Simulation

simulation

1. SIMULATION Presented to - Dr. Sukhwinder Kaur Lecturer Nine, pgimer Chandigarh Presented By - Nisha Yadav M.Sc. Nursing 1 st Year NINE, PGIMER Chandigarh

2. Outline Introduction Definition Purposes Characteristics Uses in nursing Types of simulation Principles Applications Procedure of simulation Activities in simulation Steps of simulation Values of simulation Advantages Disadvantages Demonstration Conclusion

3. Introduction Simulation is a technique that enables adult learners to obtain skills, competencies, knowledge or behavior by becoming involved in situations that are similar to those in real-life. This method of teaching attempts to address problems of real-life conditions & to discuss them completely after the presentation is over. Nurse educators strive to mimic reality in their practice laboratories, they find that nursing students often do not make the imaginative leap required to visualize dummy model as a real life patient.

4. Meaning Simulation is the basis of sensitivity training, socio drama, role playing & psychodrama. It is not actual teaching. Certain underlying skills to teaching can be modified, described & practiced like any other skill. It is assumed that through role perception the psychological appreciation of the classroom problems will grow and develop in the student teacher a basis for handling the problems in the class

5. Definition Simulation may be defined as a role playing in which the process of teaching is enacted artificially and an effort is made to practice some important skill of communication through this. Simulation is a technique the enable adult learners to obtain skills, competencies, knowledge or behavior by becoming involved in situations that are similar to those in real life (R Sudha) Role play in which the process of teaching is displayed artificially and an effort is made to practice some important skills of communication through this technique (K P Neeraja )

6. Purposes To help students practice decision making and problem solving skills and to develop human interaction abilities in a controlled and safe setting By means of active involvement in a simulation exercise, a game, or a role-playing situation, the student achieves cognitive, affective and psychomotor outcomes. Students have a chance to apply principles and theories they have learned and to see how and when these principles work.

7. Characteristics of simulation Systematic planning Proper involvement of students Feedback Proper environment Based on system approach Training is provided on artificial situations Proper adjustment of time factor

8. Uses in Nursing Increasing awareness of the need to address patient safety. In the acquisition of communication skills. The ability of simulation to enhance clinical practice Learn to solve problems efficiently with minimal wasting of time and resources. Used to evaluate the student learning and competence. It is used to achieve many nursing outcomes Simulation can help nursing student gain skill in applying the nursing process

9. Types of simulation Written simulation Audio visual simulation Live simulated situations

10. Written simulation Individual uses either paper and pencil latent image format. The purposes includes problem solving, decision making. To evaluate student’s ability to apply the skill.

11. Audio visual simulation An entire simulation can be placed on videotape. Management vignettes can be dramatized and filmed. Questions can be created for the viewers right on the screen, and the alternative outcomes, dependents on which approaches to a solution are chosen, can be all taped.

12. Live simulated simulation Lincoln, Layton and holdmen (1978) described their experiences with simulated patients. The patients were healthy people, usually students, who were trained in the role they were to play. Simulated patient used their own history as much as possible but memorized and added the elements of the history that had been created for the simulation. Nursing students found the experience to be beneficial. They would be much more relax and confident when meeting their first real patient.

13. Cont.. Video recording : can be used to help students develop physical examination skill in much the same way as for interviewing skills. Simulation devices :These devices include those for cardiac auscultation, breast examination, prostate palpation, pelvic examination and laryngeal examination. Simulated patients : These can also be used very much the same way as for history taking with the similar advantages. Model examination Oral simulation Computerized simulation

14. Points to remember while preparing simulation Initiate the problem in a realistic manner, it should contain the elements a nurse would encounter in real life situation Reflect problem solving process by requiring a series of sequential interdependent decisions Enables the learner to obtain the necessary information and/or feedback related to a previous decision as input to the next step.

15. Principles Players take on roles which are representatives of the real world and then make decisions in response to their assessment of the setting in which they find themselves. The experiences simulated are consequences which relate to their decisions and their general performance. “Monitor” the results of their actions are brought to reflect upon the relationship between their own decisions and the resultant effect

16. Application of simulation in teacher training Cruikshank (1968) has developed a teacher training system which includes : The participant is introduced into the situation (ex: if he is a new teacher in school ) The participant is provided with information and opportunities to solve the problems (for beginning teacher ) The participant is exposed to a variety of potential solutions to a particular problem. The participant is given the opportunity of observing the results of his chosen line of action. The participant is presented with role playing situations, written and response sheet.

17. Cont … The participant is introduced to the situation by film strips. The participant is also given the materials. Ex: The rules, regulations, curriculum handbook and record cards, to familiarize to the topic. The participant is presented with role playing situations, written and response sheet. The participant then identifies the factors influencing the problem, locates the relevant information, suggests appropriate alternative course of action, communicates and implements a decision. The participant then identifies the factors influencing the problem, locates the relevant information, suggests appropriate alternative course of action, communicates and implements a decision.

18. Procedure of simulation Selecting the role players : A small group of 4 to 5 student teachers is selected. The role assignments are rotated within the group to give chance to everyone. Every member of the group gets an opportunity to be the actor and the observer.

19. Cont … Selecting and discussing skills : The skills to be practiced are discussed and the topics that fit in the skill are suggested. One topic each is selected by the group members for exercise. Planning : It has to be decided who starts the conversation, who will top the interaction and when .

20. Cont … Deciding the procedure of evaluation : How to record the interaction and how to present it to actor has to be decided so that a proper feedback on his performance could be given. Provided practical lesson : The role players should be provided reinforcements on their performance to give them training for playing their part well.

21. Activities in simulation Role playing Socio-drama Gaming

22. Steps of simulation process by Goldstein and Pfeiffer (1983) Experience Sharing Processing Generalization Application

23. Experience : Experiencing or simulating the particular problem or situation. Four or five participants ,each one of them identify their own purpose of the exercise & its ultimate goal. Sharing : Participants shares their experiences after the exercise. They share both their observations of what, when and how they felt about activities or events. Often the feelings are very important to reveal their comments about objective events.

24. Processing : Processing the information gathered during the sharing stage. This is generally accomplished with all the participants. The goal of this step is to identify commonly shared experiences or perceptions & to identify common themes among the group members. Generalization : The teacher guides the group into drawing broad implications from the experience & resulting discussion. This is the most important phase of the entire process, & if left out, the learning will appear incomplete.

25. Application : The final stage of the process is to help the participants to apply the new generalization to future situations. Overall application phase is designed to give the participants a chance to apply the new concepts, feelings & ideas in real life situation

26. Requisites for good simulation process Active involvement of all students. Clarity : the decision made should be based on the clear effect and causes of the simulation process & resulting discussion. Feasibility : It measures the cost in terms of materials, space, & time against outcomes. Repeatability and reliability : These qualities are important because it is essential that simulation be repeated with the same degree of reliability relative to its outcome. This will improve the accuracy of learning as well as the credibility of simulation process.

27. Values of simulation process Enables the learner to learn directly from experience Promotes high level of critical thinking Develops in the students an understanding of the decision making process Enables the individual to emphasis with the real life situation Provides feedback to the learners on the consequences of actions & decision made Motivate the students by making real life situations exciting & interesting Enables teachers & learners to assess the realism of the situation by uncovering misconceptions.

28. Advantages Simulation offers an excellent opportunity to learn from mistakes Simulation fosters critical thinking & problem solving skills. Simulation helps students to acquire concrete meaning for abstract terms Simulation provides a realistic experiences, students can easily apply these concepts in the clinics Simulation establishes a setting where theory and practice can be combined. No risk involved. The decisions are made and carried out without physical or psychological harm to children or school as a result of practice teaching. Simulation is a teaching device that motivates and involves students. It changes teacher behavior. Introduces Freshness and novelty.

29. CONT…. Simulation is highly student centered because of its very interesting & motivating nature, effectiveness in teaching slow learners as well as fast learners & all types of students. It provides participants to deal with the consequences of their actions. Students can learn without harming the patient. Students can receive feedback on the appropriateness of their action. The controlled setting of the simulation makes it possible to have consistency in learning experiences from learner to learner.

30. Disadvantages Simulation can’t be made in all subject of the curriculum Simulation can’t be conveniently used in case of small children because mechanism is too difficult for them to follow. It requires a lot of preparation on the part of teachers Minimum of feedback sequence to choose Time consuming Need for many simulators. Simulation is costly in terms of both time and money.

31. CONT.. Simulation cannot be devised in a fraction of time. Simulation techniques also consume a lot of class room time. Simulation technique can be overused. Acquisition of necessary factual content and would result in boredom. It is possible that emotions may be aroused to an undesirable degree, especially with role playing. Not every instructor feels comfortable using simulation strategies. Requires all the information you need in front of you on a notepad.

32. Cont..  The process and outcomes of simulation methods are not always predictable. Usable for small groups. Models often easily damaged. Never same as performing technique on a patient. beware of faulty learning. Learners may not find the simulation relevant to their situation. Games application to nursing can cost hundreds of dollars each.

33. Teacher’s preparation Planning : Choosing appropriate simulation Assign reading before class Point out textbook & library resources to prepare Teacher is responsible for maintaining environment like ventilation, lighting, chairs tables

34. CONT… Facilitating : After introducing the activity teacher should talk relatively little. Teacher must coach students who are trying to find their way through a sticky problem and encourage creative thinking and act as information resources. Take notes during the class so that in later discussion teacher can talk about weaknesses and strengths

35. CONT… Debriefing : Teacher’s role is the final discussion or debriefing session, Immediately following the simulation when the information is fresh in everyone’s mind. Teacher should briefly summarize. Self analysis can help students gain insight into why they made certain decisions or took a specific course of action. At the end of the discussion period teacher should point out how principles and concepts have been applied and how the experience ties into the learning objectives.

36. Conclusion Simulated teaching is an innovative approach because students engage in genuine communication in playing their roles. In addition to encouraging genuine communication, active involvement, and a positive attitude, the simulated “real life” problems help students develop their critical thinking and problem solving skills. Students have the opportunity to try out new behaviors in a safe environment, which helps them develop long term motivation to master.

37. References Basheer PS. Textbook of Nursing Education. EMMESS Medical Publishers. 1 st ed. 2018; 125-30. Neerja PK. Textbook of Communication and Education Technology. Jaypee Medical Publishers. 2011. 1 st ed; 267-9

38. Thankyou…….