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The virtual nurse is having a bad day. In the corridors of her digital hospital, she encounters a dilemma at every turn: a supervisor has personal issues, a dispatcher has scheduling problems. Doctors are vague. Co-workers are needy. Patients are just plain angry. But our avatar nurse, and her human operator, are in this virtual hospital for a critical dose of reality.
The virtual hospital is part of "Your Future In Nursing," an interactive program created by Johnson & Johnson and available at DiscoverNursing.com. The program puts prospective nurses in a virtual clinic setting, where they encounter situations that can obscure or obstruct proper treatment.
Players participate in a series of role-playing scenarios, and then select a response from a pull-down menu. Real nurses, on video, appear after each scenario to explain if, or why, their choice was correct. Websites like these can help curb high drop out rates by letting student nurses know what exactly they're in for.
"I think the site is valuable, especially for new nurses who haven't been in a clinical setting," said Betty Bailey, Denver Campus Chair for the University of Phoenix College of Nursing. "In class, the focus tends to be specifically on task and skills. But in real life, you're never treating people under ideal circumstances. Student nurses must get used to different situations and stressful environments. They have to get comfortable enough to use their decision-making and critical thinking skills."
Nursing school turnover is a problem worldwide. A 2006 British study reports that more than a quarter of British student nurses left their studies. Domestically, the dropout rate for community college nursing students hovers between 18 and 20 percent.
At University of Phoenix, where the Nursing School's LPN to BSN program takes only Licensed Practical Nurses, culture shock is just one factor. "Many of our students have full-time jobs, marriages and children, on top of going to school," Program Manager Ronnie DeFord explained. "They have to balance a number of issues, and any one can affect retention." That said, DeFord agrees that a nurse's journey, from theoretical study to life-and-death practice, is a brutal transition. "Once you have to apply what you learned in a clinical setting, that's always a wake up call. You not only have to understand what's going on, you have to act on it in a way that will save lives."
For this reason, the University of Phoenix College of Nursing developed state-of-the art Simulation Labs. The first, which was unveiled in October of 2009 in Phoenix, uses realistically detailed High Fidelity Manikins—including infants—in a series of clinical simulation scenarios. "The first time [students] use the lab is for physical assessments," DeFord explained. "They practice skills like listening to heart and lung sounds, and taking vital signs. Then they practice putting in primary and secondary IVs and NG tubes."
Students then progress to immersive simulation scenarios. Developed by program managers and college chairs, these slice-of-life simulations steadily increase in detail and difficulty. "We simulate the kind of difficult interpersonal situations you can find in practice: where the patient is screaming and shouting, or the family is asking questions." DeFord said. "It's up to the nurse to control the whole environment and administer proper care."
This elaborately conceived program, called Immersive Clinical Simulation, goes beyond student retention to narrow the gap between theory and practice. "It's useful because you can see the students perform but you can also see their thinking," Bailey said. "Students can talk about their thought process, but [the simulation lab] gives us a forum to demonstrate it. Maybe they're not listening as closely as they think they are. Maybe they skip a step they think they performed. When we see things like that, valuable learning takes place."
"We want to give nursing students a safe place to make mistakes before they ever get to the bedside," DeFord explained. Like "Your Future in Nursing," the Sim Lab may intimidate students in the short term, but the goal is a more qualified nurse. "It will better prepare them to advocate for their patients," DeFord said. "And the patient can be more confident in their care."
References
Alvy, D. (2010, May). Nursing student support group eases stress. American Nurse Today.
(2008, April 9). Student nursing drop out rate high. BBC News.
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