Pediatric Emergency Department (PED) Simulation: Undergraduate Nursing Students' Experience

Background: Finding clinical placements for undergraduate nursing students is an increasing challenge. The National Council of State Boards of Nursing Simulation Study (2014) found that high quality simulation produces educational outcomes comparable to traditional clinical hours. Students report that high fidelity simulation has a positive impact on their problem solving, is more realistic, and makes learning more active than low fidelity simulation (Butler, Veltre, Brady, 2009). The undergraduate students in the simulation experience have participated in multiple simulations applying the space industries integrated model to a simulated hospital environment (Ayers, et al., 2015). Students play the role of patients. Using live models or standardized patients in simulation increases students’ critical thinking and communication skills (Maharaj, 2015). This same model of utilizing students as patient actors in a simulated hospital was implemented in the pediatric course. Twenty students spent 50% of their clinical hours in the simulation lab and 50% in the children’s hospital. However, we discovered that students had difficulty accepting their peers, playing the pediatric patient role, as realistic. Students playing the patient role limited the age range of the scenarios that could be implemented to older school age or adolescent patients.

Intervention: A high fidelity pediatric emergency department simulation (PEDS), with children of all ages playing the patient role, was developed as an innovative solution to these problems. Volunteer children and parents played the patient and parent roles. Patients presented with a variety of scripted illnesses and injuries and were moulaged accordingly. Twenty undergraduate students rotated through the roles of triage and bedside nurses. Faculty wrote the scripts, coordinated the activities, and moulaged patients. Nurse practitioner faculty played the providers.

Evaluation: Students response to the experience was positive. The majority of the students expressed that the PEDS was an excellent learning experience. They were able to interact with children of a variety of ages. Students in the PEDS were able to function independently in a safe environment.