High-Fidelity Simulation in Graduate Nurse Programming

High Fidelity Simulation (HFS) is an educational modality that meets the needs of kinesthetic learners while providing a unique opportunity to apply didactic information in the clinical setting. The area of interest for this project was use of HFS within an Advanced Physical Assessment course for graduate nurse practitioner students. The activity centered on focused assessment skills such as cardiac and respiratory assessments. The purpose of this project was to answer the question "In graduate nurse practitioner students, is High Fidelity Simulation an effective teaching strategy?" The simulation (approximately 20 minutes) was considered part of the coursework; participation in debriefing and simulation survey was voluntary. This project was approved by the Institutional Review Board.

Methods

The sample included 28 graduate nursing students. Each student received a general demographic survey, room orientation, discussion of learning objectives and a mannequin overview prior to the simulation. A folder containing the pre-briefing (patient chief complaint), the previous SOAP note from a wellness visit, baseline labs and a baseline EKG was placed in each room. During the simulation, a faculty member completed the Beckham Evaluation Tool on student performance. After the activity, students completed the Leighton Simulation Effectiveness Tool-Modified and participated in a debriefing activity. Recorded debriefing sessions, were transcribed and qualitative themes were identified.

Results

Results of this simulation experience included quantitative and qualitative data. Debriefing sessions with the graduate students revealed themes such as an increase in confidence, increase in knowledge and role performance. These sessions also highlighted areas of improvement for future use of this HFS activity. Areas for improvement included preparation for the activity, better orientation to the mannequin, and desire for the simulation environment to reflect the clinic setting. Quantitative measures of this project revealed an average score of 16 out of 20 on the Beckham Evaluation tool, which is considered a passing score by the course faculty.

Conclusion

The goal of this project was to investigate if HFS technology was effective in graduate nurse education, which preliminary results have indicated that it is. Although use of standardized patients is considered gold standard for testing purposes, use of simulation can be valuable within the graduate nurse curriculum. During the debriefing sessions students stated that it was a beneficial activity and aided in their learning. Some students felt that the experience would be better placed later in the semester and some offered suggestions to improve the experience, but all found it beneficial. In future studies, researchers should utilize a larger sample size from multiple university settings to increase the power of the study and generalizability of findings. In conclusion, there is a place for HFS technology in graduate nurse programming.