Abstract

Nine percent of new graduate nurses meet entry-level expectations for clinical judgement skills (4). The 2021 Essentials called for a transition to competency-based education to better prepare nursing graduates. Simulation allows an opportunity to care for multiple diverse patients in unique settings to develop clinical judgement and communication skills necessary for delivering quality care while being immersed in real-life system process limitations. “Exposure to clinical scenarios including rural concepts helps students develop a broader understanding of rural healthcare disparities and cultural competence. Integrating rural simulation into nursing education can boost students' confidence in their clinical abilities" (6). A gap was identified in exposure of students to rural system processes; a rural setting was selected for students to coordinate resources and provide quality care to diverse populations within a complex healthcare system.

The framework was the learning outcome model. Senior students in two BSN programs participated in a multi-patient simulation to enhance their interpersonal and therapeutic communication skills. A non-experimental descriptive study measured satisfaction and self-confidence while caring for and communicating with patients. Students were required to complete the simulation and voluntarily participated in the research study by completing the NLN Student Satisfaction and Self-Confidence in Learning survey and four open ended questions. The sample consisted of 75 of 82 participating students.

Quantitative analysis was completed. 94.7% of students were satisfied with their learning and 96% agreed that they can apply this simulation to the clinical setting. After debriefing, they expressed feeling nervous and confident as they transition into the new graduate nurse role. They recognized the importance of prioritization, communication and teamwork. They appreciated the opportunity to care for a diverse, complex patient population, including a transgender patient, in a rural setting.

This teaching approach challenged students to take a deeper dive into systems thinking and coordination of care in a rural healthcare setting. Students utilized communication skills to engage with a diverse patient population and the healthcare team. This study can be replicated as it was completed at two independent sites. Nursing programs need to explore innovative ways to incorporate systems thinking as they relate to coordination of care.

Notes

References:

1. Alrimawi, I., El-Banna, M. M., O’Reilly, C., & Muhammad, K. (2024). Integrating diversity, equity, and inclusion in nursing simulation clinical. Teaching and Learning in Nursing, 19. 439-443. https://doi.org/10.1016/j.teln.2024.01.010

2. American Association of College of Nursing. (2021). The Essentials: Core competencies for professional nursing education. https://www.aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2021.pdf

3. Brown, K. M., & Rode, J. L. (2018). Leadership development through peer-facilitated simulation in nursing education. Journal of Nursing Education, 557(1). 53-57. doi:10.3928/01484834-20180102-11

4. Kavanaugh, J. M., & Sharpnack, P. A. (2021). Crisis in competency: A defining moment in nursing education. The Online Journal of Issues in Nursing, 26(1). Manuscript 2. https://doi.org/10.3912/OJIN.Vol26No01Man02

5. Ross, J. G., Latz, E., Meakim, C. H., Arcamone, A., Furman, G., & Reynolds, K. (2022). Multiple-patient simulation and student outcomes in prelicensure nursing education: An integrative review. Clinical Simulation in Nursing, 64. 31-45. https://doi.org/10.1016/j.ecns.2021.11.007

6. Smith, J. G., Roye, J., & Hutchings, M. (2024). Enhancing nursing student perception of rural healthcare through innovation simulation education. Online Journal of Rural Nursing and Health Care, 24(1). 179-202. https://doi.org/10.14574/ojrnhc.v24i1.764

7. Zigmont, J. J., Kappus, L. J., & Sudikoff, S. N. (2011). Theoretical foundations of learning through simulation. Seminars of Perinatology, 35. 47-51. doi:10.1053/j.semperi.2011.01.002

Description

Students are unprepared to care for diverse patient populations. There's a research gap regarding coordination of care and rural healthcare system processes. BSN students participated in a multi-patient simulation to enhance interpersonal and therapeutic communication skills. Students recognized the importance of prioritization, communication and teamwork, when coordinating care for a complex population, including a transgender patient, in a rural healthcare system with limitations.

Author Details

Ashlee Fettig, MSN, RN; Kathy Roth, PhD, RN; Allison Sadowsky, MSN, RN; Joanie Weigel, MSN, RN, CCRN

Note: Order of author/presenter names as entered into event system do not match order names listed on title slide.

Sigma Membership

Xi Kappa at-Large

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Descriptive/Correlational

Research Approach

Quantitative Research

Keywords:

Simulation, Competence, Health Equity or Social Determinants of Health, Rural Setting, Diverse Patient Populations

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

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“I Would’ve Froze”- A Multi-Patient Simulation with Diverse Patients in a Rural Setting

Seattle, Washington, USA

Nine percent of new graduate nurses meet entry-level expectations for clinical judgement skills (4). The 2021 Essentials called for a transition to competency-based education to better prepare nursing graduates. Simulation allows an opportunity to care for multiple diverse patients in unique settings to develop clinical judgement and communication skills necessary for delivering quality care while being immersed in real-life system process limitations. “Exposure to clinical scenarios including rural concepts helps students develop a broader understanding of rural healthcare disparities and cultural competence. Integrating rural simulation into nursing education can boost students' confidence in their clinical abilities" (6). A gap was identified in exposure of students to rural system processes; a rural setting was selected for students to coordinate resources and provide quality care to diverse populations within a complex healthcare system.

The framework was the learning outcome model. Senior students in two BSN programs participated in a multi-patient simulation to enhance their interpersonal and therapeutic communication skills. A non-experimental descriptive study measured satisfaction and self-confidence while caring for and communicating with patients. Students were required to complete the simulation and voluntarily participated in the research study by completing the NLN Student Satisfaction and Self-Confidence in Learning survey and four open ended questions. The sample consisted of 75 of 82 participating students.

Quantitative analysis was completed. 94.7% of students were satisfied with their learning and 96% agreed that they can apply this simulation to the clinical setting. After debriefing, they expressed feeling nervous and confident as they transition into the new graduate nurse role. They recognized the importance of prioritization, communication and teamwork. They appreciated the opportunity to care for a diverse, complex patient population, including a transgender patient, in a rural setting.

This teaching approach challenged students to take a deeper dive into systems thinking and coordination of care in a rural healthcare setting. Students utilized communication skills to engage with a diverse patient population and the healthcare team. This study can be replicated as it was completed at two independent sites. Nursing programs need to explore innovative ways to incorporate systems thinking as they relate to coordination of care.