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Learning Objective 1: 1. The learner will be able to recognize potential challenges in creating multiple patient simulations and identify strategies to address these challenges.
Learning Objective 2: 2. The learner will be able to discuss the potential role of focused debriefing in identifying clinical judgment skills used in simulation exercises.
Karen Brandt, PhD, RN
Nancy Oldenburg, EdD, APN
Purpose
This study used the Human Patient Simulation (HPS) lab to develop clinical judgment skills in senior nursing students. The focus of this pilot study was to evaluate the feasibility of running simultaneous, multiple patient simulations. A second focus of this study was to assess whether a ‘focused debriefing’ method was a viable technique to assess clinical judgment skills in students participating in the scenarios. A ‘focused debriefing’ uses a more direct approach to debriefing than the typical open-ended debriefing approach.
Audience
This study will be useful to nurses who are utilizing HPS with nursing students or practicing nurses.
Methodology
Three scenarios were chosen to represent the variety of patients seen in a typical emergency department: an infant with dehydration, an adolescent with acetaminophen overdose and an adult with bowel obstruction.
Twenty-four nursing student volunteers participated in this study. Nine of the volunteers were RNs. Each student RN had the responsibility for one of the ‘patients’ in the ED. The scenario was run three times to obtain adequate data on the feasibility of the multiple scenarios. Other students filled supplementary roles. Two SIM support staff ran the computers for the simultaneous scenarios.
Data were collected regarding the level of difficulty in creating and running multiple scenarios in real time. A qualitative analysis of the focused debriefing technique was analyzed for themes related to the processes of clinical judgment used during the scenarios. Conclusion
Multiple patient simulations are possible, providing that they are well organized and well orchestrated. Focused debriefing was helpful in encouraging students to reflect on their use of clinical judgment skills within the scenarios.