2. “SIMULATION REALITY INTO REAL
WORLD
Simulation in some
form has probably been
used as a teaching
strategy in nursing
education since the
first nurse tried to
teach the first nursing
student how to do a
task properly.
3. Tell me, and I
will forget.
Show me, and I
may remember.
Involve me,
and I will
understand.”
- Confucius, 450 BC
4. MEANING
‘ Simulator (noun): any device or system that
reproduces the conditions of a situation for the
purposes of research or training’ (Collins, 2005)
5. DEFINITION
Simulation:
“… as a strategy – not a technology – to
mirror, anticipate, or amplify real situations
with guided experiences in a fully interactive
way.”
Simulator:
“…replicates a task environment with sufficient
realism to serve a desired purpose”
6. TRENDS IN NURSING EDUCATION
Providing more experimental learning opportunity
than instruction
Increased use of learning technology
More emphasis on outcome-based then process-
based education
More evidence-based education strategies and
curriculum
7. USES
Learning by doing
Improved quality of instruction
The simulation program enables multiple training
opportunities
Debriefing is an important part of the learning
experience
8. DEBRIEFING
Debriefing is a process of receiving an explanation
of a study or investigation after participation is
complete.
Debriefing (post-experience analysis) is thought to
be one of the most important features of simulation
based medical education. Simulation can lead to an
experience that is emotional and thought provoking –
experiential learning. (Think of how you feel when you
poorly execute the resuscitation of the manikin in a
simulation session.) Debriefing plays a role in the
reflection and analysis of that experiential learning.
13. Abstract
The 1975 experiment demonstrated that when
learning occurs in a realistic environment related to
work, learning is retained and reproduced. Therefore,
the more realistic the environment is to the learner’s
own area of work, the more successful the learning
will be. This was one of the first reported occasions
when it was seen that by learning in a realistic
environment enhanced the educational experience.
Simulation allows the creation of realistic simulations
to allow greater retention of what is learned Learning
using simulators . (harvey).
14. SIMULATION FIDELITY
A “system that presents a fully interactive patient and
an appropriate clinical work environment.
The degree to which a simulation and/or a simulation
device accurately reproduces clinical and/or human
parameters; in Realism.
18. High fidelity
Maximum interaction of learner
in an environment that closely
resembles reality. Scenarios using
mannequins, actors and/or props in a
structured, intentional and well-
directed production can provide a high
fidelity learning experience.
19. Over 365 facilities in 48
states/provinces in the US
and Canada, Germany,
Brazil, and Japan are
participating in the
NRCPR.
Equipment/Physical
Fidelity
EQUIPMENT/PHYSICAL
20. Over 365 facilities in 48
states/provinces in the US
and Canada, Germany,
Brazil, and Japan are
participating in the
NRCPR.
Equipment
Task
Fidelity
EQUIPMENT
TASK
21. Over 365 facilities in 48
states/provinces in the US
and Canada, Germany,
Brazil, and Japan are
participating in the
NRCPR.
Equipment
Task
Environmental
Fidelity
EQUIPMENT
TASK
ENVIRONMENTAL
22. Over 365 facilities in 48
states/provinces in the US
and Canada, Germany,
Brazil, and Japan are
participating in the
NRCPR.
Equipment
Environmental
Psychological
Task
Fidelity
EQUIPMENT
TASK
ENVIRONMENTAL
PSYCHOLOGICAL
24. COMPUTER BASED
SIMULATION
Screen-based or PC-based simulations are human
computer interactions that allow students to
experience a variety of medical skills and procedures.
This is best used with entry-level students.
25. CONT……
Strengths
Easy, flexible and unlimited access
Useful for knowledge acquisition and critical thinking
Accommodating to individual pace of learning
Good for lower/entry level students
Relatively low cost
Limitations
No physical interactivity
Low fidelity
No experiential learning
26. TASK SPECIFIC
SIMULATION
Task specific models are designed to teach
a specific task, procedure, or anatomic region.
They often resemble anatomic sections of the
body, This allows concurrent teaching of a
large class, broken down into small groups, to
increase the hands-on time for each trainee.
27. TASK SPECIFIC SIMULATION
Task trainers are mechanical parts of the anatomy
that simulate an individual skill.
Strengths
Low cost
Good for procedural practice
Limitations
Low fidelity
28. Virtual reality
Virtual reality (VR), sometimes referred to
as immersive multimedia, is a computer simulated
environment that can simulate physical presence
in places in the real world or imagined worlds.
Virtual reality could recreate sensory experiences,
including visual, taste, sight, smell, sound, touch,
etc.
29. VIRTUAL REALITY
StrengthS
Easy access
Economic for teaching multidisciplinary care
Accommodating to individual pace of learning
Good for lower level of students
LimitationS
Limited physical interactivity
Low fidelity
Limited experiential learning
31. FULL-BODIED MANNIKIN-BASED
Manikin-based simulations use high fidelity
simulators, manikins that breathe, with breath
sounds, heart tones, and palpable pulses. In
addition, the manikin has a monitor that can
display EKG, pulse oximeter, blood pressure ,
arterial wave forms, pulmonary artery wave forms,
anesthetic gases, etc. Procedures can be
performed on the simulators such as bag-mask
ventilation, intubation, defibrillation, chest tube
placement, cricothyrotomy and others.
32. FULL-BODIED MANNIKIN-BASED
The highest fidelity simulation.
"Drug administration can be simulated, and with
the use of the drug recognition unit, the simulator
will respond physiologically.
33. CONT…..
Strengths
High fidelity
Interactive experience
Using emotional and sensory components
Good for critical thinking, decision-making and
delegation
Limitations
Costly
Limited access
Dependent on availability of human
instructors/operators
Limited realistic human interactions
34. STANDADISED PATIENT
In health care , a Simulated Patient,
Standardized Patient, Sample Patient and Patient
Instructor is an individual trained to act as a
real patient in order to simulate a set
of symptoms or problems. Simulated
Patients have been successfully used in
the education and evaluation of nurses, nurse
practitioners, physicians & surgeons, physician
assisstant ,and basic, applied and transitional
medical research.
35. STANDADISED PATIENT
Strengths
Higher realism in the interpersonal and emotional
responses
Good for communication skills and interpersonal
relationships training
Good for evaluation
Limitations
Signs do not match symptoms
Inversed power dynamic
36. HUMAN CADAVER
A corpse, also called a cadaver in medical
literary and legal usage or when intended
for dissection, is a dead human body.
37. LEARNING THEORY IN PATIENT
SIMULATION
There is no “Simulation Learning Theory
But, simulation can benefit from broader
learning theories
39. Concrete
Experience
Testing implication
of
concepts in new
situation
Observation
and Reflection
Formation of abstract
concepts and
generalizations
Concrete
Experience
Observation
and Reflection
Formation of abstract
concepts and
generalizations
Testing implication of
concepts in new situation
EXPERIMENTAL LEARNING CYCLE
40. ADULT LEARNING THEORY
Adults have an intrinsic need to know
Adults have self-responsibility
Adults have a lifetime of experiences
Adults have an innate readiness to learn
Adults have a life-centered orientation to learning
Adults have internal motivators
41. PRINCIPLES OF SELECTION
Should be driven by the educational
goal/objective
Should match the level of the student
The higher the realism, the more
effective it is in engaging the student
42. POTENTIAL ADVANTAGES OF SIMULATION
Reduces training variability and increases
standardization
Guarantees experience for every students
Student-centered learning
Allows independent critical-thinking and decision-
making, and delegation
Allows Immediate feedback Allows deliberative
practice
Also uses the concept of experiential learning
43. LIMITATIONS OF SIMULATION OVER
ACTUAL CLINICAL EXPIERENCE
Not real
Limited realistic human interaction
Students may not take it seriously
No/incomplete physiological
symptoms
44. VISION FOR FUTURE
Class → Simulation C→ linical→ Real
world
Integrated into mainstream
healthcare education
45. SIMULATION AS A TEACHING
STRATERGY:CHALLENGES
Initial capital expenditures
High financial cost
Faculty development
Ongoing
faculty/administrative/technical
support