SIMULATION

PRESENTED TO- Dr. Sukhwinder Kaur

Lecturer
NINE, PGIMER
Chandigarh
PRESENTED BY- Nisha Yadav
M.SC. Nursing 1st Year
NINE, PGIMER
Chandigarh
Outline
 Introduction  Steps of simulation
 Definition  Values of simulation
 Purposes  Advantages
 Characteristics  Disadvantages
 Uses in nursing  Demonstration
 Types of simulation  Conclusion
 Principles
 Applications
 Procedure of simulation
 Activities in simulation
Introduction
 Simulation is a technique that enables adult learners to
obtain skills, competencies, knowledge or behavior by
becoming involved in situations that are similar to those
in real-life.
 This method of teaching attempts to address problems
of real-life conditions & to discuss them completely
after the presentation is over.
 Nurse educators strive to mimic reality in their practice
laboratories, they find that nursing students often do not
make the imaginative leap required to visualize dummy
model as a real life patient.
Meaning
 Simulation is the basis of sensitivity training,
socio drama, role playing & psychodrama. It
is not actual teaching. Certain underlying
skills to teaching can be modified, described
& practiced like any other skill.
 It is assumed that through role perception the
psychological appreciation of the classroom
problems will grow and develop in the
student teacher a basis for handling the
problems in the class
Definition
 Simulation may be defined as a role playing in which the process of teaching is
enacted artificially and an effort is made to practice some important skill of
communication through this.
 Simulation is a technique the enable adult learners to obtain skills,
competencies, knowledge or behavior by becoming involved in situations that
are similar to those in real life (R Sudha)
 Role play in which the process of teaching is displayed artificially and an effort
is made to practice some important skills of communication through this
technique (K P Neeraja)
Purposes
 To help students practice decision making and problem
solving skills and to develop human interaction
abilities in a controlled and safe setting
 By means of active involvement in a simulation
exercise, a game, or a role-playing situation, the
student achieves cognitive, affective and psychomotor
outcomes.
 Students have a chance to apply principles and theories
they have learned and to see how and when these
principles work.
Characteristics of simulation
 Systematic planning
 Proper involvement of students
 Feedback
 Proper environment
 Based on system approach
 Training is provided on artificial situations
 Proper adjustment of time factor
Uses in Nursing
 Increasing awareness of the need to address patient safety.
 In the acquisition of communication skills.
 The ability of simulation to enhance clinical practice
 Learn to solve problems efficiently with minimal wasting of time
and resources.
 Used to evaluate the student learning and competence.
 It is used to achieve many nursing outcomes
 Simulation can help nursing student gain skill in applying the
nursing process
Types of simulation

1. Written simulation
2. Audio visual simulation
3. Live simulated situations
Written simulation
 Individual uses either paper and pencil latent
image format. The purposes includes problem
solving, decision making.
 To evaluate student’s ability to apply the skill.
Audio visual simulation
 An entire simulation can be placed on videotape.
Management vignettes can be dramatized and
filmed.
 Questions can be created for the viewers right on
the screen, and the alternative outcomes,
dependents on which approaches to a solution
are chosen, can be all taped.
Live simulated simulation
 Lincoln, Layton and holdmen (1978) described their experiences
with simulated patients.
 The patients were healthy people, usually students, who were
trained in the role they were to play.
 Simulated patient used their own history as much as possible but
memorized and added the elements of the history that had been
created for the simulation.
 Nursing students found the experience to be beneficial. They
would be much more relax and confident when meeting their first
real patient.
Cont..
 Video recording : can be used to help students develop physical
examination skill in much the same way as for interviewing skills.
 Simulation devices :These devices include those for cardiac
auscultation, breast examination, prostate palpation, pelvic
examination and laryngeal examination.
 Simulated patients : These can also be used very much the same way
as for history taking with the similar advantages.
 Model examination
 Oral simulation
 Computerized simulation
Points to remember while preparing simulation

 Initiate the problem in a realistic manner, it should contain the

elements a nurse would encounter in real life situation
 Reflect problem solving process by requiring a series of
sequential interdependent decisions
 Enables the learner to obtain the necessary information and/or
feedback related to a previous decision as input to the next step.
Principles
 Players take on roles which are representatives of the real world
and then make decisions in response to their assessment of the
setting in which they find themselves.
 The experiences simulated are consequences which relate to their
decisions and their general performance.
 “Monitor” the results of their actions are brought to reflect upon
the relationship between their own decisions and the resultant
effect
Application of simulation in teacher
training
Cruikshank (1968) has developed a teacher training system which includes :
 The participant is introduced into the situation (ex: if he is a new
teacher in school )
 The participant is provided with information and opportunities to
solve the problems (for beginning teacher )
 The participant is exposed to a variety of potential solutions to a
particular problem.
 The participant is given the opportunity of observing the results of his
chosen line of action.
 The participant is presented with role playing situations, written and
response sheet.
Cont…
 The participant is introduced to the situation by film strips.
 The participant is also given the materials. Ex: The rules,
regulations, curriculum handbook and record cards, to familiarize
to the topic.
 Theparticipant is presented with role playing situations, written
and response sheet.
 Theparticipant then identifies the factors influencing the problem,
locates the relevant information, suggests appropriate alternative
course of action, communicates and implements a decision.
 Theparticipant then identifies the factors influencing the problem,
locates the relevant information, suggests appropriate alternative
course of action, communicates and implements a decision.
Procedure of simulation
Selecting the role players:
 A small group of 4 to 5 student teachers is selected.
 The role assignments are rotated within the group to give chance
to everyone.
 Every member of the group gets an opportunity to be the actor
and the observer.
Cont…
Selecting and discussing skills :
 The skills to be practiced are discussed and the topics that fit in
the skill are suggested.
 One topic each is selected by the group members for exercise.

Planning :
 It has to be decided who starts the conversation, who will top the
interaction and when.
Cont…

Deciding the procedure of evaluation :

 How to record the interaction and how to present it to actor has to be
decided so that a proper feedback on his performance could be given.

Provided practical lesson :

 The role players should be provided reinforcements on their performance
to give them training for playing their part well.
Activities in simulation
 Role playing
 Socio-drama
 Gaming
Steps of simulation process by Goldstein
and Pfeiffer (1983)
 Experience
 Sharing
 Processing
 Generalization
 Application
Experience:
 Experiencing or simulating the particular problem or situation.
 Four or five participants ,each one of them identify their own purpose of the
exercise & its ultimate goal.

Sharing :
 Participants shares their experiences after the exercise.
 They share both their observations of what, when and how they felt about
activities or events.
 Often the feelings are very important to reveal their comments about
objective events.
Processing :
 Processing the information gathered during the sharing stage.
 This is generally accomplished with all the participants.
 The goal of this step is to identify commonly shared experiences or perceptions
& to identify common themes among the group members.

Generalization :
 The teacher guides the group into drawing broad implications from the
experience & resulting discussion.
 This is the most important phase of the entire process, & if left out, the learning
will appear incomplete.
Application :
 The final stage of the process is to help the participants to apply
the new generalization to future situations.
 Overall application phase is designed to give the participants a
chance to apply the new concepts, feelings & ideas in real life
situation
Requisites for good simulation process

 Active involvement of all students.

 Clarity : the decision made should be based on the clear effect and
causes of the simulation process & resulting discussion.
 Feasibility : It measures the cost in terms of materials, space, & time
against outcomes.
 Repeatability and reliability : These qualities are important because
it is essential that simulation be repeated with the same degree of
reliability relative to its outcome. This will improve the accuracy of
learning as well as the credibility of simulation process.
Values of simulation process
 Enables the learner to learn directly from experience
 Promotes high level of critical thinking
 Develops in the students an understanding of the decision making
process
 Enables the individual to emphasis with the real life situation
 Provides feedback to the learners on the consequences of actions &
decision made
 Motivate the students by making real life situations exciting &
interesting
 Enables teachers & learners to assess the realism of the situation by
uncovering misconceptions.
Advantages
 Simulation offers an excellent opportunity to learn from mistakes
 Simulation fosters critical thinking & problem solving skills.
 Simulation helps students to acquire concrete meaning for abstract terms
 Simulation provides a realistic experiences, students can easily apply these
concepts in the clinics
 Simulation establishes a setting where theory and practice can be combined.
 No risk involved. The decisions are made and carried out without physical or
psychological harm to children or school as a result of practice teaching.
 Simulation is a teaching device that motivates and involves students. It changes
teacher behavior. Introduces Freshness and novelty.
CONT….
 Simulation is highly student centered because of its very interesting
& motivating nature, effectiveness in teaching slow learners as well
as fast learners & all types of students.
 It provides participants to deal with the consequences of their
actions.
 Students can learn without harming the patient.
 Students can receive feedback on the appropriateness of their action.
 The controlled setting of the simulation makes it possible to have
consistency in learning experiences from learner to learner.
Disadvantages
 Simulation can’t be made in all subject of the curriculum
 Simulation can’t be conveniently used in case of small children
because mechanism is too difficult for them to follow.
 It requires a lot of preparation on the part of teachers
 Minimum of feedback sequence to choose
 Time consuming
 Need for many simulators.
 Simulation is costly in terms of both time and money.
CONT..
 Simulation cannot be devised in a fraction of time.
 Simulation techniques also consume a lot of class room time.
 Simulation technique can be overused.
 Acquisition of necessary factual content and would result in
boredom.
 It is possible that emotions may be aroused to an undesirable degree,
especially with role playing.
 Not every instructor feels comfortable using simulation strategies.
Requires all the information you need in front of you on a notepad.
Cont..
 The process and outcomes of simulation methods are not always
predictable.
 Usable for small groups.
 Models often easily damaged.
 Never same as performing technique on a patient. beware of faulty
learning.
 Learners may not find the simulation relevant to their situation.
 Games application to nursing can cost hundreds of dollars each.
Teacher’s preparation
Planning :
 Choosing appropriate simulation
 Assign reading before class
 Point out textbook & library resources to prepare
 Teacher is responsible for maintaining environment like
ventilation, lighting, chairs tables
CONT…

Facilitating :
 After introducing the activity teacher should talk relatively
little.
 Teacher must coach students who are trying to find their way
through a sticky problem and encourage creative thinking and
act as information resources.
 Take notes during the class so that in later discussion teacher
can talk about weaknesses and strengths
CONT…
Debriefing :
 Teacher’s role is the final discussion or debriefing session,
Immediately following the simulation when the information is
fresh in everyone’s mind.
 Teacher should briefly summarize.
 Self analysis can help students gain insight into why they made
certain decisions or took a specific course of action.
 At the end of the discussion period teacher should point out how
principles and concepts have been applied and how the
experience ties into the learning objectives.
Conclusion
 Simulated teaching is an innovative approach because students engage in genuine
communication in playing their roles. In addition to encouraging genuine
communication, active involvement, and a positive attitude, the simulated “real
life” problems help students develop their critical thinking and problem solving
skills.
 Students have the opportunity to try out new behaviors in a safe environment,
which helps them develop long term motivation to master.
References

 Basheer PS. Textbook of Nursing Education. EMMESS Medical Publishers. 1 st

ed. 2018; 125-30.
 Neerja PK. Textbook of Communication and Education Technology. Jaypee
Medical Publishers. 2011. 1st ed; 267-9
Thankyou…….