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Background: In March 2020, COVID-19 forced institutions of higher education, faculty, staff, and students to transition to emergency remote learning. This unprecedented time provided the opportunity to reenvision the delivery of nursing education and operation of the college of nursing, using the principles of the four Cs of interorganizational partnering as a guide supported by positive organizational scholarship. Method: The Villanova University Fitzpatrick College of Nursing designed and implemented strategies to provide seamless learning opportunities for students in undergraduate and graduate nursing programs, while providing necessary support and future planning for the upcoming academic year. Results: Online and virtual learning platforms integrated into curricula assisted students to meet course objectives and program outcomes. Strategies for effective communication, collegiality, and collaboration within and among the college, university, and nursing community served as mechanism for innovation. Conclusion: Communication, cooperation, coordination, and collaboration, along with positive organizational strategizing and support contributed to a successful transition during the COVID-19 pandemic; many of the approaches implemented during the emergency transition will continue into the future. [ J Nurs Educ. 2020;59(12):675–682.]

Background: Nurses are members of interprofessional cadres of health care professions with vital roles as disaster shelter volunteers and leaders for recovery efforts. Nurses must be equipped with the skills needed to care for communities postdisaster. Providing students with opportunities to engage in interprofessional simulated disaster experiences is an effective method for preparing them to work in leadership roles during disasters. This article describes a case study in the use of simulation to enhance health care students' knowledge and interprofessional collaboration roles in disaster management. Method: The Disaster Aftermath Interprofessional Simulation (DAIS) tabletop exercise was developed by nursing and public health faculty. Results: Students prioritized health interventions and investigated a foodborne outbreak in an emergency shelter. Students applied knowledge from their respective disciplines, collaborating to develop plans to protect populations. Conclusion: The DAIS is an innovative method for preparing nursing students to work as interprofessional team members in disaster response and recovery. [ J Nurs Educ . 2020;59(6):353–356.]

Background: Simulation can extend ethics education in undergraduate nursing programs beyond the cognitive domain. However, the degree to which nursing students recognize and respond to microethical dilemmas in simulation is unknown. Method: Using a mixed-methods convergent parallel design, 68 third- and fourth-year undergraduate nursing students completed a sensitivity questionnaire. Twelve students also participated in an interview. Data were compared to create meaning. Results: Many students reported having a high level of ethical sensitivity toward microethical dilemmas during simulation. However, some students expressed uncertainty in their ability to identify microethical dilemmas during nurse–patient interactions. Students also reported limited confidence in being able to transfer their ethical knowledge to the practice setting. Conclusion: Nurse educators must be moral agents during simulated learning experiences by helping students learn what microethical dilemmas are and strategies to manage them. [ J Nurs Educ . 2020;59(2):88–92.]

Background: Confusion remains about the use of the observer role in simulation. Observational learning is an emerging form of brain-based learning that is applicable to experiential learning and simulation, warranting the further exploration of theoretical foundations. This article describes how observational experiential learning theoretically supports the use of observer roles in simulation. Method: Constructs and concepts from experiential learning and observational learning theories were explored in tandem with brain-based learning evidence from different disciplines. Results: Observational experiential learning was developed by merging these theories together in simulation and debriefing to support both observer and participant roles for learning outcomes. Conclusion: Observational experiential learning incorporates experiential learning, social learning, and social cognitive theories to support the use of the observer role. Educators should consider strategies to foster attention and motivation through prebriefing, debriefing, and observational brain-based learning protocols. [ J Nurs Educ . 2020;59(1):7–14.]

Background: Near-peer teaching is a form of peer-assisted learning with at least 1 year of difference between the groups of students. Method: A near-peer simulation allowed junior nursing students to obtain a focused history and assessment, administer medications, and provide patient education to senior students. Senior students provided performance feedback to the junior students. Faculty gave additional feedback and facilitated a group debriefing session. All students were asked to complete an anonymous online postsurvey. Results: One hundred nine junior and senior students completed the immediate postsurvey. The mean score was 2.14, corresponding to the “agree” response. Nearly three quarters (73%) of the students indicated they agree or strongly agree that “the simulation provided a variety of ways to learn.” Five themes emerged: Improved Confidence in Assessment Skills, Communication, Connecting Nursing Content, Peer Feedback and Interaction, and Awareness of Community Resources. Conclusion: Near-peer simulation is a beneficial teaching strategy for nursing students. [ J Nurs Educ . 2020;59(1):54–56.]

Background: Training with virtual patients has been proposed as a suitable learning activity to improve clinical reasoning skills for nursing students. However, published instruments with the capacity to assess students' reasoning process in the encounter with virtual patients are lacking. Method: Deductive and abductive analyses were used to adapt the Lasater Clinical Judgment Rubric (LCJR) to assess nursing students' clinical reasoning skills in the encounter with virtual patients. The new rubric's ability to capture nursing students' clinical reasoning processes was tested using deductive analysis and statistical analysis. Results: A grading rubric for virtual patients, the vpLCJR, was developed. Cronbach's alpha showed .892, indicating good internal consistency. Conclusion: The rubric vpLCJR, which deconstructs aspects of clinical reasoning for both students and faculty members, can be used to clarify expectations, assess students' clinical reasoning process, and provide feedback for learning when nursing students encounter virtual patients. [ J Nurs Educ. 2018;57(7):408–415.]

Background: Simulation is an integral component of health care education. Research suggests a positive relationship between simulation and learning outcomes. Kirkpatrick's framework is a four-level model based on the premise that learning resulting from training programs can be classified into four levels: reaction, learning, behavior, and results. Evaluation of educational impact provides valuable feedback to educators that may assist with development and improvement of teaching methods. Method: This review is based on the PRISMA guidelines for conducting a systematic review. Inclusion criteria included articles (a) written in the English language, (b) published between 2000 and 2016, (c) describing a debriefing intervention after high-fidelity patient simulation, and (d) based in health care. Results: Thirteen studies met criteria for inclusion in the review. Conclusion: Results indicated a paucity of studies at the highest levels of evaluation, indicating an area where future research is needed to assist with the development and improvement of simulation education. [ J Nurs Educ . 2018;57(7):393–398.]

Background: The study purpose was to examine changes in physical therapy (PT) and nursing (RN) student attitudes toward interprofessional learning (IPL) and interprofessional collaboration (IPC) following a high-fidelity code simulation. Method: PT ( n = 42) and RN ( n = 35) students, while working together to transfer a simulated patient, had to respond to a sudden and unexpected medical emergency. Pre- and postsurveys included the Interdisciplinary Education Perception Scale (IEPS), Readiness for Interprofessional Learning Scale (RIPLS), and Attitudes Toward Health Care Teams Scale (ATHCTS). A control group (PT, n = 41; RN, n = 33) of students were also surveyed. Results: Statistically significant between- ( p < .003) and within-group differences ( p ⩽ .006) occurred for the IEPS (competency and autonomy, perceived need for and perceptions of actual cooperation), the RIPLS (teamwork and collaboration, professional identity), and the ATHCTS (team value and efficiency). Conclusion: The IPL experience using high-fidelity simulation fostered the development of attitudes necessary for effective IPL and IPC. [ J Nurs Educ. 2017;56(8):456–465.]

Background: Competency in end-of-life (EOL) care is a growing expectation for health professions students. This study assessed the impact of four EOL care scenarios, using high-fidelity simulation, on the perceived learning needs and attitudes of pharmacy and nursing students. Method: On three campuses, pharmacy students ( N = 158) were exposed to standard paper EOL case scenarios, while a fourth campus exposed eight graduate nursing and 37 graduate pharmacy students to simulated versions of the same cases. Results: The paper-based groups produced similar pre–post changes on the End of Life Professional Caregiver Survey. Results were pooled and compared with the simulation-only group, revealing significantly higher changes in pre–post scores for the simulation group. Conclusion: Students participating in the simulation group showed some significant differences in attitudes toward EOL care, compared with students in the classroom setting. [ J Nurs Educ. 2017;56(4):205–210.]

Background: The effects of stress on nursing students' health and learning is important to educators. The purpose of this review was to critically integrate the literature related to the stress that nursing students experience regarding high-fidelity simulation (HFS). Method: Literature from multiple search engines and databases was systematically searched. Keywords and Boolean combinations included nursing students , simulation , stress , anxiety , and self-efficacy . Qualitative or quantitative studies published in English between 2010 and 2015 and studies including the effects of simulation on nursing student anxiety and stress were included. Seventeen studies were chosen. Results: Overall, students reported either moderate or high stress associated with simulation, but they rated the HFS experience as a valuable learning tool. Conclusion: This review demonstrated student acceptance of simulation as a learning strategy. However, more high-quality studies are needed to investigate techniques that can be implemented to decrease the negative effects of simulation stress on nursing students. [ J Nurs Educ. 2017;56(3):139–144.]

Background: Clinical instructors play an important role in the education of nursing students. Nursing faculty must provide orientation and support for clinical instructors to ensure quality clinical experiences for students. Simulation can be used as a teaching strategy to prepare clinical instructors for clinical teaching. The purpose of this article is to describe the use of simulation to prepare clinical instructors in the role of teaching and increase confidence to provide clinical education to students. Method: Clinical instructors attended an orientation program that included simulation. During the simulation, nursing student volunteers role-played situations that required instructors to intervene for patient safety. Following the simulation, clinical instructors completed an online survey to measure confidence in teaching students. Results: Twenty-six clinical instructors participated in the simulation with student volunteers and completed the survey. Conclusion: Clinical instructors thought the simulation prepared them for clinical teaching, increased their confidence, and assisted them to provide student feedback. [ J Nurs Educ. 2015;54(8):468–471.]

Clinical judgment is an essential skill needed by RNs. Employers expect new graduate nurses to enter the work-force with established clinical judgment skills. Therefore, nurse educators must ensure that prelicensure nursing students develop clinical judgment before graduation. This qualitative, interpretive description study reviewed the reflective journals of 30 prelicensure nursing students who participated in four progressive high-fidelity simulation (HFS) scenarios during a medical–surgical nursing course. Eight themes were identified in the reflective journals: (a) expectations about the patient, (b) recognition of a focused assessment, (c) interpretation of medications, laboratory data, and diagnostics, (d) communication with the patient, (e) collaboration and interprofessionalism, (f) prioritizing interventions, (g) skillfulness with interventions, and (h) incorporation of skills and information into real patient situations. This study indicated that reflective journaling following progressive HFS scenarios may be an effective teaching–learning strategy to assist prelicensure nursing students in the development of clinical judgment. [ J Nurs Educ . 2015;54(1):36–40.]

Background: Nursing students often describe initial clinical experiences as extremely anxiety producing. Anxiety can decrease performance ability and, consequently, increase the risk for patient harm. Strategies to decrease this anxiety related to clinical experiences are limited within the nursing education literature. Method: Faculty in a 4-year baccalaureate nursing program developed and implemented formative capstone simulation scenarios with standardized patients, integrating therapeutic communication, essential patient care skills, and clinical reasoning for novice nursing students prior to their entry into their first clinical practicum. This article discusses the rationale, development, and implementation of these formative capstone simulation scenarios. Results: Anecdotal student and faculty comments related to the formative capstone simulation scenarios were positive. Conclusions: Formative capstone simulation scenarios offer a method to prepare novice students for initial clinical practicum that is well received. Research is needed to formally examine the relationship between formative capstone simulation scenarios and student anxiety related to initial clinical practicum. [ J Nurs Educ . 2016;55(10):587–589.]

The Lasater clinical judgment rubric (LCJR) is a standardized scoring method to assess student clinical judgment. The aims of this study were to (a) develop a scenario-specific clinical judgment assessment tool guided by the LCJR and (b) evaluate the new assessment tool’s psychometric properties and ability to assess clinical judgment. Content validity was established using an expert panel. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to assess the psychometric properties of the instrument. Convergent validity was identified using critical thinking. A three-factor model identified and confirmed with EFA and CFA was used in the new assessment tool to assess 250 undergraduate nursing students from three universities in Seoul, South Korea. The internal consistency using Cronbach’s alpha coefficient was 0.825. Results of this study can provide nursing faculty with ways to develop and use new assessment tools in nursing education. [ J Nurs Educ . 2014;53(11):623–629.]

Due to today’s complex needs of hospitalized patients, nurses’ competence and strategies to improve competence are of growing importance. Simulation is commonly used to influence competence, but little evidence exists for comparing how presimulation assignments influence competence. A randomized control trial was used to compare the efficacy of three simulation preparation methods (expert modeling/intervention, voice-over PowerPoint/active control, and reading assignments/passive control) on improving competence for providing care to multiple patients among senior undergraduate novice nurses. Competence was measured at two time points (baseline and following a 5-week intervention) by two blinded raters using the Creighton Simulation Evaluation Instrument. Twenty novice nurses participated in the trial. No significant differences were noted in raw improvements in competence among the three groups, but the expert modeling (Cohen’s d = 0.413) and voice-over PowerPoint methods (Cohen’s d = 0.226) resulted in greater improvements in competence, compared with the passive control. [ J Nurs Educ. 2014;53(11):615–622.]

This article details how a small college of nursing affiliated with a faith-based health care corporation integrated the education of end-of-life care into a megacode simulation. Students participated in a high-fidelity simulated megacode scenario in which the simulator died. Following de-briefing, student groups participated in an additional scenario in which faculty coached them through postmortem care and interaction with a family member and a hospital chaplain. As a result of this multidimensional, interprofessional simulation, students developed heightened skill in applying basic life-saving measures, increased knowledge of and comfort with postmortem care, and increased awareness of the emotions elicited by the experience. [ J Nurs Educ. 2014;53(11):659–662.]

The purpose of this project was to examine the clinical judgment and reasoning skills of nursing students in high-fidelity simulation. Two levels of students ( N = 104), novices and those who are slightly more advanced, participated in individual videotaped simulations. Afterward, interviews were conducted to explore what the student was thinking and feeling during simulation. Five themes emerged from the interviews: thinking like a nurse, assessment, looking for answers, communication, and magical or reflective thinking. There was a clear distinction in the reasoning skills of the novice students compared with students with more clinical experience. Tanner’s model of clinical judgment in nursing is used to understand the findings of the study. [ J Nurs Educ. 2014;53(9):519–525.]

Simulation has gained much attention in the literature for its contributions to nursing education; however, the simulation process itself and how each of the components—prebriefing, scenario, and debriefing—are effective for learning are understudied. Specifically, how prebriefing may enrich simulation for learners without adequate prior clinical experience or how it may develop complex thinking skills and clinical judgment is not well understood. This article comprehensively reviews the available nursing simulation literature about the phenomenon of prebriefing and critically evaluates its current role as a component of nursing simulation. Gaps in the reviewed literature regarding the definition and purpose of prebriefing, alternate learning structures used in prebriefing, and use in relation to learner outcomes were identified. Implications for undergraduate nursing education and recommendations for further research are discussed. [ J Nurs Educ. 2014;53(3):136–141.]

High-fidelity human patient simulation (HFHPS) is an innovative teaching tool. However, limited data exist regarding factors affecting faculty use of HFHPS in undergraduate nursing education. Using a convergent, parallel, mixed-methods design, predictors of undergraduate faculty ( N = 139) use of HFHPS were explored. Data were collected using a Web-based survey. Results indicated a high percentage of HFHPS use in nursing programs but a low percentage of HFHPSs substituting for traditional clinical hours. Faculty who substituted clinical hours with HFHPS had lower self-efficacy beliefs around HFHPS than other faculty surveyed. Qualitative data supported the quantitative findings, including themes that HFHPS provided a safe environment for learning, but it was a mixed result. Results support that nursing faculty’s beliefs about HFHPS were strongly associated with HFHPS use. Specifically, self-efficacy beliefs and further exploration of the meaning of a safe environment for student learning should be addressed in future studies. [ J Nurs Educ. 2014;53(3):142–150.]

Schools of nursing are challenged to find clinical placements in public health settings. Use of simulation can address situations unique to public health, with attention to specific concerns, such as environmental health. Environmental health is an integral part of public health nursing and is a standard of professional practice. Current simulations focus on acute care situations, offering limited scenarios with a public health perspective and excluding environmental health. This study’s simulation scenario was created to enhance nursing students’ understanding of public health concepts within an environmental health context. Outcomes from the simulation include the need for integration of environmental issues in public health teaching. Students stated that this scenario provided a broader understanding of the environmental influences that can affect the client’s and family’s health. This scenario fills a void in simulation content, while providing an interactive teaching and learning strategy to help students to apply knowledge to practice. [ J Nurs Educ . 2014;53(1):48–51.]

Previous reviews of simulation relating to critical thinking and efficacy called for more research on the effects of simulation and safety. Safety, as a skill performance outcome of high-fidelity simulation, is reviewed. Data included studies of nursing education that linked safety dimensions with high-fidelity simulation at all student levels. Only primary sources published since 2007 were included. This integrative review evaluates data using scores to assign value to the evidence, analyzes data within categories defined as safety behaviors, and compares evidence using a matrix of factors and outcomes. Definitions of safety and measurement tools are critiqued. Findings reveal that simulation-enhanced clinical experiences may decrease medication errors. Any evidence about perceived improvement in safer communication has not been translated into practice. Knowledge and attitudes of safety may be improved with simulation, depending on the students’ educational levels. More comparative studies are needed to support theoretical models of simulation.

This study aimed to determine a poverty simulation’s influence on nursing students’ attitudes toward poverty. Five cohorts of baccalaureate nursing students participated in the study; two cohorts (experimental group, n = 103) participated in the simulation and three did not (control group, n = 75). The Attitudes Towards Poverty Short Form was administered before the simulation and 6 weeks later; higher scores indicated more positive attitudes toward poverty. Experimental group pretest scores were higher. Higher pretest global scores were negatively correlated with religious affiliation (Spearman’s rho = −0.294, p = 0.000) and positively correlated with prior poverty exposure (Spearman’s rho = 0.284, p = 0.000) and liberal political views (Spearman’s rho = 0.444, p = 0.000). Controlling for pretest differences, posttest mean scores for the experimental group (78.73) were significantly higher ( p = 0.007). The poverty simulation is an engaging learning experience providing an opportunity for students to gain sensitivity in working with this population.

This study examined the relationship between communication and nursing students’ team performance by determining whether variations in team performance are related to differences in communication regarding five task-relevant functions: assessment, diagnosis, planning, implementation, and evaluation. The study results indicate a positive relationship between nursing students’ team performance and comments focused on the implementation of treatment(s) and the evaluation of treatment options. A negative relationship between nursing students’ team performance and miscellaneous comments made by team members was also observed.

The NLN Jeffries Framework describing simulation in nursing education has been used widely to guide construction of human patient simulation scenarios and serve as a theoretical framework for research on the use of simulation. This framework was developed with a focus on prelicensure nursing education. However, use of human patient simulation scenarios is also a way of providing practice experiences for graduate students learning the educator role. High-fidelity human patient simulation offers nurse educator faculty a unique opportunity to cultivate the practical knowledge of teaching in an interactive and dynamic environment. This article describes how the components of The NLN Jeffries Framework can help to guide simulation design for nurse educator preparation. Adapting the components of the framework—which include teacher, student, educational practices, design characteristics, and outcomes—helps to ensure that future faculty gain hands-on experience with nurse educator core competencies.

End-of-life care is an essential part of undergraduate nursing education. However, students may not have the opportunity to be exposed to an actual end-of-life situation during clinical rotations. A pilot project was implemented to evaluate the use of forum theatre to teach end-of-life care to undergraduate nursing students. A simulation used live actors, with theatre faculty and students playing the roles of a hospice patient, family members, and nursing students providing end-of-life care. Additional nursing students were participant observers. Using forum theatre methods, students identified important moments that occurred during the simulation and suggested alternative actions for those moments. The simulation was repeated using those alternatives and was evaluated by the students. Group debriefing was provided by nursing faculty with all students. A reflective journal entry was completed by all students. Project outcomes indicated that forum theatre was an effective teaching method for the topic of end-of-life care.

The number of older adults with caregiving needs is rapidly escalating, and the majority of these adults are cared for at home by unpaid family members. Nurse educators must better prepare nurse graduates to meet the needs of this population, as well as to include family caregivers as part of the health care team. This article describes the design, implementation, and preliminary outcomes of a unique learning experience, the Life of a Caregiver Simulation, which uses narrative pedagogy to increase students’ awareness and understanding of the needs of older adults, their family caregivers, and the community services they use. Subjective data from students ( N = 25) indicated the simulation served as an effective catalyst for students to experience first-hand and understand the stress and burdens of caregiving.

This research study examined whether a transfer of learning (i.e., growth in clinical competency) occurred from the simulation laboratory to the clinical bedside and if it did occur, how. The study design was descriptive research, using 14 acute care nurse practitioner students. Observations were done in the simulation laboratory with a standardized patient and then in the clinical setting with an actual patient. The results showed significant growth in overall clinical competency from the simulation laboratory to the clinical bedside ( M diff = 0.08, SE = 0.02, t (13) = 3.03, p = 0.01, r = 0.64). A statistically significant correlation was noted between the overall competency scores of students in the simulation laboratory and the overall competency scores in the clinical setting, with r (12) = 0.63, p < 0.01. Three themes emerged from the students’ responses regarding how the simulation experience affected their clinical competency.

This study investigated the use of live simulation using simulated patients portraying people with intellectual disabilities. The study sample consisted of 173 health students. Using the simulation framework of Jeffries, students worked in groups of three; each student participated in at least one interaction with a simulated patient while the facilitator and other students in the group provided peer reflections. Students were given a specific task to complete with the patient simulator (e.g., obtaining a blood pressure reading). Student self-confidence and satisfaction with the simulation was measured using a questionnaire followed by students’ personal reflections and focus group feedback. Results indicate that students highly valued the simulation and thought it positively influenced direct care to patients with learning disabilities.

This study investigated the effectiveness of modules involving standardized patients and role-plays on training communication skills. The first module involved standardized patients and an Objective Structured Clinical Examination (OSCE); the second module consisted of peer role-plays and a written examination. A randomized posttest-only control group design with first-year nursing students was used. The intervention group received one-to-one communication training with direct oral feedback from the standardized patient. The control group had training with peer role-playing and mutual feedback. The posttest involved students’ rating their self-efficacy, and real patients and clinical supervisors evaluated their communication skills. No significant differences were found between self-efficacy and patient ratings. However, the clinical supervisors rated the intervention group’s communication skills to be significantly ( p < 0.0001) superior. Assessments by clinical supervisors indicate that communication training modules including standardized patients and an OSCE are superior to communication training modules with peer role-playing.

Human patient simulation (HPS) is increasingly being used as both a teaching and an evaluation strategy in nursing education. To meaningfully evaluate student performance in HPS activities, nurse educators must be equipped with valid and reliable instruments for measuring student performance. This study used a novel method, including leveled, video-archived simulation scenarios, a virtual classroom, and webinar and e-mail communication, to assess the reliability and internal consistency of data produced using the Creighton Simulation Evaluation Instrument. The interrater reliability, calculated using intraclass correlation (2,1) and 95% confidence interval, was 0.952 (0.697, 0.993). The intrarater reliability, calculated using intraclass correlation (3,1) and 95% confidence interval, was 0.883 (–0.001, 0.992), and the internal consistency, calculated using Cronbach’s alpha, was α = 0.979. This article includes a sample of the instrument and provides valuable resources and reliability data for nurse educators and researchers interested in measuring student performance in HPS activities.

The clinical faculty at the University of Maryland School of Nursing recognized that many students in the adult health course were struggling in the clinical environment. The faculty had access to a remediation program that was self-directed and did not provide individualized instruction. The limitations of the remediation program prompted a redesign that focused on a student-centered approach. The new remediation program involves a four-step process using human patient simulators and individualized instruction based on students’ learning needs. The revised remediation program has been in place for more than a year, and the clinical faculty have reported a noticeable improvement in students’ clinical knowledge, skills, and judgment at the completion of the program. In addition, the program has helped to decrease the attrition rate of students from the clinical component of the adult health program by 4% to 6%.

Caring for families during an illness experience is increasingly recognized as a core of nursing practice. Yet research reports deficiencies in the current state of family nursing care. It is possible that these deficiencies are rooted in a lack of integrating family care throughout nursing education and a focus on the biomedical science paradigm. As a relational skill, family care requires different pedagogical approaches to effectively teach family nursing. Simulation is one such approach. Even though simulation is rapidly moving into nursing education, the primary focus is teaching psychomotor nursing skills, rather than caring and family nursing.

Pharmacology decision making requires clinical judgment. The authors created interactive microsimulation applying drug information to varying patients’ situations. The theory-based microsimulation requires situational analysis for each scenario. The microsimulation uses an interactive format that allows the participant to navigate through three separate virtual clients’ situations. Correct clinical decisions are rewarded by sounds and by video footage of the patient improving. Conversely, incorrect choices show video footage of the patient decompensating. This micro-simulation was developed to help students learn from the consequences of incorrect medication decision making in the virtual world without harming patients. The feedback of watching an incorrect decision on a patient helps students associate cause and effect on patient outcomes. The microsimulation reinforces the ease with which medication errors can occur and the extent of possible sequalae. The development process used to incorporate the technology in the nursing curriculum is discussed.

Nursing faculty from three schools of nursing collaborated to develop a simulation project to enable nursing students to practice and apply principles related to delegation, supervision, scope of practice, leadership, and culturally competent care. A simulated five-bed hospital was created where students were assigned to teams to plan and care for these patients. After the simulation exercise, students participated in a debriefing session in which they reflected on their performance.

This study assessed the effectiveness of a learner-centered simulation intervention designed to improve the communication skills of preprofessional sophomore nursing students. An innovative teaching strategy in which communication skills are taught to nursing students by using trained actors who served as standardized family members in a clinical learning laboratory setting was evaluated using a two-group posttest design. In addition to current standard education, the intervention group received a formal training session presenting a framework for communication and a 60-minute practice session with the standardized family members. Four domains of communication—introduction, gathering of information, imparting information, and clarifying goals and expectations—were evaluated in the control and intervention groups in individual testing sessions with a standardized family member. The intervention group performed better than the control group in all four tested domains related to communication skills, and the difference was statistically significant in the domain of gathering information ( p = 0.0257).