Exploring the Performance Outcomes of Senior Level Nursing Students in a Multiple Patient Simulation

The new nurse graduate must be prepared for the complexities of the workplace. Research has shown a gap in transition from education to practice highlighting the importance that experience plays in providing safe and effective care. This exploratory study used a multiple patient simulation, where the student managed the care of three simulated patients at one time, to investigate their ability to utilize surveillance, to identify subtle cues of patient deterioration and to take action to manage a complication. The methodology was guided by the National League for Nursing (NLN)/Jeffries Simulation Framework because of the positive correlation between simulation design and student outcomes. Twelve students volunteered for the role of primary nurse and were the source for data collection. Performance outcomes were evaluated by an independent rater who viewed videotapes of each student’s performance and measured the behaviors using the Seattle University Simulation Evaluation Tool. The evidence showed that the students focused on physical tasks such as applying oxygen without gathering enough clinical evidence to prioritize the plan of care. Delegation, communication and use of the health care team were areas in need of further development while an overwhelming workload emerged as the major barrier to managing care with competing demands. The findings from the study support the use of multiple patient simulation as a teaching-learning strategy to improve decision making, and ultimately the care provided to patients as a new graduate