IntroductionSimulation using high fidelity human patient simulators (HPS) in nursing education has become a common practice for nursing schools across the country.

Nurse educators particularly baby boomers (who may not be as technical savvy as other generational learners) are challenged to incorporate the use of HPS into the curriculum to meet the needs and learning styles of millennial learners.

Faculty fears related to technology, time constraints, and how to integrate simulation into the nursing curriculum have been identified as challenges to using HPS and the reasons why equipment remains in the box underutilized.

MethodsWe conducted a review of the literature on integrating simulation using high fidelity simulators (HFS) into the nursing curriculum. Several studies identified common barriers to integrating simulation and offered suggestions on how to over come common barriers.

Results

Conclusion

Simulation has become an integral part of nursing education. To spark motivation to use high fidelity HPS simulation, educators and administrators need to be exposed to simulation to identify the advantages of its application.

Reducing the barriers, strengthening educators as facilitators, and implementing incentive programs for integrating simulation have been successful in using this pedagogy.

Scheduling simulation activities to correlate with the theory content in the curriculum of an accelerated entry level master program is challenging for educators. However, literature supports designating a simulation lab coordinator to serve as a resource for faculty who are not familiar or comfortable with simulation is essential to developing and maintaining a quality simulation program.

Angela T. Williams MSN, RNArneta Finney MSN, WOCN,WCC, PHN, RN

Marcia Elliott MSN, RN

Literature citedAnderson, M., Bond, M. L., Holmes, T. L., & Carson, C. L. (2011, Month). Acquisition of simulation skills: Survey of users. Clinical

Simulation in Nursing, Vol(X), 000-000. doi: 10.1016/j.ecsn

Hermanns, M., Lilly, M. L., & Crawley, B. (2011, Marcg). Using clinical simulation to enhance psychiatric nursing training of baccalaureate students. Clinical Simulation in Nursing, 7(2), e41-e46. doi: 10.1016/j.ecns.2010.05.001.

Howard, V. M., Englert, N., Kameg, K., & Perozzi, K. (2011, January). Integration of simulation across the undergraduate curriculum: Student and faculty perspectives. Clinical Simulation in Nursing, 7 (1), e1-e10

Jansen, D. A., Berry, C., Brenner, G. H., Johnson, N., & Larson, G. (2010, November). A collaborative project to influence nursing faculty interest in simulation. Clinical Simulation in Nursing, 6(6), e223-e229. doi:10.1016/j.ecns.2009.08.006

Jansen, D. A., Johnson, N., Larson, G., & Berry, C., Brenner, G. H., (2009, January). Nursing faculty perceptions of obstacles to utilizing manikin-based simulations and proposed solutions. Clinical Simulation in Nursing, 5(1). doi:10.1016/j.ecns.2008.09.004.

Linder, L. A., & Pulsipher, N. (2008, October). Implementation of simulated learning experiences for baccalaureate pediatric nursing students. Clinical Simulation in Nursing, 4(3). doi:10.1016/j.ecns. 2008.09.002

Wilt, K. E., & King, M. (2011, Month) Time well spent: Integrating simulation into an accelerated 1-year BSN program. Clinical Simulation in Nursing, Vol (X), 000-000. doi: 10.1016/j.ecns.2010.10.002

Overcoming the barriers of integrating simulation into a nursing curriculum

Integrate into the curriculum

Overcoming the challengesDedicated simulation

coordinatorWorkload release time for faculty to gain

understandingFaculty Training: to provide best practices in

simulation education methodology for facilitation, debriefing, and scenario writing

Ongoing faculty development and orientation of new faculty Technological support

ConstraintsLack of time for learning to operate complex computerized equipment

Lack of time for planning and preparation

Lack of faculty training to correctly utilize evidence based best practices Lack of technological support Lack of Administrative support for

workload reduction and faculty training

ChallengesFear of looking foolish in front of students

or colleaguesFear of using technology

Equipment underutilized due to lack of training on use of complex simulation equipment Part-time clinical faculty lack the interest Limited number of students who can

experience simulation scenario at one time

NursingCourse

SimulationScenario

Learning Objectives

Physical Assessment/ Fundamentals

Care of patient with abnormal vital signs, abnormal heart and lung soundsCare of patient at risk for falls / Student identifies side rails down, bed brake off

Perform auscultation of heart and lung sound and identify abnormal soundsIdentify abnormal vital signsIdentify falls risk and implement safety precautions

Medical-Surgical Care of patient with heart failure with digoxin toxicity/ Care of patient with hypoglycemia

Recognize Respiratory distressRecognize sign & symptoms of hypoglycemiaRecognizes the need to call physicianand report patient’s condition using Situation Background Assessment Recommendation (SBAR)

Maternal - Child Care of postpartum patient experiencing magnesium sulfate toxicity

Identify signs and symptoms of magnesium toxicity and pulmonary edemaPerform respiratory assessment & notify physician of findings using SBAR

Mental Health Care of patient experiencing symptoms of depression with suicidal ideationCare of patient with anxiety and possible substance abuse problems.

Discover and identify the situation Perform initial assessment and manage situationComplete a psychiatric intake form and demonstrate caring therapeutic communication techniques

Pediatrics Care of pediatric patient with asthma Perform a physical assessment on a pediatric patientRecognize respiratory distress and demonstrate bag valve mask

Advanced Medical- Surgical Care of patient with a cerebral vascular accidentMock Code

Recognize signs and symptoms of an acute ischemic stroke. Performs focused assessment following ABC principlesIdentify fatal arrhythmia , activate code blue and initiate CPR

Faculty Development•Paid time for faculty training in simulation methodology for facilitation, debriefing, and scenario writing

•Ongoing faculty development with brown bags and workshops at least twice per semester

•Offer incentives for learning technology, designing scenarios, and running simulations.

•Orientation for part time and new faculty to identify their roles in simulation and to address anxiety related to use of simulation