Presentation setting sim center agenda 2010 ver4

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This document outlines a 10-step strategic plan for developing an effective nursing simulation center that integrates simulation technology into clinical practice. It discusses two studies that found simulation improved nursing students' cognitive skills and self-efficacy. The strategic plan covers assessing needs, setting goals, implementing best practices, ensuring fit with curriculum, building staff capacity, creating a implementation plan, conducting process and outcome evaluations, continuous quality improvement, and sustainability. The conclusion emphasizes that simulation centers benefit students and faculty by allowing skills practice in a safe environment, but require resources, management and a clear vision to fully integrate this teaching methodology.

International Conference of Education, Research and Innovation November 15th, 16th, and 17th Rena Boss-Victoria and Cynthia J. Hickman DEVELOPING A MODEL FOR INTEGRATING SIMULATION TECHNOLOGY-ENHANCED NURSING EDUCATION AND CLINICAL PRACTICE TO IMPROVE SAFETY, EFFECTIVENESS AND EFFICIENCY

TheDevelopmentProcessForBeginning A Simulation Center Identifyingstepsthatwillhelponetoaccomplishthemission Executing a carefullylaidoutstrategy Measuringprocesseverystep of theway Establishing a direct link betweenstrategy and execution Potentialbarriersprovidingneededopportunity

Study 2 Study 1 The Purpose Of Study Compare effectiveness of two instructional methods to teach specific nursing education content. Study Results Suggest use of a teaching strategy involving human patient simulator HPS method made a (+) difference in the nursing students' ability to answer questions on a test of cognitive skills. Use of (HPS) as a tool for learning provides a mechanism by which students can participate in: ,[object Object]

observe outcomes from clinical decisionsSinclair, B., Ferguson, K. 2009. The Purpose Of Study Assess students' perceptions of self-efficacy for nursing practice through use of a mixed-methods study integrating simulations into a nursing theory course. Students were exposed to a combination of lecture and simulation Study Results: Students reported higher levels of satisfaction, effectiveness and consistency with their learning style when exposed to the combination of lecture, simulation and audio-visual technologies. Data suggest students' self-confidence may be increased through use of simulation as a method of teaching and learning. Brannan, J.D., White, A., & Bezanson, J. L. 2008;

ProgramCurriculumMethodologiesthat lead toMastery of PsychomotorSkills Simulation Centers’ Foci Engage in scholarshipdesignedaroundevidence-basedresearch Steppingstonesforintegration and competencebuilding Addedvalvetoadultlearner’sexperience encourage active learning criticalthinking problemsolvingprocesses

#1 Needs/Resources #10 Sustainability #2 Goals # 9 Improve/ CQI #3 Best Practices #8 Outcome Evaluation #4 Fit #5 Capacities # 7 Implementation/ Process Evaluation #6 Plan Fig. 1 Simulation Center Strategic Plan

SIMULATION CENTER STRATEGIC PLAN #1 Needs/Resources -AcademicEnvironmentTransformationEvent Gatheringrelevant data Supplyinventory /requirements Technologycapacities & systemnetworking, audio-video Data tosupportblending of new/existingresources Staffing, scheduling , orientations, trainings #1 Needs/ Resources

Nurse EducatorsMustFunction As CompetentPractitioners

SIMULATION CENTER STRATEGIC PLAN #2 Goals Seekingclarityand commitment Vision/purpose, mission and goals, withmeasurableobjectives Sharedvision Missionclaritybetweeneducator and student Ongoingassessment and feedback

SIMULATION CENTER STRATEGIC PLAN #3 Best Practices EvidenceAssessment Level of Evidence Study’svalidity, theextent of biaspresent, and theoverallusefulnessorapplicability Integration of bestscientificevidence, appraisedevidence and evaluation of organizationaloutcomesafterimplementation of strategiesbasedonevidence. Pooling and blendinginterdisciplinaryexpertise Answering “how are wedoing” Curriculumreflective of programoutcomes Usingsimulationeducationmethodology

SIMULATION CENTER STRATEGIC PLAN #4 Fit - Goodness Of FitToTheSimulationIntegrationProcess Ensurethatthere are rules and general policyguidelines A climateforgrowth, change and themaintenance of thesimulation center strategy Considerapproachestolearning Integratingvariousmethodsforlearnersuccess Allowstudentstoimmediatelypracticewhatwaslearned in a didacticsetting. Abilitytopractice in a timelyperiod

SIMULATION CENTER STRATEGIC PLAN #5 Capacities involvesa highlyinteractiveprocesstobuildcapacities Criticalappraisal of administration, faculty and students Prioritiesforstrategyimplementation Working as a collaborative and team Simulation and technology trainings Simulationcurriculumplanning Timelinedevelopment

SIMULATION CENTER STRATEGIC PLAN #6 The Plan -Definingand confirmingthe plan forimplementation Step-wisephasingmethodology Scaffolding Decisiongrid Strategiesrelatable and relevanttoaims of theacademicprogram Providingsafeclinicalexperiencesforstudents.

SIMULATION CENTER STRATEGIC PLAN # 7 Implementation/ Process Evaluation Ensurefidelity of demonstrationmethods/ applications Scheduled regular supervisionforbenchmarks Safety in thesimulation centers remain a highpriority Supportfromfaculty and administrationensuringsystemrequirements are met Pre-appraised and an a proactive plan forimplementation, policies and rules guide thesimulation center activities

SIMULATION CENTER STRATEGIC PLAN #8 Outcome Evaluation- processoutcomeevaluation SimulationIntegrationMonitoring And Evaluation Plan. Cumulativebenchmarkindicators Simulationeducationmethodology - uniquewaytoeducatethenextgeneration of nurses Simulation centers can promoteadvancements in technology and education Theoutcomedesired- competent, criticalthinkers, problem-solvers, and proficientskillacquisitions

SIMULATION CENTER STRATEGIC PLAN # 9 Improve/ CQI relatedtotheneedtoimprove,modify and re-examine decisions Simulation centers Can deliverbetter training forstudents Assist in delivery of qualitypatientcare Addressaspects of integrity, improvedconsistency, and enhancedconfidence Coreareasfor CQI in simulationintegration Ethics, professionalism, and confidentiality

SIMULATION CENTER STRATEGIC PLAN #10 Sustainability - FocusingonSustainment Validationforstudies and replication of procedures. Refine performance standardsforpracticecompetencies Evaluationof thequality of simulation-basededucation and assessment and evaluationmethods Benefits of simulationteachingstrategy Introduce, improve, & reinforceareas in learner’sprogram Increase safety, validateskillswithpractice, addressdifferentlearningstyles Improvethecoordination of cognitive, affective, and psychomotorskills Thechallenge

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Model for approach_complete rev3

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Presentation setting sim center agenda 2010 ver4

1. International Conference of Education, Research and Innovation November 15th, 16th, and 17th Rena Boss-Victoria and Cynthia J. Hickman DEVELOPING A MODEL FOR INTEGRATING SIMULATION TECHNOLOGY-ENHANCED NURSING EDUCATION AND CLINICAL PRACTICE TO IMPROVE SAFETY, EFFECTIVENESS AND EFFICIENCY

3. TheDevelopmentProcessForBeginning A Simulation Center Identifyingstepsthatwillhelponetoaccomplishthemission Executing a carefullylaidoutstrategy Measuringprocesseverystep of theway Establishing a direct link betweenstrategy and execution Potentialbarriersprovidingneededopportunity

5. practice skills

6. observe outcomes from clinical decisionsSinclair, B., Ferguson, K. 2009. The Purpose Of Study Assess students' perceptions of self-efficacy for nursing practice through use of a mixed-methods study integrating simulations into a nursing theory course. Students were exposed to a combination of lecture and simulation Study Results: Students reported higher levels of satisfaction, effectiveness and consistency with their learning style when exposed to the combination of lecture, simulation and audio-visual technologies. Data suggest students' self-confidence may be increased through use of simulation as a method of teaching and learning. Brannan, J.D., White, A., & Bezanson, J. L. 2008;

7. ProgramCurriculumMethodologiesthat lead toMastery of PsychomotorSkills Simulation Centers’ Foci Engage in scholarshipdesignedaroundevidence-basedresearch Steppingstonesforintegration and competencebuilding Addedvalvetoadultlearner’sexperience encourage active learning criticalthinking problemsolvingprocesses

8. #1 Needs/Resources #10 Sustainability #2 Goals # 9 Improve/ CQI #3 Best Practices #8 Outcome Evaluation #4 Fit #5 Capacities # 7 Implementation/ Process Evaluation #6 Plan Fig. 1 Simulation Center Strategic Plan

9. SIMULATION CENTER STRATEGIC PLAN #1 Needs/Resources -AcademicEnvironmentTransformationEvent Gatheringrelevant data Supplyinventory /requirements Technologycapacities & systemnetworking, audio-video Data tosupportblending of new/existingresources Staffing, scheduling , orientations, trainings #1 Needs/ Resources

10. Nurse EducatorsMustFunction As CompetentPractitioners

11. SIMULATION CENTER STRATEGIC PLAN #2 Goals Seekingclarityand commitment Vision/purpose, mission and goals, withmeasurableobjectives Sharedvision Missionclaritybetweeneducator and student Ongoingassessment and feedback

12. SIMULATION CENTER STRATEGIC PLAN #3 Best Practices EvidenceAssessment Level of Evidence Study’svalidity, theextent of biaspresent, and theoverallusefulnessorapplicability Integration of bestscientificevidence, appraisedevidence and evaluation of organizationaloutcomesafterimplementation of strategiesbasedonevidence. Pooling and blendinginterdisciplinaryexpertise Answering “how are wedoing” Curriculumreflective of programoutcomes Usingsimulationeducationmethodology

13. SIMULATION CENTER STRATEGIC PLAN #4 Fit - Goodness Of FitToTheSimulationIntegrationProcess Ensurethatthere are rules and general policyguidelines A climateforgrowth, change and themaintenance of thesimulation center strategy Considerapproachestolearning Integratingvariousmethodsforlearnersuccess Allowstudentstoimmediatelypracticewhatwaslearned in a didacticsetting. Abilitytopractice in a timelyperiod

14. SIMULATION CENTER STRATEGIC PLAN #5 Capacities involvesa highlyinteractiveprocesstobuildcapacities Criticalappraisal of administration, faculty and students Prioritiesforstrategyimplementation Working as a collaborative and team Simulation and technology trainings Simulationcurriculumplanning Timelinedevelopment

15. SIMULATION CENTER STRATEGIC PLAN #6 The Plan -Definingand confirmingthe plan forimplementation Step-wisephasingmethodology Scaffolding Decisiongrid Strategiesrelatable and relevanttoaims of theacademicprogram Providingsafeclinicalexperiencesforstudents.

16. SIMULATION CENTER STRATEGIC PLAN # 7 Implementation/ Process Evaluation Ensurefidelity of demonstrationmethods/ applications Scheduled regular supervisionforbenchmarks Safety in thesimulation centers remain a highpriority Supportfromfaculty and administrationensuringsystemrequirements are met Pre-appraised and an a proactive plan forimplementation, policies and rules guide thesimulation center activities

17. SIMULATION CENTER STRATEGIC PLAN #8 Outcome Evaluation- processoutcomeevaluation SimulationIntegrationMonitoring And Evaluation Plan. Cumulativebenchmarkindicators Simulationeducationmethodology - uniquewaytoeducatethenextgeneration of nurses Simulation centers can promoteadvancements in technology and education Theoutcomedesired- competent, criticalthinkers, problem-solvers, and proficientskillacquisitions

18. SIMULATION CENTER STRATEGIC PLAN # 9 Improve/ CQI relatedtotheneedtoimprove,modify and re-examine decisions Simulation centers Can deliverbetter training forstudents Assist in delivery of qualitypatientcare Addressaspects of integrity, improvedconsistency, and enhancedconfidence Coreareasfor CQI in simulationintegration Ethics, professionalism, and confidentiality

19. SIMULATION CENTER STRATEGIC PLAN #10 Sustainability - FocusingonSustainment Validationforstudies and replication of procedures. Refine performance standardsforpracticecompetencies Evaluationof thequality of simulation-basededucation and assessment and evaluationmethods Benefits of simulationteachingstrategy Introduce, improve, & reinforceareas in learner’sprogram Increase safety, validateskillswithpractice, addressdifferentlearningstyles Improvethecoordination of cognitive, affective, and psychomotorskills Thechallenge

20. Benefitstosimulation

21. FACULTY AND STUDENT EXPERIENCES Seetherelationshipbetweenclassroomand simulationenvironment Use confirmedinnovativeteachingstrategiesbasedon learningobjectives studentlearningneeds EffectiveWitnessedstudent-centeredlearning in charge of owneducationalexperience Incorporatelived- experiences amakedecisionsaboutownlearning. Motivationishigh engagevoluntarily in thelearningprocess Aneducatorneedstobeprepared, confident and competent.

22. CONCLUSION CONCLUSION Understandingtheeducationalprocessrequired in educating nurses, capitalizingonstudents’ strength, and embracingvariouslearningstyles are allfactorspertinenttosuccessfulSimulation Centers. Studentsand faculty can benefitfrompracticingtheirskills in a simulationenvironmentaftergainingknowledgethatlendstowardscompetence. In spite of theresistant and challenges, accordingtoresearch, students are eager and excitedtoincorporatevariousstrategiestoincreasetheirknowledge and skillsutilizingSimulation Centers. Itis a greattool and motivator. However, withoutvision, people, management, and resources, thedevelopment and integration of thismethodologyislimited

Editor's Notes

Greetings ColleaguesfortheAdvancement of Simulation Center StrategicPlanning, Implementation, and ProcessEvaluation. Itisindeed a pleasuretohavetheopportunityforsharing and learningbasedonformativedevelopmentalexperiencesforscience, education and simulationtechnology.
The mandate tochangetheprevailingculturefromopinion-basedpracticetoevidence-basedpractice EBP has influencedmodelsdesigned as decision –makingapproachestoadvancetheintegration of simulationeducationmethods in highereducationhealthprofessionalprograms, specificallyamongundergraduate and graduateeducationnursingprograms. Simulationisone of themostrapidlygrowingstrategies in clinicaleducation and definingthebestpracticesfordisseminationisessentialtotheintegrationprocess. Theintent of thispaperistofacilitatetheopportunityto explore anapproachtoseekevidence-basedoutcomes in theprocess of simulationintegration in clinicalnursingprofessionaleducation. Doingthingsmany times withoutproofor data indicatingefficacyis a waste of time, talent, and money. Theefforts in education and technologyforsimulationintegrationrequiresseriousattentiontocapability-building and center developmentstrategies.
A criticalappraisal of theeffortstointegratesimulationeducationrequiresknowledge of researchdesign and personal development. Thedevelopmentprocessforbeginning a Simulation Center beginwith a focusonidentifyingstepsthatwillhelponetoaccomplishthemission, executing a carefullylaidoutstrategy and measuringprocesseverystep of theway. Itisbelievedthattheonlywaytoachievetheoverarchingmissionistoestablish a direct link betweenstrategy and execution.Mostinstitutionshave a strategic plan, howeververyfewexecuteupontheirstrategies. Researchindicatesthatorganizations do notexecutethedescribedstrategyforfourmainreasons: Vision -- lack of a sharedvisionPeople – unmotivatedorlimitedunderstanding of clearlydefined performance objectives and measurementguidelines—howtheday-to-dayactivitiescontributetothebiggerpicture in processforthefidelity of theinterventionbasedonevidence. Management- urgenttrumpsstrategic—staffingdecisions are drivenbywhatiseasiestorleastpainfulratherthanwhatismoststrategictoachievetheobjectives and proactivelymonitoredforprogresstowardsstrategyexecution.Resource – resources are thefinancial, human, and physicalassetsthat are usedfortherendering of theeducationservicesthathavevaluetotheinstitution. Mosteducationalinstitutions are challengedbyresourcebarriers, especiallyduringtheseturbulenteconomic times in the U.S.However, recognizingpotentialbarrierstothesimulationintegrationstrategyprovidestheopportunityneededtocriticallyappraise, whyare wehere? As educators, wehave a responsibilitytoprovideaccurateinformation, opportunitiestopracticewhatweteach, and fairmethods of evaluation. Additionally, wemustbemindful of theinternal and externalfactorsthatmayinhibitlearning and beaccommodatingwhenappropriate. Accommodatingmay mean notonlyrecognizingthepotentialbarriers, butremovingthem so students’ educationaljourneywillbeachieved. Currenttrendssuggesteducators are commandedtoconstructstrategiesforpartnerships in thiseducational arena. Integratingsimulationeducationofferstheabilityto “connectthedots” ifyouwillthat can bedemonstrated in simulation performances. Theendproductisstudentsthat can demonstratecriticalthinkingability, skillsattainment, and self-confidence. Itisimperativethatthevisionisclear; thepeople are motivatedbyevidencebasedpractices, managementissupportive, and stewardship of resourcesis sincere.
Theevidence-basedrationalestosupportanadministration’sdecisionstoincreasesimulationmethodologies in healthprofessionseducation, whetheritismedical, nursing, oralliedhealth are many. Abovethosethathavebeencitedduringthisprofessionalconferences, theliterature has providedevidence of benefits and challenges. Toreview a few, thefollowingstudieswereconductedrecentlytopresentthesignificantfindings as evidence. But in general terms a Simulation Center iscreatedtomeettheever-changingdemands of nursingeducation, as well as those of the new graduates at thebedsideor in thecommunity; and forcompetencebuilding and validationbytheadministration and facultyBut in general terms a Simulation Center iscreatedtomeettheever-changingdemands of nursingeducation, as well as those of the new graduates at thebedsideor in thecommunity; and forcompetencebuilding and validationbytheadministration and faculty[2]. Directingfinancial, human and physical capital towardtheintegration of simulation and technologymethodswithinexistingnursingeducationcurriculumprogramsis a shiftoccurring in manyinstitutionalsettings. Key specialtyareafacultymustberecruitedoridentifiedtogenerateinterest and involvement in specificways. Allcoreclinicalcourseswithin a programcurriculum are expectedtobeincluded in thisappraisalforintegrationtoassesscurrentmethods and activities in general and relatedprogramrequirementsspecificallyforformativeprocessmeasurement.
ProgramCurriculummustbe inclusive in simulationtoinclude a survey of thedidacticsetting and identifyingevidenced-basedteachingtoolsthat can aid in cognitiveattainment. Thesetoolsshouldincludemethodologiesthatwilladdvalvetotheadultlearner’sexperience. Theyshouldalsoencourage active learning, criticalthinking, and problemsolvingprocessesthat show thewaytomastery of psychomotorskills. Constructingthesetypes of opportunities are steppingstonesforintegration and competencebuildingleadingto positive outcomesusingSimulation Centers. Wewantcorecompetenciesthat guide thedevelopment of and activitywithinthe centers tohavesoundfoundations. Simulation Centers’ focusiscritical and centers mustberequiredtoengage in scholarshipdesignedaroundresearch. Nurse educatorsduethemselvesaninjusticeifthey bypass and are notcommittedtomakingevidence-basedresearch a reality in thisarea of academia.
Thechargeistocreate a Simulation Center strategic plan thatwillhave a significantimpactontheclinicalpracticeoutcomes of futurestudents and willhavethecapacitytocomplementthecontinuingeducationeffortsforclinicalpracticeimprovementorcertification of experienced and advancedpracticenursingprofessionals. Thecalltoactionisclearfor EBP and evaluationstrategies. Tothatend, the ten 10 stepsappliedforframing a simulationinformaticsinfrastructure in theacademicenvironment are presented in fig. 1 as anapproachtooutcomesforprocessevaluation in settingthestageforsimulationintegration
Theinitialstep in theapproachcallforneeds/resourceappraisals:Itiswithinthisframethattherealities of environmentrelevance and requirementsmustbeconsidered. Thismayinvolvebutnotlimitedto (notexhaustivelistings) gatheringrelevant data to describe outfittingrequired in thephysicalenvironment, supplyinventory /requirements, technologycapacities (systemnetworking, audio-video, data to describe resourcesavailableforblending new/existing), staffing, scheduling , orientations, trainings. Thisissometimesreferredto as anacademicenvironmenttransformationeventwhichwillvary in scope and scalebasedontheappraisal of resourcesavailable. Thehuman capital aspectisessentialtothesimulationintegrationprocessforthepurpose of aligningpeoplewiththestrategy. Thekeyobjectiveistocloseskill gaps in strategicSimulation Center positions thatalloweachfacultytobeequippedwiththesimulationassessmenttoolstheyneedtocarryouttheirwork at peak performance levels. Itisimpossibletoestablish a high-performingsimulation center unlessthefacultyknowswhatisexpected of them, howtheir performance willbemeasured and rewarded, and whatsupports are in place toenhancetheirconfidence and abilitytoserve.
Itbecomesdifficultto prepare competent nurses usingsimulationmethodologiesif nurse educators are notfunctioning as competentpractitioners. Breakingawayfromtraditionalapproachestolearning has tobereplacedbytheeducatorabilitytoembracethismethod of learningwhichoffers so manyopportunitiesto reduce orresolvethefragmentation in knowledge and skillsbylimitedlearningpatterns, lack of competency and apprehension.
Thesecondstep in theapproachseeksclarity and commitmentthroughclearlystatingthevision/purpose, mission and goals, withmeasurableobjectivesdefinedbyresponsibility and functions. Again, thesharedvisionthat can becommunicated at eachlevel in theacceptedvoice of themissionallowsthealignment of information capital totheevidenced-basedstrategic plan forexecution in thecompletion of formativetasks and activitiesrequiredforsimulationintegration. As we look at evaluationfrom a prospectivelens, ourmissionshouldbeclearbetweeneducator and student. Opportunitiestocorrectstudentweaknessesshouldbefollowedbyisolatingpeaks time forusage in Simulation Center tobenefitthestudent. Sinceformativeevaluationsallowsfortheenhancement of learning, ongoingassessment and feedbackremains a feature of itsvision.
Thethirdstep in theapproachgivesprioritytobestpracticesthat are recognizedwithin a contextfor meta-analysiscriticalappraisal. Thisednotonlyforlevel of evidencebutalsoforthestudy’svalidity, theextent of biaspresent, and theoverallusefulnessorapplicabilitytoone’sclinicaleducationsituation. Appraisingsoundness of themethods, theextent of thesearch, and themethodologicalquality of theretrievedstudybecomesthechallengeforadministration and faculty. Itisindeed a searchforintegration of bestscientificevidence, appraisedevidence and evaluation of organizationaloutcomesafterimplementation of strategiesbasedonevidence. Pooling and blendinginterdisciplinaryexpertiseforsharing and dissemination, such as withinthestructure of thisconference, isintendedtoachieveanenvironmenttoquestion and explore a particular area of simulationeducationforeffect and influence.[7] Administration and facultymustbeabletoaccess and use meaningfulinformationtomakecriticaldecisions, set priorities, and allocateresources. Theeffortsto determine implementationregimesmaybeusedtoaddressquestionsduringtheintegrationprocessthataddress, “How are wedoing” and theusefulness of evidence in helpingstudentsthrough and withthe use simulationclinicalexperiencesforlearning. Itisalso vital thatcurriculumreflectprogramoutcomes, evidencedbystudents’ linking and practicingtheirknowledgebasedonsoundresearchthatisreliable and validated. EPB isthekeytothegrowth of the art and science of nursing. Creatinganenvironmentforlearningmustalwaysconsidertheevidence, evidencegivesmerittowhywe use a method of teaching. Thereismountingresearchnoted in theliteraturethatreportincreases in test scores and clinical performance usingsimulationeducationmethodology[8-12]. Validatingtheseobservationswithevidencewillhelp determine iftheeffects of simulationonstudent performance is real ordoessimulationonlyaugmentclinicalexperiences. Simulation Centers have a global presence. Itishighly probable thisindicatesresearchisbeingconducted; and changes in teachingstrategies and curriculum are in thefuture.
Step 4 referstofitand sometimesthisnotionmaybereferredto as goodness of fittothesimulationintegrationprocess. Itisbelievedthatfit of thestrategymustaligntothespecificsdefinedbyinstitutionalobjectives, theprogramrequirements and coursespecificexpectedoutcomes. Theintentistoensurethatthere are rules and general policyguidelinesfortheSimulation Center operationswillsupport a climateforgrowth, change and themaintenance of thesimulation center strategyforformativeprocessevaluation. Ifweconsiderhowtheadultlearnerlearns, thenwealsoconsiderapproachestotheirlearning. Integratingvariousmethodsforlearnersuccessisanessentialelement. Simulation Centers mustallowstudentstoimmediatelypracticewhatwaslearned in a didacticsetting. Theirreadinesstoattainknowledge and skillisassociatedwiththeabilitytopractice in a timelyperiodcloselyrelatedtothe audible range of informationreceived. Optimization of thegoodness of fit in simulationintegrationbecomes popular toallshareholders. Whatgetsmeasuredgets done!!
Step 5 involves a highlyinteractiveprocesstobuildcapacities. Thisemphasisoncapacityincludesthecriticalappraisal of administration, faculty and students. Working as a collaborative and team, simulation and technology trainings, simulationcurriculumplanning and timelinedevelopment emerge as prioritiesforstrategyimplementation. Identification of keyspecialtyfaculty roles and responsibilities, coursespecificcriticalbehaviors, and indicatorsformonitoring are essentialtopreparatory and pilotingstagesforsimulationintegration. The transition from a didactic environment into clinical practice is reported as a time of fear and uncertainty among nursing students. Offering positive experiencesbyadministrators and facultytoembraceSimulation Centers wouldbe of benefittonursingstudents’ education. Simulationeducationmethodology as a strategyforteaching and learning can augmentthedidacticenvironment and offer a win-winsituation. Regardless of thestudent’slevel (LeveloneorLevelfour), nurse educatorsmustconcernthemselveswiththecontenttaught in thedidacticsettingisproficient and transferableintocriticalthinking, skillacquisition, and problem-solvingbehaviors[13=14]. Clear and frequentcommunication and rewardsystems are integral tofostering a climatethatismotivating and innovative. Clinicalfacultyorientations, promotion and tenurepolicies, and annual performance reviewsmustbeconsidered in communicationstoachievehighlevels of accountabilitytowhatisexpectedforsimulationintegrationvalue and continuousinvestment.
Step 6 referstothe plan. Defining and confirmingtheplan forimplementation. Thismayalsobereferredto as theroadmapforsimulation center development and nursingcurriculumintegration as developedbyadministration and facultythatmaybedesigned as a step-wisephasingmethodology. Itisnotuncommonfortheobjectives of the plan tobescaffoldtofacilitatethedevelopmentprocess and a decisiongridthatwillpromoteteamexploration, discussion, role-playthatpromotesmodeling and testing of eachcriticalpaththatisexpectedtoadvancetheoverarchingmission. A customizesimulationintegration plan isintendedtomakestrategiesrelatable and relevanttoaims of theacademicprogram. Nurse educators are facedwithmanyobstacles in providingsafeclinicalexperiencesforstudents. Ensuringstudentsgaintheneededknowledgefromsimulation centers; facultymustbeadequatelyprepared and beabletogiveclearguidelinestostudent. Educators are challengedwithmultitasked as theyadjustto new technology. Howwillthelabbestaffed? Nurse educatorshaveopportunitiesto prepare competentpractitioners in a safesetting. Beingprepared and trainedisessentialtothisinteractivelearningenvironment. Once facultyistrained, preparing and guidingstudents can begin. Maintaining a positive attitudeisimportantforstudentstowitness. Policies and proceduresmustbewritten and compliance has tobeenforced once implementation has beencompleted.
Step 7 istheimplementationstage. In addition and concurrently, processevaluationisconductedtoensurefidelity of demonstrationmethods/applicationsisemployed. Forexample, anadministration and teamdecisionto use a modelto observe students in simulationwillprovidethecontext, background, and relationshipforapplications. There are scheduled regular supervisionforbenchmarks of simulationclinicalexperiences and technologysystemequipmenteffectiveness. Accreditation agencies are promotingsimulationeducationmethodology as a valuabletoolforthefuture. Thereisanexpectationthat safety in theSimulation Centers remain a highpriority. Success of theprogramrequiressupportfromfaculty and administrationthatensuressystemrequirements are met as welltoolsforevaluation. The pre-appraised and proactive plan forimplementation, policies and rules guide theSimulation Center activities in theformativeprocessevaluation.
Step 8 referstoprocessoutcomeevaluation as theresult of theSimulationintegrationmonitoring and evaluation plan. Thecumulativebenchmarkindicators are expectedtoprovide data forprogramanalysis in thecontext of progress and evaluationwithintheformativeprocess. Theinformationgathered can define significantfindingsforpreparatorystage, pilotingstage and theimplementationstageforsettingthestageforintegration. Byutilizingsimulation as a methodforlearning, it prepares studentsfortheir role as nurses and can reduce therisk of injury, error, ordeath of patients. Enhancingthelearning of students and ultimatelypromotingthebestpossiblepractice in theclinicalsettingis central. Simulationeducationmethodologyoffers a uniquewaytoeducatethenextgeneration of nurses. Simulation Centers can promotetheadvancements in technology and education. Competent, criticalthinkers, problem-solvers, and proficientskillacquisitionsbecometheoutcomedesired
Step 9 isdirectlyrelatedtotheneedtoimprove, modify and re-examine decisionsthat can promotethecontinuousquality and correctiveactioninterventions. Simulation Centers willdeliverbetter training forstudentstoassistwithqualitypatientcare. Integrity, improvedconsistency, and enhancedconfidence are thehallmark of maintainingallaspect of theseareas. Coreareasfor CQI in simulationintegrationmustincludeethics, professionalism, and confidentialityrelatedtoallmaterials and activitiesapplied in thelearningprocessoutcomeforadministration, faculty and students
Step 10, the final stepisfocusedonsustainment.Theresearchprovidesvalidationforstudies and thecontentwillfacilitatereplication of procedures. Replicationallowstheface of simulationto resemble the “real world” and to refine performance standardsforpracticecompetenciesthat are set basedonevaluation of thequality of simulation-basededucation and assessment and evaluationmethodsforinstitutionalizationwithintheprograms of nursing and otherhealthprofessions. Benefitstosimulation are many. Thisteachingstrategy can introduce, improve, and reinforcemultipleareas in thelearner’sprogram and buildconfidence prior to real clinicalexperiences. Italso can increase safety, validateskillswithpractice, addressdifferentlearningstyles, and improvethecoordination of cognitive, affective, and psychomotorskills. Theneedforcompetency-basednursingeducation and standardmethodstomeasureeffectiveness of simulationtechnology performance remains. Thechallengebeforeustodayistoidentify a Simulation Center approachtooutcomesthat can appliedto determine ifthe use of Simulationmethods, as a new thirdlegonthestool of science and educationwillinfluenceclinicalskillretention (judgment, safety) and competencies (clinicalskills, basicknowledge) of pre-licensure, experienced and advancedpracticenursing in thecontext of clinical performance and error prevention.
Benefitstosimulation are many. Thisteachingstrategy can introduce, improve, and reinforcemultipleareas in thelearner’sprogram and buildconfidence prior to real clinicalexperiences. Italso can increase safety, validateskillswithpractice, addressdifferentlearningstyles, and improvethecoordination of cognitive, affective, and psychomotorskills. Theneedforcompetency-basednursingeducation and standardmethodstomeasureeffectiveness of simulationtechnology performance remains. Thechallengebeforeustodayistoidentify a Simulation Center approachtooutcomesthat can appliedto determine ifthe use of Simulationmethods, as a new thirdlegonthestool of science and educationwillinfluenceclinicalskillretentionjudgment, safety and competenciesclinicalskills, basicknowledge of pre-licensure, experienced and advancedpracticenursing in thecontext of clinical performance and error prevention.
FACULTY AND STUDENT EXPERIENCESSeeingfirsthandtherelationshipbetweentheclassroom and theactivities in thesimulationenvironmentconfirmedinnovativeteachingstrategiesmustbebasedonbothlearningobjectives and studentlearningneedsWitnessedstudent-centeredlearning can beeffectivebecausestudentsdemonstratedtheirdesiretobe in charge of theirowneducationalexperience. Student-centeredlearningis a valuable concept and one I will use consistently. Knowles 1970 states, “at itsbest, anadultlearningexperienceshouldbe a process of self-directedinquiry”. Adults’ readinesstolearnisincreased as theydevelop and incorporatetheirlived- experiences in theenvironment of learningWith so muchdiversity, itisparamountthatadultstudents are allowedtomakedecisionsabouttheirownlearning. Adultlearners’ motivationtolearnishigh; becausetheyengagevoluntarily in thelearningprocess, thereforeaneducatorthatisresponsibleforstudentinstruction, needstobeprepared, confident and competent.
CONCLUSIONUnderstandingtheeducationalprocessrequired in educating nurses, capitalizingonstudents’ strength, and embracingvariouslearningstyles are allfactorspertinenttosuccessfulSimulation Centers. Students and faculty can benefitfrompracticingtheirskills in a simulationenvironmentaftergainingknowledgethatlendstowardscompetence. In spite of theresistant and challenges, accordingtoresearch, students are eager and excitedtoincorporatevariousstrategiestoincreasetheirknowledge and skillsutilizingSimulation Centers. Itis a greattool and motivator. However, withoutvision, people, management, and resources, thedevelopment and integration of thismethodologyislimited

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