A University of Hawaiʻi at Mānoa nursing simulation designed by the School of Nursing and Dental Hygiene to prepare future nurses to care for Hawaiʻi's aging population is showing promising results.
The Aging With Grace program significantly increased nursing students' self-reported confidence using telehealth and received high participant ratings, according to findings published in the Journal of the American Association of Nurse Practitioners . The simulation is now a required competency activity for undergraduate nursing and graduate nurse practitioner students.
Nearly one in five Hawaiʻi residents is 65 or older, yet only a small percentage of the state's registered nurses and nurse practitioners hold certifications in geriatrics.
"Our novel geriatric simulation curriculum can build the knowledge, confidence and collaborative skills needed to care for older adults with increasingly complex health needs," said Courtnee Nunokawa, assistant professor and director of the Doctor of Nursing Practice program. "The evidence-based Aging With Grace curriculum was designed by our faculty to address a critical workforce need."
Following a patient's journey
Unlike traditional simulations focused on a single medical encounter, Aging With Grace follows the same patient through three stages of care: independent living, post-stroke rehabilitation and long-term care.
Undergraduate nursing and graduate nurse practitioner students collaborate to address the patient's changing physical, emotional and medical needs.
Trained actors from HealthCAST , a partnership between UH Mānoa nursing and the Department of Theatre and Dance , portray patients to create realistic clinical experiences. Faculty also used artificial intelligence to generate a photograph of the simulated patient's deceased spouse, adding emotional depth.
The curriculum emphasizes five components of age-friendly care: What Matters, Medication, Mentation (mental health, memory, and cognitive function), Mobility and Multimorbidity (co-occurrence of multiple chronic conditions).
The simulation involved 125 students across six sessions in March and April 2024. Of the 112 students who completed evaluations, participants rated the experience highly and reported statistically significant improvements in telehealth confidence across all measured areas.
Faculty are exploring partnerships with other health disciplines, health care organizations and community groups to expand the program.
