July 21, 2023By Lance Baily

Latest Nursing Simulation Research from Clinical Simulation in Nursing Journal

The field of nursing simulation has made tremendous strides forward over the past several decades. One way this revolution is made possible is through clinical simulation research being conducted across the globe. The International Nursing Association for Clinical Simulation and Learning (INACSL) journal Clinical Simulation in Nursing is constantly sharing updates that include article reviews, more information on standards of best practice, research briefs, and overall innovations in simulated nurse education and training. This HealthySimulation.com article provides an overview of the latest clinical simulation highlights as of August 2023 and explains how these updates impact the healthcare simulation community overall.

Editorial: Interdisciplinary Education and Research in Healthcare Simulation (Nicole Harder, RN, PhD, CHSE, CCSNE, Editor-in-Chief, Clinical Simulation in Nursing): In the ever-evolving field of healthcare simulation, many are asking what can be done to further advance the science of simulation. While there have been new modalities such as extended reality technologies and artificial intelligence, and unique uses of simulation in classroom settings, I believe that simulationists are often overlooking interdisciplinary simulation as a powerful tool in simulation design, implementation, and research. Within the realm of health care simulation, the convergence of various disciplines holds immense value, unlocking new frontiers in education, training, and patient safety. This is not a new concept, however I consistently hear about barriers such as limited access to other disciplines or limited time to organize and implement interdisciplinary simulation and research. This is indeed something that needs to be addressed however should not preclude us from striving to implement more interdisciplinary strat

The Presence of Simulated Telehealth in Prelicensure Nursing Education: A Scoping Review (Kelly L. Rossler, PhD, CHSE, CNE et al): A national call to explore strategies to increase the number of community and public health nurses exists. During COVID-19, the use of simulated telehealth technology surged within academia. Incorporation of simulated telehealth technology in the curriculum of prelicensure nursing programs can be one pathway to increase the nursing workforce. The 22-item Scoping Review Checklist (SRC) process was followed to conduct a scoping review of the use of simulated telehealth technology in prelicensure nursing education within the past 10 years. MeSH terms (PubMed) of telemedicine and telenursing were used to conduct a broad search. Additionally, searches with CINAHL, EBSCO, Medline, Embase, ProQuest, Cochrane, ERIC, and Nursing and Allied Health databases with diverse subject headings were used. A total of 10 articles met the selection and inclusion criteria. Literature missing a clearly identifiable telehealth strategy and lacking specific research designs or data collection processes was evident. While emerging, this scoping review revealed a scarcity of research focused on the use of simulated telehealth technology in prelicensure nursing education.

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Dementia Simulation Impact on Empathy of Nursing and Physical Therapy Students: A Quantitative Study (Sara M. Deprey, DPT, PhD et al): As the population ages, the incidence of Alzheimer’s disease and related dementias (ADRD) increases. Health care students participated in a simulated dementia experience to increase their understanding of the lived reality of people diagnosed with ADRD. A foundation for therapeutic relationships is understanding which incorporates empathy. Health care professionals possessing empathy have demonstrated improved patient satisfaction. This study found a statistically significant increase in overall empathy postsimulation measured by the combined PT and EC subscales. The PT subscale also had a statistically significant increase indicating that students increased in the cognitive dimension of empathy post simulated dementia experience. There was no statistically significant change in the EC subscale or affective dimension of empathy post experience.

Nursing Students’ Acceptance of an Online Computer-based Simulation System Utilizing the Technology Acceptance Model (Anita M. Stephen, PhD, RN, CNL, CHSE et al): The utilization of online simulation to teach nursing students has increased. The purpose of this study was to discover if external factors of instruction and support influence nursing students’ acceptance of an online computer-based simulation.The acceptance of online computer-based simulations in nursing students are influenced by external factors of instruction and support.

Nursing Students Reported More Positive Emotions About Training During Coronavirus Disease 2019 (COVID-19) After Using a Virtual Simulation Paired With an In-person Simulation (Jason M. Harley, PhD et al): Virtual simulations (VS) are educational tools that can help overcome the limitations of in-person learning highlighted during the Coronavirus disease 2019 (COVID-19) pandemic. Research has illustrated that VS can support learning, but little is known about the usability of VS as a distance learning tool. Research on students’ emotions about VS is also scarce, despite the influence of emotions on learning. VS can be an emotionally positive, effective, efficient, and satisfying distance learning supplement to traditional simulations.

Implementation and Evaluation of a Virtual Reality-Based Cognitive Assessment and Rehabilitation Simulation Course in Undergraduate Nursing Students: A Pre-Post Study (Guichen Li, MSc et al): Virtual reality has gradually been applied to nursing education, with many advantages. A quasi-experimental, pretest-posttest study was conducted to verify the teaching effectiveness of a virtual reality-based cognitive assessment and rehabilitation simulation course. The Chinese version of the Critical Thinking Disposition Inventory was used to measure the critical thinking abilities of participants. The teaching evaluation included the evaluation of the virtual system, course, teaching, and students themselves. The course can significantly improve the critical thinking ability of nursing undergraduates and provide an effective teaching method.

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Development and Evaluation of a Wearable Simulator System (Cynthia Sherraden Bradley, PhD, RN, CNE, CHSE, ANEF et al): Peer physical examination is a clinical teaching-learning approach used for decades because of the convenient sample of peers for practicing. However, this approach has limitations when learning to assess abnormalities and threatens psychologically safe learning. A wearable simulator system was designed for learning physical examination skills to minimize ethical and learning challenges. The wearable simulator system offers a promising teaching-learning alternative with scenario-specific auscultation and palpation feedback to provide a safe, repeatable, and consistent simulation experience.

Effectiveness of Debriefing for Meaningful Learning (DML) Combined with Empathy Map on Prelicensure Nursing Students’ Competency: A Quasi-Experimental Study (Cheng-Yi Huang, RN, PhD et al): Debriefing for Meaningful Learning (DML) is a systematic debriefing process. DML combines with empathy map has yet to be empirically tested. The DML combined with empathy map showed significantly better improvements in four aspects of clinical reasoning: awareness of clinical signals, confirmation of clinical problems, decision and implementation of the action, and assessment and reflection (p < .05). The total and subscale empathy scores of the interventional group also showed significantly different at post-test than the control group (p < .05). DML combined with empathy map in debriefing enhanced nursing students’ ability to analyze a patient’s information from patients’ perspectives, integrate theoretical knowledge and care activities.

Gender Affirming Postop Care Simulation for Prelicensure Nursing Students: A Pilot Project (Mollie Ness, BSN, RN, PHN et al): Transgender and nonbinary individuals experience significant health disparities which are further complicated by traumatic past experiences with underprepared healthcare professionals who lack understanding of the unique health needs of gender-diverse individuals. Without learning opportunities for health sciences students, including nursing, disparities will persist. A QI project with a pre and posttest design was conducted to evaluate a simulation focused on gender affirming postoperative care of a patient and loved one during the gender-affirmation journey. Ten prelicensure Master of Nursing students in their final year participated in a 20-minute simulation followed by a Debriefing for Meaningful Learning debriefing. Knowledge, skills, comfort, and attitudes mean scores improved after simulation and debriefing. Students reported positive feedback, including appreciation for the inclusion of gender-diverse care. Simulation provides a safe space to practice gender-affirming language, communication, and nursing skills as nurse educators seek to increase diverse prelicensure learning experiences.

Excellence via Strategic Experiential Learning (ExSEL): A Continuous Improvement Project for Developing Clinical Reasoning and Management (David R. Trinidad, DNP, ACNP et al): This improvement project explored using virtual patient simulations to increase an AGANCP students’ confidence applying clinical decision-making skills. Students showed higher clinical reasoning scores with a virtual-patient case-base pedagogy, and higher clinical management scores using traditional didactics. Higher clinical confidence scores were more frequent within the case-based approach than the traditional pedagogy. A well-structured educational strategy using virtual-patient cases showed effectiveness in gaining competence and confidence learning clinical decision-making.

A Comparison of Nurses’ Situation Awareness and Eye-Tracking Data in Precardiac Arrest Simulations (Patrick Lavoie, RN, PhD et al): Eye tracking has emerged as a new technology for assessing nurses’ visual attention in simulation, but its relationship with situation awareness, a precursor to clinical decision-making, remains to be defined. This study compared role-based situation awareness and visual attention using eye-tracking in simulation. This study was the first to combine eye-tracking and situation awareness data to compare two nursing roles during a precardiac arrest simulation. The findings also suggest gaps and learning needs in nurses’ understanding of signs of patient deterioration and other nontechnical skills.

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