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Gabaone of the early pioneers of medical simulations, describes the diverse applications of simulation in healthcare and may be a useful resource in the initial step of simulation development. Dimensions to consider include 1 purpose and aims of the simulation activity; 2 unit of participation; 3 experience level of participants; 4 healthcare domain in which the simulation will be applied; 5 healthcare discipline of personnel who will participate; 6 type of knowledge, skills, attitudes, or behavior to be addressed; 7 age of the patient being simulated; 8 technology applicable or required; 9 site of simulation participation; 10 extent of direct participation; and 11 feedback method.
Any particular application of simulation can be categorized as a point or range in each dimension. For example, dimension 1 purpose and aims of the simulation activity ranges from educational, training, and performance assessment to research e.
The first step in developing a simulation is determining the overall purpose and goals of the training, as well as to consider the desired methodology or technique of simulation.
Jeffries designed features of a well-developed simulation, including clearly written objectives; fidelity or realism that mimics real life situations; building a level of complexity; providing cues for participants as the simulation progresses; and debriefing during and after the simulation is finished.
Jeffries framework is helpful in the actual design of a simulation and debriefing. Another method for overall simulation development that has been successful includes a five step process: In the first phase, key concepts are identified.
Key concepts are subsequently mapped to clinical standards in Phase 2. This is an important step to ensure that the focus of the simulation is in alignment with current requirements and standards.
It is important to have clinical experts involved in this phase of the work to ensure realism and fidelity in the scenario. Once the scenario has been developed, debriefing questions should be developed. Feedback should be requested from participants for all aspects of the scenario, including fidelity, implementation process, and overall experience.
Participants should be asked to provide feedback about all aspects of the simulation e. A variety of simulation development frameworks can be used in Phase 3 to design the actual simulation.
Phase 4 debriefing development should utilize the appropriate method of debriefing based on the simulation scenario goals and objectives.
Exemplars of Simulation in the Practice Area Even the brief review above provides multiple examples of simulation in a variety of practice settings using several different simulation techniques. A variety of simulation methodologies can be used for education and training of practicing nurses.
This can include high and low fidelity mannequins, virtual environments, and unfolding video case simulations. Video Unfolding Case Simulations A variety of simulation methodologies can be used for education and training of practicing nurses.
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In an effort to improve the overall effectiveness of the annual competency blitz at a large Midwestern health system, educators and faculty collaborated to develop an interactive delivery method. Participants were placed into groups of 8 to 10 staff where the videos were reviewed and discussed.
Throughout each video, there were opportunities to pause and ask debriefing questions related to content. For example, one of the videos showed a patient who was placed in restraints inappropriately.
The discussion centered on how the use was inappropriate and possible alternatives to restraints. Ambulatory Care A multi-faceted educational approach aimed at improving nurse competencies in diabetes self-management was initiated with 21 ambulatory care nurses. The scenarios required the nurses to interact with three patients: Each scenario required nurses to identify underlying issues for the patient, collaboratively create mutual goals, and consider next steps for the patient.
Three unfolding scenarios were developed using high-fidelity simulation. The simulation scenarios focused on acute respiratory failure requiring intubation; atrial fibrillation requiring treatment; and mental status changes. These were areas of high volume on the unit and important for overall patient care.
In an intensive care unit, several simulation scenarios were developed and implemented to support nurses who needed to learn a new procedure using complex technical equipment for very critically ill patients. The focus here was on troubleshooting alarms with the equipment and managing patient responses to therapy.Impact of Training and Development on Organizational Performance Abstracts - Training and Development, On the Job Training, Training Design and Delivery style are four of the most important aspects in organizational studies.
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The impact of training and development on employee performance Abstract: In today’s dynamic environment the stipulate for professional and highly skillful workforce are necessary for every organization to perform well in this environment.
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