1. MS.J.JAYANTHI.,MSc(N).,
LECTURER IN PAEDIATRIC
NURSING
GRACIOUS COLLEGE OF
NURSING

2. “SIMULATION REALITY INTO REAL
WORLD
Simulation in some
form has probably been
used as a teaching
strategy in nursing
education since the
first nurse tried to
teach the first nursing
student how to do a
task properly.

3. Tell me, and I
will forget.
Show me, and I
may remember.
Involve me,
and I will
understand.”
- Confucius, 450 BC

4. MEANING
‘ Simulator (noun): any device or system that
reproduces the conditions of a situation for the
purposes of research or training’ (Collins, 2005)

5. DEFINITION
Simulation:
“… as a strategy – not a technology – to
mirror, anticipate, or amplify real situations
with guided experiences in a fully interactive
way.”
Simulator:
“…replicates a task environment with sufficient
realism to serve a desired purpose”

6. TRENDS IN NURSING EDUCATION
Providing more experimental learning opportunity
than instruction
Increased use of learning technology
More emphasis on outcome-based then process-
based education
More evidence-based education strategies and
curriculum

7. USES
Learning by doing
Improved quality of instruction
The simulation program enables multiple training
opportunities
Debriefing is an important part of the learning
experience

8. DEBRIEFING
 Debriefing is a process of receiving an explanation
of a study or investigation after participation is
complete.
 Debriefing (post-experience analysis) is thought to
be one of the most important features of simulation
based medical education. Simulation can lead to an
experience that is emotional and thought provoking –
experiential learning. (Think of how you feel when you
poorly execute the resuscitation of the manikin in a
simulation session.) Debriefing plays a role in the
reflection and analysis of that experiential learning.

9. THE ROLE OF SIMULATION

13. Abstract
 The 1975 experiment demonstrated that when
learning occurs in a realistic environment related to
work, learning is retained and reproduced. Therefore,
the more realistic the environment is to the learner’s
own area of work, the more successful the learning
will be. This was one of the first reported occasions
when it was seen that by learning in a realistic
environment enhanced the educational experience.
Simulation allows the creation of realistic simulations
to allow greater retention of what is learned Learning
using simulators . (harvey).

14. SIMULATION FIDELITY
A “system that presents a fully interactive patient and
an appropriate clinical work environment.
The degree to which a simulation and/or a simulation
device accurately reproduces clinical and/or human
parameters; in Realism.

18. High fidelity
 Maximum interaction of learner
in an environment that closely
resembles reality. Scenarios using
mannequins, actors and/or props in a
structured, intentional and well-
directed production can provide a high
fidelity learning experience.

19. Over 365 facilities in 48
states/provinces in the US
and Canada, Germany,
Brazil, and Japan are
participating in the
NRCPR.
Equipment/Physical
Fidelity
EQUIPMENT/PHYSICAL

20. Over 365 facilities in 48
states/provinces in the US
and Canada, Germany,
Brazil, and Japan are
participating in the
NRCPR.
Equipment
Task
Fidelity
EQUIPMENT
TASK

21. Over 365 facilities in 48
states/provinces in the US
and Canada, Germany,
Brazil, and Japan are
participating in the
NRCPR.
Equipment
Task
Environmental
Fidelity
EQUIPMENT
TASK
ENVIRONMENTAL

22. Over 365 facilities in 48
states/provinces in the US
and Canada, Germany,
Brazil, and Japan are
participating in the
NRCPR.
Equipment
Environmental
Psychological
Task
Fidelity
EQUIPMENT
TASK
ENVIRONMENTAL
PSYCHOLOGICAL

23. TYPES OF SIMULATION
Computer-based clinical
simulations
Task-specific simulators
Virtual reality
Full-bodied manikin-based
Standardized patients
Human cadavers

24. COMPUTER BASED
SIMULATION
Screen-based or PC-based simulations are human
computer interactions that allow students to
experience a variety of medical skills and procedures.
This is best used with entry-level students.

25. CONT……
Strengths
Easy, flexible and unlimited access
Useful for knowledge acquisition and critical thinking
Accommodating to individual pace of learning
Good for lower/entry level students
Relatively low cost
Limitations
No physical interactivity
Low fidelity
No experiential learning

26. TASK SPECIFIC
SIMULATION
 Task specific models are designed to teach
a specific task, procedure, or anatomic region.
They often resemble anatomic sections of the
body, This allows concurrent teaching of a
large class, broken down into small groups, to
increase the hands-on time for each trainee.

27. TASK SPECIFIC SIMULATION
 Task trainers are mechanical parts of the anatomy
that simulate an individual skill.
Strengths
 Low cost
 Good for procedural practice
Limitations
 Low fidelity

28. Virtual reality
 Virtual reality (VR), sometimes referred to
as immersive multimedia, is a computer simulated
environment that can simulate physical presence
in places in the real world or imagined worlds.
Virtual reality could recreate sensory experiences,
including visual, taste, sight, smell, sound, touch,
etc.

29. VIRTUAL REALITY
StrengthS
Easy access
Economic for teaching multidisciplinary care
Accommodating to individual pace of learning
Good for lower level of students
LimitationS
Limited physical interactivity
Low fidelity
Limited experiential learning

31. FULL-BODIED MANNIKIN-BASED
 Manikin-based simulations use high fidelity
simulators, manikins that breathe, with breath
sounds, heart tones, and palpable pulses. In
addition, the manikin has a monitor that can
display EKG, pulse oximeter, blood pressure ,
arterial wave forms, pulmonary artery wave forms,
anesthetic gases, etc. Procedures can be
performed on the simulators such as bag-mask
ventilation, intubation, defibrillation, chest tube
placement, cricothyrotomy and others.

32. FULL-BODIED MANNIKIN-BASED
 The highest fidelity simulation.
 "Drug administration can be simulated, and with
the use of the drug recognition unit, the simulator
will respond physiologically.

33. CONT…..
Strengths
High fidelity
Interactive experience
Using emotional and sensory components
Good for critical thinking, decision-making and
delegation
Limitations
Costly
Limited access
Dependent on availability of human
instructors/operators
Limited realistic human interactions

34. STANDADISED PATIENT
 In health care , a Simulated Patient,
Standardized Patient, Sample Patient and Patient
Instructor is an individual trained to act as a
real patient in order to simulate a set
of symptoms or problems. Simulated
Patients have been successfully used in
the education and evaluation of nurses, nurse
practitioners, physicians & surgeons, physician
assisstant ,and basic, applied and transitional
medical research.

35. STANDADISED PATIENT
Strengths
Higher realism in the interpersonal and emotional
responses
Good for communication skills and interpersonal
relationships training
Good for evaluation
Limitations
Signs do not match symptoms
Inversed power dynamic

36. HUMAN CADAVER
 A corpse, also called a cadaver in medical
literary and legal usage or when intended
for dissection, is a dead human body.

37. LEARNING THEORY IN PATIENT
SIMULATION
There is no “Simulation Learning Theory
But, simulation can benefit from broader
learning theories

38. EXPERIMENTAL LEARNING THEORY
Dominant learning theory in
simulation
David Kolb – Chief proponent
Based on Kurt Lewin’s Experiential
Learning Cycle

39. Concrete
Experience
Testing implication
of
concepts in new
situation
Observation
and Reflection
Formation of abstract
concepts and
generalizations
Concrete
Experience
Observation
and Reflection
Formation of abstract
concepts and
generalizations
Testing implication of
concepts in new situation
EXPERIMENTAL LEARNING CYCLE

40. ADULT LEARNING THEORY
Adults have an intrinsic need to know
Adults have self-responsibility
Adults have a lifetime of experiences
Adults have an innate readiness to learn
Adults have a life-centered orientation to learning
Adults have internal motivators

41. PRINCIPLES OF SELECTION
Should be driven by the educational
goal/objective
Should match the level of the student
The higher the realism, the more
effective it is in engaging the student

42. POTENTIAL ADVANTAGES OF SIMULATION
Reduces training variability and increases
standardization
Guarantees experience for every students
 Student-centered learning
Allows independent critical-thinking and decision-
making, and delegation
Allows Immediate feedback Allows deliberative
practice
Also uses the concept of experiential learning

43. LIMITATIONS OF SIMULATION OVER
ACTUAL CLINICAL EXPIERENCE
Not real
Limited realistic human interaction
Students may not take it seriously
No/incomplete physiological
symptoms

44. VISION FOR FUTURE
Class → Simulation C→ linical→ Real
world
Integrated into mainstream
healthcare education

45. SIMULATION AS A TEACHING
STRATERGY:CHALLENGES
Initial capital expenditures
High financial cost
Faculty development
Ongoing
faculty/administrative/technical
support

46. Vote for
Simulation