Increasing student nurses’ preparedness for undertaking community nursing roles through simulation


When did you first introduce the innovation?

Less than 12 months ago

Please describe the innovation you have developed

My colleague, Gillian Morris (now University of Dundee) and I¬†developed a community simulation scenario for first year undergraduate student nurses. This was carried out following their first semester teaching block and prior to the first clinical experience which is a community placement. The aim was to evaluate nursing students’ learning around caring for patients within a home setting through the use of simulation.The session was carried out in a simulated home environment. Academic and clinical staff played the parts of the patient and carer as did more senior students. The first year student nurses took the roles of the district nurse and student nurse on a community visit. Technical, non-technical and effective skills were all part of the scenario including communication, infection control procedures and a non-touch technique dressing. At any point throughout the structured scenario, students could stop and ask questions or advice which increased their confidence and learning from the experience. All students took part in a scenario. Feedback was also given and discussed by the whole group following the scenario.

What prompted you to develop this innovation?

Community nursing teams contribute to the increasing provision of complex care in community settings and this often includes some of the most vulnerable members of society and often in extremely challenging environments (Department of Health, 2013).

This simulated learning experience was aimed at equipping the students with the skills and confidence to work in a community environment in alignment with the shift from hospital to community care.

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

It was apparent that the majority of clinical skills teaching was taking place in a ward based setting and not specifically focusing on community situations in the practical sense. The community simulation suite is available in QMU within the occupational therapy division. It seemed opportune to use this and expose students to specific issues and situations that may help them prepare for the community setting in an appropriate simulation environment.

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

Simulation has an established history in preparing nurses to become competent in clinical skills. However, Unsworth et al (2011) argue that simulation has not been developed to its potential for primary care environments. This innovation has expanded the clinical skills simulation that student nurses are exposed to and given further opportunity for interactive group work which is preparing them for the transition from theory to practice using a safe and supportive environment.

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

It is anticipated that this community focused simulation has better prepared students for nursing patients in a home environment and stimulated their interest in the community nursing role. This can be developed throughout the 4 years of the BSc (Hons) Nursing course.

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

A qualitative evaluation study was undertaken with the first year cohort of 39 students. Questionnaires were completed by the students post- session and post- practice placement.

Results from the questionnaires showed that all students felt better prepared for placements within a home environment and felt more confident in the application of the skills undertaken during the first semester.

There were many comments and suggestions which were extremely positive and gave some good ideas for how this simulation scenario may be developed further.

The intention is to expand on the scenarios this year to include a health visiting scenario as this was not included previously.

The placements to health visitors are increasing and this will give some opportunity to widen the learning using the expertise of our community team.

There is also scope to alter the scenarios and change the patient situation to consider issues of learning disability, mental and child health to broaden student learning within the undergraduate curriculum.

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

The details of this evaluative study were presented at the 6th International Clinical Skills Conference at Monash University in Prato, Italy in May 2015. We now plan to write this up for publication.

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

An abstract has also been submitted to present at the next ENTER conference to be held at QMU in November 2015.