CASN and CAE: Improving the Training of Baccalaureate Nursing Students

| Roxanne Blanford

Simulation-based training is commonly defined as "the creation of a situation or environment in which a student or practitioner experiences a representation of a real event to practice a skill, learn new abilities, gain an understanding of systems or human actions, or for the purpose of performance evaluation" (Loprieato et al., 2016).

Initially developed to improve pilot training and enhance aviation safety, realistic simulation is progressively being utilized as a key element in healthcare education.

Patient simulation in Canadian nursing education has, likewise, grown substantially in recent years, facilitated by three levels of fidelity (high, mid-range, low fidelity). Programs are also integrating advanced technologies (interactive computer manikins and videos; virtual learning environments; 3-D/augmented reality) with more traditional, lower-tech methods (non-computerized task trainers, Standardized Patients and role play) to maximize training.

CAE & CASN: Top 10 Nursing Simulation Situations

In 2017, CAE made a proposal to the Canadian Association of Schools of Nursing (CASN) to revise and update a package of high-fidelity simulation scenarios for adults.

Considering that "the importance of practice learning experiences for nursing students is a long-accepted essential component of nursing education in Canada," and CASN's imperative to create national consensus-based recommendations to identify the most important complex clinical situations necessary to experience in adult care nursing before entering practice (as well as those which would support the Canadian healthcare context and Canadian 'entry-to-practice' competencies), CASN saw this as an invaluable opportunity for worthwhile collaboration. 

Creating the CASN/CAE Healthcare "Top 10 Adult Nursing Situations for High Fidelity Simulation"

In cooperation with CAE Healthcare (the 'worldwide training partner of choice' in healthcare education solutions and simulation-based products and services), CASN formulated a list of ten top situations in adult nursing for simulation to highlight and emphasize the value of clinical training in the most complex clinical events, specific to the baccalaureate nursing program.

The list of situations (ranging from postoperative hemorrhage and multiple organ dysfunction syndrome, to heart failure, opioid overdose and end-of-life care), was assessed, refined, thoroughly reviewed and validated by a working group of experts from across Canada.

After much discussion, evaluation and judicious revision, the final list of ten situations was adopted in July 2018.

Existing CAE Healthcare clinical scenarios were selected by the working group. These simulation scenarios were then updated and adapted to the Canadian context with a view towards creating quality clinical learning resources that could be integrated within the top ten situations. 

Lastly, the International Nursing Association for Clinical Simulation and Learning Standards (INASCL) of Best Practice: Simulation (2016) informed the review and revisions, which were initially carried out by the working group, with insightful guidance on design, facilitation, and debriefing of simulation experiences in nursing education.

Important elements of care that needed to be included in simulation also emerged (i.e., communication, unfolding scenarios, adverse event reporting, and interprofessional collaboration).

Following an in-depth review, the final CAE scenarios supporting the list was confirmed in January 2019 and incorporated within the top ten situations. 

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Developed to enhance clinical skills in interprofessional communication, critical reasoning and judgment, the following "Top 10 Adult Nursing Situations for High Fidelity Simulation" are intended to provide both realistic and valuable learning experiences in healthcare and patient management, all within the risk-free setting of simulation.

  1. Hypo and Hyper Glycemia (Chronic Diabetic)
  2. Deteriorating Patient (Postoperative Hemorrhage)
  3. Respiratory Distress (Pulmonary Embolism)
  4. The Dying Patient (End of Life Care)
  5. Cardiopulmonary Arrest
  6. Sepsis and Multiple Organ Dysfunction Syndrome
  7. Fluid Volume Deficit (Electrolyte Imbalance of the Geriatric Patient)
  8. Congestive Heart Failure Exacerbation
  9. Cardiogenic Shock Secondary to Acute Myocardial Infarction
  10. Opioid Overdose 

The Canadian Association of Schools of Nursing (CASN) recommends that all baccalaureate nursing students experience these situations prior to entering real-life clinical practice.

Contact CAE and learn how your program may benefit from this joint initiative to improve the quality of training within Canadian baccalaureate nursing.

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