Nursing education is the foundational pillar that enables future nurses to become competent and knowledgeable in their respective practices. This education was normally provided to nursing students through various didactic theoretical lectures and practical clinical training but recently, the use of advanced simulation technology as an adjunct educational tool has slowly become a significant addition to student centric learning.

History of Simulation

The concept of simulation practice can be traced back to the fields of military, aviation, and nuclear power (with military having used simulation the longest), dating back to the 18th century. Simulation was initially created as a cost-effective strategy for training professionals because it was considered exorbitant to train in these areas in the real world. As the years progressed however, the healthcare profession realized the practicality and usefulness of incorporating advanced simulation technology into educational practice and as a result, spurred the growing movement of simulation in healthcare training settings and educational establishments around the world.

The Impact of Simulation on Nursing Students

The emergence of computer technology has led to the development of innovative tools for healthcare professionals such as simulation technology and patient simulators Simulation technologies have had a profound effect on the nursing profession because it allows nursing students to apply their recently learned skills and knowledge to solve real life scenarios in a safe and structured setting.

In a typical simulation session, two students are often asked to participate and mimic the roles of a registered nurse or a certified nurse assistant (CNA). The rest of the remaining students are then asked to go to a separate room and observe the scenario through a one-way mirror and a live video stream. At the start of the session, the facilitator usually gives report on the patient, which allows the students to familiarize themselves with the patient’s situation, history, charts, and medications in order to successfully manage and implement high quality nursing care for the patient. As the simulation progresses, the facilitator controls the patient’s prognosis and provides cues to the team to enhance the realism of the situation. Once the simulation is completed, the students are then asked to head back to the debriefing room to discuss their experiences.

During the debriefing session, the students learn through self-reflection, group interaction, and questions asked by the facilitator. The use of group discussion engages students in reflective learning and enables the group members to consider a situation from multiple perspectives and consider other alternatives in order to broaden their scope of practice and clinical understanding. By performing simulation scenarios on a regular basis, students are able to develop better critical thinking skills, decision-making abilities, and application of theoretical knowledge in real-life situations.

Facilitating Simulation into Nursing Practice

According to the Institute of Medicine (IOM), approximately 98,000 people die every year from medical errors in U.S. hospitals, and a significant number of those deaths are associated with medication errors. This means that adverse events affect nearly 1 of 10 patients in the hospital setting. Based on this staggering number, the IOM called for a systematic change in healthcare practices and identified simulation practice as a resource to address the needed reform. By fostering experiential learning, simulation ingrains good nursing habits early, while discouraging bad nursing habits from forming before it becomes second nature.

In addition to allowing individuals to hone their nursing skills, simulation has also proven to increase student confidence and self-efficacy once they transition into the clinical setting. Nursing efficacy is an important aspect in nursing practice because it gives the students the confidence required to provide excellent nursing care to their patients. By incorporating what they have learned in simulation, more students are self-reliant in their capabilities, which are invaluable in ensuring that patient safety is implemented in the hospital setting.

Implications for Future Nursing Practice and Further Study

The shortage of availability of clinical sites is quickly becoming the norm for many nursing schools due to changing healthcare reform and the struggling economic crisis. One solution to combat the shortage of clinical sites however is to utilize simulation practice to replicate essential aspects of clinical situations for beginning nursing students. The National Council of State Boards of Nursing is currently conducting a landmark, longitudinal study to examine the knowledge and clinical competency outcomes of students when simulation technology is used in the place of actual clinical experiences. Although calls for additional research in these areas need to be performed, simulation is still quickly gaining momentum as the gold standard for effective learning practice in nursing education.

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Jonathan V. Llamas, DNP, RN-BC, PMHNP-BC, PHN

Dr. Jonathan V. Llamas is a board-certified nurse leader, psychiatric-mental health nurse practitioner, motivational speaker, and freelance writer from Los Angeles, CA. He received his BSN degree from West Coast University North Hollywood in 2013 and recently completed his DNP degree from Loma Linda University in 2019. He currently serves as the Chapter President for West Coast University and also functions as a contributing writer for Minority Nurse Magazine (Springer Publishing Company) and NP Student Magazine. His passions include promoting mental health awareness and inspiring the future generation of nurses through his #AspireToInspire campaign.
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