Simulations in Nursing Programs

Instructor: Jennifer Reyes

Jennifer has taught Nursing in ADN, BSN, and MSN programs and has a Master's degree in Nursing Education.

This lesson explores the importance of simulation exercises in nursing and provides an overview of various teaching strategies for use in the simulation laboratory setting.

What Is Simulation?

Nurses learn a lot while they are in an academic setting, but transferring this knowledge into clinical practice can be difficult. Interactive, practice-based instruction can help to bridge the gap and give nursing students the interactive experiences they need to improve the quality of care that they provide. Many nursing programs are meeting this educational need with simulations that allow students to practice their skills in a safe, nonthreatening environment.

Simulation uses technology to mimic real-world experiences and processes. In nursing education, the use of patient simulators has begun to take place of real patients to help supplement student clinical experiences. This allows the student to make mistakes without risking the safety and health of the patient. Simulation experiences are also a superb tool to compliment complex didactic nursing lessons. Nursing educators may choose to use a simulation lab to further promote understanding of certain disease processes, such as heart failure or different types of shock.

Faculty members usually set up a scenario or case-study that the student can work through in a simulation setting (instead of a hospital or clinical setting). This gives the faculty more control to make clinical experiences more uniform and focus on meeting the educational needs of students who are struggling.

Simulation can also help boost the student's learning and critical thinking skills. In a simulation experience, students have the opportunity to develop psychomotor skills, clinical reasoning, clinical judgment, and problem-solving skills. Simulation also opens the door to reflective thinking using debriefing after scenarios have been played out.

Simulation Teaching Strategies

There are several teaching strategies nursing instructors can utilize when incorporating simulation into learning. These strategies include role-playing, human patient simulators (mannequins and computer programs), standardized patient simulation (the use of an actor to portray the patient), hybrid simulation (a combination of standardized and human patient simulators), and debriefing.


  • Role-playing allows students to participate in an experience in various roles. The interaction with each other in these new assumed roles helps students gain different perspectives on various topics as well as promotes autonomy in students. Role-playing is also a simple, straight-forward method that can be completed without much equipment or cost. Students can be assigned roles to playout with each other on a given topic or emotion. Role-playing requires minimal planning compared to other avenues of simulation.
  • There are several ways an instructor can utilize role-play and the scenario can be as complex or minimal as you would like. Take into consideration the topic you would like to utilize role-playing for. For example, when teaching students how to therapeutically communicate to their patients, you might pair up students and ask one to act as a nurse who must prepare the patient for surgery and the other to act as the patient who is anxious about surgery. Another way to incorporate role-play may involve teaching students how to provide patient education to patients or family members. Having a student act as a parent of a sick child and having another student act as the nurse providing discharge education on the illness can help students learn how to provide education, utilize appropriate resources, and communicate in a distracting situation.

Human Patient Simulator Cases

  • Human patient simulator (HPS) cases require the use of simulator manikins and computer software. Typically, the software comes with preloaded scenarios, but faculty can also write their own. The manikin can be manipulated to produce patient reactions such as pupil dilation, increased heart rate or breathing, or seizure activity. The scenario can become progressive and the student's responses can shape the outcome and certain learning experiences within the scenario. This can be especially useful to enhance critical thinking skills and clinical judgement and assessment skills.

Standardized Patient Simulation

  • Standardized patient simulation experiences employ actors to act out a specific condition or diagnosis. This is useful for helping student's development of psychomotor skills. This type of simulated experience is best for large scale simulation, such as disaster training that requires numerous students in various roles that are working together, and for specific development of skills, such as health assessment or taking a patient's blood pressure or temperature. This type of experience usually requires the faculty member to write a simulation experience to provide the actors with direction.

Hybrid Simulation Experiences

  • Hybrid simulation experiences are a combination or standardized patient simulation and human patient simulator scenarios. The method may utilize both manikins with the preloaded scenarios and actors to play the role of family members, social workers, or another member of the interdisciplinary team. This will help develop communication techniques and continue to promote problem-solving skills.

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