Abstract
Introduction
Implicit learning during clinical placements includes patient safety issues. Simulation scenarios offer ways to improve the learning process and students’ awareness of patient safety. The aim of this study was to develop a prototype simulation scenario based on real student experiences.
Methods
This was a mixed-method study using a multi-phase design. Nursing students’ experiences of workplace events they identified as possible threats to patient safety were collected between 2017 and 2019. These experiences were used to develop an interprofessional scenario about patient safety.
Results
A range of scenario materials were produced including a video. Participation in the scenario video had positive impacts including: “feeling safer” while performing nursing activities and more timely detection and reporting of errors. Nursing students reported that participation in the scenario taught important lessons about patient safety, communication, listening to patients and healthcare collaboration.
Conclusions
The role-playing methodology of the scenario provided opportunities for reflection on patient safety and improved interprofessional understanding and communication in an emotionally safe environment.
References
Bagnasco A, Zanini M, Catania G, Aleo G, Turunen H, Tella S, Sara-Aho Arja, Vizcaya-Moreno MF, Pérez-Cañaveras RM, Myhre K, Ringstad Ø, Ekman Gerd A-S, Porras J, Rossi S, Morey S, Johnsen L, Patterson L, Larkin V, Azimirad M, Khakurel J, Dasso N, Haatainen K, Timmins F, Wilson-Menzfeld G, Sasso L, Pearson P, Steven A. Learning From Student Experience: Development of an International Multimodal Patient Safety Education Package. Nurse Educ 2022;47(4):E75-E79. doi:10.1097/NNE.0000000000001138
Eraut M. Non-formal learning, implicit learning and tacit knowledge in professional work. . In: Coffield F, ed. The Necessity of Informal Learning. 1st ed. Bristol: Policy press; 2000:12-31.
Steven A, Tella S, Turunen H, Flores Vizcaya-Moreno M, Pérez-Cañaveras RM, Porras J, Bagnasco A, Sasso L, Myhre K, Sara-Aho A, Ringstad Ø, Pearson, P. Shared learning from national to international contexts: a research and innovation collaboration to enhance education for patient safety. J Res Nurs 2019;24(3-4):149-164. doi: 10.1177/1744987118824628
Steven A, Magnusson C, Smith P, Pearson PH. Patient safety in nursing education: contexts, tensions and feeling safe to learn. Nurse Educ Today 2014;34(2):277-284. doi:10.1016/j.nedt.2013.04.025
Allan H, Magnusson C, Steven A. Learning to keep patients safe - emotional safety for learning and complexity in the nursing workforce. In: Dyson S, McAllister M, eds. Routledge International Handbook of Nurse Education. 1st ed. London: Routledge; 2019.
Levett-Jones T, Lathlean J. ‘Don’t rock the boat’: Nursing students’ experiences of conformity and compliance. Nurse Educ Today 2009;29(3):342-349. doi:10.1016/j.nedt.2008.10.009
Jack K, Levett-Jones T, Ion R, Pich J, Fulton R, Ylonen AM, Hamshire, C. ‘She would wash the patients as if she was scrubbing a dirty plate in the sink’: Exploring nursing students experiences of care delivery. Nurse Educ Today 2020;90:104444. doi:10.1016/j.nedt.2020.104444
Jack K, Levett-Jones T, Ylonen A, Ion R, Pich J, Fulton R, Hamshire C. "Feel the fear and do it anyway" ... nursing students' experiences of confronting poor practice. Nurse Educ Pract 2021;56: 103196. doi: 10.1016/j.nepr.2021.103196
Sevenhuysen SL, Kent F, Wright C, Williams C, Bowles KA, Matthews K, Ayton D, Maloney S. "Why have you done it that way?" Educator perceptions of student-initiated conversations about perceived deviations from evidence-based clinical practice. Nurse Educ Today 2021;98:104768. doi:10.1016/j.nedt.2021.104768
Lee S. Revisit Role-Playing Activities in Foreign Language Teaching and Learning: Remodeling Learners’ Cultural Identity? Electron J Foreign Lang Teach 2015;12:346-359.
Jeffries PR. A framework for designing, implementing, and evaluating simulations used as teaching strategies in nursing. Nurse Educ Perspect 2005;26:96–103.
Díaz-Agea JL, Manresa-Parres M, Pujalte-Jesús MJ, Soto-Castellón MB, Aroca-Lucas M, Rojo-Rojo A, Leal-Costa C. What do I take home after the simulation? The importance of emergent learning outcomes in clinical simulation. Nurse Educ Today 2022;109:105186. doi:10.1016/j.nedt.2021.105186
Dreifuerst KT, Bradley CS, Johnson BK. Debriefing: an essential component for learning in simulation pedagogy. In: Jeffries PR, ed. Clinical simulations in nursing education: from conceptualization to evaluation. 3rd ed. Philadelphia: Wolters Kluwer; 2021.
Levett-Jones T, Lapkin S. A systematic review of the effectiveness of simulation debriefing in health professional education. Nurse Educ Today 2014;34(6):e58-63. doi:10.1016/j.nedt.2013.09.020
Kim YJ, Yoo JH. The utilization of debriefing for simulation in healthcare: A literature review. Nurse Educ Pract. 2020;43:102698. doi:10.1016/j.nepr.2020.102698
Sawyer T, Eppich W, Brett-Fleegler M, Grant V, Cheng A. More Than One Way to Debrief: A Critical Review of Healthcare Simulation Debriefing Methods. Simul Healthc 2016;11(3):209-217. doi:10.1097/SIH.0000000000000148
Kirkman T, Hall C, Winston R, Pierce V. Strategies for implementing a multiple patient simulation scenario. Nurse Educ Today 2018;64:11-15. doi:10.1016/j.nedt.2018.01.032
INACSL Standards Committee. INACSL standards of best practice: SimulationSM Simulation design. Clin Simul Nurs 12(S), S5-S12. doi:10.1016/j.ecns.2016.09.005.
Steven A, Pearson P, Turunen H, Myhre K, Sasso L, Vizcaya-Moreno MF, Pérez-Cañaveras RM, Sara-Aho A, Bagnasco A, Aleo G, Patterson L, Larkin V, Zanini M, Porras J. Khakurel J, Azimirad M, Ringstad Ø, Johnsen L, Haatainen K, Wilson G, Rossi S, Morey S, Tella S. Development of an International Tool for Students to Record and Reflect on Patient Safety Learning Experiences. Nurse Educ 2021; 47(3), E62-E67. doi:10.1097/NNE.0000000000001142
Arthur C, Levett-Jones T, Kable A. Quality indicators for the design and implementation of simulation experiences: a Delphi study. Nurse Educ Today 2013;33(11):1357-1361. doi:10.1016/j.nedt.2012.07.012.
Wighus M, Bjork IT. An educational intervention to enhance clinical skills learning: Experiences of nursing students and teachers. Nurse Educ Pract 2018;29:143-149. doi:10.1016/j.nepr.2018.01.004
Bjørk IT, Christiansen B, Havnes A, Hessevaagbakke E. Exploring the black box of practical skill learning in the clinical skills center. J Nurs Educ Pract 2015;5(11). doi:10.5430/jnep.v5n11p131
Hardie L, Lioce L. A Scoping Review and Analysis of Simulation Facilitator Essential Elements. Nurs Prim Care 2020;4:1-13.
Zigmont JJ, Kappus LJ, Sudikoff SN. The 3D model of debriefing: defusing, discovering, and deepening. Semin Perinatol 2011;35(2):52-58. doi:10.1053/j.semperi.2011.01.003
Saldaña J. The coding manual for qualitative researchers. Third edition.. ed: Los Angeles : SAGE; 2016.
Yu A, Flott K, Chainani N, Fontana G, P DA. Patient Safety 2030. London, UK: NIHR Patient Safety Translational Research Centre at Imperial College London and Imperial College Healthcare NHS Trust 2016.
Macleod CE, Brady DR, Maynard SP. Measuring the effect of simulation experience on perceived self-efficacy for interprofessional collaboration among undergraduate nursing and social work students. J Interprof Care 2022;36(1):102-110. doi:10.1080/13561820.2020.1865886
Kirkpatrick A, Ball S, Connelly S, Hercinger M, Hanks J, Potthoff M, Banzhaf S, McCafferty K. Intraprofessional Simulation's Impact on Advanced Practice and Baccalaureate Student Self-Efficacy. Clin Simul Nurs 2018;16:33-39. doi:10.1016/j.ecns.2017.11.005
Madsgaard A, Smith-Strom H, Hunskar I, Roykenes K. A rollercoaster of emotions: An integrative review of emotions and its impact on health professional students' learning in simulation-based education. Nurs Open. 2022;9(1):108-121. doi:10.1002/nop2.1100
El Hussein MT, Harvey G, Bell N. The Influence of Nursing Simulation on Patient Outcomes and Patient Safety: A Scoping Review. Clin Simul Nurs 2022;70:37-46. doi:10.1016/j.ecns.2022.06.004
Bagnasco A, Zanini M, Catania G, Aleo G, Turunen H, Tella S, Sara-Aho A, Vizcaya-Moreno MF, Pérez-Cañaveras RM, Myhre K, Ringstad Ø, Ekman Gerd AS, Porras J, Rossi S, Morey S, Johnsen L, Patterson L, Larkin V, Azimirad M, Khakurel J, Dasso N, Haatainen K, Timmins F, Wilson G, Sasso L, Pearson P, Steven A. Learning from student experience: development of an international multi-modal patient safety education package. Nurse Educ doi:10.1097/nne.0000000000001138