Researchers with the New York University College of Nursing are evaluating a new teaching model that uses high-fidelity human patient simulation as a partial substitute for traditional clinical teaching experiences.
The new model increased faculty capacity by increasing student-to-teacher ratios per semester while actually decreasing student-to-teacher ratios in individual teaching sessions, according to a university news release.
The previous and traditional laboratory and hospital based instruction model required 4.5 faculty instructors for 24 students. With the incorporation of this model using high-fidelity human patient simulation, only three faculty instructors are needed for the same 24 students. Additionally, student group sizes decreased by 25% for both hospital-based clinical and classroom-based laboratory sessions.
"This model gives us a win-win during the current faculty shortage — by reducing the demand for high-quality clinical instructors while simultaneously reducing the number of students an instructor teaches each simulation or lab session," Hila Richardson, RN, DrPH, FAAN, principal investigator for the evaluation and a clinical professor at NYUCN, said in the news release.
"We feel confident that patient safety is protected by allowing closer supervision of students on the clinical unit and preparing them for 'real-life' clinical practice in the safety of the simulation lab."
High-fidelity simulation, in conjunction with or as a substitute for hospital-based clinical education, offers a safe learning environment in which students can make errors and have time for self-reflection and learning. Students receive a guided debriefing after the session, said Mattia J. Gilmartin, RN, PhD, the study's coauthor and an NYUCN senior research fellow.
The high-fidelity clinical experience makes many students feel more confident about working with patients and ensuring their safety in the hospital setting, according to the school. Additionally, faculty can feel more confident that students have experiences across the range of common clinical situations rather than relying on the ad hoc nature of a hospital day to provide the needed experiences to meet learning objectives.
In the new model, students spend half their clinical days in a simulated clinical learning experience. The simulation and hospital-based days are scheduled for alternate weeks. The clinical faculty remains in the hospital setting, alternating clinical groups of six students each week and thus supervising a total of 12 students per semester. Before implementation of the simulation model, hospital-based faculty supervised eight to 10 students each week for the semester.
NYUCN refers to the simulation experience as an "on-campus" clinical day and the hospital or healthcare agency experience as an "off-campus" clinical day. Students must follow the same policies for uniform, attendance, preparation and professional behavior in both settings. Off-campus instructors are asked to find patient care experiences that align with both the lecture and simulation content whenever possible.
The school's evaluation will provide the information needed to better understand how this model can assist in mitigating the nursing faculty shortage while allowing nursing school enrollment to keep pace with future needs. The school also hopes the evaluation will show that when used as an equally sound and valued educational approach, the model can enhance the traditional model of clinical learning to prepare new nurses for increasingly complex health settings.
Financial support for the study came from the Robert Wood Johnson Foundation's Evaluating Innovations in Nursing Education Program. To access the study via subscription or purchase on the website of the Journal of Nursing Education, visit http://bit.ly/xkY4oD.
The new model increased faculty capacity by increasing student-to-teacher ratios per semester while actually decreasing student-to-teacher ratios in individual teaching sessions, according to a university news release.
The previous and traditional laboratory and hospital based instruction model required 4.5 faculty instructors for 24 students. With the incorporation of this model using high-fidelity human patient simulation, only three faculty instructors are needed for the same 24 students. Additionally, student group sizes decreased by 25% for both hospital-based clinical and classroom-based laboratory sessions.
"This model gives us a win-win during the current faculty shortage — by reducing the demand for high-quality clinical instructors while simultaneously reducing the number of students an instructor teaches each simulation or lab session," Hila Richardson, RN, DrPH, FAAN, principal investigator for the evaluation and a clinical professor at NYUCN, said in the news release.
"We feel confident that patient safety is protected by allowing closer supervision of students on the clinical unit and preparing them for 'real-life' clinical practice in the safety of the simulation lab."
High-fidelity simulation, in conjunction with or as a substitute for hospital-based clinical education, offers a safe learning environment in which students can make errors and have time for self-reflection and learning. Students receive a guided debriefing after the session, said Mattia J. Gilmartin, RN, PhD, the study's coauthor and an NYUCN senior research fellow.
The high-fidelity clinical experience makes many students feel more confident about working with patients and ensuring their safety in the hospital setting, according to the school. Additionally, faculty can feel more confident that students have experiences across the range of common clinical situations rather than relying on the ad hoc nature of a hospital day to provide the needed experiences to meet learning objectives.
In the new model, students spend half their clinical days in a simulated clinical learning experience. The simulation and hospital-based days are scheduled for alternate weeks. The clinical faculty remains in the hospital setting, alternating clinical groups of six students each week and thus supervising a total of 12 students per semester. Before implementation of the simulation model, hospital-based faculty supervised eight to 10 students each week for the semester.
NYUCN refers to the simulation experience as an "on-campus" clinical day and the hospital or healthcare agency experience as an "off-campus" clinical day. Students must follow the same policies for uniform, attendance, preparation and professional behavior in both settings. Off-campus instructors are asked to find patient care experiences that align with both the lecture and simulation content whenever possible.
The school's evaluation will provide the information needed to better understand how this model can assist in mitigating the nursing faculty shortage while allowing nursing school enrollment to keep pace with future needs. The school also hopes the evaluation will show that when used as an equally sound and valued educational approach, the model can enhance the traditional model of clinical learning to prepare new nurses for increasingly complex health settings.
Financial support for the study came from the Robert Wood Johnson Foundation's Evaluating Innovations in Nursing Education Program. To access the study via subscription or purchase on the website of the Journal of Nursing Education, visit http://bit.ly/xkY4oD.
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