This document outlines a pilot project to develop a simulation laboratory to improve quality and safety instruction for senior nursing students. The project introduced students to simulation scenarios focusing on cardiopulmonary resuscitation. Students participated in an introductory simulation session and skills evaluation. Feedback was collected through a survey, and results suggested students felt more confident in their skills and comfortable with simulation after the sessions. The project provides a framework for evidence-based simulation implementation that can be used by other institutions.

1. Pilot Project for the Development of a Simulation Laboratory
Jill Van Der Like

2. Introduction

3. Purpose
The purpose of this project was to initiate the development of a simulation laboratory
that could improve the instruction of quality and safety among undergraduate senior-year
nursing students.

4. Quality and Safety
Quality and safety has been determined as critical focus areas for improvement in nursing
education (Quality and Safety Education for Nurses (QSEN), 2012). Nursing organizations
such as the American Nurses Association (ANA) support the evidence-based QSEN
competencies that incorporate simulation for a culture of safety (Barnsteiner, 2011).

5. Evidence-based practice (EBP) in Simulation
A common barrier to simulation implementation:
Lack of an EBP strategy

6. EBP Strategy
Evidence-Based Practice Implementation Guide:
Create awareness and interest
Build knowledge and commitment
Promote action and adoption
Pursue integration and sustained use
(Cullen and Adams, 2012)

7. Rationale
Research is needed for effective simulation implementation in Florida.
(Sole, Guimond, and Amidei, 2010)

8. Framework: Experiential Learning
• Kolb (1984) • Tanner (2006)
Reflective Observation (RO) Clinical Judgment Model
Experiential evidence contributes to the application of critical thinking (Newhouse, 2007).

9. Simulation
Simulation is a clinical setting that allows the student to freely explore the critically
thinking mind; their own, and the other minds of the group including the instructor.

10. Implementation
1. An introduction to simulation scenario was created for
instruction.
2. An evidence-based scenario was created using the American
Heart Association guidelines for cardiopulmonary resuscitation
and emergency cardiovascular care science.
(American Heart Association, 2012)

11. Application
Participants:
• 2 Faculty members
• 37 undergraduate senior-year nursing students
Scenarios:
• Introduction to Simulation (2 hours)
• Student Skills Evaluation (2 hours)
Procedure:
• Introduce faculty and students to simulation
• Instruct faculty and students on simulation objectives of briefing, scenario, and
debriefing

12. Assessment
Head…

13. Continued Assessment
to toe!

14. Cardiac Emergency
Skills Evaluation

15. Tools
1. Tanner’s Clinical Judgment Model (2006)
• Noticing
• Interpreting
• Responding
• Reflecting
2. Lasater Clinical Judgment Rubric (LCJR) (2007)
• Defined dimensions of effective noticing, interpreting, responding, and reflecting
3. Reflective debriefing phases
• Reactions phase (initial reaction)
• Analysis phase (simulation assessment)
• Summary phase (lessons learned)
(Rudolph, Simon, Raemer, and Eppich, 2008)

16. Scenario Links
Introduction to Simulation Student Skills Evaluation

17. Technology

18. Laerdal Medical
http://www.facebook.com/LaerdalMedical?ref=ts&fref=ts

19. Implications
This quality improvement (QI) project provides a framework
for evidence-based implementation of simulation. A template
was created for faculty to follow during integration of simulation
into the curriculum. This project can also be used as guidance
for other academic institutions integrating evidence-based
simulation scenarios into the curriculum.

20. Dissemination
Collaboration with appreciation…

21. Evaluation
Skills Evaluation Survey
1) Strongly agree 2) Agree 3) Undecided 4) Disagree 5) Strongly Disagree
• I understand the purpose of simulation. ( )
• I feel that simulation in nursing curricula enhances clinical quality and safety. ( )
• I felt more confident for my skills evaluation after the Introduction to
Simulation and Student Skills Evaluation scenarios. ( )
• I was comfortable with assessment of a human patient simulator. ( )
• I feel that simulation hours should represent clinical hours. ( )

22. Discussion
Feedback welcome: jjv8@students.uwf.edu or jvanderlike@pensacolastate.edu

23. References
American Heart Association. (2012). 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency care science.
Doi:10.1161/CIRCULATIONAHA.110.970939. Retrieved October 12, 2012 from
http://circ.ahajournals.org/content/122/18_suppl_3/S685.full#sec-2
Barnsteiner, J. (2011). Teaching the culture of safety. The Online Journal of Issues in Nursing, 16(3). Doi:10.3912/OJIN.Vol16No03Man05
Cullen, L., & Adams, C.L. (2012). Planning for implementation of evidence-based practice. The Journal of Nursing Administration,
42(4), 222-230.
Florida Center for Nursing (2012, September 14). Qualitative research component for the Florida Center for Nursing project entitled
“Promoting the Use of Simulation Technology in Florida Nurse Education”. Executive summary. Retrieved September 14, 2012,
from http://www.flcenterfornursing.org/files/Simulation_Project_Qualitative_Data_Exec_Summary.pdf
Kolb, D.A. (1984). Experiential learning: Experience as the source of learning and development. Retrieved September 29, 2012
from http://academic.regis.edu/ed205/Kolb.pdf
Lasater, K. (2007). Clinical judgment development: Using simulation to create an assessment rubric. Journal of Nursing Education,
46(11), 496-503.
Newhouse, R.P. (2007). Diffusing confusion among evidence-based practice, quality improvement, and research. The Journal of
Nursing Administration, 37(10), 432-435.
Newhouse, R.P., & Pettit, J.C. (2006). The slippery slope. Differentiating between quality improvement and research. The Journal
of Nursing Administration, 36(4), 211-219.
Quality and Safety Education for Nurses . (2012). About QSEN. Retrieved September 7, 2012 from http://www.qsen.org/about_qsen.php
Rudolph, J.W., Simon, R., Raemer, D.B., & Eppich, W.J. (2008). Debriefing as a formative assessment: Closing performance gaps in
medical education. Society for Academic Emergency Medicine, 15(11), 1010-1016. Doi:10.1111/j.1553-2712.2008.00248.x
Sole, M.L., Guimond, M.E., & Amidei, C. (2010). Quantitative research component for the Florida Center for Nursing project entitled
“Promoting the Use of Simulation Technology in Florida Nurse Education”. A partners investing in nursing’s future project. Retrieved
September 14, 2012 from http://www.flcenterfornursing.org/files/SimulationProjectQuantitativeDataExecSummary.pdf
Tanner, C.A. (2006). Thinking like a nurse: A research-based model of clinical judgment in nursing. Journal of Nursing
Education, 45(6), 204-211.