Use of a Critical Care Simulation as Preparation for Capstone Clinical Experiences

Abstract

Background Critical care units are often utilized during a capstone clinical experience to enhance critical thinking and reasoning. Student preparation for these rotations, however, is varied and often inadequate, leading to incapacitating fear and anxiety, which interferes with learning.

Methods Prior to the capstone experience, students are engaged in three simulation experiences. Objectives focus on providing care for critical care patients who are intubated patient with invasive hemodynamic monitoring, have high flow oxygen delivery and chest tubes, and with variable EKG interpretations affecting physiologic presentation. Faculty engage students into the simulations, while modeling confidence and performance of a critical care nurse. This model is consistent with the theories of Experiential Learning and Deliberate Practice.

Findings Prior to the simulation, students voice significant anxiety and fear of the critical care environment. At the conclusion of the capstone rotation, student reflections reveal the simulation experience allowed time and safety to critically think regarding critical care patients. Increased confidence improved self-assurance associated with responsibilities of a critical care nurse, encouraging greater attention to critical thinking and reasoning of higher acuity patients.

Conclusion The use of critical care simulation decreases fear and anxiety prior to a critical care capstone clinical experience. Diminishing incapacitating feelings provides less restriction for critical thinking and reasoning. Mindfully constructed simulations with clear objectives help to inoculate the student against fears associated with a cohort population. Therefore, students are better able to engage in both experiential and deliberate learning, resulting in a more enhanced and meaningful clinical experience.