Designing and Implementing Models for the Innovative Use of Simulation to Teach Nursing Care of Ill Adults and Children: A National, Multi-Site, Multi-Method Study

by Janis C. Childs RN, PhD, Associate Professor of Nursing

Project Sponsors: National League for Nursing (NLN) and Laerdal

Problem

Discoveries and development in educational technology make a wide array of options, such as sophisticated simulators, available to faculty to facilitate experiential learning. Such developments also create an environment that is ripe for systematic and substantial change. To create the most effective and efficient ways of teaching nursing, faculty members need to develop a wide range of methods of engaging students in learning activities, including simulation. By incorporating collaborative simulation technologies into nursing courses, faculty can begin to explore the impact of such strategies on learning, critical-thinking, and problem-solving skills. This study will explore various parameters related to the use of simulation in basic nursing education programs and their relationships to selected student outcomes.

Significance

This simulation activity offers numerous health care providers a significant educational tool that meets the needs of today’s learners by providing them with interactive, practice-based, instructional technologies.

Testing and implementing teaching strategies that use collaborative simulations has the potential to enhance the following:

  1. More effectively utilize faculty in the teaching of basic clinical skills and interventions.
  2. Allow learners more flexibility to practice based upon their schedules. The learner could access the simulation at his/her convenience and not be required to practice the skills in front of an instructor, although that option would remain available for those who needed the extra instruction or reinforcement. The learner can revisit this skill a number of times in an environment that is safe, non-threatening and conducive to learning.
  3. Actively involve students in their learning process. By interacting with the simulation, examples and exercises, the learner is required to use a higher-order of learning rather than simply mimicking the teacher role model. Decision-making and critical-thinking skills are required by this teaching modality.
  4. Improve student instruction, allow better consistency of teaching overall clinical and didactic instruction, increase learner satisfaction in the classroom and clinical setting, allow the possibility for safer, non-threatening practice of skills and decision making, and provide education in a state-of-the-art learning environment.
  5. Contribute to the refinement of the body of knowledge related to the use of simulation in nursing education by beginning to formulate best practices related to design and use of collaborative simulation technologies.
  6. Lead to potential external funding for other collaborative simulation projects in teaching and the promotion of decision-making skills among health professionals.

Purpose

The overarching purpose of this exploratory, national, multi-site project is to study various parameters related to the use of simulation in basic nursing education programs and selected student outcomes. Specifically, it is designed to:

  1. Explore the relationships between the use of collaborative simulation technologies and student learning
  2. Identify significant parameters for using a variety of collaborative simulation technology tools in nursing education.
  3. Begin to formulate best practices related to the design and the use of collaborative simulation technologies.
  4. Test constructs in the Collaborative Simulation Technology Model as they relate to using simulation to promote student learning
  5. Contribute to the refinement of the body of knowledge related to the use of simulation in nursing education.

Theoretical Framework:

Instructional strategies and tools must be based on some theory of learning and cognition (Bednar, Cunningham, Duffy, & Perry, 1995). Many educators prefer an eclectic approach, selecting principles and techniques from many theoretical perspectives. In the case of educational research, the collaborative educational learning tools have drawn upon behavioral, cognitive information processing, humanistic, and sociocultural theories among others. To enhance integration of research findings, however, when measurement tools, concepts, teaching strategies are developed, the strategies should be meaningful and be derived from the theoretical viewpoint.

Research related to the use of simulations in education is most effectively grounded in theories such as the following: learner-centered, constructivist theory, and socio-cultural perspectives on collaborative technology. Cunningham (1996) has proposed three models of mind that could guide our concepts on learning and cognition: mind as computer, mind as brain, and mind as rhizome, providing for an infinite number of connections within and without the social cultural milieu. Each of these metaphors point to a view of instruction in general that see: a) learning as information processing – a cognitive skills approach; b) learning as experiential growth and pattern of recognition; and c) learning as a socio-cultural dialog activity – a social constructivist or socio-cultural approach. If learning is predominantly information processing, then instruction should provide for efficient communication of information and effective strategies for remembering. If learning is predominantly experiential growth, then instruction should focus on experiences and activities that promote the individual development of the appropriate cognitive networks. And finally, if learning is predominantly a socio-cultural experience, then instruction should provide opportunities for embedding learning in realistic tasks leading to participation in a community of practice, such as simulation experiences.

Research Questions for the Multi-Site Study:

  1. Does using the Collaborative Technology Model as a framework for the development of simulation activities enhance student learning?
    2. · Is there an increase in knowledge gains?
    · Can students demonstrate competency with the skill sets being taught?
    · Do students feel confident about their ability to perform skills, make decisions related to relevant patient-care situations?
    · Are there gains in students’ abilities to think critically?
  2. How satisfied are learners with simulation activities that have been designed within the framework of the Collaborative Technology Model?
  3. What teacher behaviors seem to affect the success of simulation activities?
  4. What elements are most significant in creating a learning environment that is conducive to and promotes learning using simulations?
  5. What discrete design elements of the simulation activity can be manipulated to promote learning?
Simulation Model