Reevaluating Simulation in Nursing Education: Beyond the Human Patient Simulator

Abstract

The human patient simulator or high-fidelity mannequin has become synonymous with the word simulation in nursing education. Founded on a historical context and on an evaluation of the current application of simulation in nursing education, this article challenges that assumption as limited and restrictive. A definition of simulation and a broader conceptualization of its application in nursing education are presented. The need for an ideological basis for simulation in nursing education is highlighted. The call is made for theory to answer the question of why simulation is used in nursing to anchor its proper and effective application in nursing education.

A experiência clínica simulada no ensino de enfermagem: retrospectiva histórica

“…The study fit into a historical-social paradigm (5) , used written (letters, course-packs, manuals) and photographic documents as primary sources, and the following secondary sources: textbooks, master's theses, doctoral dissertations and journal articles focusing on teaching about the theme (3,(6)(7)(8)(9)(10)(11)(12)(13) . To respond to the goal and compose the material, a work plan was elaborated, including the identification and location of the sources.…”

“…It is mainly through emerging concerns with care humanization and the assertion of bioethical and legal thinking that some of the strategies used for decades in students' learning of technical procedures start to be reconsidered and questioned, mainly those procedures in which the other person (patient or fellow student) is the practical learning object (3) .…”

“…This idea is reinforced if we consider that the vulnerability of disease processes makes it difficult for ill people to practice their autonomy, which compromises their ability to refuse an intervention a student will perform. The need to inform patients that it is the first time the student is performing a technical procedure is another source of strong anxiety for both, which makes it necessary to adapt teaching strategies to ethical and legal precepts (3,4) .…”

“…Recent technological development led to the availability of high-fidelity patient simulators, which present realistic, human and physiological responses to acute conditions, trauma and interventions, permitting high levels of realism in simulations, which enhances students' immersion and its consequent advantages (1)(2)(3)(4) . But this has not always been the case and, even today, many schools invest little in simulated practice with a view to competency development.…”

What Can We Learn About Debriefing From Other High-Risk/High-Stakes Industries?

“…Video-facilitated debriefing has been reported in recent experimental studies [2][3][4][5][6][7], which have 1 2 reported inconsistent results. Grant and colleagues [3] concluded that video-facilitated simulation feedback is potentially useful in increasing desirable clinical behaviours in a simulated environment.…”