Simulation offers nursing students experiences with varied clinical patient cases in a safe, controlled environment comparable to an acute care setting. It allows students to develop skills like critical thinking, clinical reasoning, and communication through realistic scenarios using mannequins or standardized patients. The instructor guides students and assesses their competency through simulation before clinical placements. Research shows simulation improves identification of conditions like pediatric sepsis and enhances self-confidence. While faculty training and clear objectives present challenges, simulation provides a standardized, flexible learning method with demonstrated benefits.

1. SIMULATION AS A TEACHING STRATEGY
VENEETHA ROY
MSN,RN,ARNP, C-PNP
UNIVERSITY OF BUFFALO

2. INTRODUCTION
 Patient simulation offers nursing students with varied clinical
patient experiences
 Comparable to that of an acute setting.
 Conventional nursing emphasizes on memorization
 Nurse educators are now increasingly looking up to simulation for
provision of high acuity patient care experience in a risk free,
controlled learning environment (Katz, Peifer, & Armstrong, 2010).
 Simulation is being used by nursing educators to enhance
learning outcomes and promote safety of the patients, (Billings &
Halstead, 2012).

3. DEFINITION OF SIMULATION
 Simulations provide the opportunity for students to think
critically, problem solve, use clinical reasoning and care for
diverse patients in a non-threatening, safe
environment,”(Seropian, 2003).
 Simulation utilizes a clinical scenario which involves a student
or a group of students providing care to a patient which is
usually a mannequin, an actor or a standardized patient in a
realistic clinical environment ,” (Jeffries, 2012).

4. DESCRIPTION & USES
 The use of human patient simulators (HPSs) has become common
practice and simulation based pedagogy allows students to integrate
psychomotor skill performance, critical thinking, clinical judgment and
communication skills while gaining confidence in the clinical setting
and also offers an opportunity for assessment and remediation of skills
and continued learning, (Durham & Alden, 2010).
 Various organizations have recognized its value as a teaching
technique including the Commission on Collegiate Nursing Education
(CCNE), National League for Nursing (NLN), NCSBN etc. There are
different levels of sophistication and a variety of simulators are
available for creation of simulation scenarios.
 Simulators can be categorized according to fidelity and how closely it
represents a realistic situation.

5. ROLE OF INSTRUCTOR & STUDENT
 Simulations offer flexibility and can assist with students educational
needs.
 It can be accessed in a safe environment for practice and mastering
clinical skills with or without an instructor’s presence, (Billings & Halstead
2012).
 Instructors can be present for extra instruction or reinforcement.
 Simulation can facilitate the learning of clinical skills and measure skill
competency before taking students to the clinical unit.

6. BENEFITS/ADVANTAGES
 The major benefits of clinical simulation include a consistent and standardized experience for all.
 One major advantage of concept mapping is that it can be used in various settings and populations.
 The nursing student can access the simulation according to their own schedule which gives the benefit of
flexibility. Student instruction is improved and there is increased consistency in the material being taught.
 Learner satisfaction is increased as the students can practice high acuity patient care in safe, non-
threatening environments.

7. BARRIERS
 Most of the challenges center on nursing educator preparation.
 Nursing faculty should be trained well in the art and science of simulation as without
groundwork, Simulation can be hard to implement.
 It is important to have clear learning objectives when one undertakes a simulation scenario as
it is easy to feel overwhelmed and lose focus on what the learner outcomes should be.
 Adequate time needs to be provided to the learner to experience simulation, reflect upon the
experience and understand feedback provided so that the learning objectives of the
simulation can be met.
 There is time that needs to be taken to teach and to learn how to develop and properly use
simulation

8. EFFICACY
 After reviewing the literature, Adler et al concluded that acute care event management skills such as
identification of pediatric sepsis can be objectively evaluated using patient simulation (Adler et al., 2007).
 The study concluded that simulation could be used to measure and enhance resident competencies in
acute care management of cases such as Sepsis, Apnea, Asthma and Supraventricular Tachycardia.
 According to Nishisaki et al, a simulation training for first year Pediatric Critical Care fellows was organized
by seven institutions and high-fidelity simulation was utilized for airway management, vascular access,
resuscitation, sepsis, trauma/traumatic brain injury, delivering bad news.
 A survey at the end of the program revealed that the training helped enhance clinical performance and
self-confidence in diagnostic ability of those participating (Nishisaki et al., 2009).

9. REFERENCES
Adler, M.D., Trainor, J.L., Siddall, V.J., McGaghie,W.C., (2007). Development and evaluation of high-fidelity simulation case
scenarios for pediatric resident education. Ambulatory Pediatrics, 7(2), 182-186.
Billings, D. M., & Halstead, J. A. (2012). Teaching in nursing: a guide for faculty. St. Louis, Mo.: Elsevier/Saunders.
Brannan, J. D., White, A., & Bezanson, J. (2008). Simulator effects on cognitive skills and confidence levels. Journal of Nursing
Education, 47(11), 495–500.
Durham,C.F., & Alden, K.R.(2010). The nuts and bolts of using simulation. In L. Caputi (Ed.), Teaching nursing: The art and
science, Glen Ellyn,IL: College of DuPage Press, 28-55.
Gaberson, K. B., Oermann, M.H., Campbell, S.H., (2010). Clinical teaching strategies in nursing. New York, Springer Publishing
Company.
Jeffries, P.R. (2012). Simulation in nursing education: From conceptualization to evaluation (2nd ed). New York,NY: National
League for Nursing.
Katz, G. B., Peifer, K. L., & Armstrong, G. (2010). Assessment of patient simulation use in selected baccalaureate nursing
programs in the United States. Simulation in Healthcare, 5(1), 46–51.
Nishisaki, A., Hales, R., Biagas, K., Cheifetz, I., Corriveau, C., Garber, N., Hunt, E., Jarrah, R., McCloskey, J., Morrison, W., Nelson,
K., Niles, D., Smith, S., Thomas, S., Tuttle, S., Helfaer, M., Nadkarni V. (2009). A multi-institutional high-fidelity simulation "boot
camp" orientation and training program for first year pediatric critical care fellows. Pediatric Critical Care Medicine, 10(2),
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Scherer, Y., Bruce, S., Graves, B., Erdley, W., (2003). Acute care nurse practitioner education: Enhancing performance through
the use of clinical simulation. AACN Clinical Issues: Advanced Practice in Acute & Critical Care, 14,331–341.
Seropian, M. (2003). General concepts in full scale simulation: Getting started. Anesthesiology and Analgesia, 97(6), 1695–
1705.