Fresh simulation options in Critical Care nursing education.
The Critical Care (General) Nursing Programme in the Faculty of Health Sciences, Stellenbosch University, South Africa is a one-year post graduate programme. The practical component of the course consists of a number of individual practical procedures e.g. suctioning of the intubated patient as well as several case presentations. In order for students to be able to do a case presentation they need to understand and integrate the critically sick patient’s disease process as well as the medical and nursing management. In order for the students to pass the case presentations satisfactory is often a challenge as a much higher cognitive level is expected than when performing the individual practical procedures.
Why the idea was necessary
During the course of the programme weekly individual clinical guidance is provided to the students at the bedside in the critical care units. The purpose of these bedside sessions is for the students to discuss the critically sick patients with a critical care nurse educator in order to develop their integration, reasoning and case presentation skills. Students however tend to use these teaching opportunities only to practice and to be assessed on the individual practical procedures. Therefore graduates often possess of the skills to do the individual practical procedures, but because they find it difficult to integrate and understand the patient’s disease process they lack insight in the holistic picture of the patient.
What was done
A case study design was used for this study. The practical procedures identified as suitable for simulation were demonstrated, practiced and assessed in simulation in the Clinical Skills Centre (CSC). The study focused on describing how the tutors and students involved experienced the use of simulation as well as how the use of the CSC for reaching competency in some of the practical procedures impacted on the available teaching time in the clinical settings.
Evaluation of results and impact
The result of completing the majority of the practical procedures in simulation was that
• more time was available for the students to practice doing case presentations with the critical care nurse educators during their clinical teaching sessions.
• students and tutors valued the use of simulation and enjoyed the sessions in the CSC.
The issue of how successful the transfer of learning from the CSC to the clinical areas takes place poses very valid questions when it comes to simulation. It is vital that students should be able to transfer the learning that has occurred in the simulated setting to the clinical context. Further research on this subject could serve to establish whether students can apply the procedures they have been assessed on in the CSC equally well on real patients, or, if not, what measures can be implemented to facilitate this process.
Elize archer, Universtiy of Stellenbosch
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Date published: 2010-12-13
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