SPOKANE, Wash. – Washington State University nursing students have completed their part in a national study of simulated patient use in education. In addition to contributing to the larger effort, lessons learned will help WSU better prepare students and provide expertise to groups outside the university.
“We’ve gotten so much out of the study, and we are excited at the direction our program is moving,” said Kevin Stevens, director of the College of Nursing’s program of excellence in clinical performance and simulation (PECPS).

After two years, 480 hours of simulation and 105 simulated patients, 60 bachelor of science in nursing students completed their part in Phase II of the National Council of State Boards of Nursing (NCSBN) National Simulation Study. This landmark study, involving five associate and five baccalaureate programs nationwide, is investigating the ideal mix of simulation and clinical training needed to best prepare nurses.

WSU is one of only two programs in the West selected to participate and the only one in the Northwest.

Stronger teaching

While WSU’s portion of the study is complete, the college continues to analyze the results of coordinating so many hours and patient scenarios in the simulation lab. This analysis will help strengthen future simulated clinical experiences in undergraduate and graduate programs.

For example, because of the study, more faculty plan to incorporate a debriefing style in their teaching, said Stevens. Using this model, students tell faculty what went well or not during the simulation rather than instructors telling students what they need to know.

“The study really pushed our faculty to understand and embrace simulation as an effective learning tool,” said Stevens.

Continuing education

New opportunities are also being explored, and the college is pursuing partnerships with regional health care organizations.

Already working with groups like Spokane Regional Health District, the University of Washington Medex Physician Assistant program and the Washington Air National Guard 141st Medical Group, the college is offering simulated learning experiences and providing consultation on how simulation can be used offsite for continuing education.

Breadth of experience

Throughout the study, students were challenged with complex patients and scenarios. Using a high-fidelity manikin or standardized patients – faculty acting as patients – students practiced scenarios they might encounter in practice.

Patients might be having an anaphylactic reaction to antibiotics, suffering from a stroke or experiencing liver failure or cardiac/code blue. And scenarios weren’t limited to a hospital emergency room setting; instead, students might see a patient during a staged home visit, in jail or on the street.

“There are just many situations where nursing students might not have the chance or the ability to practice a skill on a live patient,” Stevens said. “With simulation, students can experience a variety of scenarios under supervision – and be prepared when it really happens in practice.”

Depth of experience

Robert Stokes, a 2013 B.S. nursing graduate, volunteered to participate in the study. From the start, he was fascinated with the idea of swapping time in more varied simulated settings for time working with live patients in clinical settings.

“There are so many scenarios in clinical settings where we, as students, would have been asked to get out of the way if there was an emergency so the licensed professionals could assist,” he said. “With simulation, I got to work with and care for the very sick patients.”

Stokes also felt that participating in the study would make him a better prepared nurse.

“Once that manikin started talking, it immediately became like a real patient,” he said. “It gave immediate feedback about how I was doing, such as in administering CPR. The manikin could evaluate the force of compressions and whether it was receiving the right amount of oxygen. It’s just amazing.”

Next: Following up on graduates

The national study now moves into the third and final phase: NCSBN will follow up with nursing graduates in the workplace to evaluate the clinical competency of those from the simulation study groups.

“The study will accomplish a few things,” Stevens said. “First, we are hoping to identify the appropriate amount of clinical time that can be substituted with simulation.

“We’ll also learn how the amount of simulation the students in the study received influences their clinical abilities once they are hired into a nursing position,” he said. “To assess this part of the study student’s job supervisors will be involved.”

About the NCSBN Nursing Simulation Study

The study aims to:
• highlight best practices in simulation use
• evaluate the learning occurring when various amounts of simulation are substituted for time spent in direct patient care settings
• establish key simulation standards and learning experiences in each core clinical course
• evaluate new graduates’ ability to translate educational experiences into the workplace

About the program of excellence in clinical performance and simulation

The PECPS program prepares students for professional nursing practice, providing safe and equitable health care for all patients. Students gain experience through active learning using manikins, standardized patients and realistic health care scenarios under the guidance of experienced faculty and staff. In delivering educationally sound, realistic simulation learning experiences to students and partners, the program is advancing the clinical competence of the health care workforce within WSU and local communities.

About the WSU College of Nursing

Founded in 1968, the college educates more than 1,000 students each year, one of the largest educators of nurses on the West Coast. WSU offers nursing degrees at the bachelor’s, master’s and doctoral levels at five sites across the state. The college is active in research, supporting the health care needs of rural communities and providing students with interprofessional and simulated learning opportunities at its locations statewide.

Alli Benjamin, Communications & Marketing Manager, WSU College of Nursing, alli.benjamin@wsu.edu, 509-324-7340
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