Using Individual Simulation to Promote Clinical Reasoning and Prioritization with Undergraduation Nursing Students

Abstract

Background: Traditional simulations typically occur in a group setting with multiple students gathered around a simulator all trying to interact at once. This often leads to situations where few students take lead roles while weaker students fade into the background getting by with minimal participation. This leads to difficulties in faculty evaluation of individual student performance, especially regarding clinical reasoning abilities.

Purpose: The purpose of this study was to determine the effectiveness of individual simulation activities on the development of clinical reasoning. Methods: Five students enter the simulation lab at one time and are each randomly assigned to one patient. Each student is provided with a video report and pertinent information. The students individually assess their assigned patient and complete SBAR reports. Faculty members are present as resources to answer questions. Students then enter a group deliberation where they report findings and recommendations to peers. The group prioritizes patients based on acuity and care needed. In the final part of deliberation, the faculty member reviews the group’s prioritization and debriefs key concepts. Students provide feedback through both self and peer assessments of group members. Scenarios gradually increase in difficulty and focus. The first simulation focuses primarily on patient assessment, the use of SBAR, and ability to prioritize. The second simulation requires the participant to also identify the highest priority problem for the patient, recommend interventions, and role-play nurse/family communication.

Results/Conclusions: Results of the study will be presented, as well as, a demonstration of the individual simulation and group prioritization activity.