Abstract:

Among the numerous unprecedented challenges COVID-19 presented to all aspects of routine daily life, undergraduate accelerated nursing program faculty was faced with developing meaningful “non-clinical” clinical experiences. Students enrolled in accelerated nursing programs have already earned a baccalaureate degree in such diverse fields as culinary arts, music, journalism, and criminal justice among many other non-healthcare professions. Traditionally these students are guided to exercise and apply critical thinking and clinical judgment skills learned in the Foundations in Nursing and Health Assessment courses to patients in the hospital clinical setting. Without observing the actions of the clinical nursing staff and practicing patient care in the hospital these student nurses needed greater support in their acquisition of intuitive nursing knowledge. Prospects for extremely limited onsite, in-person teaching/learning simulation opportunities contributed to raising the stakes of this already high stakes call for disruptive innovation education for first semester nursing students during the pandemic. Further contributing to the high stakes nature of this call for innovation education was the need for delivering real-time feedback, availing observed repetitive skills practice and remediation.

The curricular aim of the four SimINTENSIVES sessions was to provide individual nursing clinical groups a multimodal opportunity to demonstrate their ability to clinically connect-the-dots of didactic coursework from both introductory courses to their simulated patients. The overarching goal was to develop and deliver realistic simulation sessions that included activities that engaged students through the cognitive, psychomotor and affective domains of learning. The education taxonomical classification of intuitive was an additional component of the learning goals for each SimINTENSIVES session. Benner identified intuition as a function of the expert nurse in her 1982 Novice to Expert Model. Research by Eckhardt and colleagues revealed “Scientific discovery learning with computer simulations leads to the acquisition of intuitive knowledge”. (Eckhardt,M., Urhahne,D., and Harms,U. 2018) The in-person multi-modal learning/practicing/remediating environment of the SimINTENSIVES sessions provided multiple discovery learning activities.

The four SimINTENSIVES were delivered as morning and afternoon sessions conducted over four days within two weeks after completing the Foundations in Nursing and Health Assessment online courses. Each session was named as Week 1 Session 1, Week 1 Session 2, Week 2 Session 2 and Week 2 Session 2 and was formatted to include a pre-simulation learning pair/Jig Saw activity, primary goal, brief clinical scenario, student learning goals, critical thinking activity, situational awareness room activity and debriefing. All sessions were conducted with strict adherence to CDC and institutional COVID-19 guidelines for utilizing personal protective equipment and maintaining social distancing. Guidelines for exposure/contact time and disinfection time between sessions were also strictly followed. Faculty participated in a specific SimINTENSIVES Orientation that included a walk-through of the above format prior to the first session.

Faculty reported the SimINTENSIVES as having an enduring positive impact on students’ critical thinking, clinical judgment, intuition and assessment skills in subsequent semesters!

Keywords:

COVID-19 Distance Learning, Simulation, Accelerated BSN, curricular innovation, intuitive knowledge.