Learning Objective #1: Differentiate between levels of human simulation technology

Learning Objective #2: Select the level of human simulation technology appropriate for the target audience when given examples

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Background: Our facility has a range of simulation technology. High fidelity simulation permits programming of various pathophysiologies, along with a drug recognition system. Mid-fidelity does not have the aforementioned capabilities, but permits rapid vital sign and heart/breath sound changes in response to assessment/interventions. Low fidelity includes traditional manikins, or other non-interactive simulators. Problem: Our clinical education department is founded upon Benner's model of novice to expert. A three-tiered system was developed to meet the educational objectives of learners at various levels of competence. Content of educational offerings and teaching methodologies are selected to best facilitate achievement of goals within each tier. With the availability of simulation technology, the task of selecting the appropriate type was undertaken. Description: The first tier targets the advanced beginner-competent, and includes introductory offerings that facilitate development of critical thinking, skills, and recognition of deterioration. Low and mid-fidelity simulation are used at this level. The second tier focuses on the competent-proficient. Offerings center on evidence based practices and ethical decision-making. Mid and high fidelity simulation are used at this level. The third tier targets the proficient-expert. High fidelity simulation is used almost exclusively at this level. Learners respond to the “patient”, and are evaluated in real time, followed by debriefing. Outcomes: The success of mid/high fidelity simulation at our facility is such that it is utilized by most healthcare disciplines. Simulation is a requirement for annual nursing competencies. Simulation is expensive however, and justification of its use essential. Identifying level of competence has facilitated appropriate use of the technology. Of interest, we have noted that the age of the learner plays a factor in the success of simulation by impacting the quality of interaction with the simulator. Other outcomes include training for debriefing techniques used by the educator, and numerous research and evidence based practice studies.