The Simulated Hospital Environment: Lessons Learned

This 96-hour integrated simulation was a phenomenal success. We were able to demonstrate the integration of space industry techniques with nursing knowledge to simulate a continuous 24-hour hospital environment. The scripted patient scenarios reflected the most common medical-surgical diagnostic categories from Centers for Medicare and Medicaid Services data which provided nursing care opportunities that not all students may experience in their clinical learning. This simulated experience proved to be more complex than current student clinical hospital experiences.

Within the first shift, it became evident that literature reflecting employer feedback of new nursing graduates was on target. Students had difficulty assuming an independent nursing role when faced with complex decision-making and organization of care. Students’ focus groups concurred, as one student noted, “it was a wake-up call!”

This experience opened the eyes of the faculty regarding missing curricular pieces at the undergraduate and graduate level. As a result of the current healthcare climate, and out of concern for patient safety, students have fewer opportunities to be as directly involved in patient care as has been the case historically. Our intention was to fill this knowledge-application void.

Phase 2 of this project is planned for Fall 2011 and will examine scalability issues.   Factors such as optimal length and number of shifts, number and complexity of patient assignments, use of technology, the learning experience of students as patient-actors, and faculty resources will be studied.

This educational innovation provided a unique opportunity for student-faculty collaboration across the curriculum, an engaging, real-world experience. The continuous 96-hour simulated hospital environment bridged the preparation-practice gap, a challenge with global implications.