Experience with simulation in the context of teaching communication skills for end of life nursing care indicated success for exactly the reasons identified by Rich above.  Define narrowly and precisely what you intend to achieve. Then, simulation, done well and with skilled debriefing afterward, can help students to reflect on their successes and areas that need additional thought & practice. In the past 5 years, there's been an explosion of nursing research about this topic.  The driver for using simulation so widely has been the competition among nursing and medical schools to secure clinical positions in hospitals for their students.  Licensing bodies permit simulation to fulfill a portion of the required clinical hours.  Starting with simulation ensures that our students put their best foot forward during on-site clinical rotations.

Without being pedantic, it depends on what you mean by "work".  For example, most students are enamored with human patient simulation.  They would tell you it better matches their desire to care for patients while, at the same time, removes most of the elements of risks of bad outcomes.  Make a mistake? Reboot and try again, no harm done.  David Gaba, the primary developer and researcher of health care simulation see https://www.researchgate.net/profile/David_Gaba) has numerous studies addressing just this question.  

I think the crucial point is that simulation is a tool for educating practitioners, and like every tool it works as well or as poorly as the hands (and brain) of the person developing, organizing and implementing the simulation.  Simulation needs skilled hands and heads in the driver's seat, and the ability to skillfully question and guide the student.  If you let the simulation "run itself" you will soon see its limitations.

Finally, there is a cost benefit analysis.  If I have a modern classroom, internet facilities, projectors and computers, I can construct a good interactive lecture with numerous pictures, graphs, and mnemonics.  But a poor teacher remains poor in spite of large expenses on technology.  If you have watched a TED talk, you have seen a good teacher speak to students with nothing more than a microphone and, in some cases, a dry erase board.  Simulation is the same; many of the devices cost 10s of thousands (and some 100s of thousands) of dollars.  Lack of user training has them sitting unused in closets gathering dust.  You and your institution, if you folow the path of simulation, need to commit to hours of training for the teachers as well as the expense of the device.

Best wishes in your search for excellence

Cheers!

Rich

Simulation can "work"  if the simulated procedure is as authentic as possible. Secondly it must provide the student an opportunity of integrating theory and practice. However the educator must be well versed with this type of teaching/learning method. Lastly the technology used for simulation must be closed to the real world situation as possible which sometimes is not the case

Experience with simulation in the context of teaching communication skills for end of life nursing care indicated success for exactly the reasons identified by Rich above.  Define narrowly and precisely what you intend to achieve. Then, simulation, done well and with skilled debriefing afterward, can help students to reflect on their successes and areas that need additional thought & practice. In the past 5 years, there's been an explosion of nursing research about this topic.  The driver for using simulation so widely has been the competition among nursing and medical schools to secure clinical positions in hospitals for their students.  Licensing bodies permit simulation to fulfill a portion of the required clinical hours.  Starting with simulation ensures that our students put their best foot forward during on-site clinical rotations.

Many thanks for the nice experience you shared,its really valuable

Agree with all of the above with a special emphasis on ensuring you have a person skilled in debriefing as this is where the majority of metacognition takes place.  Students need to reflect (think) about their thinking, why they made certain decisions, etc. Without the debriefing, it is really just practicing some skills. 

That is really nice,thanks a lot

As stated above, research has been completed to show that simulation "works" in nursing. One study I would like to mention is a national study that was completed at George Washington University. The NCSBN National Simulation Study by Hayden, Smiley, Alexander, Kardong-Egren, and Jeffries asked the following questions:

1. Does substituting clinical nursing hours with simulation impact the educational outcomes at the end of an undergraduate program?

2. Are there differences in the student's clinical competency, critical thinking and readiness for practice in new graduate nurses when they use simulation instead of clinical practice hours?

The study was done across the nation using 10 different schools. There were 3 groups. A control group that had 10% simulation in their education, another group that had 25% of their clinical time replaced with simulation, and a third group who had 50% of their clinical time replaced with simulation. 

The study found there were no significant differences in knowledge from the groups who had simulation as opposed to those who did not have simulation. They found that even if 50% of their clinical time was replaced with simulation, it did not affect their NCLEX licensing exam board scores which student nurses take after graduation to become RNs. They also discovered that 50% of students who had simulation were less stressed in their first 6 weeks of work as a new graduate working in the field of nursing.

So in conclusion, the study discovered that up to 50% of simulation can be substituted for traditional clinical experiences in all core courses across pre-licensure nursing curriculum. This was done id different geographic area in urban and rural settings with good educational outcomes. NCLEX pass rates were unaffected by substituting simulation throughout the curriculum. All groups were equally prepared for entry practice as new graduates but the simulation group felt less stress in their first 6 weeks. This study is helping policy decisions regarding the use of simulation in nursing.

The Ohio Board of Nursing recently made a policy change that stated simulation can replace clinical hours in obstetrics and pediatrics related to inability for students to get clinical placements. Simulation can be very effective because it can guarantee a situation for students that may not always happen during clinical. It is a safe place to practice and make mistakes where no one is harmed. Students get to stand alone to make decisions in simulation which helps them learn to think on their feet.

I participate in simulation in our labs in my roles  as the nursing lab coordinator. I have found  in my personal experiences that simulation does work. It is a great learning tool for students to be engaged at the application level. Hands on learners do well learning using this methodology.

Kim Kunkle, Stark State College, Nursing Lab Coordinator

It most certainly depends on what skills are being learned. It is always helpful to "see" the condition of the patient and from a personal view, always helped me the most to cement a memory for response to a situation. Some students have found labs to be very helpful ( but are many times instead of no experience with a particular situation). I continue to be concerned about the hiring of new grads with very limited practical experience unless the institution has an intern program to assure the grad is at an acceptable level of practice ability. I fear for the level of illness hospitalized patients are today to be cared for by an inexperienced nurse with no instructor present.

Thanks you for your comments and experience shared

I have learned so much from all of these responses. In my experience as a nursing instructor, administration needs to show commitment to this teaching method by allocating funds for faculty training, equipment repair and replacement, and faculty positions to run all of the needed lab sessions. Even though simulation can "legally' replace clinical rotation time, preparing, supervising, and debriefing simulation sessions is very time consuming.

Yes,, a good simulation can work both as a teaching and assessment method

Thanks Professor Gamal for your answer

most welcome Dr. Tarig. Keep up the good work.

Yes, it works well if it is done correctly. There are various simulation modalities and they have their specifics that need to be taken into account.

Thanks for the elegant answer

I believe that simulation is an integral part of nursing education.Our students are better prepared cognitively.affectively and psychomotorally when they are exposed to actual  learning experiences..In the Philippines our regulating body ,the Commission on Higher Education in its 2017 Policies and Standards for Nursing Education ,has mandated all colleges of nursing to be equipped with virtual labs where simulation can be done(CHED Memo15 series 2017)

I echo Valeriy's answer. Task performance is a matter of muscle memory. When the task is simulated in a manner less than perfect, the student imbeds imperfection in their muscle memory. It is imperative that Instructors get "it right". The old adage practice doesn't make perfect, perfect practice makes perfect.

Regards,

Christopher

We using simulation at all levels of nursing education and in the practice environment to enhance learning by allowing participants to applying didactic principles in case scenarios, without the pressure of real life.  We have used this in teaching competency, assessment and critical thinking scenarios with nurses of all levels of experience.  They appreciate the engaging methodology and see the real applications to practice. We have found more extensive changes in the behavior after receiving  mixed methodology education, including simulation.