One School's Journey through High Fidelity Simulation Curriculum Integration

Background

This abstract describes one BSN program’s journey in HFS curriculum integration. The IOM report on the Future of Nursing (2010) recognized the need for a highly educated nursing workforce to address the realities of health care in the 21st century. Nursing education facing the challenge related to clinical practice sites, many nursing program has adapted use of simulation an as educational tool to enhance clinical education.  Simulation has been found useful for teaching to improve clinical judgment, increase safety and decrease errors (Bearnson & Wiker, 2005). The use of simulation can help prepare clinically proficient health care professionals (Harder, 2010). Recent findings by the NCSBN national simulation study found substantial evidence that substituting for up to half of traditional clinical hours with high-quality simulation experiences produces comparable end-of-program education outcomes (Hayden et. al., 2014).

Curriculum Development and Simulation Program Implementation

Our school’s simulation program began small and has undergone many changes since 2005. Our program started using low fidelity simulation in the foundations nursing course to prepare students for their first clinical rotation. The overwhelming response from students encouraged faculty to move forward in using this methodology in other courses. A shared clinical simulation center in the state was established in 2009. Faculty training in immersive simulation methodology by expert simulation faculty was provided for faculty identified as simulation champions. Educational packages for simulation education were initially used to match curricular needs to enhance learning. Clinical faculty, who had various degrees of comfort and skill in setting up, implementing, and debriefing, conducted the simulations. However, variability in students HFS learning experience and costs of using the packages were no longer financially sustainable. The program’s simulation coordinator worked with faculty simulation champions from each level of the program to identify student learning needs, mapped out the curriculum with faculty teaching the didactic courses and developed clinical HFS scenarios that were congruent across the curriculum. Jeffries (2005, 2007) framework was used to guide the development and design of the scenarios. Schedules were mapped out and logistical planning was addressed with the clinical simulation center SIM ops committee. During this time, the program established the concierge simulation model where a dedicated set of faculty trained in simulation methodology will facilitate the scenario and conduct debriefings. This provided consistency in the HFS learning experience for BSN students and simulation technicians.

Outcomes

Integrating HFS in the nursing curriculum takes time, resources, and dedicated faculty. Full implementation of the newly developed HFS scenarios were undertaken in summer and fall 2013 and continues to be implemented in the curriculum to augment student clinical learning experiences. With the HFS curriculum infrastructure in place, the program is now positioned to conduct a more robust research focusing on evaluation of student learning, knowledge transfer, simulation and debriefing practices.