Editor's Note: This article is excerpted from The NLN Jeffries Simulation Theory, a monograph published by the National League for Nursing, copyright 2015.Based on the thorough synthesis of the literature by Adamson (see page 282) and discussion among simulation researchers and leaders, the NLN Jeffries Simulation Framework (2005, 2007, 2012) is now referred to as the NLN Jeffries Simulation Theory with a few minor changes within the conceptual illustration. The concepts of this theory are briefly described below to provide more clarity and to explain the new NLN Jeffries Simulation Theory. (See the Figure for a diagram of the theory.)CONTEXTContextual factors such as circumstances and setting impact every aspect of the simulation and are an important starting point in designing or evaluating simulation. The context may include the place (academic vs. practice; in situ vs. lab) and the overarching purpose of the simulation, for example, whether the simulation is for evaluation or instructional purposes.BACKGROUNDWithin this context, the background includes the goal(s) of the simulation and specific expectations or benchmarks that influence the design of the simulation. The theoretical perspective for the specific simulation experience and how the simulation fits within the larger curriculum are all important elements of the background and inform the simulation design and implementation. Finally, the background of a simulation includes resources such as time and equipment, as well as how these resources will be allocated.DESIGNOutside of and preceding the actual simulation experience are specific elements that make up the simulation design. Although some elements of the simulation design may be changed during implementation of the simulation experience, there are aspects of the design that need to be considered in preparation for the simulation experience.The design includes the specific learning objectives that guide the development or selection of activities and scenario(s) with appropriate content and problem-solving complexity. Elements of physical and conceptual fidelity - including decisions about equipment, moulage (physical), and appropriate, predetermined facilitator responses to participants' interventions (conceptual) - are established as part of the simulation design. Participant and observer roles (including whether or not videography will be used), progression of activities, and briefing/debriefing strategies are all established as part of the simulation design.SIMULATION EXPERIENCEThe simulation experience is characterized by an environment that is experiential, interactive, collaborative, and learner centered. This environment requires the establishment of trust; both the facilitator and participant share responsibility for maintaining this environment. They enhance the quality of the simulation experience through "buying-in" to the authenticity of the experience and suspending disbelief. This helps promote engagement and psychological fidelity within the simulation experience (Kiat, Mei, Nagammal, & Jonnie, 2007; Leighton & Sholl, 2009; van Soeren et al., 2011).FACILITATOR AND EDUCATIONAL STRATEGIESWithin this simulation experience is a dynamic interaction between the facilitator and the participant. The literature about the characteristics these individuals bring to the simulation experience and how they affect the simulation experience is extensive. Facilitator attributes include (but are not limited to) skill, educational techniques, and preparation (Parker & Myrick, 2012; Parsh, 2010). The facilitator responds to emerging participant needs during the simulation experience by adjusting educational strategies such as altering the planned progression and timing of activities and providing appropriate feedback in the form of cues (during) and debriefing (toward the end) of the simulation experience.PARTICIPANTParticipant attributes also affect the simulation learning experience. …

NLN Jeffries Simulation Theory: Brief Narrative Description.

Virtual versus face-to-face clinical simulation in relation to student knowledge, anxiety, and self-confidence in maternal-newborn nursing: A randomized controlled trial

https://www.nursingsimulation.org/article/S1876-1399(13)00060-1/pdf

Causes of Student Anxiety during Simulation: What the Literature Says

Aims
To evaluate the effect of an active learning program on competency of senior students.

Background
Active learning strategies have been used to help students achieve desired nursing competency, but their effectiveness has not been systematically examined.

Design
A descriptive, cross-sectional comparative design was used. Two cohort group comparisons using t-test were made: one in an active learning group and the other in a traditional learning group.

Methods
A total of 147 senior nursing students near graduation participated in this study: 73 in 2010 and 74 in 2013. The active learning program incorporated high-fidelity simulation, situation-based case studies, standardized patients, audio-video playback, reflective activities and technology such as a SmartPad-based program.

Results
The overall scores of the nursing competency in the active group were significantly higher than those in the traditional group. Of five overall subdomains, the scores of the special and general clinical performance competency, critical thinking and human understanding were significantly higher in the active group than in the traditional group. Importance-performance analysis showed that all five subdomains of the active group clustered in the high importance and high performance quadrant, indicating significantly better achievements. In contrast, the students in the traditional group showed scattered patterns in three quadrants, excluding the low importance and low performance quadrants. This pattern indicates that the traditional learning method did not yield the high performance in most important areas.

Conclusion
The findings of this study suggest that an active learning strategy is useful for helping undergraduate students to gain competency.

Competency and an active learning program in undergraduate nursing education

AIM The purpose of this manuscript it to disseminate findings from a systematic review of the literature related to the NLN/Jeffries Simulation Framework. BACKGROUND This review was initiated by the National League for Nursing to illuminate what is currently known about best simulation practices, research to support these practices, and priorities for future research. It is part of a larger project aimed at further developing the NLN/Jeffries Simulation Framework. METHOD Searches using CINAHL, the journal Simulation in Healthcare, and reference lists from key documents yielded 1,533 relevant publications for the period January 2000 to September 2014. RESULTS The final review of the literature includes 153 studies. Three themes, along with key issues, gaps, and best practices supported by the literature, were identified. CONCLUSION This systematic review provides empirical support for the major components of the NLN/Jeffries Simulation Framework and contributes to its further development.

A Systematic Review of the Literature Related to the NLN/Jeffries Simulation Framework.

The primary purpose of this study was to test a hypothesized model describing the direct effects of learning variables on anxiety and cognitive learning outcomes in a high-fidelity simulation (HFS) experience. The secondary purpose was to explain and explore student perceptions concerning the qualities and context of HFS affecting anxiety and learning. This study used a mixed methods quantitative-dominant explanatory design with concurrent qualitative data collection to examine variables affecting learning in undergraduate, beginning nursing students (N = 124). Being ready to learn, having a strong auditory-verbal learning style, and being prepared for simulation directly affected anxiety, whereas learning outcomes were directly affected by having strong auditory-verbal and hands-on learning styles. Anxiety did not quantitatively mediate cognitive learning outcomes as theorized, although students qualitatively reported debilitating levels of anxiety. This study advances nursing education science by providing evidence concerning variables affecting learning outcomes in HFS.

Variables Affecting Learning in a Simulation Experience: A Mixed Methods Study

Reports indicating problems with quality and safety in our healthcare institutions have led to a change in how the science of safety and delivery of high-quality patient care is taught. Changing how students are educated requires nurse educators to be innovative in bridging the gap between education and practice. This article describes replicable, innovative strategies to equip faculty to lead a change in nursing curricula using Kotter's 8 steps of change.

A time for change: QSENizing the curriculum.

https://www.nursingsimulation.org/article/S1876-1399(13)00232-6/pdf

Kelly P. Beischel

Papers

Variables Affecting Learning in a Simulation Experience: A Mixed Methods Study

A time for change: QSENizing the curriculum.

Using a Standardized Patient to Teach Fall Safety