Staging Clinical Simulations: Tips & Procedures for CNEs

Instructor: Alyssa Campbell

Alyssa is an active RN and teaches Nursing and Leadership university courses. She also has a Doctorate in Nursing Practice and a Master's in Business Administration.

Staging clinical situations, or utilizing simulation, can be a very effective teaching strategy. Learning how to apply this powerful educational method to clinical situations will be explored further in this article.

Staging Clinical Situations

Thanks to technological and creative advances in education, clinical situations can be staged to present a highly realistic learning experience. Staged clinical situations, commonly referred to as simulation, can be a highly effective teaching strategy and can be as simple or as complex as desired. Simulation has many characteristics and can be:

  • Communication or skill-based
  • With a large group of people or a very small group of people
  • Can involve manikins or standardized patients (live actors portraying a clinical scenario)
  • Any length of time
  • Held in a simulation lab or in situ (held within the actual clinical setting)

While simulation allows a lot of variety, all simulations are created with a common goal: to provide a realistic clinical experience for clinicians (or students) to learn and practice various skills. This kind of preparation provides the learner with an opportunity to safely work through any situation and establish sensitive skills.

How to Include Simulation in Your Teaching Plan

While simulation is useful for all types of learning experiences, it is particularly beneficial for low-volume, high-risk scenarios. An example of this would be a team of clinicians running a code blue simulation, a simulation of an event where a patient spontaneously stops breathing or their heart stops beating. Code blue is considered low-volume, high-risk because even though it doesn't happen too often in the real clinical environment, decisions and actions need to be completed quickly - a patient's life depends on it! During an actual code blue, a patient requires life-saving care for resuscitation (actions that clinicians perform to restart the heart or breathing).

Getting Ready: Determine What You Need

As the nurse educator, Jackie, has noticed that the last time her team ran a code blue, it was disorganized, no one knew their roles, and her team had difficulty initiating resuscitation. This was a perfect opportunity to educate with a simulated code blue.

Jackie knew that she had to design a case that would be realistic for her team. She decided that the simulation would be in situ, on the actual clinical unit, and that the whole scenario would take place in an empty patient room. Jackie was able to borrow a low-fidelity manikin (anatomically correct with realistic human features, but is very limited in responsiveness) to simulate a patient for the code blue experience. She wrote a scenario setting the team up with a few key items:

  • What the simulated patient (the manikin) was doing just before he stopped breathing
  • Any pertinent background information
  • Prepared herself to alert the team if their interventions were working, as evidenced by a change in vital signs, and appropriate physiological responses that cannot be portrayed by the manikin

During the Simulation

Jackie was aware that pulling people from the clinical environment would be difficult because they are actively working. She decided to plan the simulation after the shift so that a group can get together and enter the simulated experience as a team.

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