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Overall the AR module was better received compared with the control group with regards to realism, identifying landmarks, visualization of internal organs, ease of use, usefulness, and promoting learning and understanding.

Simulation, once the domain of those faculty who enjoyed the technical aspects of using computerized mannequins, has now moved to center stage in nursing education. Nursing programs realize that they can no longer afford to consider simulation as merely an 'add-on.’ Simulation today includes role play, standardized patients, virtual simulation, and computerized mannequins. It is now imperative to integrate simulation throughout the entire curriculum. Today, simulation allows students to learn skills; develop clinical reasoning abilities; and to become competent in caring for patients/families in a safe environment. The variety of simulation-based learning options can offer a way to replace traditional, and often hard to find, clinical experiences. In this article, the author describes the background, theoretical basis, and current uses of simulation; reports on simulation effectiveness in nursing; shares educational strategies to enhance effectiveness; and considers simulation methods and feedback and debriefing strategies. The conclusion addresses simulation evaluation, and the future of simulation in nursing education.

BackgroundNurse managers have a pivotal role in fostering unit climates supportive of implementing evidence-based practices (EBPs) in care delivery. EBP leadership behaviors and competencies of nurse managers and their impact on practice climates are widely overlooked in implementation science. The purpose of this study was to examine the contributions of nurse manager EBP leadership behaviors and nurse manager EBP competencies in explaining unit climates for EBP implementation in adult medical-surgical units.MethodsA multi-site, multi-unit cross-sectional research design was used to recruit the sample of 24 nurse managers and 553 randomly selected staff nurses from 24 adult medical-surgical units from 7 acute care hospitals in the Northeast and Midwestern USA. Staff nurse perceptions of nurse manager EBP leadership behaviors and unit climates for EBP implementation were measured using the Implementation Leadership Scale and Implementation Climate Scale, respectively. EBP competencies of nurse managers were measured using the Nurse Manager EBP Competency Scale. Participants were emailed a link to an electronic questionnaire and asked to respond within 1 month. The contributions of nurse manager EBP leadership behaviors and competencies in explaining unit climates for EBP implementation were estimated using mixed-effects models controlling for nurse education and years of experience on current unit and accounting for the variability across hospitals and units. Significance level was set at α < .05.ResultsTwo hundred sixty-four staff nurses and 22 nurse managers were included in the final sample, representing 22 units in 7 hospitals. Nurse manager EBP leadership behaviors (p < .001) and EBP competency (p = .008) explained 52.4% of marginal variance in unit climate for EBP implementation. Leadership behaviors uniquely explained 45.2% variance. The variance accounted for by the random intercepts for hospitals and units (p < .001) and years of nursing experience in current unit (p < .05) were significant but level of nursing education was not.ConclusionNurse managers are significantly related to unit climates for EBP implementation primarily through their leadership behaviors. Future implementation studies should consider the leadership of nurse managers in creating climates supportive of EBP implementation.Electronic supplementary materialThe online version of this article (10.1186/s13012-018-0753-6) contains supplementary material, which is available to authorized users.

In healthcare, the sustained presence of hierarchy between team members has been cited as a common contributor to communication breakdowns. Hierarchy serves to accentuate either actual or perceived chains of command, which may result in team members failing to challenge decisions made by leaders, despite concerns about adverse patient outcomes. While other tools suggest improved communication, none focus specifically on communication skills for team followers, nor do they provide techniques to immediately challenge authority and escalate assertiveness at a given moment in real time. This article presents data that show one such strategy, called the Effective Followership Algorithm, offering statistically significant improvements in team communication across the professional continuum from students and residents to experienced clinicians.

Simulation has had a long and varied history in many different fields, including aviation and the military. A look into the past to briefly touch on some of the major historical aspects of simulation in aviation, military, and health care will give readers a broader understanding of simulation's historical roots and the relationship to patient safety. This review may also help predict what the future may hold for simulation in nursing. Health care, like aviation, is driven by safety, more specifically patient safety. As the link between simulation and patient safety becomes increasingly apparent, simulation will be adopted as the education and training method of choice for such critical behaviors as communication and teamwork skills.

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As the use of simulation-based experiences increases, the INACSL Standards of Best Practice: Simulation are foundational to standardizing language, behaviors, and curricular design for facilitators and learners.