Learning from mistakes in a simulated nursing leadership laboratory

Human patient simulation in nursing education has become an accepted and expected form of pedagogy. Research on the use of human patient simulation to evaluate student performance, however, is still at an early stage. The vast majority of these sources report the unit of analysis as the nurse-patient dyad (one nurse-one patient) situated in an infrequently occurring, high-risk, or costly event such as a code blue, and the literature reveals little evidence on the efficacy of the use of simulation for the care of multiple patients. The teaching innovation, discussed herein, involving a simulation, used a leadership scenario of a routine day in an acute-care hospital unit. The aim of the project was to provide a high-fidelity simulation of the competing demands on a nurse's time and attention while caring for multiple patients. Working as a team, using principles of prioritization, delegation, scope of practice, and communication, senior baccalaureate nursing students assumed the various roles of interdisciplinary team members as they moved through staged sequences of changing patient and unit conditions. This was followed by debriefing session that prompted the students to identify their errors in judgment, including sending the wrong patient to the operating room, failing to rescue a patient, and failing to delegate critical tasks to other nursing team members.