Life in the Fast Lane: Preparing Nursing Students for Real World Multi-Patient Scenarios
A 57-year-old patient has high blood pressure that is continuing to spiral out of control and their level of consciousness is declining. A 60-year-old patient has a 102 degree fever and is in severe respiratory distress. A 26-year-old patient needs a wound dressing changed and is in moderate pain.
Who requires your attention the most?
These are just a few examples of the fast-paced multi-patient simulation scenarios that are being developed by Jennifer Teater, Ed.D. and assistant clinical professor of nursing. These simulations will help prepare future registered nurses for the National Counsel State Boards of Nursing (NCSBN) new Next Generation National Council Licensure Examination (NCLEX) starting April 2023.
Teater has specifically tailored simulations to meet the criteria to evaluate student performance objectives such as clinical reasoning and prioritization based on the NCSBN’s Clinical Judgement Measurement Model used on the NCLEX.
“In most clinical simulation experiences, students focus on providing care to one simulated patient at a time,” said Teater. “However, new graduate nurses are expected to manage care for a group of patients in an ever-changing and complex health care arena. Juggling multiple patient assignments requires nurses to have effective clinical judgement and critical thinking skills. Because of limitations in the clinical setting, nursing students may not receive multiple-patient assignments, hindering them from developing these necessary skills.”
Students can practice high-stakes patient care decisions in an environment that promotes collaboration, communication, and critical thinking. The clinical simulations involve two simulated patients, in a single room, cared for by two teams of two nursing students. Students are required to administer medications, recognize, and analyze cues for potential patient problems, prioritize hypotheses, call providers, implement nursing interventions, and evaluate outcomes of the care provided.
“There can be a great deal of apprehension on the students’ part to apply the knowledge gained in the classroom to an actual patient,” said Teater. “This multi-patient clinical simulation allows students the ability to practice their independent critical thinking and clinical judgment skills, just as they would in caring for multiple patients in the hospital setting. This is an opportunity for students to have a safe environment to practice and learn from mistakes without harming any actual patients.”
Feedback has been overwhelmingly positive with students reporting increased confidence in individual decision-making, a greater appreciation of the teamwork required for patient care, an enhanced ability to apply nursing knowledge to a novel situation, and a better understanding of the “big picture” when it comes to patient care.
One student noted, “I loved it because I got to put my knowledge to the test. There wasn’t an instructor right there, ready to tell us what to do next. It was great to work as a team and to be able to bounce ideas off each other.”
Teater’s work continues the long-standing tradition of excellence and innovation in nursing education at IU Southeast.
“As a nurse educator, I want to provide students with a solid foundation of knowledge and assist them in developing the critical thinking and judgement skills they will need to be successful in their future professional careers,” said Teater. “By providing students with exposure to a variety of clinical situations in the simulated environment, they can be better equipped to provide safe, effective care and work as contributing members of the health care team.”