SIMULATION TO PREPARE STUDENT NURSES FOR CLINICAL PRACTICE - AN AUSTRALIAN PERSPECTIVE

Background: The use of simulation environments to develop clinical judgment and skills in undergraduate nursing curricula is a teaching and learning strategy widely used in nursing education.[1] Some of the benefits of simulated learning include the ability to provide students with a safe environment to practice clinical skills, learning to deal with errors without harm to the patient, developing critical thinking skills and improving the ability to process difficult cases in their own time. In addition, a simulated learning environment can help students to develop communication skills in relationships with patients, relatives and professional colleagues and boost confidence when undertaking clinical placements.[2] Within the Australian context, students are required to undertake 800 hours in clinical practice during the degree to meet registration requirements. To enhance undergraduate students preparedness for clinical practice Murdoch University has developed a comprehensive curriculum of simulation. This paper will describe a pre placement simulation delivered to first year students in preparation for an aged care placement. Over two academic semesters students are taught clinical and non-technical skills, in preparation for a two week clinical placement in an aged care facility. Immediately prior to the clinical placement a program of simulation is delivered at the University campus to consolidate the year's learnings. The curriculum for the pre placement program was developed by academics in consultation with a provider of aged care services. The pre placement program includes 6 hours of classroom activities developing non-technical skills (induction to an aged care facility, setting objectives, receiving feedback, reviewing assessment strategies, developing respect and gaining perspectives of older adults) and 6 hours in a simulated ward consolidating clinical skills (hand washing, bed making, providing personal hygiene, assistance with feeding and mobilization, clinical handover and conducting a heath assessment). Students use a combination of low fidelity mannequins, role play and problem based enquiry to complete the class room and ward activities. Methods: A simple numerical assessment scale which also provided opportunity for narrative feedback was used to gather feedback from the students, educators and nurses supervising the students on placement. Evaluation: Feedback from the students, educators and nurses providing supervision was overwhelmingly positive. Feedback indicated that the classroom activities and ward based simulations were relevant and useful in preparation for clinical practicum, allowed the development of skills in the provision of care and provided the opportunity to practice statutory assessments. Conclusions/recommendation: The simulation experienced by first year nursing students, immediately prior to their aged care placement, provided a good foundation to consolidate and practice previously acquired skills. Students expressed they felt well prepared and ready to commence their placements in the following week. This model of pre placement simulation will be integrated across the three year Bachelor of Nursing program.