Simulation as a Nursing Education Disrupter.

Simulation as an evidence-based pedagogy began emerging at a time when many constraints were being imposed on clinical experiences for nursing students. As research illuminated the advantages of simulation and standards were developed, educators began to recognize the limitations of the clinical setting, such as the inability to provide experiences in teamwork and delegation, and a focus on tasks. Simulations are crafted to provide an experience that matches content that is being taught in class, and debriefing techniques guide learners in a reflective process that promotes the development of clinical reasoning and judgment. The National Council of State Boards of Nursing study concluded that simulation could be substituted for 50% of clinical hours. Simulation-exposed gaps in the curriculum and its pedagogical principles are now extending to adaptations of its use in the classroom and in clinical postconferences. They are also shaping teacher-student conversations in the office and the hallways. Use of simulation for assessment is beginning to evolve. In a little more than 10 years, it has started a revolution that will continue to have a major impact on all aspects of nursing education in the future.

Emerging Theories Influencing the Teaching of Clinical Nursing Skills.

BACKGROUND: Recognition is increasing that many psychomotor skills essential for safe nursing practice are not being retained. New theories and methods are emerging that, when applied in an organized pedagogical model, could influence initial learning and the retention of critical psychomotor skills. METHOD: This article explains and applies emerging educational theories and concepts relevant to skills teaching in nursing. RESULTS: Theories and concepts on cognitive load, deliberate practice, mastery learning, overlearning, spaced learning, and skill decay are integrated to provide a framework for teaching skills in nursing. An example is included of using this framework for skills instruction and practice. CONCLUSION: This framework may improve the nurse educator's ability to prepare learners to perform skills safely in both the skills laboratory and patient care settings and to retain skills. [J Contin Educ Nurs. 2019;50(6):257-262.].

Health Information Technology Scholars Program: From Implementation to Outcomes.

AIM: This article reports the development, implementation, and outcomes of the Health Information Technology Scholars (HITS) program. BACKGROUND: HITS is one of nine faculty development collaborative projects funded by the Health Resource Service Administration to integrate information and other technologies in nursing education and practice. METHOD: In addition to evaluating the content and context of the program, the evaluation includes descriptive statistics, goal attainment scaling, diffusion of innovation index, utilization of knowledge survey, and exemplars from scholars. RESULTS: The HITS program developed 265 faculty across 132 nursing programs in 43 states over 5 years. HITS scholars impacted more than 59,000 students and 9,000 other faculty. These technology leaders have numerous presentations, publications, and awards. CONCLUSION: Success of the HITS program is attributed to the strength of the faculty development collaborative partnership, the applicant selection process, and the program design.

Establishing Inter- and Intrarater Reliability for High-Stakes Testing Using Simulation.

AIM: This article reports one method to develop a standardized training method to establish the inter- and intrarater reliability of a group of raters for high-stakes testing. BACKGROUND: Simulation is used increasingly for high-stakes testing, but without research into the development of inter- and intrarater reliability for raters. METHOD: Eleven raters were trained using a standardized methodology. Raters scored 28 student videos over a six-week period. Raters then rescored all videos over a two-day period to establish both intra- and interrater reliability. RESULTS: One rater demonstrated poor intrarater reliability; a second rater failed all students. Kappa statistics improved from the moderate to substantial agreement range with the exclusion of the two outlier raters' scores. CONCLUSION: There may be faculty who, for different reasons, should not be included in high-stakes testing evaluations. All faculty are content experts, but not all are expert evaluators.

Summative Simulated-Based Assessment in Nursing Programs.

BACKGROUND: Summative simulated-based assessments are intended to determine students' competence in practice. These assessments need to be carefully designed and implemented especially when the results are used to make high-stakes decisions. METHOD: Critical steps need to be followed to design simulations for summative assessment, ensure the validity of the assessment and reliability of the ratings, and train evaluators. RESULTS: Guidelines for using simulation for assessment in nursing are suggested. The guidelines are based on the literature and the authors' experiences from a project that examined the feasibility of using simulation for determining students' competence in performance at the end of the nursing program. CONCLUSION: Summative simulation-based assessments need to be valid, measuring the knowledge and skills they are intended to, and reliable, with results being reproduced by different evaluators and by the same evaluator at another time. [J Nurs Educ. 2016;55(6):323-328.].

The National League for Nursing Project to Explore the Use of Simulation for High-Stakes Assessment: Process, Outcomes, and Recommendations.

AIM: This project was designed to explore the feasibility of using simulation for high-stakes assessment in pre-licensure RN programs. METHOD: A think tank of experts recommended simulation scenarios suitable for assessing students at the end of their program. Two teams were formed: one to design the simulations, the other to develop the evaluation plan. Scenarios were piloted and refined, then sent to schools across the country. Student performances on video recordings were scored by raters. RESULTS: Essential elements of simulation design, implementation, evaluation tools, and processes were found. CONCLUSION: Well-designed and facilitated scenarios, delivered in the controlled environment of the simulation center, can be a reliable and valid tool for evaluating the clinical skills of students.

The evolution of educational information systems and nurse faculty roles.

Institutions of higher education are purchasing and/or designing sophisticated administrative information systems to manage such functions as the application, admissions, and registration process, grants management, student records, and classroom scheduling. Although faculty also manage large amounts of data, few automated systems have been created to help faculty improve teaching and learning through the management of information related to individual students, the curriculum, educational programs, and program evaluation. This article highlights the potential benefits that comprehensive educational information systems offer nurse faculty.