Welcome to Session 1. At the conclusion of this session, the learner should be able to; one, identify opportunities for integration of simulation into a course, program, and/or curriculum. Two, discuss importance of a strategic plan and theoretical framework when integrating simulation into a course, program, and/or curriculum, and three, discuss the alignment of a theoretical framework, a strategic vision and plan, and the International Nursing Association for Clinical Simulation and Learning or INACSL Standards of Best Practice in Simulation. Before we get started throughout this module, the terms learner and participant will be used interchangeably. Simulation is a sophisticated pedagogy and profoundly powerful teaching methodology. As with any other teaching methodology, simulation should be explicitly related to specific measurable, short and long-term student learning outcomes, and there must be a plan for assessment and evaluation of effectiveness. Once it's been determined that student learning outcomes are best met by experiential learning or learning by doing or learning through experience, and it's been determined that the resources are available to support an appropriate simulation design. A systematic plan may be made to integrate simulation into the curriculum. It's important that the objectives of the simulation activity itself be clearly defined and communicated to both learners and facilitators. As opportunities for integration of simulation are considered, a plan for assessment and evaluation of the simulation activity, the learners and the simulation facilitators is essential. Those tests with curricular design must consider what questions may be answered from the data that will be generated. What conclusions can be made from the data collected given the validity and reliability of the measurement tools, and how might the data be otherwise use to inform future curricular changes? Let's approach these questions by taking a look at an evaluation framework commonly used in simulation. First developed in 1959, The Kirkpatrick framework for learner evaluation is often used to support evaluative processes and simulation-based learning. Each of the four levels may be easily applied to simulation, and should be carefully considered as you formulate an assessment and evaluation plan. It's essential that you consider the simulation design and measurement tools necessary to generate data at the desired level of evaluation. Let's take a closer look at each of the levels through the lens of simulation in health care education to better illustrate that point. Level one is very basic, it relates to the learner reaction to the activity. We often want to know if learners are satisfied with components of the simulation and/or the overall activity. We often gather this type of self-report data through simple surveys distributed at the end of a simulation activity. Moving onto level two, this level actually evaluates learning, but requires an evaluation of baseline knowledge prior to the simulation. At level two, we're looking to generate evidence that learners gain knowledge and/or our skills as a result of the simulation. Here we often use measurement tools that generate data regarding self-report of increase confidence and clinical competence, but are often lacking valid and reliable tools to substantiate those claims. As you might imagine in addition to an evaluation of baseline knowledge, level two also requires measurement of learning after the simulation activity. It's common for a simulation post-tests to show immediate improvement over pretest scores but without continued practice and reinforcement, it's difficult to demonstrate a lasting impact on knowledge acquisition after a single simulation activity. Level three examines behavior and application of knowledge and skills. Here we are looking to generate evidence that knowledge and skills learned as simulation are being applied in the clinical setting. At level four, we're looking to generate evidence that the simulation activity actually improves patient outcomes. We've talked a bit about a framework for evaluation as you consider curriculum integration of simulation. Now let's take a look at how we might view the potential integration of simulation, through the lens of the domains of learning that provide a framework for classifying and measuring student learning. Introduced by Benjamin Bloom in 1956, the three domains of learning are widely accepted, and their common methods for achieving outcomes associated with each of them. Learning outcomes evolving factual knowledge and clinical decision-making are in the cognitive domain. Common methods for achieving cognitive outcomes include reading, lectures, and problem-based learning. Learning outcomes inclusive of emotions beliefs and attitudes fall in the affective domain. Common methods for achieving affective outcomes include experiential learning and reflective writing or journaling. As we've already mentioned, simulation-based learning is experiential. In addition, best practices in simulation call for reflective analysis of the experience through debriefing. Lastly, learning outcomes relative to the acquisition of skills, behaviors, and procedural techniques are in the psychomotor domain. Common methods for achieving psychomotor outcomes include; supervised clinical experiences, work with standardized patients, the use of models, and test trainers. When writing learning outcomes specific to a particular simulation activity, it's important to think about which domains are relevant to the simulation activity, and as you plan for a curricular integration, are resources sufficient to support the desired method? It may be that you are trying to design a simulation event that allows for achievement in all three domains of learning, which may be too ambitious and out of alignment with the simulation method and achievable measurement tools. As a rule of thumb, a simulation activity should have no more than a total of three to four student learning outcomes. We've touched on the importance of developing strategic and meaningful plans for integration of simulation to include alignment with objectives, evaluation, and domains of learning. But any plan to integrate simulation first begins with strategic vision of what a simulation activity that is integrated in psychology curriculum, and aligned with the INACSL Standards for Best Practices in Simulation actually looks like. The path to the vision may change and the subject to revision, but the vision of this ideal simulation does not. The strategic vision defines the plan for growth and evaluation and evolution and the plan must be inclusive of all stakeholders and resources. Those with curricular and simulation expertise should be included in the strategic plan as well as should instructional designers whenever possible. Careful inventory a resource should take into account, the personnel necessary to serve as simulation facilitators, and any education necessary for those facilitators to meet standards of best practice and simulation. A realistic assessment of available simulation space, equipment and funding is also a critical piece of the strategic plan. So how might alignment with a theoretical framework position those planning curricular integration of simulation to INACSL Standards of Best practice? The NLN Jeffries simulation theory offers a framework to inform the strategic vision that defines a plan for curriculum integration of high-quality simulation. Consider each of the components of the theory, and how each might inform a strategic vision for curricular integration of simulation. The first is context. Contextual factors such as circumstances and setting, impact every aspect of the simulation and are an important starting point. Within this context or set of circumstances is the background. The background includes learning outcomes of the simulation, and how it fits into the larger picture. Both of which influenced the design and implementation of the simulation activity. The background also includes resources such as space equipment and personnel. This should sound familiar as we previously discussed how the strategic vision defines a plan for growth and evolution including necessary resources. The third concept is design, which includes the specific learning outcomes. This two should sound familiar as we've touched on learning outcomes relevant to the domains of learning. The development or selection of activities appropriate for the level of learner and clarification of the roles of all participants and facilitators are included in the design as is a plan for debriefing. The simulation experience the fourth concept, is characterized by an environment that is interactive, collaborative, and learner-centered. This environment requires the establishment of trust, both the facilitator and participant share responsibility for maintaining this environment. The dynamic interaction between the facilitator and the participant within the simulation experience is captured in the concepts relative to facilitator and educational strategies and participant, with both facilitator and participant characteristics affecting the learning experience. Lastly, outcomes of the simulation activity may be separated into three components; participant, patient, and system outcomes. As you might imagine the measurement of outcomes calls for an assessment and evaluation plan. This slide provides further illustration of the alignment among the NLN Jeffries simulation theory. A strategic vision for high-quality simulation, a strategic plan for curriculum integration of simulation, and in an axial standards for best practice. The first version of the standards was published in 2011, with several revisions sent. Reflective of the growing state of science and simulation, and demand for high-quality simulation, we now have nine standards; design, outcomes and objectives, facilitation, debriefing, participant evaluation, professional integrity, inter-professional education, operations, and a simulation glossary. Each comprised by a set of criteria. The standards are intended to be used collectively, with no one standard taking precedence over another. If you haven't done so already I encourage you to familiarize yourself with each of the standards. As you identify opportunities for curriculum integration of simulation, formulate a vision for high-quality simulation and embark on a plan. I encourage you to start with the strategic vision grounded in a framework that best positions you for best practices. It's now time for you to complete the knowledge check for this session.
