Simulation central to nursing education during pandemic

Each year the Society for Simulation in Healthcare (SSH) celebrates Healthcare Simulation Week in September to recognize the role simulation plays in boosting the safety, efficacy and efficiency of health care delivery, along with the health professionals-technologists, researchers, educators and others-who use simulation in practice.

The onset of the COVID-19 pandemic underscored the value and importance of health care simulation and the professionals who work in the industry as many nursing schools, including the University of Cincinnati College of Nursing, were forced to abruptly move from in-person clinical experiences to fully online simulation-based learning. The college has used simulation in its curriculum for decades to prepare students for real-world clinical environments.

In March, however, COVID-19 prohibited many students from entering health care settings, requiring faculty to rely exclusively on simulation.

"It shifted our focus to providing our students with clinical reasoning activities that would continue to facilitate their growth as nurses and develop the skills needed for safe patient care," says Donna Green, PhD, assistant professor and undergraduate program director. Simulation is needed to enhance students' ability to gather and analyze patient information, evaluate its significance and determine an appropriate course of action.

A team of administrators and faculty, including Green, selected and implemented new simulation platforms to quickly transition to an online-only clinical format to support academic progression during the Spring 2020 semester when the COVID-19 pandemic forced a statewide, weeks-long quarantine. Without simulation in place of clinicals, many undergraduate and accelerated master's students would not have graduated on time.

Over the summer, UC College of Nursing welcomed back a few groups of students to its on-campus skills and simulation laboratory to prepare students to re-enter health care settings with the changes brought on by COVID-19. Simulation at the college has also changed. Labs have been reconfigured to comply with federal recommendations to prevent the spread of COVID-19, including six feet of spacing between stations.

"We used to think of safety as psychological-making sure people feel comfortable making mistakes," says Robin Wagner, DNP, skills and simulation labs director. "Now, you have to feel physically safe, too."

These superficial space changes are temporary as the world works to control COVID-19, but its impact on simulation in health care education will last as faculty find new ways to educate students outside of the lab and clinical setting. For example, Eileen Werdman, DNP, assistant professor and accelerated master's program director, worked with a local manufacturer to design and print 120 3-D models of body parts for students to use to practice skills from a distance.

"The silver lining in the coronavirus cloud for simulation is that now, more than ever, simulation supports learning the way the brain likes to learn," says Wagner. "We are able to create the context of patient care in the high fidelity lab and extend it into students' remote learning spaces through effective use of technology and advanced simulation design."