Simulation: The Future

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Simulation The Future

• Thomas J. Doyle, MSN, RN
• Chief Learning Officer
• Director of Education Training

2
Learning Objectives

• Discuss the use of high-fidelity simulation by
  nursing across the globe
• Discuss the issues affecting nursing education
  around the world
• Discuss the issues with new graduates entering
  the workforce in the US
• Identify changes that are needed in how nurses
  are educated in the 21st century

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Simulation is Not New!
4
Use of High-Fidelity Simulators in Nursing
Education

• Where did it all start?

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The Innovators 1996-2001

• Issenberg (2006) describes these groups as the
  risk takers with the initiative and willingness
  to expend effort, and resources, in trying to do
  something radical
• This occurred in the mid to late 1990s primarily
  in the US community colleges
• The first US university nursing programs adopted
  the technology between 1999-2001

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Global Expansion

• Adoption of simulation as a pedagogy has rapidly
  expanded in the new millennium
• Numerous driving forces
• METIs Program for Nursing Curriculum Integration
  (PNCI) has powered the rapid expansion
• US version since 2005
• UK version since 2007

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Issues Facing Nursing Education

• Challenges are numerous
• Nursing shortage
• Looming faculty shortage
• Increased enrollment with decreased clinical
  placement sites
• Decreased patient availability
• Information explosion
• Todays learner is radically different

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Issues with New Graduates Entering the Work Force

• New graduates have no practical experience
• Enormous burden on the fiscal and human resources
  of an organization
• 50 leave their first job in the first year
• Current nursing shortage is unique
• Population is aging and acuity is increasing

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More Issues

• Most orientation programs are same old ways,
  different day
• Didactic based sage on the stage
• Patient Safety initiatives are at the fore front
• Consumer awareness
• Organizational initiatives
• Thus a new approach is required!

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Patient Simulation and Skill Training

• Practice in a safe environment
• Learn rare events
• Repetition of cases and experiences
• Develop problem solving skills and thinking
• Learn from errors without patient harm
• Practice teamwork
• Practice skills with increasing complexity
• Allows educators to evaluate competencies

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A New Model is Required for Nursing Education

• A Radical Approach!

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A New Model

• Simulation based curriculum model
• Skills are front loaded using a blended
  learning approach
• Self-directed learning CBT
• Task trainers
• High-fidelity clinical simulation
• Competency demonstrated before entering clinical
  practice
• Clinical becomes the forum to implement what they
  have learned in simulated learning environments

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Questions to be Answered

• How much of real clinical can be replaced by
  all forms of simulation?
• What is the proper mix of CBT, task trainers, and
  high-fidelity simulation?
• What is the minimum set of simulated clinical
  experiences that are required?
• What does the learners portfolio look like as
  they enter the work force?

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Discussion

• Tdoyle_at_meti.com