Simulation is a technique that allows learners to gain skills and competencies by participating in realistic simulated situations. It can be used to practice decision making, problem solving, and human interaction skills in a safe and controlled environment. There are various types of simulations ranging from low to high fidelity that incorporate different levels of realism. Simulation provides many benefits for nursing education such as allowing students to experience real situations without risk to patients, receiving immediate feedback, and building confidence. It is an effective method to help students transition from the classroom to clinical practice.

1. SIMULATION
Kshyanaprava Behera
Assistant Professor
SUM Nursing College, SOA DTU

2. SIMULATION

3. DEFINATION
Simulation is a technique that enables adult learner to obtain skills, competencies,
knowledge or behaviour by becoming involved in situations that are similar to those in
real life.
MEANING (REPRODUCTIVEOF REAL LIFESITUATION)
• Simulation is the basis of sensitivity training, sociodrama , role-playing and psychodrama.
• In health care simulation may refers to “A device representing a simulated patient or part of a patient
;such as device can respond to and interact with the action of the learner”.

4. PURPOSE-
• To help student practice decision making &
problem solving skills.
• To develop human interaction abilities in a
controlled and safe setting.
• To achieve cognitive affective &
psychomotor outcome in a simulation
exercise or roleplaying situation.
• To see how and when the theories work

5. PRINCIPLES-
 Clear stated objectives
 Actual patient care experience
 Proper orientation of proceedings/scenario
 Use of problem solving and critical reasoning
 Role of educator must be as a facilitator
 Simulation should be collaborative approach
between educator and simulator
 Feedback and Evaluation of stimulatory session

6. CHARACTERISTICS OF SIMULATED TEACHING-
Can be used in research work.
It can be used for rehearsal before going to classroom
teaching.
Effective for practice of teaching skills by the pupil
teacher.
Effective feedback can be provided.
It is very convenient method.

7. TYPESOFSIMULATION-
1)Part Task Trainer- or low-tech or static task trainers,
are designed to replicate only a part of the body or
portion of the environment. The learning objectives are
often task specific.
• Example—
 Teach of injection technique to arm by using orange
or banana.
 Using mannequin for teaching neonatal
resuscitation.
 Urinary catheter trainer & pelvic examination trainer.
 Plastic IV Arm.

8. 2] Standardized patient-
standardized patient or sample patient (SP)( also known as patient
instructor), in health care, is an individual who is trained to act as a real
patient in order to stimulate a set of symptoms or problems.
• Used for-
 Physical assessment skills.
 History taking.
 Teaching communication skills
 Teaching clinical skills.
 Interaction with psychiatric client
 Clinical examination.
• Example-. Teach the student how to collect history from psychiatric
patient.

9. 3] Screened based computer simulator-
This include computer application for simulation.
• Use-
 Model various aspects of human physiology.
 Model of specific task or environment.
 Making clinical decision.
 Observe the result in action.
• Example- computer –assisted instruction programs or
web-based programs

10. 4] Complex task trainer-
i. Haptic systems- this type of technology is particularly useful
in learning environments where the faculty cannot clearly see
where the student is assessing the patient. It allow a learner to
perceive tactile and other stimuli to the senses through a
complex , computer generated environment .
ii. Virtual reality- These virtually- reality scenarios offer an
opportunity for the learner to practice skill via computer- based
traning, including-
 Surgical skills.
 Bronchoscopy.
 Intravenous.
 Central line catheterization.

11. 5] Integrated simulators (Human Patient
simulator)- or human patient simulators(HPS) combine
computer technology and part-or whole-body mannequins to
provide a more realistic learning experience. Integrated
computer technology housed in the mannequins to respond in
real time to specific care intervention and treatment.
• Example-
 Medications, Chest compressions, Needle decompressions.
 Chest tube placement, and other physiologic interventions
and subsequent responses..
• These interactive mannequins are capable of realistic
physiologic responses, including
 Respiration, pulses, heart sounds, breath sounds, urinary
output, and pupil reaction.

12. TYPE OF SIMULATION EQUIPMENT
LOW –FIDELITY SIMULATORS
• It is less often in detail & vitality of living
situation.by introducing & practicing psychomotor
skill, they generally lack the realism
:
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13. MODERATE –FIDELITY SIMULATORS
• It offers more realism than a low fidelity model. It
is useful as both introduction tools & tools for
developing deeper understanding of specific,
complex subject matter & competencies.

14. HIGH –FIDELITY SIMULATORS
• It produce the most realistic simulated patient
experiences. High –fidelity unit must not only ‘have the
outward appearance of reality but also react in realistic
ways to student interventions units & are the most
costly.
/

15. LEARNING OBJECTIVES OF THE SIMULATIONPROCESS
• Develop highly complex cognitive skills, such as decision-making,
evaluating and synthesizing.
• Impact positively on the learner’s values, beliefs and attitudes.
• Sharpen human relation skills and communication skills
• Unlearn negative attitudes or behaviour.

16.  STEPS OF SIMULATION PROCESS
 Experience
 Sharing
 Processing
 Generalization
 Application

17. REQUISITES FOR A GOOD SIMULATION
PROCESS
Clarity Feasibility
Active-
involvement
Repeatability
and reliability

18. ADVANTAGES OF THE METHOD
• Simulation establishes a setting where theory and practice can be
combined
• It develops the problem-solving skills.
• Improves their critical thinking skills.

19. ADVANTAGES contd..
• It may be used in the classroom or in the laboratory as structural
activity or as an independent study assignment, can provide
immediate feedback and corrective action.
• It promotes student-student. Teacher- student and student
interactions.

20. ADVANTAGES contd..
• It enhances decision-making skills.
• Students can experience real situation without client risk.
• The feelings of self –confidence and competence of the students are
increased

21. ADVANTAGES FOR NURSING EDUCATION
• The clinical setting can be realistically simulated
• There is no threat to patients safety
• Active learning can occur
• Specific and unique patient situations can be presented

22. ADVANTAGES FOR NURSING EDUCATION
• Errors can be corrected and discussed immediately.
• Enhanced cognitive, psychomotor, communication and
discussion skills
• Benefits of immediate- feedback

23. ADVANTAGES FOR NURSING EDUCATION
• Increased confidence, shifted attitude and smooth transition from
the classroom or laboratory to the health care setting.
• Increases the ability of the faculty to identify students’ performance
levels.

24. DISADVANTAGES OF THE METHOD
• The whole process is time consuming to develop & of high cost.
• Must be realistic enough for transfer of learning environment.
• The technique must be structured so that all learners are become involved in the
situation and problem-solving process
• There is a need for many simulators. But all the students may not be involved, who
may not get the experience

25. LIMITATIONS IN SIMULATION TECHNIQUE
• Simulation cannot be made in all subjects of the curriculum.
• Simulation cannot be conveniently used in case of small children
• It requires a lot of preparation on the part of teachers.
• Simulation reduces the seriousness of learning.

26. LIMITATIONS IN SIMULATION TECHNIQUE
• Minimum of feedback sequence to choose.
• Time consuming.
• Difficulty in using analytic approach.
• Need for many simulators.

27. COMPUTER-BASED SIMULATIONPROGRAMME
• It involves the use of software developed to simulate a
subject .the software may be of low, moderate or high-
fidelity & can test many aspect of learning, such as skill,
knowledge, and critical thinking.it is convenient because
student may practice & learn independently outside the
regular class hours.

28. ADVANTAGES
• Controlled
• Cost
• Reproducible and predictable
• Programmable
• Ease to use
• Simultaneous use by many students
• Entertaining
• May be less stressful for both students and
faculty .

29. FULL-SCALE SIMULATION
Full-scale simulation is probably the most
recognized form of simulation in health
care. It attempts to recreate all of the
elements of a situation that are perceptible
to students.it involve real people, real physiology,
real interaction ,real action & realistic responses &
interactions

30. ADVANTAGES
• participants learn by realistic experience
• Individual Watching the live broadcast learn as observers
• When scenario participants and observers gather as a group, they all learn
by sharing their experiences in group discussion

31. ROLEOFTEACHERINSIMULATION
Planning
Facilitating
Debriefing

32. THE FUTURE OF NURSING SIMULATION EDUCATION
• “Using simulations allows nursing students to step in to the
role of a full-fledgednurse for a time when they are with the
manniqin, they have to make decisions & act without advice
from a teacher or experiencednurse they can make mistakes
& learn from them”