International Nursing Association For Clinical Simulation And Learning Research Articles

Use of different debriefing methods after in situ simulation with intensive care unit nurses.

The debriefing phase is the simulation phase where performance improves and learning occurs. This study examined the effects of the learning conversation (LC)-based, 3D (defusing, discovering and deepening) model-based and unstructured debriefing methods on satisfaction and debriefing experience after in-situ simulation among intensive care unit (ICU) nurses. In this randomized controlled experimental study, three debriefing methods were compared, according to which 119 ICU nurses were divided into the following groups: LC group (n = 38), 3D group (n = 40) and control group (n = 41). In- situ simulation was performed with an intensive care patient scenario. p < .05 was considered statistically significant. The total Debriefing Experience Scale-Experience with Debriefing part scores were 89.76 ± 8.10 in the LC group, 88.90 ± 8.70 in the 3D group and 88.29 ± 7.28 in the control group. No significant difference was found in debriefing experience and satisfaction between the groups (p > .05), but a significant difference was observed in the LC group. The groups showed a homogeneous distribution regarding participant characteristics. Debriefing experience and satisfaction do not differ between the methods. Implementation of the simulation in the ICU in - situ with ICU nurses is beneficial in obtaining a fidelity experience. Performing the debriefing application after simulation in line with the model supports the International Nursing Association for Clinical Simulation and Learning (INACSL) debriefing standards.

How Close Are Interprofessional Debriefers to Meet the INACSL Standards of Debriefing Practices? A Qualitative Study

Aim: This study aims to determine whether the debriefings performed by different health professions for nearly a decade meet the INACSL standards of best debriefing practices. Methods: In order for learning to occur in simulation, there must be a adequate debriefing session. An adequate debriefing should be based on the criteria described in the standards of best practices published by the International Nursing Association for Clinical Simulation and Learning (INACSL). A high quality, adequate, and effective debriefing must be carried out in accordance with each standard. Results: Most of the debriefers are female. Over half had two years or less experience with simulation, and a quarter had training in simulation or debriefing. The results are presented in five contexts (Competent Debriefer, Environment, Effective Debriefing, Theoretical Framework, and Objectives and Outcomes.), which conform to the four standards covered by the INACSL standards of best practices. Conclusions: Except for the feedback, the debriefings do not meet the INACSL standards of best practices. However, the debriefers are aware of the importance of debriefing and are willing to improve their skills. Most of the debriefers have learned debriefing from observation or the literature. With this study, it was ensured that debriefers gained awareness in terms of INACSL standards. At the same time, this study will also provide awareness about the standards for the literature.

Use of prebriefing in simulation-based experience for nursing education: a scoping review

Embracing innovative pedagogies and structured pre-simulation activities in healthcare simulation enhances learning and clinical performance. The Society for Simulation in Healthcare (SSH) and the International Nursing Association for Clinical Simulation and Learning (INACSL) propose a three-phase approach of prebriefing, simulation-based experiences and debriefing. This scoping review explored the impact of prebriefing pedagogies, aiming to enhance nursing students’ chances of success in simulation-based learning experiences. This scoping review encompassed the existing literature on simulation in nursing education, specifically focusing on prebriefing strategies. The existing literature revealed variations in the contexts, educational concepts, prebriefing pedagogy and outcome measures employed in simulation-based experiences. None of the studies established a correlation between dependent variables and prebriefing pedagogy strategies. Instead, most studies utilized a combination of dependent variables to measure the correlated aspects of prebriefing, namely personal development and engagement. The recognized prebriefing strategies serve as valuable resources for nurse educators when designing the prebriefing phase of a simulation-based experience.

Where Are We Now? A Follow-up Survey on Regulation of Simulation Use in United States Prelicensure Nursing Programs

BackgroundApproval of simulation in substitution of traditional clinical hours increased in nursing programs during the COVID-19 pandemic, yet these temporary and inconsistent between states. Variability and a return to “pre-pandemic” limits on simulation use amplify questions about consistency of learner outcomes. MethodsBoards of Nursing (BONs) of the United States and District of Columbia (DC) were queried to verify accuracy of simulation regulations posted on the International Nursing Association for Clinical Simulation and Learning (INACSL) regulatory map and to identify factors contributing to regulatory changes. ResultsApproximately half of respondents indicated information posted on the INACSL regulatory map is accurate for their state. Almost 30% of respondents indicated information is not accurate. Some states could not confirm accuracy of simulation regulations posted. ConclusionsMany nursing programs expanded the use of simulation during the COVID-19 pandemic. Reverting to “prepandemic” limited simulation use presents a missed opportunity to advance nursing education and align simulation regulation with the growing body of evidence supporting its outcomes.

Creative Solutions for Complex Circumstances: The Utilization of Virtual Reality in a Specialty Course

Simulations for nursing education have shown positive impacts on critical thinking skills of nursing students. In this collaborative project an immersive 360 VR simulation for an antepartum assessment was created for utilization in a pre-licensure course. The International Nursing Association for Clinical Simulation and Learning (INACSL) Standards in Best Practice℠ Simulation Design, Objectives & Outcomes, Facilitation, and Debriefing were utilized for development of an immersive 360 VR simulation.

Medication competence: a concept analysis

ObjectiveThis paper aims to provide a thorough concept analysis of medication competence, within the context of nursing education. Also, to establish a clear definition of the concept for research purposes, and to improve the communication and use of the concept in healthcare practice. Design & methodsThe Walker and Avant concept analysis was utilized as a framework to develop a comprehensive understanding of the phenomena of medication competence in nursing education. Data sourcesA review of literature on medication competence was conducted using the electronic databases of EBSCOhost, CINAHL Complete, Web of Science, Ovid full text, ERIC, ScienceDirect, International Nursing Association for Clinical Simulation and Learning (INASCL), PubMed, Google Scholar, and PsychLit. Search terms included medication competence, medication safety, medication management, medication skills, healthcare, nursing, and nursing students. ResultsThe literature search resulted in 39 articles that met the inclusion criteria. Three defining attributes were identified: pharmacovigilant, effective skills competence, and interprofessionality. Antecedents, consequences, and empirical referents of the concept medication competence were also highlighted. ConclusionsInsight gleaned from this concept analysis will enhance the ability of nurse educators to effectively educate and assess medication competence among nursing students. By defining medication competence it validates the importance of further quantitative and qualitative research exploration of medication competence among nursing students and other healthcare specialties. Thus, this concept analysis establishes the springboard for innovative educational interventions, as well as future research in nursing education.

42 Updates to the International Nursing Association for Clinical Simulation and Learning Simulation Debriefing Standard of Best Practice

Debriefing is a key component of all simulation-based educational (SBE) activities and is an activity for which a multitude of approaches and models have been developed and implemented (Oriot &amp; Alinier, 2016). To improve SBE practice in general, the International Nursing Association for Clinical Simulation and Learning (INACSL) has outlined a set of Simulation Standards of Best Practice first published in 2013. Revisions to these standards have occurred every few years, including expanding the topics covered as developments in this domain have occurred and the use of simulation has expanded.The aim of this study was to present the changes in the Simulation Debriefing Standard in comparison to those last published (INACSL Standards Committee, 2016).From 2019 to 2021, a group of simulation educators and researchers, the authors of this abstract, representing multiple specialities, simulation societies and geographic areas began meeting to review and revise the Simulation Debriefing Standard based on the latest literature. This group identified several items that would benefit from being updated, including expanding the terminology of this Standard to encompass Feedback, Debriefing and Guided reflection as distinct but integral components of this key phase of simulation-based experiences.An updated version of the Simulation Debriefing Standard of Best Practice will soon be published by INACSL in Clinical Simulation in Nursing. Some of the updates include expansion to understand and allow electronic systems to be recognized as components of the debriefing process and emphasizing the need for practice and review of the skill of facilitators in the techniques of debriefing. The new Simulation Debriefing Standard provides clear information and guidance to the simulationists. It includes four as opposed to the five criteria in the 2016 version (INACSL Standards Committee, 2016). The updated criteria can still be matched to those from the previous edition (see colour coding in Criteria of the 2016 and 2021 INACSL debriefing standards of best practiceIt is expected that the revised Simulation Debriefing Standard of Best Practice will be welcomed by the simulation community, which includes the healthcare educators and simulation technology developers, but also the learners. It has been designed as a guide to help educators in all the key aspects of debriefing, providing feedback and facilitating guided reflection conversations that will ultimately benefit learners. It includes an updated list of useful references readers can consult to find additional information.

Transforming National League for Nursing Advancing Care Excellence for Seniors Unfolding Cases into Virtual Simulations: An Innovative Approach for Interactive Learning

BackgroundTwo National League for Nursing (NLN) Advancing Care Excellence for Seniors (ACE.S) cases were transformed into engaging and interactive virtual simulation learning experiences due to the COVID-19 pandemic. MethodsThe purpose of this article is to describe the process of designing and implementing this novel approach to virtual simulation. ResultsFaculty aligned each virtual simulation with existing course outcomes, student learning outcomes, concept-based learning principles, and best practices of The International Nursing Association for Clinical Simulation and Learning (INACSL) standards. ConclusionsPractical strategies used to convert these unfolding case studies into virtual simulations for a small private Christian university of undergraduate junior level accelerated nursing students will be revealed.

Is simulation-based team training performed by personnel in accordance with the INACSL Standards of Best Practice: SimulationSM?\u2014a qualitative interview study

BackgroundAnesthesia personnel was among the first to implement simulation and team training including non-technical skills (NTS) in the field of healthcare. Within anesthesia practice, NTS are critically important in preventing harmful undesirable events. To our best knowledge, there has been little documentation of the extent to which anesthesia personnel uses recommended frameworks like the Standards of Best Practice: SimulationSM to guide simulation and thereby optimize learning. The aim of our study was to explore how anesthesia personnel in Norway conduct simulation-based team training (SBTT) with respect to outcomes and objectives, facilitation, debriefing, and participant evaluation.MethodsIndividual qualitative interviews with healthcare professionals, with experience and responsible for SBTT in anesthesia, from 51 Norwegian public hospitals were conducted from August 2016 to October 2017. A qualitative deductive content analysis was performed.ResultsThe use of objectives and educated facilitators was common. All participants participated in debriefings, and almost all conducted evaluations, mainly formative. Preparedness, structure, and time available were pointed out as issues affecting SBTT.ConclusionsAnesthesia personnel’s SBTT in this study met the International Nursing Association for Clinical Simulation and Learning (INACSL) Standard of Best Practice: SimulationSM framework to a certain extent with regard to objectives, facilitators’ education and skills, debriefing, and participant evaluation.

Onward and Upward: Introducing the Healthcare Simulation Standards of Best PracticeTM

Onward and Upward: Introducing the Healthcare Simulation Standards of Best PracticeTM

Crossing the Power Line: Using Virtual Simulation to Prepare the First Responders of Utility Linemen

Virtual reality (VR) healthcare simulation has helped learners develop skills that are transferable to real-word conditions. Innovative strategies are needed to train workers to improve community safety. The purpose of this pilot project was to evaluate the use of a VR simulation applying the International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice: SimulationSM Simulation Design with eight power line workers. Six power industry supervisors and educators assisted in facilitating three VR simulations with eight linemen participants. Kotter’s eight steps to leading change and the INACSL Standards of Best Practice: SimulationSM Simulation Design were utilized in working with energy leaders and VR developers to carry out this pilot project. Pre- and post-implementation surveys demonstrated a 28% improvement in participants’ learning outcomes. All three learning objectives were met. This project demonstrated the successful application of a translational framework and the INACSL Standards of Best Practice: SimulationSM in a VR context in the power industry. This process may be helpful to guide or inspire further adoption of VR in unconventional settings.

The Impact of Clinical to Simulation Hour Ratios on Nursing Student Learning

Simulation is utilized in nursing education worldwide as an adjunctive experiential method of learning, either in replace of, or addition to, traditional clinical instruction. While every state in the nation incorporates simulation in their nursing curriculum, there is remarkable variation among state authorizing agencies as to which clinical to simulation hour ratio is ideal. The purpose of this quantitative, non-experimental, retrospective cohort project was to determine the impact of a 2:1 clinical to simulation hours ratio (whereby two hours of clinical are fulfilled by one hour of high-fidelity simulation [HFS]) on baccalaureate prelicensure nursing student learning in a medical-surgical course by examining Health Education Systems Incorporated (HESI) medical-surgical specialty exam scores amongst two independent groups. The research institution transitioned from a 1:1 to a 2:1 ratio at a 20% substitution rate pursuant to the Colorado State Board of Nursing (BON) rules that state if the school is nationally accredited and follows the International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice, the nursing program may replace two hours of traditional clinical with one hour of simulation. An independent sample t-test compared the HESI medical-surgical specialty exam scores for the 1:1 (Group A) and the 2:1 (Group B) clinical to simulation hours ratio groups. There were no significant differences in scores for Group A (M = 927.13, SD = 136.18) and Group B (M = 956.09, SD = 144.24; t (331) = -1.88, p = .06, two-tailed). The magnitude of the differences in the means (mean difference = -28.95, 95% CI: -59.22 to 1.31) was small according to Cohen’s (1988) convention (d = 0.21). The results of this project suggest that a 2:1 ratio may be implemented without negatively affecting standardized examination scores. More research is needed to explore the impact that higher ratios have in other courses, at other institutions, and among associate degree students.

Response to 'ASPiH standards for simulation-based education: process of consultation, design and implementation'.

The International Nursing Association for Clinical Simulation and Learning (INACSL) developed seven Standards of Best Practice: Simulation in 2011 with the purpose of providing a framework to guide best practice for the international simulation community. Since that time, the INACSL Standards of Best Practice: Simulation have guided simulation educators and practitioners around the globe in the use of evidence-based simulation. As of 2017, there are eight INACSL Standards of Best Practice: Simulation, plus a glossary1 2 and they are updated every 4 years. Since their inception, the Board of Directors of INACSL and their membership have worked tirelessly to update and revise these standards based on the …

Author response to published editorials on ASPiH standards for simulation-based education.

We would like to thank the International Nursing Association for Clinical Simulation and Learning (INACSL), The Gathering of Healthcare Simulation Technology Specialists (SimGHOSTS) and the Association of Standardised Patient Educators (ASPE) for their supportive and helpful reflections on our standard-setting article. Simulation-based education (SBE) is widely acknowledged as a key educational modality that has led to a paradigm shift in healthcare education. Despite its popularity and increasing application, it is still too often used only as a one-off interaction with learners. The use and evaluation of simulation as part of an overarching approach to patient safety has been insufficiently explored. There are few studies linking SBE to clinical outcomes.1 There remains poor capture of data of operational or cost-effectiveness of SBE and we continue to be unclear as to how best to deliver SBE as not all training programmes produce benefit.1 2 Underlying many of the issues highlighted is a lack of standardisation in the approach to SBE with failure to adopt best practice in design and delivery of SBE programmes.1 It is this challenge that the Association for Simulated Practice3 in Healthcare (ASPiH) took up in 2015, which resulted …

Debriefing Virtual Simulation Using an Online Conferencing Platform: Lessons Learned

Debriefing is a critical conversation following simulation to reframe the context of a situation, facilitate students’ reflection, assess critical thinking, evaluate learning, and improve future performance. However, there is a significant gap in the literature regarding how to effectively debrief following immersion in virtual simulation. The International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice: SimulationSMDebriefing (2016) were developed to support effective simulation and learning when incorporated with design and development; yet, debriefing for virtual simulation may not have been fully conceptualized when the standards were established. Alternative debriefing methods specifically aimed at debriefing virtual simulation must be explored and implemented in order to “enhance learning and heighten participant self-awareness and self-efficacy” (INACSL Standards Committee, 2016, p. S21). This article provides an example of how a synchronous, Web-based Internet conferencing platform was used to conduct debriefing sessions following immersion in an asynchronous virtual learning environment with family nurse practitioner students in an online graduate program. The lessons learned and recommendations are generalizable for all simulation populations.

The Association of Standardized Patient Educators (ASPE) Standards of Best Practice (SOBP)

In this paper, we define the Association of Standardized Patient Educators (ASPE) Standards of Best Practice (SOBP) for those working with human role players who interact with learners in a wide range of experiential learning and assessment contexts. These human role players are variously described by such terms as standardized/simulated patients or simulated participants (SP or SPs). ASPE is a global organization whose mission is to share advances in SP-based pedagogy, assessment, research, and scholarship as well as support the professional development of its members. The SOBP are intended to be used in conjunction with the International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice: SimulationSM, which address broader simulation practices. We begin by providing a rationale for the creation of the ASPE SOBP, noting that with the increasing use of simulation in healthcare training, it is incumbent on ASPE to establish SOBP that ensure the growth, integrity, and safe application of SP-based educational endeavors. We then describe the three and a half year process through which these standards were developed by a consensus of international experts in the field. Key terms used throughout the document are defined. Five underlying values inform the SOBP: safety, quality, professionalism, accountability, and collaboration. Finally, we describe five domains of best practice: safe work environment; case development; SP training for role portrayal, feedback, and completion of assessment instruments; program management; and professional development. Each domain is divided into principles with accompanying key practices that provide clear and practical guidelines for achieving desired outcomes and creating simulations that are safe for all stakeholders. Failure to follow the ASPE SOBP could compromise the safety of participants and the effectiveness of a simulation session. Care has been taken to make these guidelines precise yet flexible enough to address the diversity of varying contexts of SP practice. As a living document, these SOBP will be reviewed and modified periodically under the direction of the ASPE Standards of Practice Committee as SP methodology grows and adapts to evolving simulation practices.

Using the INACSL Simulation™ Design Standard for Novice Learners

BackgroundThe International Nursing Association for Clinical Simulation and Learning (INACSL) has released Standards of Best Practice™ for simulation. The purpose of this paper is to discuss the use of the INACSL Simulation Design Standard (SDS) to create a novice simulation experience for sophomore nursing students. MethodThis pilot study was conducted with sophomore nursing students over several semesters (n = 143) in a foundational nursing course to prepare students for fundamental respiratory concepts. Expert certified healthcare simulation educators facilitated and debriefed each simulation-based experiences (SBE). The Creighton Clinical Evaluation Instrument (C-CEI©) was used to provide feedback to students. Students also completed a post Simulation Perspective Survey after each experience. ResultsEighty percent of the students believed that the simulations were a valuable learning experience and helped to stimulate critical thinking. The SDS was an effective method providing clear guidelines for designing SBE for novice nursing students. ConclusionsThe SDS provides a clear format for designing SBE for novice nursing students. This article provides a concrete example on the implementation of the SDS framework in SBE, promoting the integration of best practice in simulation.

A CLEAR Approach for the Novice Simulation Facilitator

Facilitating a simulated clinical experience for prelicensure nursing students requires skills. Frequently, the experience is planned, presented, and debriefed by an educator assigned as the facilitator. The International Nursing Association for Clinical Simulation and Learning (INACSL) Best Practice Standards℠ provide the goals for all simulation experiences. This article identifies challenges frequently experienced by the novice facilitator in meeting the standards. A table with the acronym CLEAR has been developed to identify challenges and strategies to assist the novice facilitator to meet the INACSL Best Practice Standards: Simulation Standard V: Facilitator℠ recommendations. The strategies provide the facilitator innovative ways to promote successful simulation learning experiences.

After the National Council of State Boards of Nursing Simulation Study—Recommendations and Next Steps

BackgroundThe National Council State Boards of Nursing (NCSBN) Simulation Study has generated increased conversation about the use of simulation in nursing education. MethodAt the 14th Annual International Nursing Association for Clinical Simulation and Learning (INACSL) conference in Atlanta Georgia, a panel discussed the results and significance of the National Council of State Boards of Nursing (NCSBN) Simulation Study. ResultsPanel members discussed movements in nursing education in the eight months since the study’s release, implementation of the recommendations from the study in practice and academic settings, and methods to achieve the necessary faculty development needed in simulation. ConclusionThe use of simulation in nursing education is expanding.

Student and educator experiences of maternal-child simulation-based learning: a systematic review of qualitative evidence protocol.

Review question/objective The overall aim of this systematic review is to identify the appropriateness and meaningfulness of maternal-child simulation-based learning for undergraduate or pre-registration nursing students in educational settings to inform curriculum decision-making. 1. What are the experiences of nursing or health professional students participating in undergraduate or pre-licensure maternal-child simulation-based learning in educational settings? 2. What are the experiences of educators participating in undergraduate or pre-licensure maternal-child simulation-based learning in educational settings? 3. What teaching and learning practices in maternal-child simulation-based learning are considered appropriate and meaningful by students and educators? Inclusion criteria Types of participants Participants will include undergraduate or pre-registration or pre-licensure nursing or midwifery or health professional students and educators participating in maternal-child simulation-based learning. Midwifery or undergraduate medical students are included as participants as their clinical learning experiences are similar to undergraduate nursing students. However students in graduate, postgraduate, or specialty education programs and practising nurses or other health care professionals (continuing education) will be excluded from this review because the purpose is to identify the implications for undergraduate or pre-registration nursing programs. Undergraduate or pre-registration education differs from continuing professional education as students are more likely to be learning this way of thinking or clinical reasoning for the first time. The pedagogical approaches used also differ from continuing professional development. Phenomena of interest This review will consider studies that investigate simulation-based learning experiences that are relevant to maternal-child nursing. Our primary interest in this review is in preparing nursing students for senior level maternal-child practice placements and transition to working as an Registered Nurse. However, we will include all qualitative studies and case reports of simulation-based learning that involve pre-registration nursing or health professional students. Context The purpose of this review is to identify the implications of this body of knowledge for undergraduate or pre-registration nursing programs in Canada This review will include qualitative research that may be applicable to the Canadian context for nursing education, such as reports from North America, Europe, Australia and New Zealand.