Let’s Play Hospitals: A Simulated Paediatric Hospital Ward for Nursing students and Children

Introduction/background: Undergraduate nursing programs are tasked with preparing nursing graduates to care for people across the lifespan. This includes the paediatric patient. However, undergraduate programs do not always have paediatric specific courses, nor are there sufficient clinical placements for students to gain exposure or experience with paediatrics. As a result, graduates may lack competence and fear caring for children. Aim/objectives: The aim of this study was to enhance undergraduate nursing students’ work readiness and confidence to care for children by immersing them in a simulated hospital paediatric ward with specifically designed activities. Their experiences were then evaluated. Methods: Following ethical clearance, participants were recruited across all years from a Bachelor of Nursing programme. Participants were briefed and then involved in a paediatric simulated hospital experience with groups of children from 2-8 years. A mixed methods approach was used to gather data. Participants were asked to complete a confidence scale (White 2014) questionnaire pre and post their experience and a simulation satisfaction scale (Levett-Jones et al., 2011) post the experience. Inductive thematic analysis was used to find meaning in the data and SPSS assisted with the analysis of the quantitative data. Results: Both qualitative and quantitative data indicated a marked improvement in paediatric nursing skills and work readiness among the student nurses after the simulation experience. The quantitative data illustrated statistically significant improvements in paediatric nursing skills in relation to clinical learning, clinical reasoning and clinical confidence as a result of the simulation experience. The post simulation reflection opportunity has further reinforced the students’ paediatric nursing skills. The qualitative data indicated that the students who were unconfident and nervous to communicate effectively and perform medical play with children became confident after the simulation experience. Similarly, most students who indicated that they were not ready for paediatric nursing prior to the simulation experience showed confidence or positive thoughts towards paediatric work readiness after the simulation experience. In addition, those who showed some level of clinical confidence and paediatric work readiness were able to reinforce and enhance their work readiness through the simulation training. Many students however highlighted the importance of further simulation training throughout their nursing training for them to be competent in paediatric nursing. Discussion The simulated childrens ward involved using four different activity stations.Children aged between 2- 8 years rotated around each station and were provided a real time experience by undergraduate nursing students. The nursing students had the opportunity to experience children’s play, practice age related communication and provide explanations to the children about hospital related procedures that the children may encounter. The high level of satisfaction reported and increased confidence in students regarding dealing with children proved to be beneficial in preparing them for real world practice. With the lack of paediatric placements, it is necessary that nursing curricula examine strategies in simulation that can enhance the learning for undergraduate students about paediatrics. Conclusions: If nursing programs are preparing students to be competent clinicians caring for people across the lifespan, then careful examination needs to occur in the paediatric context. This simulated children’s hospital experience is a step in the right direction. This study also provided a guide for the transference of designing and setting up a simulated paediatric ward to other settings