Clinical Simulation in Nursing (2008) 4, e41-e47
www.elsevier.com/locate/ecsn
Featured Article
Implementation of Simulated Learning Experiences for
Baccalaureate Pediatric Nursing Students
Lauri A. Linder, MS, APRN, CPONÒ, Nancy Pulsipher, MS, RNC
University of Utah College of Nursing, Salt Lake City, UT 84112, USA
KEYWORDS Abstract: This article presents the development and implementation of simulated learning experi-
Pediatric nursing; ences for baccalaureate pediatric nursing students at the University of Utah College of Nursing. Learn-
nursing students; ing experiences include use of simulated human pediatric patients and a simulated electronic medical
baccalaureate nursing record and are included in both didactic and clinical courses. Objectives include demonstration of pe-
program; diatric nursing skills, synthesis of assessment findings, prioritization of nursing interventions, docu-
simulated electronic mentation, and multidisciplinary communication. Student feedback indicates improved confidence
medical record; when approaching pediatric patients and better preparation to respond to acute changes in the patient’s
simulated human condition. Plans include ongoing refinement of simulated learning experiences and the linking of actual
patients clinical outcomes to simulation-based learning.
Cite this article:
Linder, L. A., & Pulsipher, N. (2008, October). Implementation of simulated learning experiences for
baccalaureate pediatric nursing students. Clinical Simulation in Nursing, 4(3). doi:10.1016/j.ecns.
2008.09.002
Ó 2008 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier
Inc. All rights reserved.
Introduction presented in didactic courses, which aids in providing
continuity in learning experiences (Schoening, Settner, &
Simulation is a familiar and well-established pedagogy for Todd, 2006). Simulated learning experiences can provide
teaching clinical nursing skills. Simulation provides the all students in a given cohort with opportunities to develop
learner an opportunity to acquire essential skills in an specific clinical skills. Students also are supported in clinical
environment that approximates the actual clinical setting as decision making and the development of critical thinking
closely as possible. Because clinical placements for nursing skills in a safe and controlled environment through simulated
students have become more limited as demand has increased, learning scenarios (Jeffries, 2005). The interactive, multisen-
the role of simulated learning activities has taken on a greater sory nature of a simulated learning scenario creates an envi-
significance within the overall program of study (American ronment in which all students have the opportunity to receive
Association of Colleges of Nursing, 2008). immediate feedback from faculty members.
Simulated learning offers faculty the opportunity to As technology has advanced, new opportunities for
coordinate hands-on learning opportunities with content simulated learning have become available to guide learning
experiences. The advent of medium- and high-fidelity patient
simulators has made more realistic, interactive learning
E-mail address: (L. A. Linder). opportunities available for students (Solnick & Weiss,
1876-1399/08/$ - see front matter Ó 2008 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc. All rights reserved.
doi:10.1016/j.ecns.2008.09.002
, Simulated Learning Experiences for Baccalaureate Pediatric Nursing Students e42
2007). High-fidelity simulators provide the added benefit of patient simulator and 1 high-fidelity infant human patient
engaging all the students’ senses as they palpate, listen, ob- simulator. This area of the Simulation Learning Center
serve, and then synthesize what they see, hear, and feel supports learning experiences related to basic care, in-
with theoretical concepts from didactic course content cluding bathing, feeding, and positioning for comfort;
(Clark, 2007). These interactive opportunities provide the ad- medication administration; physical assessment, including
ditional benefit of supporting clinical decision making and vital signs; oxygen administration; vascular access options;
prioritizing interventions. Simulated electronic medical re- and blood sampling.
cords facilitate integration of multiple sources of clinical
data and support the learner in clinical decision making Simulated Electronic Medical Record
(Staggers, Gassert, & Curran, 2001). Such learning activities
are particularly valuable for the learner with minimal experi- In May 2006, the College of Nursing began use of the Utah
ence in a given clinical setting or prior to encountering a more Clinical Academic Record Excellence (UCARE), the Univer-
high-risk clinical situation. sity of Utah’s implementation of the Cerner Academic
The purpose of this article is to present the development Education Solution (AES) system (Gassert & Sward, 2007).
and implementation of simulated learning experiences for UCARE-AES is a fully functional electronic health record
baccalaureate pediatric nursing students at the University of suite that has been populated with simulated patient data. It
Utah College of Nursing. These learning experiences, in serves as a high-fidelity clinical information system simulator,
both didactic and clinical courses, include activities with allowing students to learn patient information management
pediatric human patient simulators and a simulated elec- concepts, content, and care processes within a controlled aca-
tronic medical record. demic environment. Use of the UCARE-AES system supports
students in gaining beginning-level informatics competencies,
including using administration applications for practice man-
Simulated Learning in the University of Utah agement; using sources of data relating to patient care and
College of Nursing practice; accessing, retrieving, and entering data for patient
care; and documenting patient care and education (American
Strategic Plan Association of Colleges of Nursing, 2008; Gassert & Sward,
2007; Staggers, Gassert, & Curran, 2002).
An important component of the strategic plan for the The UCARE-AES system contains a simulated medical
University of Utah College of Nursing is to enhance quality center that is divided into several units, reflecting the clinical
education through innovative technology-based delivery focus of each semester within the baccalaureate program.
modalities, including the use of simulation (University of Students are assigned to their respective semester-based units
Utah College of Nursing, 2007). Technological resources to as patients. Students create a userID and password to access
support teaching have been implemented throughout the bac- the system and to document care (Gassert & Sward, 2007).
calaureate program and range from the use of learning-sys- Faculty members receive a userID and password that allow
tem software applications supporting classroom-based them to access and review students’ documentation.
teaching to the use of human patient simulators and a simu- Faculty representatives from each semester team were
lated electronic medical record to support clinical teaching. involved in designing and developing selected aspects of the
electronic medical record for use within their respective
Simulation Learning Center courses. For example, pediatric course faculty provided input
regarding the selection of pediatric pain assessment tools and
The College of Nursing’s Simulation Learning Center is the documentation of pediatric assessments, including
a 5,600-square-foot facility. The center is divided into growth and development. Examples of documentation re-
dedicated suites to support teaching in medical-surgical, ma- sources within the pediatric unit of the UCARE-AES system
ternity, pediatric, and critical care nursing (University of include growth and development, including comparison of
Utah College of Nursing, 2008). The Simulation Learning findings with developmental norms; ongoing assessment
Center emphasizes care in the inpatient setting and features findings; patient and family education; and an ongoing
low- to high-fidelity human patient simulators. Also con- nursing plan of care. The UCARE-AES system also includes
tained within the Simulation Learning Center are monitoring a tool for compiling significant patient findings into situation,
equipment and supplies for demonstrating clinical skills. background, assessment, recommendation (SBAR) format
Plans are under way to expand the Simulation Learning Cen- to support students in preparing to communicate significant
ter into a 10,600-square-foot facility, with the goal of devel- findings as interdisciplinary health care team members.
oping it to support interdisciplinary education and research SBAR is the communication format recommended by the
(University of Utah College of Nursing, 2007, 2008). Joint Commission, the accrediting organization for health
The existing pediatric nursing suite features 12 infant services organizations in the United States, to facilitate accu-
and 4 pediatric low-fidelity human patient simulators, as rate and timely patient-related communication among health
well as 1 infant and 1 pediatric moderate-fidelity human care team members (Haig, Sutton, & Whittington, 2006).
pp e41-e47 Clinical Simulation in Nursing Volume 4 Issue 3
