Implementation of an emergency management simulation for pre-licensure graduate nursing students

Nursing students have limited clinical opportunities to manage emergencies which require specific clinical skills, critical decision making, and effective team dynamics. Our needs assessment identified gaps in student knowledge of emergency roles and responsibilities, and a perceived disconnect between didactic and clinical courses. To bridge these gaps, we developed a 4-hour emergency management simulation-based clinical experience for pre-licensure graduate nursing students at the end of their fifth term. Our setting is an accredited simulation center within an urban academic medical center and university. Four high-fidelity mannequin scenarios were developed to align with the learning objectives and the INACSL Standards of Best Practice: SimulationSM. Each scenario incorporates didactic course content including shock states, arrhythmias, delivering bad news, and interprofessional communication. We introduce resuscitation roles, responsibilities, and outcomes. Groups of 4 students each rotate through one 15-minute scenario, while the remaining 8 students observe via a monitor in a separate room. Trained clinical faculty facilitate the activities, including prebriefing and debriefing using PEARLS or Modified Plus-Delta. Anecdotal and formal evaluations from students and faculty have been positive. This simulation-based clinical experience provides pre-licensure graduate nursing students a significant opportunity to synthesize course content at the end of term and apply emergency management knowledge in a safe clinical environment; it also requires demonstration of Basic Life Support (BLS). Future development includes use of a standardized patient as a family member and including other student professionals. Including more robust pre-work and individual student evaluation would enable us to provide BLS renewal during this experience.