Situated Learning and Improved Simulations for Pre-Graduate Nursing Students

Monday, 9 November 2015

Maureen A. Barry, RN, MScN
Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada

Nursing students in our accelerated undergraduate program participate in structured simulations in all clinical courses throughout their two-year program of study. This poster will discuss the pilot use of impromptu student-driven simulations to prepare pre-graduation students for their final clinical practicum. At least half of the student enter consolidation following a community placement and experience anxiety related to their skill level and lack of recent practice in a hospital setting. The purpose of the pilot was to help students develop their clinical reasoning skills, their clinical skills and feel more confident about their upcoming placement in the context of a situation as close to reality as possible.

Siutated cognition or situated learning is a learning theory that lends itself to the preparation of pre-graduate nurses for higher order thinking in the context of an authentic environment such as simulation. In this pilot, students worked together collaboratively in impromptu simulations prior to their last clinical placement. Situated cognition learning techniques such as collaboration, coaching, use of multiple roles and perspectives, articulation of learning, use of technology and reflection were used to promote learning.

Senior students were invited to sign up ahead of time, specify their learning needs (e.g. giving injections, focused health assessment, prioritizing, etc.), and identify their upcoming clinical placement (e.g. medicine, surgery, etc.).  Student groups of 3-4 students worked together in the lab for 2- 4 hours just prior to the start of their practicum placement.  Two faculty members experienced in simulation-based learning led the scenarios and debriefing sessions. Little preliminary work was done on the simulation scenarios. Scenario development was tailored to the students in the scenario and created in the moment.  Pre-simulation briefing was very important to ensure “a psychologically safe context for learning” and active engagement of student learners who did not know each other very well (Rudolph, Raemer & Simon, 2014). Highlights of this learner-centered activity as well as feedback from both students and faculty involved will be shared in this poster.