Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
Clinical Simulation Scenario Development
Simulation as a means to validate physical assessment and
procedural skills was already being used by Virginia Commonwealth
University School of Nursing when the delegation and prioritization
scenarios were introduced. The scenario development was driven
by a review of NCLEX-RN pass rates and anecdotal reports from
graduates who indicated they were most challenged by NCLEX-RN
questions that assessed their ability to prioritize and delegate the
care of patients. Consequently, scenarios were developed to
achieve the following objectives:
1. teach the skills of delegation and prioritization,
2. synthesize previously acquired nursing knowledge,
3. enhance student knowledge of the scope of practice of licensed
and unlicensed nursing personnel, and
Given the objectives of the simulation, it was determined that the
most appropriate learners would be senior nursing students who
already had experience in a variety of clinical settings. The
simulation was introduced to senior nursing students enrolled in
their final senior clinical course. This course is designed to be a
capstone experience that allows students to obtain concentrated
study in a clinical area of interest while working with individually
assigned baccalaureate prepared preceptors.
Faculty members collaborated with a graduate student majoring in
nursing administration and leadership who was completing a threesemester
practicum to design the elements of the simulation. The
graduate student developed scenarios using authentic patient data
that was sanitized of identifying information. Patient data were
obtained by conducting chart reviews of patients admitted to a busy
35-bed acute care medical unit and selected for scenario
development based on both the complexity of the clinical
presentation and the frequency with which the diagnoses were
encountered on the unit. Common diagnoses included diabetes,
HIV, and hepatic failure. Comorbid conditions included impaired
cognition and alcohol dependence and withdrawal. Scenarios were
developed to challenge student knowledge, assessment ability, and
critical thinking skills while also serving as a platform for review of
NCLEX-RN content. A sample scenario is provided in Appendix 1.
Simulation Design
The simulations were staged in a full service simulation laboratory.
All appropriate patient equipment such as IV pumps, PCA pumps,
feeding pumps, monitoring equipment, and imitation medications
were available to the participants. Students also had access to the
on-line policy and procedure manual for Virginia Commonwealth
University Health System.
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