Rapid Cycle Deliberate Practice Facilitation in a Nurse Residency Program
Maureen Washock, BSN, RN, CPN; Julie Sobolewski, MSN, RN, CPN, RNC-NIC
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Nurse residency programs may have inherent gaps in what their learners take away from their simulations that can be addressed with an alteration in simulation facilitation technique. A fundamental lack of knowledge and experience may sabotage the traditional simulation-debrief structure when working with novice nurses. The concept of rapid cycle deliberate practice (RCDP) as described by Elizabeth Hunt et al in 2014 will be discussed as well as how its incorporation in a nurse residency program could improve both confidence and skills of a novice learner as compared to traditional facilitation techniques alone. RCDP allows participants to leave a simulation having the physical experience of having performed all the critical criteria for success correctly. Unlike the traditional simulation structure of a simulated event followed by a debrief, RCDP technique incorporates quick correction of error followed by facilitated practice in rapid sequence without interruption by lengthly debriefs. Not all simulations are ideal for the application of RCDP such as those that require substantial critical thinking on the part of the learner as opposed to perfomance of actions. Simulations primarily exercising the learner's knowledge and application of algorithms (such as BLS, ACLS, PALS or facility-defined protocols) are ideal and when successfully facilitated can help both cement the learners' ability to apply critical protocols in a timely and effective manner as well as build their confidence. Boosted confidence in simulation performance may help set the stage for traditional simulation where application of critical thought processes both in the scenario and debrief may be more effective and better received.
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