Evaluating learning and providing feedback on perfomance in relation to high fidelity simulation experiences


When did you first introduce the innovation?

Less than 12 months ago

Please describe the innovation you have developed

I run a trauma scenario in the second year of the undergraduate nursing programme which includes a range of activities and delivery methods. Students are expected to participate in a high fidelity simulation experience in a small group led by myself and a small team of other academics and a dedicated technician. As part of the scenario learning contexts include leadership, management, teamwork, clinical reasoning and decision making alongside the clinical aspects of the case which is a young man who is in a road traffic collision with a drunk driver. The simulation builds on their previous more basic experiences of this type of learning and is designed to prepare them for undertaking the acute illness management course in their third year. As the objective is to see how they perform as a team in a critical situation we have developed a mechanism of performance assessment using a structured teamwork evaluation tool (following evaluation of a range of existing tools we developed one based on the PACT evaluation tool Brock et al 2013) and follow this up with a structured reflection exercise on an electronic discussion board following their debrief.

What prompted you to develop this innovation?

Having run this scenario several times i felt that although the objective was to identify how they perform as a team and in their individual roles we were not providing them with specific feedback in relation to this and were not evaluating the impact of learning on the student. Considering the level of staff time and resources applied to simulation it is important to be able to justify this approach and ensure that it does have an impact on practice.

In your view, what is it about this innovation that makes it different/important?

Having participated in simulation in a variety of places both nationally and abroad I have noted that feedback and evaluation is often quite weak and generally is limited to a quick debrief at the end. Many students are shell shocked at the level of the experience and are not always in a position to evaluate the impact of it on their learning or their practice. Having an opportunity to receive structured feedback on their performance and reflect on it either that day or later has provided valuable data demonstrating impact.

To what extent does your innovation make use of existing approaches, resources or technologies?

The approach uses our existing Moodle provision which allows for the set up of discussion boards where students can share experiences and comment. They post their reflection following the structured guidance offered and are encouraged to read each others. The feedback sheet for the team is based on an existing template (Performance and Assessment of Communication and Teamwork available at: http://collaborate.uw.edu/educators-toolkit/tools-for-evaluation/performance-assessment-of-communication-and-teamwork-pact-tool.

To what degree has this innovation led to changes in education or clinical practice?

The evaluation data from the students and staff has been useful in both justification of resources for this activity (and others) and ensuring that students can develop the skills required for safe and effective practice as a registrant. Data suggests that students value the opportunity to reflect on the experience in their own time and also benefit from the feedback of their peers. The structured feedback provides clear information on how they performed together and what they could do to improve their teamworking, communication etc. It is too early to identify whether or not it has an impact on their practice as a registered nurse as we have not yet evaluated that but have plans to do so.

What evidence do you have of the impact of the innovation?

Evidence from student evaluations

(3) The simulation and reflection was useful in helping me to understand the value of effective teamwork and decision making?
– 1 Poor (0): 0
– 2 Satisfactory (0): 0
– 3 Good (0): 2 (5.88 %)
– 4 Very Good (0): 18 (52.94 %)
– 5 Excellent (0): 14 (41.18 %)
Average: 0.00

(4) The simulation session and reflection helped me to identify areas I need to develop in order to become a confident nurse?
– 1 Poor (0): 0
– 2 Satisfactory (0): 1 (2.94 %)
– 3 Good (0): 4 (11.76 %)
– 4 Very Good (0): 9 (26.47 %)
– 5 Excellent (0): 20 (58.82 %)
Average: 0.00

There is also feedback from the external examiner on the approaches used and the amount of value the students place on the trauma scenario.

To what degree has the innovation been disseminated in your organisation or elsewhere?

The full innovation has only been used in April this year and although the reflective element was disseminated at the Faculty Learning and Teaching conference earlier this year i have not yet had an opportunity to complete any meaningful dissemination.

Please provide details of any plans you have to disseminate the innovation in the future.

I am presenting at the Turku University Applied Sciences International Conference in September.