Collaborative Learning: An Analysis of Critical Care Nursing Simulation

Tuesday, 31 October 2017: 8:00 AM

Kristin Schams, DNP
School of Nursing, University of Northern Colorado, Greeley, CO, USA
Audrey Elizabeth Snyder, PhD
School of Nursing, Univeristy of Northern Colorado, Greeley, CO, USA
Dean L. Zeller, MS
School of Mathematics, Univeristy of Northern Colorado, Greeley, CO, USA
Krisinda M. Caywood, BSN
School of Nursing, University of Northern Colorado, Loveland, CO, USA

Purpose: To evaluate the effectiveness of collaborative simulation teaching strategies using undergraduate nursing students (UNS) and advanced practice registered nurse (APRN) students in acute care scenarios.

Background: High fidelity patient simulation (HFPS) has been conventionally used to educate undergraduate nurses, enhance clinical experiences, and increase preparedness in complex patient situations (Davis, Kimble, & Gunby, 2014; Curl, Smith, Chisholm, McGee, & Das, 2016). Simulation has grown in its popularity as an option for graduate nursing education due to added pressure on developing affordable and quality clinical experiences for increasing student numbers (Quail et al, 2016). Advanced Practice Nurse Practitioners students learning advanced patient care roles should also have the opportunity to utilize simulation to capture the clinical variation found in patient populations. This group of healthcare providers will most likely be working in high stress and high-stake patient environments and team training in simulation offers one option for a safe learning environment. Furthermore, Kesten, Brown, & Meeker (2015) found that after four complex case management simulation scenarios and debriefing, their APRN students improved in leadership, prioritization, delegation, collaboration, and professionalism scores. One type of approach in simulation education that has not been documented as often is the use of both undergraduate and graduate nursing students as a team in acute care simulation scenarios. These skills are essential for safe patient outcomes and mimic the healthcare environment that employs the opportunity for individuals from various backgrounds, training, and educational levels to work together (Motola, Devine, Chung, Sullivan, Issenberg, 2013).

Methods: Participants in this study included fifth semester bachelor in science UNS and graduate adult gerontology acute care nurse practitioner students in their final semesters before clinical submersion for their respective programs. The UNS and APRN students participated in a critical care simulation and debriefing together facilitated by their course faculty. IRB review and approval were obtained. Participation in the collaborative simulation activity was a course expectation; however, the post event survey was anonymous and voluntary and in no way affected their grade in the course. Anonymity of participants was maintained. Survey data consisted of open-ended questions to solicit feedback on the collaborative learning experience. Qualitative summary comments were summarized and grouped in InVivo software and a qualitative analysis was conducted.

Results: Qualitative analysis identified students’ liked collaborating and learning from each other. The simulation promoted understanding of the importance of communication, was realistic and felt like a real patient encounter. Undergraduate nursing students felt it was good to have an experience in a more emergent situation and feel the sense of urgency with the APRN student standing in the room. Both student groups learned more about the differences in scope of practice and their role. It was recognized that NPs have a larger scope of practice and RNs can use them as a resource but NPs depend on RNs. Students recognized that when caring for a patient, everyone is working toward the same goal.

Implications: Undergraduate and graduate students can be placed in a collaborative learning environment with positive outcomes for learning. This experience allowed the APRN students and UNS to stay in their respective role and learn how multiple disciplines can collaborate on equal levels for the benefit of the patients.

Funding: This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number DO9HP28677-01-00 Advanced Nursing Education. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.