Krysia Warren Hudson

Second Life simulation as a strategy to enhance decision-making in diabetes care: a case study

AIMS AND OBJECTIVES The case study evaluated the Second Life perceived usability and the decision-making of insulin administration via situational awareness at two different simulation freezes during Second Life simulation. BACKGROUND Due to safety issues stemming from nursing knowledge deficits of insulin administration, the use of simulation via practice in a virtual immersive environment, Second Life was evaluated in a case study of practicing nurses. DESIGN This case study used a single convenience group, post-test design. METHODS Perceived usability was evaluated using the System Usability Scale. Evaluation of decision-making was evaluated via Situational Awareness Score at two simulation freezes in the Second Life simulation with practicing nurses (n = 12). RESULTS Nurses with more years of practice reported difficulty in using Second Life. As age increased, the total Situational Awareness Score decreased. Day shift nurses were more likely to obtain a High Situational Awareness Score. CONCLUSIONS Although usability was nearly obtained, virtual immersive environments for nurses has promise to provide practice in aiding clinical decision-making. RELEVANCE TO CLINICAL PRACTICE Finding a new platform to allow all nurses to practice difficult clinical decisions is key. A virtual immersive environment, like Second Life, can provide simulation for nurses to practice making such difficult decisions.

Use of Virtual Simulation to Impact Nursing Students’ Cognitive and Affective Knowledge of Evidence-Based Practice

BACKGROUND Today’s nurse educators are faced with the challenge of teaching evidence-based practice (EBP) in a meaningful way. Along with the struggle of bringing forward current evidence in this dynamic age of information, nurse educators are encouraged to use the latest technology to make the highest impact on student learning outcomes. Virtual simulation is an emerging pedagogy that may facilitate optimal learning through the use of experiential learning and technology. Virtual simulation has been suggested to be an effective pedagogy to teach select skills in nursing. Research has demonstrated that use of virtual simulation is effective in teaching communication, decision-making, team work, leadership, disaster training, and the art of instruction (Caylor, Aebersold, Lapham, & Carlson, 2015; Farra, Miller, Timm, & Schafer, 2013; Foronda, Budhathoki, & Salani, 2014; Foronda, Gattamorta, Snowden, & Bauman, 2014; Foronda, Lippincott, & Gattamorta, 2014; Hudson, Taylor, Kozachik, Shaefer, & Wilson, 2015). Virtual simulation builds upon principles of experiential learning and adult learning (Knowles, Holton, & Swanson, 1998; Kolb, 1984). There is, however, a paucity of evidence surrounding use of virtual simulation to teach EBP. The aims of this study were to examine the impact of an in-class, group virtual simulation exercise on nursing students’ (a) cognitive knowledge of EBP and (b) affective knowledge about how evidence affects clinical decision-making.

The Evolution of EHR-S Functionality for Care and Coordination

The purpose of electronic health record systems (EHR-S) functionalities is to improve patient safety by reducing medical errors that lead to harm and to facilitate the measurement of care quality by providing access to process and outcomes data. Through collaborative standards development, the definition and translation of healthcare work into specific system functionalities for improving clinical data capture, communication and coordination has evolved from technical “wish lists” into commercially available products that meet the needs of multiple stakeholders: patients, clinicians, managers, systems developers, payers and regulatory agencies. Important technical drivers in the development and adoption of EHR-S functionalities have been: (a) progressive regulatory requirements for reporting quality measures and (b) lessons learned from deployment of EHR systems and other health information technology. A growing area of attention and challenge for health IT functionality development is in supporting longitudinal care coordination for patients with complex and chronic disease across time, providers and resources. Work in this domain has focused on (a) aligning and connecting Patient Centered Medical Homes and Medical Neighborhoods via data/communication standards to facilitate health information exchange (HIE) and (b) building the information infrastructures to facilitate the collection and reporting of quality measures related to care processes and outcomes.

Bridging Technology: Academe and Industry

There is an identified gap between the academic preparation of nursing students and the needs/expectations of clinical agencies who hire them after graduation (Nursing Executive Center of the Advisory Board Company, 2008). Based on the results of a survey of nursing school academic leaders and frontline hospital leaders (nurse managers, directors, educators, and charge nurses), the report identifies a “preparation-practice gap” that reflects the concerns of hospital leaders about the “practice readiness” of new nursing graduates in six general areas: clinical knowledge, technical skills, critical thinking, communication, professionalism, and management of responsibilities. Only 10.4% of the 135 nurse executives who responded to this survey agreed that new graduates are fully prepared in these areas, while 89.9% of 362 nursing school leaders agreed.