care area
– complex computer drive human patient simulation manikins.
• Considering the realistic nature of simulation and its hands-
on active approach to learning, it seems that the use of
simulation modalities can be a powerful tool in moving
student nurses, as well as any practitioner, towards
achieving the informatics competencies.

6. Incorporating EHR’s into
the Learning Environment
There are two main approaches to the incorporation of
an EHR into the learning environment, whether used
within a simulated clinical environment as part of a
patient care scenario or as a stand-alone learning tool.
1. The EHR can be created specifically for simulation
purposes, ranging from a well-developed Microsoft
Access database through commercially available products
designed specifically for simulation purposes.
2. Use of a real EHR system, either within a hospital-based
simulation center or through a partnership with a health
care facility or an EHR vendor.

7. Challenges and Opportunities
• Seven key steps were established to meet the 10-
year vision of the TIGER initiative.
• Of particular interest is the call to take an active
role in the design and integration of informatics
tools that are “intuitive, affordable, usable,
responsive and evidence-based”.
• This truly promotes new and innovative strategies
for informatics education as well as significant
opportunities for collaboration between industry,
academia and clinical practice.

8. What Does the Future Hold?
• Incorporating the simulated EHR into the
classroom in new and innovative ways.
• The EHR can become a powerful way for
learners to make important connections about
caring for patients with a specific disease
process or to learn concepts of
pathophysiology or pharmacology.