NR 525 Week 5 Graded Discussion: Replacement of Clinical Hours with Simulation
It is becoming more difficult to find adequate clinical facilities for
... [Show More] student experiences. In addition, there is no guarantee of students being able to participate in all aspects of patient care. Due to these and other issues, some nursing schools have begun to substitute simulation experiences for clinical experiences. In this discussion question, debate, the pros and cons regarding the use of high-fidelity simulation to replace clinical hours for nursing students? Also, discuss the regulations from the state board of nursing in your state about using simulation to replace clinical hours?
ANSWER
I find it somewhat disturbing that we having difficulties finding adequate instructional sites for nurses to do their clinicals. That tells me that these facilities need to be closely monitored, possibly reviewed, and adequately addressed. But it is also a travesty to the young learning individuals. Nurses need to see, hear, and smell their experiences. Nurses use sensory to best learn and understand their saturations and receiving information. With a fake mannequin in a quiet, clean room with no else to interrupt you seems “far-fetched” and “unrealistic”. My state for example is in favor of more simulation. According to floridanursing.gov, the law revises clinical training to include simulation and the use has been increased to 50% for each content area. This is removing from the clinical experiences that new nurses should have. Small “mom-and-pop” as we call them are showing up everywhere and providing substandard education to nurses for excessive amounts of money. We hear about the “nursing shortage” but this doesn’t mean we should sacrifice a decent education to shove more people through the doors. Nurses are pivotal member of the healthcare team, hospital, nursing homes, surgeries couldn’t function with them. Our nurses deserve honest, real-life experiences, and use simulation as a secondary choice or fulfillment for practical skills such as Foley catheter teaching, IV insertions and bags, using pumps, and bandaging. According to Sohn, Ahn, Lee, Park, and Kang (2013) reported improvements in the practice efficacy of nursing students in areas of assessment, prioritization, and health promotion in high-fidelity simulation (pg. 153).
Nurses should have more clinical hours to experience patients, medication administration, nursing diagnosis etc. Having simulation exercises for beginning nurses would be a great way to expose them certain skills, but I believe that real clinical experience will be more valuable as the nurse develops her/his skills down the line.
References
Chapter 2014-92, Laws Of Florida, Became Effective on July 1, 2014
http://floridasnursing.gov/latest-news/chapter-2014-92-laws-of-florida-became-effective-on-july-1-2014/
Sohn, M., Ahn, Y., Lee, M., Park, H., & Kang, N. (2013). The problem-based learning integrated with simulation to improve nursing students’ self-efficacy. Open Journal of Nursing, 3, 95–100. https://doi.org/cc2f
YOUNG-HEE, K., KYUNG-HYE, H., & OK-HEE, C. (2018). SIMULATION EDUCATION WITH PROBLEM-BASED LEARNING: EFFECT ON NURSING STUDENTS' COMMUNICATION APPREHENSION. Social Behavior & Personality: An International Journal, 46(1), 151-160.
Collapse SubdiscussionAmber Gase
Amber Gase
7:22pmMar 28 at 7:22pm
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Professor and Class,
There is a fine line when it comes to setting guidelines. You want to leave room for nursing schools to be creative and successful but you do not want guidelines to be so loose that students are not getting a rich experience. I do not know that there is a “right” answer.
I think some of the simulation experiences should happen with real people so students can practice interpersonal skills and handling uncomfortable situations. For example, in my nursing school we had a simulation on domestic abuse where we interviewed volunteer actors about their home situation. Students had a chance to practice compassion without experiencing it in the field. Also, some skills like ambulating a patient are better with volunteers and impossible with just a mannequin.
High-fidelity simulation with a mannequin were helpful in my experience, but it was difficult to respond in real-time because of the delay in voice response. Thinking quickly and critically is difficult when the feedback is not realistic. Well-designed simulations with small groups are ideal.
Patient experiences should be very rich especially if schools are cutting back on these. It would be beneficial to have a low clinical instructor to student ratio because sometime I felt like I was thrown to the wolves and did not know what I was missing or where I could do more. Also, I think having opportunities to shadow a nurse would be helpful because it would teach time management and you could see how nurses focus their assessment.
Amber
Amber,
I can agree with you and on the use of simulation with small groups. The unrealistic voice and sounds can sometimes overwhelm nurses. Simulations are meant for practice scenarios and cannot truly replace the real interactions with patients and environmental stressors. Nurses should be given the opportunity to be placed with novice nurses in the hospital setting. Possible consider working closely with a few hospitals and requesting a list of possible nurses who are comfortable with having someone watch them and permit them to have a few basic experiences. I found this personally to be very helpful during my clinical rotations. Simulation can have positive effects on students’ learning (Weatherspoon & Wyatt, 2012). I found that providing simulation hours for common skills encouraged practice, confidence, and preparedness in the student. This encouraged nursing students to be conscious of what was expected in the clinical setting and prepare them with the basic theory and practical skills. I believe that experience and confidence is important to nursing students, and it needs to be valued more than not. Like you said, Amber, it gives nurses the chance to practice compassion in the real life setting unlike a mannequin who can’t react like a human.
Reference
Weatherspoon, D. L., & Wyatt, T. H. (2012). Testing computer-based simulation to enhance clinical judgment skills in senior nursing students. Nursing Clinics of North America, 47(New Directions in Nursing Education), 481-491. doi: 10.1016/j.cnur.2012.07.002 [Show Less]