Simulation vs Classroom Learning: Are They Equal?

Background: High fidelity simulation (HFS) has been used extensively in undergraduate nursing programs.  Nurse practitioner programs are adopting simulation, but there is limited outcome data from the nurse practitioner (NP) student population. A pilot study comparing the outcomes of classroom learning alone to classroom learning plus participation in a HFS experience evaluated learning outcomes through the use of a 10-item quiz is presented.

            SMARTER (Simulation Module for Assessment of Resident Targeted Event Responses) offers an approach to the creation of simulation content and evaluation of student performance during case-based sessions. SMARTER, an event based approach to training, was developed using competencies for residents in emergency medicine, and was adapted to nurse practitioner performance measures, using NONPF acute care pediatric NP competencies. The competencies guided the development of  learning objectives and measurable KSA’s (knowledge, skill and attitudes) to be evaluated. Targeted student responses were identified and evaluation of student performance was incorporated within the eight-step design. A standardized participant enacting the role of the parent was also incorporated in the HFS to provide a more realistic acute care environment.

Method/Results: The research design was a one group pretest-posttest design. Participants were second year pediatric acute care NP students.  Post-test scores did increase after participation in the simulation experience, but the increase was not statistically significant.  The SMARTER behavioral assessment tool demonstrated that learners met the majority of targeted responses during the HFS. Mean scores on the Meti Simulation Evaluation Tool indicated that the students strongly agreed that the simulation experience increased their confidence, strengthened skills, with managing real patients and had an overall positive educational experience. The debriefing process allowed students the chance to discuss their decision making processes during the simulation. Students also received feedback from the standardized participant during debriefing. 

 Conclusions:  Despite a non-significant increase in post test scores following the simulation experience, student evaluations demonstrated that students perceived an increase in confidence and knowledge acquisition as a result of the simulation experience. Students preferred the simulation experience to classroom learning, as it offered them an opportunity to view their deficits in a safe learning environment.