For nursing faculty, seeking the holy grail of simulation makes a difference in clinical performance (Kirkpatrick Level 3 evaluation). Meyer, Connors, Hou, and Gajewski (2011) demonstrated better performance in clinical after two weeks of simulation substituted for clinical, compared to groups without the simulation experience. This group devised a fairly simple but ingenious study design (see the article as it is much clearer with a visual): clinical faculty, employed by the hospital, were blinded to which students had been in simulation. All students in a clinical group were scored by their faculty every two weeks. Those with simulation first were scored consistently better than students who had not been in simulation.
Simulations were designed to cover things most frequently required of nurses in pediatrics, and were designed to move from simple to complex—with increasing complexity over the two weeks of simulations.
A simple evaluation tool with good reliability and validity, which evaluated performance, communication, clinical judgment, therapeutic skills, interprofessional communication, and documentation, was used biweekly by the clinical faculty to evaluate student performance. As clinical faculty, we are very aware of how little time we get to spend with any one student to form an opinion about ability and judgment. We know that our mental snapshots and words for the evaluation forms come from flitting images in the hallways, short conversations, skill observations at the bedside…frequently for 8–10 students spread out over the clinical rotation. However, in this study, students performed clinical skills significantly better after simulation. This is important in itself, as Ironside and McNelis (2010) found that clinical faculty spend almost 70% of their time observing students performing skills in clinical. Meyer et al. reported that these students did not perform better in clinical judgment. However, it is rare that students are allowed to make significant clinical judgments at the clinical site. The authors suggested that a more specific clinical judgment tool might have changed those scores. But that is for another study. This is a study deserving of replication.
Ironside, P.M., McNelis, A.M. (2010). Clinical education in prelicensure nursing programs: Results from an NLN National Survey 2009. National League for Nursing, New York.
Meyer, M.N., Connors, H., Hou, Q., Gajewski, B. (2011). The effect of simulation on clinical performance. Simulation in Healthcare, 6, 269–277.