Nurse Practioner: Virtual Simulation

Shirley Musclow, Lawrence S. Bloomberg Faculty of Nursing

WHAT IS THE INNOVATION THAT YOU HAVE INTRODUCE TO YOUR TEACHING PRACTICE?
The Lawrence S. Bloomberg Faculty of Nursing offers a Nurse Practitioner graduate program taking in local, regional, national and international students on a path to a professional certification that culminates through an extended class registration exam. As a fully on-line master’s program, our students come from every province and territory in the country. We offer a hybrid program with both on-line education and mandatory/non-mandatory on-campus components.  Our students gain access to elective on-campus components using virtual classroom technology. We are also offering virtual classroom technologies for some of our on-line courses, where students have the option of attending class on-campus, on-line or through a virtual environment.  So far, student evaluations of this virtual technology have been extremely positive.

An important focus of the program is for students to develop advanced health assessment and diagnostic reasoning skills to students.  We do this through case-based learning in our low and high-fidelity Simulation Lab at the Lawrence S. Bloomberg Faculty of Nursing.  Students engage with ‘simulated patients’ to enhance their health assessment and diagnostic reasoning skills and to prepare for their OSCE (Objective Standardized Clinical Examination).  In the past, the ‘practising’ of these skills in our simulation lab has been an optional component of the program.  Much of this ‘practice’ has been gained through clinical placements in hospital and community settings.  Our goal has been to revolutionize the way advance practice nurses develop clinical skills and we have developed a set of resources that enable skill development  using video technology in a virtual classroom environment linked directly to our Simulation Lab. We are trialing these new technologies in ‘virtual simulation’ in our “VITAL” Project – Virtual Interactive Teaching and Learning, which partners a remote student with an on-site student in the Simulation Lab.  Through this remote environment students participate in a virtual assessment, conducting health histories and physical assessments on simulated patients with common health problems.

To overcome student isolation, and help build a community of practice to support the on-going professional development of our students as clinicians, we are also using virtual classrooms to establish social presence through course work for selected curriculum components including access to guest lecturers from remote and international locations.

WHAT RESEARCH INFORMS YOUR WORK IN THIS AREA?
Our program builds on the work of others.  It is informed by researchers and other University and Faculty initiatives such as ePresencing and LMS utilities including Blogs and ePortfolios. In particular, the program is influenced by the scholarship of teaching and learning as applied to the nursing profession, with attention to establishing a social presence for the distant education student.

PLEASE DESCRIBE THE IMPLEMENTATION PROCESS. WHAT WAS INVOLVED?
As new strategies are introduced they are piloted with smaller groups and the program seeks feedback from the students and instructors. For example an experiment with Twitter as a tool for micro-blogging for self-reflection was undertaken last year. Privacy issues are a concern and currently we are moving to using new institutionally supported technologies as they are more secure and we are able to leverage central services. The program delivery strategies and pedagogy are continually being reviewed and improved.

WERE THERE ANY OBSTACLES THAT NEEDED TO BE OVERCOME?
One challenge area is instructors work load as they learn to use new technology as an additional requirement to the teaching process. Also, it is important to have a backup plan in case the technology does not work as anticipated. Contingency plans are very important.

WHAT ARE THE BENEFITS FOR THE LEARNERS IN THIS PROGRAM?
The main benefit is flexibility for students and instructors, with learning occurring any place and even any time as sessions are archived. Web-based delivery allows leading experts to be brought into the program and gives students access to expertise they would not otherwise be able to experience. Our students feel empowered by being able to interact and learn with their peers by using on-line technologies to create their own media objects, self-reflect through course blogs, as well as actively participate in collaborative projects through the use of Wikis — all as part of the course experience.

WERE THERE ANY SURPRISES OR UNEXPECTED OUTCOMES?
We have been able to leverage video archives and related resources to enhance the student experience through review or use by students not able to participate in real time.  While not necessarily a goal of the program, one side benefit has been learning experiences for the faculty involved and new professional development opportunities arising through the course design and delivery process.

DO YOU HAVE ANY PLANS FOR THIS PROJECT IN THE FUTURE?
New ideas keep emerging as the program goes forward. Virtualizing simulations is an important area of new development for the program in order to bring the curriculum to life and further engage the students. Also of note, the nursing program has several global collaborations in research, education and practice. This includes Aboriginal communities in Canada and internationally including Brazil, Ethiopia, India, Spain, Australia, Finland, Mexico, and India.   The faculty is interested in broadening the participation of partners and students globally.