Elsevier

Nursing Outlook

Volume 56, Issue 4, July–August 2008, Pages 159-166
Nursing Outlook

Article
Education
Using clinical simulations in geriatric nursing continuing education

https://doi.org/10.1016/j.outlook.2008.02.006Get rights and content

Accompanying an increased number of older adults in the population is the need for knowledgeable and clinically competent nurses to provide care for this group, especially those experiencing sudden changes in health status. A continuing education program was designed to improve geriatric nursing competencies through the use of clinical simulations. Three-day nurse educator institutes and one-day workshops for registered and licensed practical nurses were offered to 312 nurses. The clinical simulations that were developed specifically focused on acute health events or conditions. Specific geriatric clinical competencies were also emphasized. Different types of clinical simulations included unfolding cases, use of a human patient simulator, and online case studies. Geriatric nursing knowledge significantly increased and clinical simulations were well-received. Clinical simulations involving the human patient simulator were highly rated. Clinical simulations are an excellent teaching strategy to help nurses increase knowledge and skill in caring for older adults.

Section snippets

Rationale for Geriatric Nursing Clinical Simulations

The use of clinical simulations provides an innovative milieu to practice geriatric nursing skills that include high level problem-solving and multi-task performance in a risk-free environment.13 According to constructivist learning theory, all learning is individually constructed from one's experience during interaction with the physical, mental, and social world by building and adjusting current knowledge structures.14 This suggests that the focus of learning should be on constructing active

Overview of the Program

In 2003, the University of North Carolina at Chapel Hill School of Nursing was awarded a 3-year Comprehensive Geriatric Education Program grant by the Health Resources and Services Administration (HRSA, grant number D62HP01913). The specific purposes of this grant were to: (1) develop peer-reviewed geriatric clinical simulations in the long-term care and acute care settings appropriate for 3 levels of learner: registered nurses, licensed practical nurses and nursing assistants; (2) offer

Results

A total of 312 nurses participated in 14 continuing education (CE) offerings: 7 RN workshops, 4 LPN workshops, and 3 NEIs. Informed consents were signed by 283 participants (90.7%). The 29 participants who did not sign informed consent forms were scattered across the CE offerings except for the last LPN workshop, in which only 7 of 15 informed consent forms were submitted. This may have been due to a personnel change in the CE department prior to the workshop and the person was unaware to draw

Discussion

There is great need for nurses with geriatric nursing competencies in assessing and treating acute exacerbations of chronic conditions, new acute illnesses or sentinel events such as hip fractures. Evidence of nurse shortages, especially those with geriatric expertise, is alarming to nurse educators and clinicians desiring to improve geriatric nursing care. Many initiatives in schools of nursing18 and in hospitals19 are underway. Increasing geriatric competencies in already-practicing nurses

Conclusions

Clinical simulations are effective in increasing geriatric nursing knowledge. Nurse participants enjoyed the interactive nature of clinical simulations, especially those that used a HPS. Research is needed to determine if the self-reported increase in skills levels translate into better patient care.

Mary H. Palmer, PhD, RN, C, FAAN is Umphlet Distinguished Professor at the University of North Carolina at Chapel Hill, Chapel Hill, NC.

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  • Cited by (13)

    • Great geriatric syndromes: Acquisition of nursing competencies and undergraduate nursing students' perceptions through high-fidelity simulation training

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      Furthermore, no research study to date has shown the effectiveness of the MAES© methodology in improving the acquisition of the necessary nursing competencies for adequate management of these syndromes, as this methodology has been mainly applied for adequate nursing management of adult patients (Arizo-Luque et al., 2022). The clinical simulation methodology has shown nursing students' improvement in their geriatric knowledge (Palmer et al., 2008), clinical judgment (Johnson et al., 2012), leadership skills (DeBrew and Hensley-Hannah, 2017), and interprofessional collaboration (Brown et al., 2021) in caring for older people. However, none of these studies used standardized patients in their simulation sessions.

    • The effects of high-fidelity simulation training on empathy and attitudes toward older people among undergraduate nursing students: A quasi-experimental study

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      This methodology meets all the requirements defined by the International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice: SimulationSM (INACSL Standards Committee, 2016) and has proven to be more effective than traditional simulation-based learning (Díaz Agea et al., 2019). Previous studies have demonstrated the effectiveness of simulation-based training in geriatric education (Palmer et al., 2008; Siew et al., 2021), specifically improving the attitudes toward older people (Ross et al., 2017) and empathy (Chua et al., 2021; Levett-Jones et al., 2019) among healthcare students. However, there is a paucity of literature regarding the use of clinical simulation in nursing education focused on the adequate management of great geriatric syndromes.

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    Mary H. Palmer, PhD, RN, C, FAAN is Umphlet Distinguished Professor at the University of North Carolina at Chapel Hill, Chapel Hill, NC.

    Vicki Kowlowitz, PhD is a Clinical Associate Professor at the University of North Carolina at Chapel Hill, Chapel Hill, NC.

    Jane Campbell, RN, MSN, APRN, BC is an Adjunct Assistant Professor at the University of North Carolina at Chapel Hill, Chapel Hill, NC.

    Carlye Carr, MSN, FNP, APRN, BC is a Nurse Practitioner for Palliative Care, Durham Regional Hospital, Duke University Health Systems, Durham, NC.

    Roberta Dillon, RN, MSN, CNS was a Clinical Instructor at the University of North Carolina at Chapel Hill, Chapel Hill, NC.

    Carol F. Durham, RN, MSN is a Clinical Associate Professor at the University of North Carolina at Chapel Hill, Chapel Hill, NC.

    Lindsay Allen Gainer, RN, MSN is a Nurse Manager, Hematopoetic Stem Cell Transplant Unit, Chidren's Hospital, Boston, MA.

    Jeanne Jenkins, RN, MSN, MBA was a Clinical Assistant Professor at the University of North Carolina at Chapel Hill, Chapel Hill, NC.

    Julianne B. Page, RN, MSN is a Clinical Assistant Professor at the University of North Carolina at Chapel Hill, Chapel Hill, NC.

    Joyce Rasin, PhD, RN is an Associate Professor at Widener University, Chester, PA.

    Funding source: Health Services and Resources Administration.

    Comprehensive Geriatric Education Program.

    Grant Number: D62HP01913.

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