Utilizing Simulation Scenarios in a Family Nurse Practitioner Curriculum to Improve Advanced Health Assessment Skills

Monday, 22 July 2013

Cheryl K. Giefer, PhD, APRN, FNP-BC
Karen Johnson, MSN, APRN, FNP-C
Jennifer O'Brien Harris, MSN, APRN, FNP-C
Amy Hite, DNP, APRN, FNP-BC
Department of Nursing, Pittsburg State University, Pittsburg, KS

Learning Objective 1: Describe a teaching strategy which evaluates Family Nurse Practitioner studentsí ability to apply assessment skills, formulate differential diagnoses, and plan therapeutic interventions.

Learning Objective 2: Apply simulation in a predictable environment for Family Nurse Practitioner students to demonstrate a practice situation under realistic conditions on standardized case scenarios.

Purpose: This project was initiated with the Advanced Health Assessment course and is a course redesign to improve advanced health assessment skills in Family Nurse Practitioner (FNP) students. Additionally, the purpose of this project includes addressing the challenge of evaluating FNP student clinical performance considering the differences in clinical sites, patients and preceptors. Simulation scenarios were introduced to evaluate FNP students’ assessment and documentation skills and continue across the FNP curriculum to assess evidence-based practice competencies in all Primary Care courses.

Methods: The methodology included the use of high-fidelity simulators as a teaching tool. The project integrates technology which includes an interactive patient care simulation while documenting the findings using Typhon, an electronic student tracking/documenting system. Simulation scenarios offer the advantage of relatively consistent experiences in a safe, risk-free environment. The simulation scenario increases the students’ awareness of their client-care skills and allows for faculty, self, and peer evaluation. This instructional approach allowed learners to engage in experiential learning covering the National League for Nursing Core Competencies for Nurse Educators and The National Organization of Nurse Practitioner Faculties (NONPF) Domains.

Results: The results are reflected in student evaluations which showed improved ability to: perform advanced health assessments; formulate differential diagnoses; plan therapeutic interventions; utilize simulation for evaluation of assessment skills and critical thinking. Students and faculty felt the simulation project incorporated realistic scenarios, integrated curricular content and benefited learning while improving self-confidence.

Conclusion: One challenge in evaluating FNP student clinical performance is related to differences in clinical sites and asynchronous evaluations. This project is significant as FNP students are educated to meet Nurse Practitioner Core Competencies, described by NONPF. According to NONPF (2011), the NP “practices independently managing previously diagnosed and undiagnosed patients and uses advanced health assessment skills to differentiate between normal, variations of normal and abnormal findings”.