Learning from mistakes in a simulated nursing leadership laboratory

Area of Science:

• Nursing Education
• Healthcare Simulation
• Patient Care Management

Background:

• Human patient simulation is established in nursing education but research on evaluating student performance is limited.
• Existing research primarily focuses on single-patient, high-risk scenarios, with little evidence on multi-patient simulation efficacy.
• This study addresses the gap by simulating a routine acute-care hospital unit environment.

Purpose of the Study:

• To evaluate the efficacy of high-fidelity simulation in a multi-patient scenario for senior baccalaureate nursing students.
• To assess students' ability to manage competing demands on time and attention while caring for multiple patients.
• To identify common errors in clinical judgment, prioritization, delegation, and communication during simulated patient care.

Main Methods:

• A high-fidelity simulation was designed to replicate a routine day in an acute-care hospital unit.
• Senior baccalaureate nursing students participated in team-based scenarios, assuming interdisciplinary roles.
• Students navigated staged sequences of changing patient and unit conditions, applying principles of prioritization, delegation, scope of practice, and communication.
• A structured debriefing session followed the simulation to analyze student performance and identify errors.

Main Results:

• The simulation effectively presented the competing demands on nurses caring for multiple patients.
• Students demonstrated challenges in prioritization, delegation, and communication, leading to critical errors.
• Identified errors included incorrect patient transfers and failure to rescue or delegate essential tasks.
• The debriefing facilitated student recognition of judgment errors in a complex care environment.

Conclusions:

• High-fidelity simulation provides a valuable tool for teaching and evaluating complex, multi-patient care scenarios in nursing education.
• Simulation effectively reveals critical areas for improvement in nursing students' leadership, decision-making, and teamwork skills.
• This approach enhances preparedness for the realities of acute care nursing practice, emphasizing the importance of effective delegation and communication.