We successfully adapted TeamSTEPPS for use with our medical and nursing students, educated facilitators, and implemented the course. Our students improved their knowledge of vital team and communication skills, attitudes toward working as teams, and were able to identify effective team skills.

The student clinical experience is rich, yet challenges arise in providing experiences where leadership skills can be developed and used in nursing practice. To increase student confidence and enhance student ability to safely and effectively prioritize, delegate, and implement care for numerous patients, a simulation-based learning (SBL) experience was developed. The SBL experience involves multiple patient simulators, case study analysis, and a debriefing session. Ninety-seven senior nursing students participated in this program. Students reported through Likert surveys to either "agree" or "strongly agree" that the SBL was well organized (87%, n = 84), prompted realistic expectations (59%, n = 57), the scenarios were believable (73%, n = 71), case studies increased understanding (66%, n = 64), and that the SBL experience increased understanding of prioritizing and delegating care (69%, n = 67). Seventy-eight percent (n = 76) reported "more confidence in ability to work as a team" and 55% (n = 52) reported "more confidence in prioritizing and delegating care."

This is a report of an educational strategy to prepare nursing students to respond to disasters. The strategy includes an emergency preparedness disaster simulation (EPDS) implemented in a school of nursing simulation lab using patient simulators, task trainer mannequins, and live actors. The EPDS immerses student groups into a "tornado ravaged assisted-living facility" where the principles of emergency preparedness can be employed. A total of 90 B.S.N. students participated in the EPDS in the final semester of their senior year. Student post-simulation survey responses were overwhelmingly positive, with mean scores of 4.65 (on a 5-point Likert scale) reported for the EPDS "increasing understanding of emergency preparedness" and "well organized." Mean scores were over 4.40 for "scenario believability, increasing knowledge base, increasing confidence in working in teams, ability to handle emergency preparedness situations and to work more effectively in hospital or clinic." The lowest mean score of 4.04 was for "prompting realistic expectations." Owing to the effectiveness of this educational strategy, the EPDS has been incorporated into the undergraduate curriculum.

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The simulation program within our nursing curriculum covers a wide array of content areas and has been rated very highly by students and faculty. Due to this success, requests for increased simulation experiences have grown dramatically. The challenge lies, however, in logistically accommodating large student groups in finite periods of time. To overcome these constraints, an alternative plan was devised where half of the students actively participate in the simulation while their cohort observes. Both groups participate in the debriefing process. Findings revealed no significant differences (p=.97) between the simulation and observational groups on scoring of the test items related to this content (n=92). Over 70% reported the simulation experience as enjoyable, well-organized, clarified issues, increased knowledge and prepared them to work in a hospital. These findings indicate that the use of this alternate plan was effective for student learning and could therefore be incorporated into the simulation program design.