Faculty Perception of Proposal to Increase Simulation Hours to 50% of Clinical Experience

INTRODUCTION:

The importance of nursing faculty in the utilization of simulation in nursing education is pivotal; however, research about faculty perceptions regarding clinical simulation is lacking.  Academic and clinical faculty feelings and attitudes may impact the viability of clinical simulation as an alternative to clinical experiences.  Therefore it is essential to solicit information on these factors.

PURPOSE:

The purpose of this research was to solicit affective faculty feedback about clinical simulation as a substitute for clinical experiences. 

METHOD:

This was a descriptive, qualitative study, using a researcher- created tool.  Purposeful sampling was utilized in order to limit sample size, due to time constraints.  Descriptive statistics were used to describe the sample. Responses were transcribed and aggregated into a multi-page Excel spreadsheet.  A summary page was created, from which pivot tables were utilized to analyze, compare, contrast, and present the data.

OUTCOME:  

The research question for this project was:  How does the faculty of the surveyed ADN program feel about the possibility of replacing up to 50% of traditional clinical with simulation? A global view of the results revealed a majority of participants harboring both positive and negative feelings about the possibility of replacing up to 50% of traditional clinical with simulation. The over-arching theme revealed in this survey was concern for student preparedness for professional practice.  Supporters of clinical simulation as a replacement to clinical experience cited that students would continue to experience “real” clinical.  Respondents indicated that students would practice communication skills with real patients, interact with real healthcare team members, and experience the pace of reality.  Additional advantages to clinical simulation included consistent experiences for every student, experience in a safe environment, exposure to experiences not typically encountered in clinical experiences, opportunity to recording performance, and post-simulation debriefing. The survey data revealed that opponents to clinical simulation also cited the above positives regarding simulation; however they assigned more value to traditional clinical experiences.  Respondents felt that while simulation has a definite place in the learning experience, it should be utilized for learning and practicing, that there is no replacement for traditional clinical.

The second theme identified was excitement and resignation.  Nursing educational programs are finding it increasingly difficult to secure rich clinical experiences for students This fact appeared to contribute to the resignation reflected in the data showing that every participant gave a response, other than zero, for what portion of simulation should replace traditional clinical.  The lowest of these percentages was 10%, while the highest was 50% among respondents who expressed positive and negative support.  Twenty-five percent of the participants were not resigned to the initiative, rather they voiced excitement that evidence supports what they believed.  The nursing profession is known for making things work whether we completely believe the evidence or not,-as long as no harm comes to the patients. 

IMPLICATIONS FOR NURSING EDUCATION, PRACTICE, AND RESEARCH:

Simulation has presented nursing education a promising way of providing quality experiences for nursing students.  While many faculty members are strong proponents of this initiative, many others are reluctant to accept simulation as alternative to clinical experience. Understanding faculty feelings about clinical simulation will assist leaders in academia to develop strategies to successfully engage reluctant faculty