Helene Cunningham

Using Clinical Simulation to Teach Patient Safety in an Acute/Critical Care Nursing Course

High-fidelity simulation using lifelike mannequins has been used to teach medical and aviation students, but little is known about using this method to educate nurses. The process and methods authors used to develop, implement, and evaluate high-fidelity simulation experiences in an acute/critical care elective for senior nursing students are described. Authors share their insight, experiences, and lessons learned, along with practical information and a framework, in developing simulations and debriefing.

Error identification and recovery by student nurses using human patient simulation: Opportunity to improve patient safety

This study examined types of errors that occurred or were recovered in a simulated environment by student nurses. Errors occurred in all four rule-based error categories, and all students committed at least one error. The most frequent errors occurred in the verification category. Another common error was related to physician interactions. The least common errors were related to coordinating information with the patient and family. Our finding that 100% of student subjects committed rule-based errors is cause for concern. To decrease errors and improve safe clinical practice, nurse educators must identify effective strategies that students can use to improve patient surveillance.

Human patient simulation: teaching students to provide safe care

The use of human patient simulation as a teaching methodology for nursing students has become popular. Using human patient simulation effectively demands paying careful attention to the details of the simulation, debriefing, and evaluation processes. Our experience in designing simulation experiences and evaluating student behaviors confirms the resource-intensive nature of human patient simulation and the need for clear, measurable objectives. When used properly, human patient simulation offers a unique opportunity to teach nursing students important patient safety principles.

Using simulated clinical scenarios to evaluate student performance.

Given the high financial investment that nursing education programs make to incorporate high-fidelity simulation training, it is important to evaluate its usefulness in student learning and evaluation. Faculty developed an evaluation tool for simulated clinical scenarios, using both high- and low-fidelity modalities that delineated components and their relative weights, adapted to match the changing expectations for evolving novices. The authors discuss scoring, debriefing, and remediation.

Eye Tracking as a Debriefing Mechanism in the Simulated Setting Improves Patient Safety Practices

Introduction:Human patient simulation has been widely adopted in healthcare education despite little research supporting its efficacy. The debriefing process is central to simulation education, yet alternative evaluation methods to support providing optimal feedback to students have not been well explored. Eye tracking technology is an innovative method for providing objective evaluative feedback to students after a simulation experience. The purpose of this study was to compare 3 forms of simulation-based student feedback (verbal debrief only, eye tracking only, and combined verbal debrief and eye tracking) to determine the most effective method for improving student knowledge and performance. Methods:An experimental study using a pretest-posttest design was used to compare the effectiveness of 3 types of feedback. The subjects were senior baccalaureate nursing students in their final semester enrolled at a large university in the northeast United States. Students were randomly assigned to 1 of the 3 intervention groups. Results:All groups performed better in the posttest evaluation than in the pretest. Certain safety practices improved significantly in the eye tracking–only group. These criteria were those that required an auditory and visual comparison of 2 artifacts such as “Compares patient stated name with name on ID band.” Conclusions:Eye tracking offers a unique opportunity to provide students with objective data about their behaviors during simulation experiences, particularly related to safety practices that involve the comparison of patient stated data to an artifact such as an ID band. Despite the limitations of current eye tracking technology, there is significant potential for the use of this technology as a method for the study and evaluation of patient safety practices.

10-Minute Assessment for Patient Safety

One of the most difficult tasks that a novice student needs to master is the conceptual organization of the patient assessment; many of our clinical students spend a good amount of time standing outside a patient room trying to figure out what to do first. Our 10-minute assessment provides a script, a road map, and a method of student and self-evaluation, which increases student and faculty confidence and encourages patient safety.