Journal of Nursing Education

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An Innovative Teaching Approach of Revolving, Multistudent, In-Class Simulations

Tonya A. Schneidereith, PhD, CRNP, CNE

Simulation is a proven strategy, it but may limit the number of student participants. Moving simulations into the classroom provides the opportunity to reach large groups of students at one time (Berndt et al., 2015; Beyer, 2012; Carson & Harder, 2016).

Learning Goal and Objectives

The goal was to demonstrate refined application of didactic content. The objectives included the (a) demonstration of safe nursing behaviors, including an appropriate physical assessment; (b) effective and developmentally appropriate communication with the patient and family; and (c) determination of appropriate nursing interventions through the collection, synthesis, and analysis of data.

Learning Strategy

This process was integrated into three sections of a pediatric nursing course for first-semester seniors, with an average class size of 25 students. During the first week, each student was assigned a number that correlated with a numbered popsicle stick. Throughout the semester, for a total of six classes, a manikin and appropriate supplies were brought to class, course content was reviewed and discussed, and the final portion of class was dedicated to the revolving, multistudent simulation. To start the scenario, a stick was drawn to select the first participant who received report from the night nurse (i.e., course faculty). The same faculty member would also assume the role of parent and voice of the child. The randomly selected student would provide care at the beginning of the “shift,” for approximately 1 to 3 minutes. Next, a second student would be randomly selected, the first student would return to his or her seat, and the second nurse would pick up the scenario where the previous nurse stopped. This random selection would continue for approximately 6 to 10 students for approximately 20 minutes. The random selection required all students to (a) actively scrutinize the unfolding scenario and consider appropriate next steps, and (b) participate in the class debrief. This debrief, which lasted approximately 20 minutes, would reflect on the actions of all of the participants, including reactions, correct behaviors, and opportunities for change and improvement.

Student Evaluation and Learning

When these simulations were first instituted, the students fumbled over actions, words, and next steps. However, as students became more accustomed to the format and expectations, an improvement existed in the ability to analyze the situation and determine appropriate interventions. Students not only learned from the mistakes made in previous weeks, but the ability to extract appropriate information from the patient or family member occurred more rapidly. An end-of-course Likert-style survey was conducted and included the statement, “Having in-class simulations helped me apply the material reviewed in class,” to which more than 54% selected either agree or strongly agree. When given the prompt, “What I learned from in-class simulations,” students reported:

  • I think I learned a lot from in class situations. I did not become too comfortable with the simulations because my nerves would always get the best of me. Standing in front of the professor and whole class can be intimidating. Nevertheless, I do think it is a great idea that also makes you critical[ly] think and apply what you learn into a possible real-life scenario.
  • The family is almost as important as the child. They both have needs.

When asked about recommendations for change, one student stated:

  • Maybe find a way to somehow make transitions smoother, sometimes it was a bit unclear what was expected from each nurse.

Another student stated:

  • Remove the sticks from the students who went the previous week, so everyone has a chance to go.

Throughout nursing education, complaints have existed regarding students not having enough opportunities to apply didactic material, yet tests have application-style questions. Although opportunities exist for improvement, this unique activity allows many students to participate in a hands-on activity, to build on learning from week to week, and to critically consider what the next best action should be, especially if their number is called.

Tonya A. Schneidereith, PhD, CRNP, CNE

SIMPL Simulation


  • Berndt, J., Dinndorf-Hogenson, G., Herheim, R., Hoover, C., Lang, N., Neuwirth, J. & Tollefson, B. (2015). Collaborative classroom simulation (CCS): An innovative pedagogy using simulation in nursing education. Nursing Education Perspectives, 36, 401–402. doi:10.5480/14-1420 [CrossRef]
  • Beyer, D.A. (2012). Effectiveness of human patient simulator as a classroom teaching strategy. Clinical Simulation In Nursing, 8, e301–e305. doi:10.1016/j.ecns.2011.01.005 [CrossRef]
  • Carson, P.P. & Harder, N. (2016). Simulation use within the classroom: Recommendations from the literature. Clinical Simulation in Nursing, 12, 429–437. doi:10.1016/j.ecns.2016.03.009 [CrossRef]

The authors have disclosed no potential conflicts of interest, financial or otherwise.


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