Speed Simulation offers a unique twist to the concept of simulation by bringing students to the point of learning and offering opportunity for maximum exposure to multiple concepts. This method was used in a recent Nurse Educator Institute (NEDI), designed to advance the educational skills of hospital nurse educators and preceptors. Twenty course participants were a part of this 3-hour undergraduate/graduate blended elective. The goal of the Speed Sims activity was to provide hospital educators and preceptors with simulation exercises to enact the principles learned in the NEDI. The five-step process is outlined in Table 1, including the integration of graduate students as authors of the seven case scenarios for role-play and as “standardized students.” For this modality, the standardized student is a live person who is trained not only to portray behaviors and skills of frequently encountered problems or issues with students and new nursing staff in the clinical setting, but also to evaluate the learners’ actions (Kyle & Murray, 2008).
Table 1: Five-Step Speed Sims Process
Preliminary needs assessment for the NEDI indicated a critical need for content regarding clinical supervision, principles, and methods. Sixteen hours of the NEDI were devoted to didactic presentations and homework regarding clinical supervision and evaluation. Next, the NEDI graduate students and faculty developed scenarios that would challenge the institute participate to handle (1) an overconfident student, (2) a student sharing confidential information via Facebook, (3) a disorganized student, (4) a student who makes a medication error, (5) an unprofessional student, (6) an unmotivated student, and (7) a student who has a “meltdown” (Table 2). Handouts of educational theory and methodologies were given afterward, along with a written synopsis of the rules, regulations, standards, and expectations of the educator in such an actual scenario. To contribute to the environmental and psychological fidelity, the simulations were conducted in the School of Nursing Clinical Simulation Center.
Table 2: Scenario Examples
Seventy-six minutes were allotted to rotate 20 participants through seven stations and participate in a debriefing session. Course participants were divided into six groups, with 3 to 4 participants in each group. Groups had 6 minutes at each station. One participant in each group served as the instructor, and the other participants were observers. These roles rotated with each scenario. Participants had 1 minute to read the scenario and then walk into the skills laboratory area and begin the role-play. At the end of 6 minutes, a loud bell rang and the groups moved to the next station and rotated group roles. Institute faculty served as resources and kept the groups on task.
At the end of the 36-minute simulation, participants convened as a large group for a 40-minute debriefing session. Debriefing is essential and is used in simulation to broaden one’s understanding that knowledge has been gained from an experience and to recognize the significance of that experience (Jeffries, 2007). The session was facilitated by all of the “Standardized Students” following a standard debriefing guide that encouraged participants to share what they learned, what was significant during the simulation, what they felt, which of their values were challenged or strengthened, and how the simulation would help them in their future practice. All (100%) of the participants agreed that the Speed Sims experience was exceptional in forcing critical thinking, applying concepts, and reinforcing content for use in real life. Even 6 months later, 95% of participants report using the events and the materials almost daily.
Janet R.M. Cooper, PhD, RN
Jean Walker, PhD, RN
Jean Marks, MSN, RN, CNRN
Mary McNair, MSN, RN, OCN
University of Mississippi Medical Center
School of Nursing
- Jeffries, P.R. (Ed.). (2007). Simulation in nursing education: From conceptualization to evaluation. New York, NY: National League for Nursing.
- Kyle, R.R. & Murray, W.B. (2008). Clinical simulation: Operations, engineering and management. Burlington, MA: Academic Press.
Five-Step Speed Sims Process
Scenerio development: The point of learning in 6 minutes; identify three critical behaviors/skills desired (psychomotor, cognitive, affective).
Role development of standardized students or standardized patients: The role-play script to enact critical behaviors or skills; props; policy, law, and standard of care with references for each critical behavior.
Procedure setting, small groups, rotating roles: Three to four individuals per group; assigned role of leader, and 1 to 2 observers of the process. Group members rotate roles every time they rotate to the next scenario.
The bell: Timed implementation to cease role-play activity and quickly move to read the next scenario; bells, whistles, and tambourines may be used. Faculties serve as resources and kept groups on task.
Debriefing: Essential time to reflect on the experience, provide feedback regarding the behaviors/skills and expectation, address problems, explore alternatives, and discuss internal or external issues that influenced student thinking.
|The instructor walked in on an overconfident student getting ready to defibrillate a patient. In this case, the patient unit was set up with a simulator and a defibrillator and a standardized student who insisted “I know what I’m doing!”
|At the medication error station, the instructor was greeted at the patient door by the student holding the insulin vial and the syringe stating, “I think I gave too much insulin. I was supposed to give 6 units and I think I gave 60 units!”