High-Fidelity Simulation of Critical Illness: An Evidence-Based Practice Summary

The purpose of this presentation is to summarize the best evidence concerning the use of high-fidelity simulation of critical illness with nursing students. Background/significance: As students finish school, there is concern about the lack of experience when caring for a critically ill patient. Local hospitals are hiring new nurses into the critical care units and emergency rooms which highlights this concern. Caring for the critically ill can be one of the most challenging duties in healthcare (Boling & Hardin-Pierce, 2016). The introduction of high-fidelity simulations that involve the care of a critically ill patient may increase the confidence of these students during the course of their nursing program. The PICOT question: In undergraduate nursing students (P), how does working through the same simulation scenario involving critically ill patients each semester (I) versus multiple different simulation scenarios each semester (C) influence the development of critical thinking and clinical judgement skills (O) throughout the nursing program (T)? Methods: A search was conducted using the following search terms: "hihg-fidelity,", "simulation", "student", "critical care", "critical illness". Databases searched included CINAHL, Google Scholar, Cochran Library, and PubMed. A literature review was conducted that yeilded few studies that examined high-fidelity simulation of critical illness. Findings: High-fidelity simulation has been found to be a positive learning environment for the advancement of many nursing skills. Critical thinking skills and clinical judgement are both increased but may be limited in relation to the number of simulation scenarios in which the students participate. For students to get the most out of the simulation component in a nursing program it does not seem that repeating the same scenario each semester would necessarily be most beneficial but rather a series of scenarios with advancing complexity. Summary: Based on the limited evidence, there is a need to further explore the use of a single critical ilness scenario versus multiple scenarios throughout a nursing program.