Simulation in preparation or substitution for clinical placement: A systematic review of the literature

Abstract

Background: In recent years, nursing education has undergone changes and restructuring due to changes that have occurred in clinical and academic settings. Currently, academic leaders are facing the challenges of an increasing number of students, the difficulty of recruiting teachers and preceptors to accompany students, and fewer clinical settings that can accommodate many interns at once. To come to terms with these changes, the idea of replacing clinical hours with simulation has emerged. On this issue, little conclusive data is available. The objective of this article is to clarify the contribution of simulation in clinical nursing education in preparation or substitution for clinical placement. Methods: The CIHNAL, MedLine, and PubMed databases, and Google and Google Scholar search engines were consulted between to conduct a systematic review of the literature between 2008 and 2014. Thirty-three articles were selected. Results: Students and teachers perceive the benefits of simulation as an adjunct to clinical placement in terms of effectiveness, self-confidence, and preparation for clinical practice. Substituting clinical placement with simulation does not seem to have a significant impact on clinical competency, critical thinking, knowledge acquisition, and self-confidence. Conclusions: The findings question the very concept of substitution and suggest that the strengths of clinical exposure through both simulation and clinical placement should be highlighted.

Medical simulation – innovation in nursing education

“…The ability to establish situations in which lesson scenarios can be conducted with a strictly defined educational goal is an important advantage of simulation. This, in turn, leads to mastery in a specific field and the verification or confirmation of students' skills and competences [14,15]. Simulation facilitates practising critical thinking and making clinical decisions in a simulated environment, which translates into improved skills which are desirable in a real environment [16].…”

“…Istotną zaletą symulacji jest możliwość zapewnienia sytuacji, w których można przeprowadzić scenariusze zajęć o ściśle określonym celu edukacyjnym, co w konsekwencji prowadzi do opanowania określonej wiedzy oraz zweryfikowania i ewentualnego potwierdzenia umiejętności i kompetencji studentów [13,14]. Symulacja zapewnia możliwość praktykowania krytycznego myślenia, a także podejmowania decyzji klinicznych w środowisku symulacyjnym, co przekłada się na doskonalenie umiejętności pożądanych w środowisku rzeczywistym [15]. Symulacja jest uważana za bardzo skuteczną metodę nauczania i uczenia się, odpowiednią do szybko zmieniającego się środowiska edukacji pielęgniarskiej i w wielu badaniach potwierdzono pozytywne aspekty symulacji.…”

Using local clinical educators and shared resources to deliver simulation training activities across rural and remote South Australia and south‐west Victoria: A distributed collaborative model

“…In 2006, the Council of Australian Governments (COAG) announced funding for additional medical and nursing training places to address projected shortfalls in the future health workforce . Expanding the use of simulation‐based education (SBE) was posited as a way to increase clinical training capacity, with emerging evidence that SBE can, in part, replace clinical time without compromising attainment of competencies required for practice …”

Evaluating a Serious Gaming Electronic Medication Administration Record System Among Nursing Students: Protocol for a Pragmatic Randomized Controlled Trial (Preprint)

“…Commonly, in-person simulated practice with high-fidelity patient simulation provides students the only functional opportunity to learn various clinical skills (eg, medication administration) prior to interacting with real patients in healthcare environments such as hospitals and in the community [7]. Although this type of in-person simulation has been found to be extremely effective toward generating clinical competency and skills [8,9], virtually all of this kind of learning is contingent on the availability of, and access to, a physical simulation laboratory. Given the increasing enrollment sizes and current financial restraints present in many universities and colleges, scalable, cost-effective, and authentic [10] technology-enabled approaches (including gamification) for clinical nursing education are warranted.…”