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Running head: PROPOSAL FOR CHANGE 1 Proposal for Change Project Introduction Joanna Shedd Nurse Education Faculty Roles and Responsibility ED8350 November 6, 2014 36487 Albatross Street Beaumont, CA 92223 951-769-7850 [email protected] Dr. Akin-Palmer 2 PROPOSAL FOR CHANGE Proposal for Change project Introduction The historic forces driving current and future trends in nursing as a profession include the rapid increase in diversity, consumer knowledge through the internet, advanced technology, and the use of high and low definition simulation to adjunct leaning in the clinical sites. Nursing education is being called upon to effectively prepare nurses for the future of the profession, and as more and more clinical sites are taken away from nursing students, innovative and advanced planning must take center stage in order to fill the gap (Heller, Oros, & Durney-Crowley, 2013). An example of an innovative technique in nursing education is the use of simulation. In order to properly train nursing students, the education leaders must begin to modify curriculums by adding resources like simulation in order to teach critical skills in a safe environment. Therefore, nursing educators must function as change agents in order to shape the future of this profession (Billings & Halstead, 2012). Not only does simulation provide excellent training opportunities without harm to human patients, simulation can also create an opportunity to practice interpersonal skills with other disciplines (Fero, O'Donnell, Zullo, Dabbs, Kitutu, Samosky, & Hoffman, 2010). The focus of this assignment will include the current issues in nursing education which is creating the need for the proposed change, the rationale for why nursing education should add simulation to their curriculum, how simulation can be used as a tool to enhance the socialization of nursing students through the use of interpersonal scenarios, and how adding simulation will align with the goals of the nursing schools mission and program goals. Proposed Change The proposed change includes the addition of high or low definition simulation to all levels of the nursing program. The method of using simulation is stated by Fero et al. (2010) to PROPOSAL FOR CHANGE 3 be a safer means of learning skills prior to caring for human patients. Therefore the use of the technology provided for training nursing students though simulation scenarios should be encouraged. These scenarios can provide a perfect medium for learning to provide skilled nursing care to clients, and to fill the increasing gap of available clinical sites for nursing students. Simulation can also be used to provide socialization between students and other interdisciplinary teams. For example, the authors Aebersold and Tschannen (2013) provided examples of alternating methods to acquire socialization into the nursing profession, and the use of high and low-definition simulation was a method proven to enhance these social skills. Simulation scenarios have been added for training nursing students as an adjunct to learning on the units with live patients. Therefore, high or low-definition simulation entails the imitation of the operation of a real-world process or system over time, and patient scenarios as well as interdisciplinary interactions can be played out in a controlled environment. This safe environment allows students to make mistakes without the risk of causing undue harm to human patients (Aebersold & Tschannen, 2013). Rationale for Proposed Change The nursing profession is facing another nursing shortage both in practice and in academia. This shortage of nurses in all areas of the profession creates a shortage of clinical sites, and The National League for Nursing (NLN, 2006) identified two major trends impacting the clinical practicum areas of nursing education. These areas include the shortage of nursing faculty, which leads to a decrease in the available clinical sites for students. For example, there is a critical need to graduate a higher number of nursing students. However, in order to graduate more nursing students there must be adequate training of skills, and the lack of clinical sites will PROPOSAL FOR CHANGE 4 require the need to replace these training arenas with simulation in order to close the gap (Nardi & Gyurko, 2013). Fero et al. (2010) surmised that the use of simulation can increase the critical thinking skills of nursing students, and simulation based performance using video vignettes along with high or low fidelity human simulation is relevant when trying to replicate the hospital experience. In addition, high or low-fidelity simulation can provide the ability to increase clinical performance in nursing students. For example, nursing students who had the opportunity to practice skills like giving medications, and conducting patient assessments in the simulation arena performed at a higher level in the clinical site. Therefore, the ability to practice clinical skills is critical to safe patient care, and the opportunity to create simulation experiences when clinical sites are not available, is clearly a necessary change for the future of nursing education. Embracing the ability to incorporate the simulation technology will become more and more of a necessity in the future (Fero et al., 2010). According to the article by Fagan, Kilmon, and Pandey (2012), students who were fortunate enough to receive a simulation experience, are reported to have better prepared for the clinical experience then students who did not receive this exposure. These students are also stated to have a higher level of safety and better prepared for patient care. The students in this study considered this virtual reality experience beneficial for varying reasons, but across the sample most students agreed that it was useful in their development of informational technology and their professional growth (Fagan et al., 2012; Shedd, 2014). Goals of the Nursing Program and the Mission of the Parent Institution Loma Linda University is a Private Christian school in Southern, California. The school of Nursing was established in 1925, and was the first organized undergraduate nursing school in PROPOSAL FOR CHANGE 5 the area. The mission statement of the school is to provide the education of professional nurses at the undergraduate as well graduate level, who are dedicated to excellence in nursing science. Individuals from diverse ethnic, cultural, and racial backgrounds are encouraged to embrace opportunities for lifelong growth, and satisfaction from a career committed to health care. Baccalaureate and graduate nursing programs, contribute to the development of expert clinicians, educators, administrators, and researchers who benefit society by providing and improving delivery of whole-person care (LLU, 2014) The mission of the parent institution states: Loma Linda University is a Seventh-day Adventist Christian health sciences institution, which seeks to further the healing and teaching ministry of Jesus Christ "to make man whole" by educating ethical and proficient Christian health professionals and scholars through instruction, example, and the pursuit of truth; expanding knowledge through research in the biological, behavioral, physical, and environmental sciences and applying this knowledge to health and disease; Providing comprehensive, competent, progressive and compassionate health care for the whole person through faculty, students, and alumni (LLU, 2014). The use of simulation is in alignment with the mission statement of the school of nursing and the parent institution. For example, the nursing school and the parent institution describe the desire to provide education, and create rich opportunities for growth in order to contribute to the development of expert clinicians at all levels. Additionally, the desire to promote lifelong learning and applying this knowledge can only be achieved through actual hands on practice, which is indicative of the experience received during the use of adjunct training opportunities in high or low-definition simulation scenarios (Fagan et al., 2012; LLU, 2014). Additionally, the mission and goals of Loma Linda University includes a statement 6 PROPOSAL FOR CHANGE regarding baccalaureate and graduate nursing programs, and how contributing to the development of expert clinicians, educators, administrators, and researchers will benefit society by providing and improving delivery of whole-person care. This whole person care can only be accomplished with adequate training opportunities for the students in this institution, and adding the technology of simulation is a necessary first step in providing proficient whole person care (Fagan et al., 2012; LLU, 2014) Conclusion Nurse educators are being called upon to change with the times, and in order to be progressive as well as adjust with this ever changing profession of nursing, these nurse leaders must be willing to have an open mind about the use of scenarios in simulation to enhance learning. In fact, the very nature of nursing education as a profession draws individuals who are committed to teaching the next generation with creativity, and not only using scenarios but creating highly specialized scenarios that will enhance the training of nursing students, should be a part of this progressive thinking (Mitchell, 2013). Nurse leaders are in the best position to be the change agents for clinical practice and education (Lewin & Regine, 2000). Therefore, as the clinical sites become less available for student nurses to practice the critical skills needed to become safe practitioners, there will need to be a shift from the traditional clinical experience to adding simulation in order to adjunct those experiences (Fagan et al., 2012). 7 PROPOSAL FOR CHANGE References Aebersold, M., & Tschannen, D. (2013). Simulation in nursing practice: The impact on patient care. Online Journal of Issues in Nursing, 18(2), 22-26. Retrieved from http://web.ebscohost.com.library.capella.edu/ehost/delivery?sid#2028531 Billings, D. M., & Halstead, J. A. (2012). Teaching in Nursing: A Guide for Faculty (4th Ed.). St. Louis, MO: Elsevier/Saunders. Fagan, M., Kilmon, C., & Pandey, V. (2012). Exploring the adoption of a virtual reality simulation. Campus - Wide Information Systems, 29(2), 117-127. doi: http://dx.doi.org/10.1108/10650741211212368 Fero, J. L., O'Donnell, J. M., Zullo, T. G., Dabbs, A., Kitutu, J., Samosky, J. T., & Hoffman, L. A. (2010). Critical thinking skills in nursing students: comparison of simulation-based performance with metrics. Journal of Advanced Nursing, 66(10), 2182-2193. doi:10.1111/j.1365-2648.2010.05385.x. Heller, B., Oros, M., & Durney-Crowley, J. (2013). The future of nursing education: 10 trends to watch. Nursing & Health Care Perspectives, 21, pages 9–13. Retrieved from https://courseroomc.capella.edu/webapps/portal/frameset.jsp?tab_tab_group_id=_2_1& Lewin, R. & Regine, B. (2000). The Soul at Work. New York: Simon & Schuster. Loma Linda University Medical Center (LLU, 2014). Mission, Values, Goals, and Beliefs Statement. Retrieved from the Loma Linda University Medical Center website at https://myllu.llu.edu/home/students/ Nardi, D. A., & Gyurko, C. C. (2013). The global nursing faculty shortage: Status and solutions for change. Journal of Nursing Scholarship, 45(3), 317-326. doi:10.1111/jnu.12030 PROPOSAL FOR CHANGE Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management, 20(1), 32-37. Retrieved from https://search.yahoo.com/yhs/search? National League of Nursing. (2005). Nurse faculty shortage fact sheet. Retrieved from http://www.nln.org/governmentaffairs/pdf/NurseFacultyShortage.pdf Shedd, J. (2014). Annotated Bibliography. Unpublished manuscript, Department of Nursing Education, Capella University, Minneapolis, Minnesota. 8