Using Simulation Technology to Identify Gaps Between Education and Practice Among New Graduate Nurses

Abstract

Applied knowledge was observed among nurse groups from a medical-surgical residency program to measure clinical performance during simulation training. Twenty groups of new graduate nurses were observed during five simulated clinical scenarios, and their performances were scored on a 24-item checklist. Nurse groups showed significant improvement (p < 0.001) in applied knowledge in four clinical domains from week 1 to week 5, and the results provided valuable information of the groups' overall performances. In two of the five scenarios, poor decisions and prioritization of competing tasks were factors associated with lower performance group scores. Complex patient conditions may pose a challenge for new graduate nurses, and standardized training during the residency program may help instructors recognize specific factors to address during the transition from education to practice.

The New RN and Emergency Patient Care Scenarios: How Simulation Can Help

“…Everett-Thomas, Valdes, Fitzpatrick, & Birnback [5], discuss the need for standardized training programs to transition the new graduate nurse. The simulation design included five conditions that included acute onset of myocardial infarction, hyperglycemic crisis, hypoglycemic crisis, sudden cardiac arrest and heart failure with severe respiratory distress.…”

“…While this is an ongoing dilemma in nursing education, healthcare leaders must Research done by Everett-Thomas, Valdes, Fitzpatrick, Rosen, and Birnback [5], shows that nurse residency programs can actually reduce costs associated with training new nurses through retention. Their study showed that with the incorporation of simulation to provide new nurses with five basic scenarios, new onset of myocardial infraction, hypoglycemic and hyperglycemic episodes, cardiac arrest and heart failure with severe respiratory distress could reduce turnover rates of new nurses by 30%.…”

“…they can make poor decisions due to many factors that include lack of experience, poor prioritization of care skills, standardized training in internship programs may assist them in attaining the goal of safe practice and that simulation training can become a familiar way to train and assist new graduate nurses to transition to practice [5]. Garvey [1] discusses failure to rescue and the nurse's impact to clinically intervene with the use of communication to escalate concerns regarding the patient condition.…”

“…Everett-Thomas et al, [5] recommend a simulation curriculum design, which incorporates five specific simulation-training scenarios. These scenarios include acute onset of myocardial infarction, hyperglycemic crisis, hypoglycemic crisis, sudden cardiac arrest, and heart failure with severe respiratory distress.…”

“…Studies suggest that nurses need clinical experience and cognitive abilities to handle stressful situations with their patients. To achieve best patient care outcomes and prevent reoccurrence of the disease process new nurses need added training [5].The intervention of adding high fidelity simulation training to the new graduate nurse internship-training program will benefit the new nurse in the education to practice knowledge gap, incorporate excellence in nursing practice by promoting high quality patient care. The simulation scenarios allow the new …”