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Nursing Simulation Evaluation: Impact on Nursing Education and Practice


The selected nursing simulation was developed by the nursing program of Montgomery College. Its purpose is to educate nursing students about specific nursing care situations they would encounter in real-life practice using a simulated context (Montgomery College, 2013).

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The simulation scenario is on the physical assessment of a hospitalized patient. The patient in the simulation is a 38-year-old female who was admitted after experiencing dehydration, vomiting, and nausea for three days. Her medical history indicates that she had a colon resection for colon cancer 22 months prior to admission. This paper seeks to demonstrate that the use of simulations impacts positively on nursing education and practice.

Benefits of Using Simulation in Nursing Education

Simulation provides nursing students with opportunities for practicing problem-solving, communication, critical thinking, and healthcare practice skills within safe environments (Sanford, 2010). It is an innovative approach to teaching nursing students about actual healthcare situations within controlled settings. Additionally, simulation allows nursing students to gain hands-on experiences in nursing care in interactive learning environments (Bambini, Washburn, & Perkins, 2009).

Simulations enable nursing students to critically reflect upon their performance in learning activities and practice. Sanford (2010) asserts that nursing students are effectively taught how to take medical history when simulations are used in the learning process. According to Sanford (2010), simulations are effective learning tools in nursing education as they provide mechanisms for providing feedback on learning experiences. They also enable nursing students to learn effectively alongside colleagues and skilled professions within healthcare settings (Bambini et al., 2009).

Objectives of the Simulation

The main learning objective of the selected simulation is to enable nursing students to differentiate between local assessment and complete or systemic physical examination (Montgomery College, 2013). The simulation is also designed in a manner that enables nursing students to apply their history taking skills in acquiring relevant data on the patient’s social, surgical, and medical history. In addition, it is meant to teach nursing students how to facilitate history taking during physical examination.

Furthermore, the simulation is designed to improve skills such as gathering and applying necessary equipment in conducting a complete assessment on a patient. The specific skills the simulation scenario seeks to develop include maintaining privacy and respect during a physical examination and implementing safety standards (Montgomery College, 2013). It also allows nursing students to communicate clearly with the patient, family members, and other healthcare providers.

The Composition of the Simulation

The International Nursing Association for Clinical Simulation and Learning (INACSL) guidelines provide that the content of simulation scenarios should be protected from disclosure (Sittner et al., 2015). The physical assessment scenario is aligned with INACSL guidelines as it preserves confidentiality requirements related to the simulation’s content during debriefing, physical assessment, history taking, and in providing feedback.

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The simulation scenario also incorporates the evidence-based practice, as provided by INACSL guidelines. The participating nurse students have a sound theoretical foundation on physical assessment and are able to demonstrate evidence-based interventions pertaining to the systemic assessment of patients. Furthermore, the participating students applied to evidence to justify the interventions they used.

The INACSL guidelines also provide that participants in a simulation experience should demonstrate ethical and professional behavior (Sittner et al., 2015). The actions of the participants are ethical and professional. For instance, they acted with respect, integrity, and honesty throughout the simulation experience and in providing feedback to the facilitator. Various learning domains are included in the simulation scenario, as provided by INACSL guidelines.

For example, the learning objectives address learning domains, such as clinical judgment, critical thinking, and working with multidisciplinary teams. Notably, the learning objectives are realistic, clear, and concise.

The INACSL guidelines stipulate that simulation scenarios should provide learners with opportunities for examining clients holistically (Sittner et al., 2015). The physical assessment simulation scenario is aligned with the holistic care guidelines of the INACSL because participants demonstrate competence in assessing the patient from social, cultural, spiritual, and cognitive contexts. The simulation takes 15 minutes while the guided reflection takes 30 minutes. This timeframe is reasonable for meeting learning objectives. Therefore, the simulation scenario is aligned with INACSL guidelines on setting appropriate timeframes for achieving learning objectives.

Application of TeamSTEPPS

The Team Strategies and Tools to Enhance Performance and Patient Safety (Team STEPPS) program provides nurses and other healthcare professionals with simple learning techniques designed to make them more efficient, adaptable, productive and accurate in promoting patient safety and healthcare quality. Even though the TeamSTEPPS approach has not been integrated into the curriculum of many nursing schools, it is effective in teaching communication skills meant to make nurses more effective in communicating with patients and other healthcare providers (Robertson et al., 2010). Notably, formal TeamSTEPPS training would allow nurses to become more effective in advocating for patients’ concerns and in learning from members of a multidisciplinary team.

TeamSTEPPS curriculum has five main modules: communication, mutual support, situation monitoring, and leadership. TeamSTEPPS approach is designed to improve the performance of healthcare professionals. Therefore, it should be used to allow nursing students to engage actively with multidisciplinary teams for the purpose of promoting patient safety (Robertson et al., 2010). TeamSTEPPS is designed to provide a structured approach to enable healthcare providers to exchange information with more accuracy and clarity. Therefore, it is useful in supporting learning within healthcare settings and in the transfer of knowledge from experienced nurses to student nurses.

TeamSTEPPS provides easy techniques for improved leadership performance. This means that its application in nursing education will allow student nurses to understand team actions and the process of sharing information. TeamSTEPPS curriculum is designed to teach students about effective situation monitoring. It also focuses on improving skills related to situation scanning and taking informed actions in healthcare practice (Guimond, Sole, & Salas, 2009).

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Therefore, TeamSTEPPS is an appropriate approach for improving the performance of student nurses in scanning healthcare scenarios and assessing patients’ circumstances for improved performance in nursing decision making. The TeamSTEPPS approach also provides reliable techniques for promoting mutual support in health care settings (Robertson et al., 2010).


Simulations advance nursing education and practice as they provide opportunities for active learning, which enables nursing students to retain learned skills and knowledge. The skills nursing students learn using simulations are easily translated into complex situations in actual healthcare environments. The INACSL guidelines provide standards and guidelines that support best practices pertaining to the application of simulation in advancing training and education.

Simulations should be developed and applied on the basis of INACSL guidelines in order to promote professionalism, ethics, and evidence-based practice in nursing education. Team STEPPS program supports nursing education through its evidence-based frameworks for improving communication, mutual support, leadership, and situation monitoring.


Bambini, D., Washburn, J., & Perkins, R. (2009). Outcomes of clinical simulation for novice nursing students: Communication, confidence, clinical judgment. Nursing Education Perspectives, 30(2), 79-82.

Guimond, M. E., Sole, M. L., & Salas, E. (2009). TeamSTEPPS. AJN the American Journal of Nursing, 109(11), 66-68.

Montgomery College. (2013). Nursing simulation scenario: Physical assessment. Web.

Robertson, B., Kaplan, B., Atallah, H., Higgins, M., Lewitt, M. J., & Ander, D. S. (2010). The use of simulation and a modified TeamSTEPPS curriculum for medical and nursing student team training. Simulation in Healthcare, 5(6), 332-337.

Sanford, P. G. (2010). Simulation in nursing education: A review of the research. The Qualitative Report, 15(4), 1006.

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Sittner, B. J., Aebersold, M. L., Paige, J. B., Graham, L. L., Schram, A. P., Decker, S. I., & Lioce, L. (2015). INACSL standards of best practice for simulation: Past, present, and future. Nursing Education Perspectives, 36(5), 294-298.

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