Transcending Competency Testing in Hospital-Based Simulation

Abstract

Simulation is a frequently used method for training students in health care professions and has recently gained acceptance in acute care hospital settings for use in educational programs and competency testing. Although hospital-based simulation is currently limited primarily to use in skills acquisition, expansion of the use of simulation via a modified Quality Health Outcomes Model to address systems factors such as the physical environment and human factors such as fatigue, reliance on memory, and reliance on vigilance could drive system-wide changes. Simulation is an expensive resource and should not be limited to use for education and competency testing. Well-developed, peer-reviewed simulations can be used for environmental factors, human factors, and interprofessional education to improve patients' outcomes and drive system-wide change for quality improvement initiatives.

Educating Oncology Nurses with Simulation: A Chemotherapy Spill

“…Simulation is used to evaluate and improve nurses' skills, competencies and confidence but is also capable of creating system wide changes. Lassche & Wilson (2016) descibe how the Quality Health Outcome Model (QHOM) is utilized to evaluate the intervention, the client, the system and the outcome. A simulation created for one purpose may reveal human factors or system issues that can be improved.…”

“…The finding may change as the simulation is repeated on different shifts with diverse staffing patterns. The simulation allows for trial and error with no harm to to patients (Lassche & Wilson, 2016). In 2009 the Joint Commission (JC) began requiring health care agencies to use a systematic, measurable way to evaluate employee competencies.…”