Using the GRASPS Model in Clinical Simulation
GRASPS is a model for demonstrating performance of understanding using authentic assessments that can be applied to clinical simulation. GRASPS is an acronym for goal, role, audience, situation, product, and standards. GRASPS represents a framework for organizing, delivering, and assessing a project-based or in our case simulation assessment. This model is often used in conjunction with ADDIE Model for instructional design. This HealthySimulation.com article is written to explain how to utilize the GRASPS model in healthcare simulation assessment.
The GRASPS model is an authentic assessment inquiry to address:
- G oal: A definition of the problem or goal
- R ole: Define the role of the student
- A udience: Identify the target audience
- S ituation: This is the context or scenario of the goal
- P roduct: What is created and why it will be created
- S tandards: Rubrics or success criteria
The ADDIE Model is useful to guide the development of healthcare education and clinical simulation. The ADDIE process is a step model that follows a circular pattern that repeats itself until the outcomes are achieved. Each step should be taken in the specific order: analysis, design, development, implementation, and evaluation. In the evaluation step, educators will obtain feedback and data to adapt or adopt the educational process for better learner outcomes.
GRASPS can be applied in the prebrief and briefing phases of simulation to inform the simulation participants of expectations and outcomes to achieve during the scenario. Therefore, ADDIE and GRASPS are complementary and can be used in conjunction with each other. Both models can be implemented to meet the INACSL Healthcare Simulation Standards of Best Practice.
Benefits of GRASPS
GRASPS grants the ability for healthcare educators in the development of authentic learning experiences: More authentic learning experiences facilitates the learner’s achievement of knowledge to grow and transition into professional healthcare practice. Clearer presentation of the purpose and content of the simulation scenario allows the faculty to provide the learner with a clearer vision of the scenario through the communication of the goals, content, and purpose of the simulation. GRASPS becomes particularly important for collaboration between educators, subject matter experts and simulationists to establish consistency because simulations are delivered by multiple professionals.
The GRASPS model clarifies roles, perspectives, and responsibilities of all members involved in the healthcare simulation. The collaborative team continues to support the simulation standards with the development of the prebriefing resources, education material, and prior experiences to assist the learners to achieve the identified goals and outcomes of the scenario.
Clear, concise communication of the expectations provides structure that allows for the faculty to articulate the evaluation rubric, assessment expectations, as well as the strategies that learners require to be successful.
A responsibility of simulation educators is to create and implement authentic learning experiences that promote attainment of knowledge, skills, and attitude for professional development. These experiences facilitate the development of critical thinking and clinical judgment in the learners. Learners perform better when there are clear expectations and directions. Ensuring learners understand both the learning objectives, and their performance towards those objectives, is a crucial component of improving outcomes at scale.
Example Application to Simulation
Here we can example the GRASPS model into an authentic experiential learning opportunity. Here is an application applied to an undergraduate nursing education program simulation for an adult health course.
- The goal within the scenario is to provide evidence-based appropriate care to the patient.
- There will be 3 Nursing Student roles in the scenario. One person will be responsible for assessing the patient, another will be responsible for documentation and medication administration, and the other will be responsible for communication and team leader.
- The audience will be the nursing team caring for a patient admitted to a medical-surgical unit. You will work as a team to develop and implement care for this patient.
- The situation is a 68-year-old female admitted with heart failure and hypertension to the med-surg unit 12- hours prior to the scenario. Her PMH includes hypertension and heart failure. Her vital signs 2-hours ago were 158/82, HR 93 irregular, RR 20 and temp 98.4. She is complaining of a headache that is getting worse.
- The performance or action for the scenario is to assess, develop, implement, and evaluate a plan for this patient.
- The standard of care should be evidence-based practice using the most up to date guidelines for hypertension and heart failure incorporating TeamSTEPPS.
Watch this recent HealthySimulation.com webinar by Jason Konzelmann on ADDIE This! GRASPing Clinical Simulation Design and Performance Assessment Concepts.
An advantage of GRASPS is authentic assessment, the use of creative learning experiences to test participant’s’ skills and knowledge in realistic simulation situations. Authentic assessment measures learner’s’ success in a way that is relevant to the skills required to function in the professional role upon completion of the degree program. The learners are required to perform the skill or task, not just recall and recite the information. Therefore, the simulation scenario should be appropriate and achievable for the learner level, realistic, have specific objectives, and be measurable for completion during the allotted time. The goals and objectives of the medical simulation should use SMART objectives. This is supported by the Healthcare Simulation Standards of Best Practice by INACSL.
The incorporation of ADDIE, GRASPS, and the INACSL Standards support the development of high quality simulations to achieve better learner outcomes. All members of the healthcare simulation team should strive to explore and incorporate the best evidence based practices to educate future and current healthcare providers.
Teresa Gore, PhD, DNP, APRN, FNP-BC, CHSE-A, FSSH, FAAN – Dr. Gore has experience in educating future nurses in the undergraduate and graduate nursing programs. Dr. Gore has a PhD in Adult Education, a DNP as a family nurse practitioner, and a certificate in Simulation Education. Dr. Gore is an innovative, compassionate educator and an expert in the field of healthcare simulation. In 2007l Teresa started her journey in healthcare simulation. She is involved in INACSL and SSH. She is a Past-President of INACSL and is a Certified Healthcare Simulation Educator Advanced (CHSE-A). In 2018, she was inducted as a Fellow in the American Academy of Nursing (FAAN). In 2021, she was inducted as a Fellow in the Society of Simulation in Healthcare Academy (FSSH) and selected as a Visionary Leader University of Alabama at Birmingham School of Nursing Alumni. During her career, Dr. Gore has led in the development and integration of simulation into all undergraduate clinical courses and started an OSCE program for APRN students. Her research interests and scholarly work focus on simulation, online course development and faculty development. She has numerous invited presentations nationally and internationally on simulation topics.