Apparently, I have been sleeping on replacing some clinicals with simulations. After all, when I was in nursing school, we practiced with simulation for the first semester before we were allowed to go to the hospital for clinical. The only other simulation experience I had, except for the first semester, was when we were learning how to start an IV in the last semester.
Oh, I know that simulation is a big thing. After all, not every patient has the illness/ailment that is being studied. It is just an expansion of the case study.
There was a study done where 25% of clinical time was replaced by simulation, and 50% of clinical time was replaced by simulation. At the end of the study, it compared a whole host of things, including how the students felt pre and post-licensure, who left their first job, and how their managers perceived them. The article was fascinating and, after the statistical math, it was found that there was no statistical significance in replacing some of the clinical time with simulation time.
AI has entered the chat with virtual reality.
This week I read an article about replacing some simulation with virtual reality.
As always the quote that comes to my mind is “Just because we can, doesn’t mean we should.”
I was unable to attribute this to any one person.
On one hand through simulation and virtual reality students will be exposed to patients that they will never have. Because these fragile patients are not given to students. They might also be exposed to patients whose physical symptoms might make them ill. In this instance, I am thinking of critical burn patients. Because these patients are so prone to infection that their interactions are tightly monitored.
However, the nursing students won’t be exposed to the breadth of human suffering, which is a large part of the job they are going to be undertaking. They will never hold the hand of the dying or bring comfort to them or their family. They will never make the real-time “catch” that is so exciting for nurses and students. This is where the nurse realizes that there is an underlying problem that is not being addressed by the doctors and elevates the problem.
Replace some of the clinical experience with simulation. Yes.
Kind of like the practice “babies” we used to do in high school. At the risk of aging myself, I am talking about the eggs and the bags of flour. Before they were replaced by robot babies.
But be aware of the risk to nursing that entails. A further avenue of study is the students who were not adequately prepared for the “ickiness” of the human conditions and leave the bedside.
The bedside needs all the nurses it can get.
Reference
Hayden, J. K., Smiley, R. A., Alexander, M., Kardong-Edgren, S., & Jeffries, P. R. (2014). The ncsbn national simulation study: a longitudinal, randomized, controlled study replacing clinical hours with simulation in prelicensure nursing education. Journal of Nursing Regulation, 5(2), 40. https://doi.org/10.1016/S2155-8256(15)30062-4
Dispatches from the Evening Shift 