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SIMULATION

INTRODUCTION
Simulation is as old as human beings on earth. Not only human beings but
even animals use this technique of simulation to their young ones to teach them to
adjust in their physical environment. A simulation presents learners with a more or
less life like model of the real world with which they interact in solving problems
from an adopted role perspective. Simulation is a powerful tool if understand and used
properly. This introduction to simulation is designed to teach the basis of simulation
including simulation function, data generation and its proper use.
Today nursing education possess a great challenge in nursing faculty to
prepare nurses who can provide and promote safe and effective nursing care, since
opportunities for developing skills is very much limited. A simulation presents learner
more or less lifelike model of a real world with which they interact in solving problem
from an adopted role perspective. It would provide opportunities to become skilful by
practising on simulators. So simulation technique is one strategy that can prevent
errors in clinical setting .This topic starts with definition of simulation, goes through a
talk about what makes up simulation, how simulation works and how to handle data
generated by the simulation.

MEANING
Simulation is the basis of sensitivity training socio drama, role playing and
psychodrama. It is not actual teaching; certain underlying skills to teaching can be
modified, described and practised like any other skill. It is assumed that through role
perception, the psychological appreciation of the class room problems will grow and
develop in the student. Teacher is a basis for handling the problem in the class.
In the world of science and technology simulation is almost must, Engineers
build models, study their performance, make some adjustments and to build a
prototype.

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Soldiers engage in mock fighting this is also an example of mock training.
In order to perform operations in human beings doctors are made to learn the
operation technique by experimenting on frogs and rats etc.

DEFINITION
R.WYNN (1964) defines “simulation is an accurate representation of a realistic
situation”.
BARTON (1970): Simulation have been defined as an operating representation of
central features of reality as an attempt to give appearance and/ or to give the effect of
something else.
I CLEMENT defines “Simulation is an enactment of a real life situation.”
D.R CRUICKSHANK (1966) defines “simulation is a creation of realistic games to
be played by participants in order to provide them with life like problem solving
experiences related to their present or future word.”
SHANNON (1975) defines “simulation is the process designing a model of real
system and conducting experiments with this model for the purpose either of
understanding the behaviour of the system or evaluating various strategies (within the
limits imposed by a criteria or set of criteria)for the operation of system.”

PURPOSES OF SIMULATION
 To help students practice decision-making and problem-solving skills and to
develop human interaction abilities in a controlled and safe-setting.
 To help the student to achieve cognitive, affective and psychomotor outcomes
through active involvement in a simulation exercises.
 To help students to apply principles and theories they have learned and to see
how and when these principles work.
VALUES
 Simulation ensures safe nursing practice by nursing students through
bridging the gap between theory and practice: In simulated environment of the
fundamental lab, student learns safe practice of nursing through the perfect
application of learned theory under the guidance of teacher. Thus simulation
bridges the gap between theory and practice.

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 Simulation is an effective technique to learn psychomotor skills: In the
simulated environment in the fundamental lab, by use of mannequins and other
equipment students learn psychomotor skill essential for giving nursing care in
clinical situations.
 Simulation helps the students to develop critical thinking abilities and
problem solving skills: Simulation the most effective way for problem solving
skill. The acquisition of problem solving skill will in turn help students to apply
the nursing process will gathering and analysing the data, identifying the
problem, setting priorities, selecting and modifying intervention and evaluating
outcomes.
 Simulation not only help the student to learn the decision making process but
also feedback regarding the consequences of the decision made: In the
simulated environment students learn decision making process by making
decision rather than simply grasping the related theory. They also get the
feedback regarding the consequences of the decision from the teachers and
classmates. In this way, students become aware of their ability to make
effective decision.
 Simulation enable students to empathize with the real life situations:
Empathy is the most desirable quality as far as a nurse is concerned and
through participating in a role play viewing its students develop this most
desirable quality, By means of empathy, students place themselves in others
position, this will help to understand others feeling and interact effectively by
employing appropriate communication styles suitable to the situation. As
interaction is taking place in a simulated environment, student gets an
immediate feedback regarding their way of interaction and communication
style. In short simulation is a good means of developing communication skills
and understanding the complexity of human relationships.
 By way of simulation teacher can easily inculcate proper attitude among
nursing students: As said elsewhere, inculcating proper attitude is a difficult
task but a nurse educator cannot ignore this aspect because proper attitude is
essential for good nursing practice. Simulation helps students to recognise in

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giving comprehensive nursing care and helps them to cultivate positive attitude
essential for successful nursing career.
 Simulation also can used to evaluate students: Questions in the simulated
form are useful in assessing the knowledge related to the practical aspect of a
subject.
CHARACTERISTICS
 Mirror real situations while providing control over extraneous variables or
constraint that might influence with learning.
 Provide a mix of experience that can be replicated for successive learners.
 Provide a safe environment in which learning has priority over patient care or
system demand.
 Focus on application rather than uncertain recall of knowledge.
 Provide immediate feedback on performance.
TYPES
• Written simulation
Individual uses either paper or pencil latent image format.
Its typical use is to teach knowledge assessment to collect the data for
patient diagnoses.
• Audio-visual simulation
An entire simulation can be placed on videotape.
Management vignettes can be dramatized and filmed. Questions can be
posed for the viewer’s right on the screen, and the alternative outcomes,
dependent on which approaches to a solution are chosen, can be all
taped.
• Live simulated simulation
Lincoln, Layton and Holdmen (1978) describe their
experiences with simulated patients. The patients were healthy people,
usually students, who were trained in the role they were to play.
Simulated patient used their own history as much as possible but
memorized and added the elements of the history that had been created

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for the simulation. Nursing students found the experience to be
beneficial. They would be much more relax and confident when
meeting their first real patient.
STEPS OF SIMULATION
Ned Flanders has recommended the following six steps which are usually
followed in simulation training technique.
• STEP 1:ASSIGNMENTS OF ROLES
The student teachers are assigned the role of teacher’s students and
observers respectively. Every people teacher has to play all the three
roles one after another. It is done on rotation basis.
• STEP 2:DECIDING THE SKILL TO BE PRACTICED
A few social skills are discussed which are to be practised by the
pupil teachers. At this stage the skill to be practised through simulated
techniques, is decided and then planning and parathion for it are made.
The topic for each trainee is selected according to his interest and
intelligence.
• STEP 3:PREPARATION OF WORK SCHEDULE
In order to run the programme of practice successfully the details of
the work schedule are prepared. At this stage it is decided who will teach
first and who will observe the lesson. It is also decided how everyone
turn by turn, will be teaching and how everyone turn by turn observing
the lesson.
• STEP 4:DETERMINING THE TECHNIQUE OF OBSERVATION
The teacher decided the procedure of observing the lesson. How
different types of data to be observed and how are these to be recorded.
The procedure to the interpretation of data is also decided through
discussion at this stage.

• STEP 5:ORGANIZING THE FIRST PRACTICE LESSON

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The first practice lesson is started and its observation are recorded
for judging the teaching behaviour. This is followed by discussion
leading to feedback and suggestion for the improvement of lesson.
• STEP 6:ALTERATION OF PROCEDURE
The whole procedure is changed at this stage. There is change of
teacher, change of observer and change of teaching skill and also there is
a change in the topic to be taught. Every student teacher is given an
opportunity to play the role of a teacher, a student and an observer
ROLE OF THE TEACHER
• Planning
Planning begins with choosing or developing and appropriate
simulation that will meet course objectives.
Assign some reading for the student to do before class.
Textbooks or library resources should be pointed out to students so that
they can prepare for the simulation.
Teacher is responsible for preparing environment, it includes
arrangement of chairs and tables, ventilations, lighting.
• Facilitating
 Teacher should function as a facilitator during the actual process of
simulation. After introducing the activity you may predict and talk
little.
 You must coach students who are finding to take their way through a
sticky problem and encourage creative thinking and act as information
resources.
 Takes notes during the class so that in later discussion you can refer
back to specific strengths and weakness of process
• Debriefing
Your role is the final discussion or debriefing session.
Immediately following the simulation when the information is fresh in
everyone’s mind. You should briefly summarize what has taken place.

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Self-analysis can help students gain insight into why they made certain
decisions or took a specific course of action. In simulations where
emotions have run high, ventilation of feelings should be part of the
debriefing.
At the end of the discussion period you should point out
how principles and concepts have been applied and how the experience
ties in to the learning objectives.
LIMITATION
 The beginner participant may face some difficulty in asking difficult kinds of
questions. A simple task such as open and closed question may provide are
introductory challenge.
 It is quite possible that during an exercise the observer may record incorrectly.
 The most common error in serious skill training that adult can play the role of
pupils.
 Simulation attempts to portray real situation in a simple way and which is very
difficult.
 There is a tendency to use the result of a single simulation as the sole basis of
generalization.
 Commercially developed simulation games are expressive.

ADVANTAGES
 Simulation is useful in promoting transfer of learning from classroom to
clinical setting.
 Simulation technique are fun and interesting, they can motivate people to learn
 It is effective to all type of students, that is slow and fast learners
 Students also learn from the faculty member who is guiding the simulation and
leading discussion.
 It encourages creative and divergent thinking.
Divergent thinking is a creative process that involves that trying to think
of as many possible solutions as you can. It is the opposite of convergent
thinking, which usually involves a thought process that follows some set

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of rules or logic (in which case there may only be 1 or few correct
answers).
In contrast to convergent thinking, divergent thinking is
usually more spontaneous and free-flow. Individuals try to keep their
mind open to any possibilities that present themselves. The more
possibilities they come up with, the better their divergent thinking
 Students can learn without harming the patient..
DISADVANTAGES
 Simulation is costly in terms of time and money.
 Technique also consume a lot of classroom time.
 It is possible that emotion may be aroused to an undesirable degree, especially
with role playing.
 The process of simulation and outcome methods are not always predictable.

SUMMARY
Simulation is a powerful tool if understand and used properly. In the above
topic we learned about definition as simulation is an accurate representation of a
realistic situation, it’s one of the purposes is to help students practise decision making
and problem solving skills and to develop human interaction abilities in controlled and
safe setting, then the value of simulation is to ensures safe nursing practise by nursing
students through bridging the gap between theory and practise, one of the principle is
the Experience simulated are consequences which relate to their decision and general
purpose, characteristics-Provide a mix of experience that can be replicated for
successive learners, Types-Written audio-visual and live simulated simulation, role of
teacher is planning, facilitating and debriefing, limitations commercially developed
simulation are expensive, advantages is a device for motivating the student, and
finally disadvantage of simulation is difficulty for beginners. So the topic teaches us
how the simulation actually works and how to handle data generated by the
simulation.

CONCLUSION

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Simulation-based training has opened up a new educational application in
medicine. Evidence-based practices can be put into action by means of protocols and
algorithms, which can then be practiced via simulation scenarios. The key to success
in simulation training is integrating it into traditional education programmes. The
clinical faculty must be engaged early in the process of development of a programme
such as this. They can then help to engage the wider medical community. Teamwork
training conducted in the simulated environment may also offer an additive benefit to
the traditional instruction, enhance performance, and possibly also reduce errors. The
cost-effectiveness of potentially expensive simulation-based medical education and
training should be examined in terms of improvement of clinical competence and its
impact on patient safety. Perhaps, with the adoption of simulation as a standard of
training and certification, health care systems will be viewed as more accountable and
ethical by the population they serve.

RESEARCH ABSTARCT
1) Leading the Way in Simulation Research
Mary K. Fey, PhD, RN, CHSE Email the author PhD, RN, CHSE Mary K.
Fey
Research Fellow, Center for Medical Simulation, Massachusetts General
Hospital, Harvard Medical School, Boston, MA 02129, USA
Assistant Professor, University of Maryland School of Nursing,
Baltimore, MD 21201, USA
PlumX Metrics
DOI: http://dx.doi.org/10.1016/j.ecns.2016.01.001

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Article Info

Abstract
How far we have come since 2002 when the first mission and vision statements were written
for the newly formed International Nursing Association for Clinical Simulation and Learning
(INACSL). INACSL has been at the forefront of simulation-based education and research
since that time. INACSL leaders were part of the team who conducted the landmark study
“Designing and Implementing Models for the Innovative Use of Simulation to Teach Nursing

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Care of Ill Adults and Children: A National Multi-Site, Multi-Method Study” (Jeffries &
Rizzolo, 2006).
© 2016 International Nursing Association for Clinical Simulation and Learning.
Published by Elsevier Inc. All rights reserved

2) Board 434 - Research Abstract Simulation: Searching for the Right Words

(Submission #1378) .
Umei, Nao MD; Berg, Benjamin MD; Ouchi, Gen; Takahashi, Shigehiro MD; Dvilabh, Vora-
at MD
Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare: December
2013
doi: 10.1097/01.SIH.0000441686.50062.57

Abstracts:
Introduction/Background:

One of the core skills required for the practice of evidence-based medicine (EBM) is the
ability to effectively perform a literature search. The ever-increasing volume of healthcare
literature causes searching and utilizing published literature to become increasingly
challenging. The quality and accuracy of the information found significantly varies with the
sophistication of the search strategy. We sought to determine if published key words in high
quality publications are an effective tool for search strategy design.

Methods:

We utilized the Cochrane reviews because of their well-established quality and


methodological rigor and focus on reviews that included randomized controlled trials. We
selected two reviews related to virtual reality based simulation education from a list of
systematic reviews on the Web site of Cochrane Collaboration; on gastrointestinal endoscopy
and laparoscopic surgery. We identified the key words which were published in the
References cited by the Cochrane for these two reviews. We then performed PubMed
searches to assess if these key words when used in the search strategy would identify the
Cochrane referenced articles.

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Results:

The two Cochrane reviews contained a total of 35 References. We excluded eight


References for which complete articles could not be obtained. Thirteen (48.1%) of the 35
References did not specify any key words in the original publication. A mean number five
key words per article was identified in those articles which contained key words. Pub Med
searches using all the key words specified by the authors yielded 6 of 14 (42.8%) of the
original publications from which the key words had been identified. We required a mean of 4
words to generate a search result which included only the Cochrane reference. The most
frequently used key words were training (11 times), simulation(10 times), virtual reality (7
times) and education (5 times). Searches using these general terms singly were unwieldy;
searching with "training" in PubMed, yielded 1,020,657 References Searching with two
terms, a general keyword and a modifier; such as "surgical training" "skills training", yielded
2,408 and 3,523 References respectively. The specific key word combination "virtual reality"
yielded 4,099 References.

Conclusion:

Searches in Pub Med with key words submitted by authors of high quality publications
failed to identify the References in search Results in the majority of instances for the articles
selected in our study. Less than half of the authors selected key words which lead to effective
search discovery. We conclude that key word selection must be done carefully to assure
optimal search discovery. Further research is required to identify optimal keyword selection
for both publication and searching

References:

1. Walsh CM, Sherlock ME, Ling SC, et al. Virtual reality simulation training for health
professions trainees in gastrointestinal endoscopy. Cochrane Database Syst Rev. 2012.

2. Gurusamy KS, Aggarwal R, Palanivelu L, et al. Virtual reality training for surgical
trainees in laparoscopic surgery. Cochrane Database Syst Rev.2009.

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3. Agoritsas T, Merglen A, Courvoisier DS, et al. Sensitivity and predictive value of 15
PubMed search strategies to answer clinical questions rated against full systematic reviews. J
Med Internet Res 2012; 12;14(3):e85.

Disclosures: Karl Storz USA.

(C) 2013 by Lippincott Williams & Wilkins, Inc.

3)Board 314 - Research Abstract Simulation as a Tool for Improving Acquisition of


Neonatal Resuscitation Skills (Submission #946).
Bruno, Christie DO; Angert, Robert MD; Rosen, Orna MD; Lee, Colleen RN; Vega, Melissa PA;
Bernstein, Peter MD, MPH; Goffman, Dena MD
Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare: December 2013
doi: 10.1097/01.SIH.0000441566.20459.73
Abstracts:

Introduction/Background:

The first few minutes after birth are most critical for a newborn. Although most infants
transition with ease, some require delivery room resuscitation.1 The quality of initial
resuscitation may impact the infant's short- and long-term outcome.2 Traditionally, neonatal
providers are present at deliveries as soon as the need is recognized and delivery of the infant
is imminent. However, in the event that the neonatal resuscitation team is not present, the
obstetric team must initiate resuscitation. While obstetric nurses complete resuscitation
training, obstetric physicians are often not required to complete neonatal resuscitation
training. In order to fulfill this educational need we hypothesize that a short instructional
session that teaches initial neonatal resuscitation steps with a simulation based curriculum
will increase obstetric physician confidence, knowledge, performance and retention of
neonatal resuscitation skills.

Methods: This was a prospective randomized, controlled trial of 33 obstetric residents.


Subjects received baseline confidence, knowledge and clinical skills assessments. Subjects
were then randomized to traditional lecture (n=14) or simulation-based (n=19) neonatal
resuscitation education with a focus on initial steps. All instructional sessions were less than
one hour in duration and both lecture and simulation interventions contained the same
content. The simulation session required that the subject learn how to resuscitate a depressed
neonate "hands on" with expert coaching. Follow-up assessments of confidence, knowledge
and clinical skills occurred at intervals of three and six months post initial instruction.
Confidence was reported based on a Likert scale of 1 (least confident) to 5 (most confident).
Knowledge was assessed using seven multiple choice questions at the three intervals.

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Clinical assessments were performed in a simulated environment and were graded as yes/no
if the subject completed individual tasks successfully in the following areas: preparation,
initial resuscitation, ventilation, cardiovascular resuscitation. Total knowledge and clinical
assessment scores were calculated. Statistical analysis was performed with paired T-tests to
test individuals improvement and Student T-test for comparisons between groups.

Results: For both the lecture and simulation-based groups, confidence increased significantly
at three and six months post instruction when compared to baseline (p<0.01). This increase in
confidence was sustained as there were no significant differences between confidence at
three and six months in both groups. Performance on knowledge assessment questions also
improved significantly from baseline at three and six months post instruction for both groups
when compared to baseline (p<0.01). Knowledge was maintained as there were no
significant differences between knowledge scores at three and six months in both groups.
Clinical assessments for the lecture group revealed no significant difference in successfully
completed tasks between baseline and three months. However, significant improvement was
demonstrated when six month performance was compared to baseline and 3 months
(P<0.01). For the simulation group, clinical assessment performance was significantly
improved at three and six months versus baseline (p<0.01) and this improvement was
sustained with no significant difference between three and six month scores. Although there
was an overall improvement in both groups, analysis with Student T-tests demonstrated that
simulation performance scores were significantly higher than the lecture group at both three
months (19.8 vs. 13.4) (p<0.01) and 6 months (19.1 vs. 17.2) (p<0.05).

Conclusion: A short, focused curriculum that teaches initial neonatal resuscitation steps via
lecture or simulation enhances subject confidence, knowledge and skills. However, education
that incorporates simulation is superior to lecture, resulting in more rapid acquisition of
clinical skills and sustained improvements in overall clinical performance. Fortunately, an
unanticipated depressed neonate is a relatively infrequent event; however, improved ability
for obstetric providers to initiate a prompt and effective neonatal resuscitation after a brief
simulation intervention, has the potential to greatly impact outcomes for these vulnerable
newborns.

References: 1. Perlman JM, Risser R: Cardiopulmonary resuscitation in the delivery room:


associated clinical events. Arch Pediatr Adolesc Med 1995; 149:20-25.

2. Casalaz DM, Marlow N, Speidel BD: Outcome of resuscitation following unexpected


apparent stillbirth. Arch Dis Child Fetal Neonatal Ed 1998;78:F112-F115.

Disclosures: None.

(C) 2013 by Lippincott Williams & Wilkins, Inc.

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4) Board #116 - Research Abstract There's More to Simulation in High School
than Driver's Ed and Fire Drills: Health Care Simulation Experience for Rural
High School Students (Submission #8538).
Croland, Joshua; Cotter, Thusitha; Dwiggins, Maggie

Simulation in Healthcare: The Journal of the Society for Simulation in


Healthcare: December 2014
doi: 10.1097/01.SIH.0000459286.99867.e2
Abstracts: 1st PLACE AWARD WINNER: PDF Only
#Abstract
Hypothesis: The objective of this study was to provide rural high school students a hands-on
experience using healthcare simulations in order to give them a more realistic perception of
medicine, stimulate interest in healthcare, and promote a stronger desire to pursue a career in
medicine. We developed a simple, easily reproducible intervention for high school seniors
and evaluated the impact our simulations had on their perspective of the healthcare field.

Methods: Eureka High School Outreach Program is a half day event that includes time spent
in wet pathology lab where the students examine organ systems, handle anatomy specimens
and have small group sessions with instructors. The second part of the morning is spent at a
simulation center where an introductory curriculum for exposing students to basic surgical
skills is run. The surgical exercises are simple, include specific performance-based learning
objectives and have clear instructions. All exercises are adapted to small groups of up to five
students and can be completed within twenty minutes. Simulation sessions include sterile
technique (scrubbing and gowning), laparoscopy, suturing and knot tying, blood pressure
monitoring and IV placement. Thirty six junior and senior high school students participated
in the event and completed pre- and - post surveys to gauge change in interest level in
medicine and impact of event on choosing a career.

Results: Thirty-six students completed pre/post surveys, with a response rate 88.9%. Only
two students reported having been a part of a simulation event in the past, although
presumably every student had at least been a part of a fire drill while at school. Before
intervention, 58.3% of students reported being interested in healthcare as an occupation,
55.6% had mentor in healthcare, 100% reported intending to pursue higher education, and of

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those, 27.7% grad school or higher. After intervention, 65.5% reported increased interest in
healthcare, 78.1% felt it was helpful in choosing a career, and 96.6% had a better
understanding of healthcare.

Conclusion: Eureka High School Outreach Program is a low resource, high impact half day
intervention that is easily replicable and can significantly promote early interest in a
healthcare career for rural students.

References: 1. Antiel RM, Thompson SM, Camp CL, Thompson GB, Farley DR. Attracting
students to surgical careers: Preclinical surgical experience. J Surg Ed 2012:301-305.

2. Drolet BC, Sangisetty S, Mulvaney PM, Ryder BA, Cioffi WG. A mentor-based
preclinical elective increases exposure, confidence, and interest in surgery. Am J of Surg
2014;207:179-186.

3. Lee JT, Son JH, Chandra V, Lilo E, Dalman RL. Long-term impact of preclinical vascular
skills course on medical student career courses. J Vasc Surg 2011;54:1193-1200.

4. Nitschmann C, Bartz D, Johnson NR. Gynecologic simulation training increased medical


student confidence and interest in women's health. Teaching and learning in Med
2014;26(2):160-163.

 5. Patel MS, Khalsa B, Rama A, Jafari F, Salibian A, Hoyt DB, Stamos MJ, Smith
BR. Early intervention to promote medical student interest in surgery and the surgical
subspecialties. J Surg Ed 2012:81-86.
 BIBLIOGRAPHY
BOOK REFERANCE

 J.C Aggarwal (2011 ) Essentials of Educational Technology, Innovations in

Teaching, Learning.Second Edition.New delhi.Vikas Publishing.280-282


 I clement (2010).Textbook on communication and Educational technology. second
edition. New Delhi.Emmens Publishers.236-238
 Jasprect Kaur Sodhi (2017) comprehensive Textbook of Nursing Education. New
Delhi Jaypee Brothers Medical Publishers.74-77
 Elsa Santatombi Devi (2008).Manipal manual of Nursing Education. New Delhi.CBS
publication

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 Shabeer P Basheer(2015).Textbook of Nursing Education,First edition,Emmess
Medical Publishers
JOURNALS

 Jeffries, Pamela R (2005). A framework for Designing, Implementing, and


Evaluating: Simulations Used as Teaching Strategies in Nursing. The
research journal of the National League for Nursing, 26(2), 96-103.
 Can’t R.P& copper S.J (2010) Simulation-based learning in nurse education
Systematic review Journal of Advanced Nursing (1), 3-15
 Calhoun, Aaron W.; Gaba, David M (2017) Simulation in Healthcare: The
Journal of the Society for Simulation in Healthcare 12(5):279-281,
 Aebersold, M., Tschannen, D., (May 31, 2013) "Simulation in Nursing
Practice: The Impact on Patient Care" OJIN: The Online Journal of Issues in
Nursing Vol. 18, No. 2, Manuscript 6.

INTERNET RESOURCES
 Simulationslideshare,july14,2016fromhttps://www.slideshare.net/FIROZQURESHI/sim
ulation-64022693
 Simulation, Wikipedia from https://en.wikipedia.org/wiki/Simulation

 Enhancing patient safety in nursing education through patient simulation, CF Durham


- 2008 from https://www.ncbi.nlm.nih.gov/books/NBK262

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ROLE PLAY

INTRODUCTION

The role play is presently a popular technique, traces back to psychotherapy of the
1930’s.From that narrow beginning, role play has spread to many and varied forms of
education from the primary levels of the elementary school to the upper echelons in
management training of business executives.

Essentially every teacher creates his own teaching method. In terms of his
personality and experience, the purposes and subject matter of instruction, he judges suitable,
choosing and adapting various technique. Role playing is a dramatization based on a
particular theme. This helps to students to experience the situation emotionally and to
develop insight. It also encourages thinking and creativity. In nursing role-play situation is
designed to reflect the interaction between a care provider and a patient in order to
implement the expected therapeutic outcome. The most important themes derived from a
role-play situation are understanding, self-disclosure and trust, respect, truth telling and
honesty, power and interpersonal conflicts, empowerment and support, reflective thoughts.

DEFINITION

 A dramatic approach in which individual student assume the role of others.(R.Sudha)


 Role playing is acting out of a clearly defined situation, usually done in front of a
group with time allotted conclusion for discussion and used to practice real life
situations.( I Clement)
 Role playing can be defined as the way one behaviour in a given position and
situation.(Elsa Santatombi Devi)

PURPOSE

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 To convey information
Role play helps to convey core information in a less dense, more
easily digestible way than one person presenting the details. They generally involve
using strong visual and audio stimuli and cues (characters and any props) which helps
the audience to remember the material presented.
 To develop specific skills
Role play helps the learner to develop the skill of self reflection in a
safe and effective environment. it also helps to develop effective communication
skills.
 To develop a situation for analysis
Role play allows to analysis a situation.Eg: historical event, social
occurrence etc

 To prevent alternative courses of action

 To developing understanding point of others


Role play helps the participants to get inside to the character and inact the
meaning of the character
 Increase students insight into typical ways of dealing
Role play helps to experience the feeling emotionally and to develop insight in
to the problem.
 Length of role play will make the situation clear and awareness can be created in
the minds of the students

VALUES

 Role playing can be used with students of most ages.


 The complexity of role situations must be minimised in using the method with
children. But we keep it simple for their limited attention span; roleplaying can be
used even in teaching pre schoolers.
 Role playing allows people to make mistakes in anon threatening environment.

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 Role playing can test several solutions to very realistic problems, and the application
is immediate.
 Role play also fulfils some of the very basic principles of the teaching learning
process such as learner involvement and intrinsic motivation.
 A positive climate often results in which one can see himself as others see him.
 The involvement of the role playing participants can create both an emotional and
intellectual attachment of the subject matter at hand. If a skilful teacher has accurately
matched the problem situation to the needs of his group, the solving of realistic life
problems can be expected.
 Role playing can often create a sense of community within the class.
 Although at first it may seems a threatening method, once the class learns to share a
mutual confidence and commitment to the learning process, the sharing of analysis
over the role situation will develop camaraderie never possible in monological
teaching such as lecture.

PRINCIPLES

 Role playing is based on philosophy.


Role playing is based on the philosophy that meanings are in people, not in
words or symbols. If that philosophy is accurate, we must first of all share the
meanings, then clarify our understandings of each other’s meanings and finally, if
necessary, change our meanings.

 Role play has to do with change in self concept

The self concept is best changed through direct involvement in a realistic and
life related problem situation rather than through hearing about such situations from
others..
 Role play should be stimulant to think and should not be an escape from discipline of
learning.
 Notice that there is no single best method of selecting the characters; the group may
do the assigning.

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 Requires rehearsal is an important feature to produce effective outcome and on
audience to help players interpret the roles.
 Role play should be able to analyse and evaluate which is an essential element to gain
maximum learning benefits.
 Role play should be done for a brief period.

CHARACTERISTICS

The role play should have clear objectives.


The role play is based on a particular theme, performed to spread the message
to the people.
It should analyse the needs in stimulated real situation.
If the real situation is done through role play, helps to analyse the effect of
the situation.
It should encourage independent thinking.
It helps the students to express their views, ideas etc.
The actors are not allowed to project their own life in the role.

The actors has to act according to their prescribed characters.

It should make the audience to participate actively.

TYPES

1. Socio drama:

Deals with interaction of people with other groups of individuals. Involves


situation more than one person and deals with problems.

For example:

A sociodrama director was asked to work with nurses, for one hour in their hospital
lounge. (The administration department asked the director to have the nurse’s talk about their
patients) After much discussion the director listed possible roles ranging from "bed, doctor,
patients, thermometer, and buzzer. The nurses selected the roles they wanted to enact. After
further discussion a theme, selected by the nurses, focused on "making a difference in our

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world" In the role of a patient, one man said to a nurse playing “the buzzer.” The “patient”
said, "Whenever I ring you the nurses never come to find out what I need or want." The
buzzer responded, "Hey, it’s not my fault! Maybe they need to make me ring louder."
Others joined in the sociodrama interactions. Once the session came to a closure, members
spoke in character and then de-rolled (the technique of more explicitly putting down, shaking
off, or otherwise indicating to the group that they are releasing their role, and they are re-
entering the role of themselves in the group) the nurses started to respond. “I guess I do that
and do not show up sooner with my sick patients”. The value of role- playing in a
sociodrama is learning by doing. The value of the theme in a sociodrama is the development
of doing by action.

2. Psycho drama

Deals with unique individuals needs/problems.

For example: Help families to adapt childhood diabetes

To relieve social barriers in an autistic child

STEPS

According to Richard (1985),the following are the steps of role play

a) Preliminary activity
Role play starts with a problem. This may be recognising by the learner or
the teacher. Role playing centres around the needs and concerns of the group. The
group is involved in some way in developing the background situation. The
situation should increase the group’s insight and deepen the ability to see
situation. So the preliminary activity includes selection of a situation. It is best to
ask for volunteers, unless there is a special reason for assigning certain roles.
After actors are chosen, they are briefed as to their roles and group has a warming
up session. This prepares them for critical observation and analysis of the
situation.
b) Model Dialogue

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The model dialogue is presented depending up on the levels of the
participants. It should be simple and clear. So that the audience can able to
understand the concept in role play.thedialogue is also in such a way that it does
not harm anyone in the audience.
c) Learning to perform the role play
After the roles have been decided, the participants are given written
descriptions about their roles and setting. the scenes are described and discussed
with them briefly. The actor should understand who he is and he should be given
some time to think, so that he can add some of his views.
d) Performing the role play
The role play is performed under a director. The director introduces the
scene and also the roles of the participants. In introducing the role play to a group
it is best to keep the problem and situation as simple as possible, involving a
familiar and non threatening situation. all members of the group should be helped
to understand what is happening and actively involved. The group members will
act their roles and the audience will actively concern with the drama. They are
supposed to pay attention to what is going on. The scene should be
succinct.Illaberate dialogue and irrelevant material is avoided. The scene is cut
when it has served its purpose.
e) Follow up
After the role play action has ended, both the participants and audience
can discuss action. This give them the opportunity to explore their feeling and
negates possibility of feeling threatened when the group makes their observation.
Following discussion, an attempt is made to summarize and evaluate the insights
derived and make plans to provide an opportunity to put in to effect, the behaviour
implied.

ROLE OF TEACHER

 Note individual students need by observing and analyse his/her needs in a simulated
real life.

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 Assist students in meeting their own need by either giving or encouraging her group
members to give her on the spot suggestions.
 Encourage independent thinking and actions by stepping aside or giving guidance for
emphasis is on student helping themselves.

ADVANTAGES

Role play provides an opportunity to practice new skills. It also helps in group
problem solving
Helps to develop sensitivity to another feeling by having the opportunity to put our
self in another position
Encourages the student in independent thinking also makes situation in an effective
manner.
Promote activity and interests in students and instils confidence in the students.

DISADVANTAGES

Role playing is a means, not an end, It requires expert guidance and leadership.
It is used as an educational technique not as therapeutic one; strongly depend upon
student’s imagination.
Time consuming in developing group remedies, should not be used when pressure of
time is present.
Limited only by teachers ingenuity and realistic use.
Effective only when learners have adequate knowledge and skills to perform what is
requested, can lead to chaos when students are not sure of expectation.
It can be tendency by some participants to only exaggerate their assigned roles.

SUMMARY

Role playing is a dramatization based on a particular theme. In the above topic we


learned about definition as, a dramatic approach in which individual student assume the role
of others. The one of the purpose is to convey information and the values is Role playing can
be used with students of most ages. Principle is role playing is based on philosophy and the
characteristics of the role play should have clear objectives types mainly are sociodrama and

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psychodrama. Steps are preliminary activity, model dialogue, learning the role play, perform
the role play, and follow up. The role of teacher is to note individual students need by
observing and analyse his/her needs in a simulated real life, advantages is to promote activity
and interests in students and instils confidence in the student , disadvantages of role playing.
CONCLUSION
Role play is a means not an end. It is used as an educational technique. It requires
expert leadership. It provides concreteness to learning situation and encourages use of
problem solving skills. It cannot be used successfully until the group understands and
accepts it. Hence role playing is relatively a new technique where people act out
spontaneously to relate human reactions and analyse the enactment. Therefore one must be
cautious in enacting such sensitive issues in trying to understand the whole situation, and a
qualified teacher should be able to lead the student group in the right direction required for
the particular situation. If the criteria of a role play are fulfilled then definitely role playing
could influence the students learning and would retain for longer period and will develop
understanding of their clients

RESEARCH ABSTRACT

1. Effects of Applying Role Playing Approach on Nursing Students' Education

Article · April 2016 with Abstract

Employing new education approach is necessary for enhancing nursing


students` students `skills; Therefore, the main purpose of this study was to comparing effects
of role playing and traditional methods on nursing students' education. The paper presents the
results of an experimental study where one group of students was taught using role-playing
and the control group was taught using traditional approach. Statistical population of the
study included all nursing students at Shiraz University and 228 nursing students were
randomly allocated in role playing and traditional training groups to participate in a 4 hour
workshop. Before and after the workshop students' skills were assessed and data gathering
tools included a self evaluation form and evaluation checklists for assessing students'
performance. Results of Paired t-test showed that the scores of role playing was more than
writing test and were statistically significant. Average of female's scores were more than
men's in both exams; and paired t-test showed a significant relation between gender and

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average of scores but average of female's scores in role playing method had a more
significant increase.

2. The importance of role-play in nursing practice

Abstract

Background: A role-play situation is designed to reflect the interaction between a care


provider and a patient in order to implement the expected therapeutic outcome. The most
important themes derived from a role-play situation are understanding, self-disclosure and
trust, respect, truth telling and honesty, power and interpersonal conflicts, empowerment and
support, reflective thoughts. Method and Material: Literature review based on studies and
reviews derived from international (Medline, PubMed, Cinahl, Scopus) and Greek (Iatrotek)
data bases concerning nurse-patient relationship in the context of therapeutic communication,
using the following key words: Role play, interaction, communication skills, patient,
therapeutic outcome Results: The issue of understanding is present in each role-play
situation. Self-disclosure is an important issue in a role-play situation, since it allows patients
to trust nurses. Additionally, during a role play situation the nurse needs to respect the
patient, while honesty is closely associated with trust and affects the credibility of the care
provider. Also, care providers need to be tolerant during their interaction with their patients
in order to avoid any interpersonal conflicts. Conclusions: The use of a role play situation
between a nurse and a patient is very important, because it can contribute to the
implementation of the expected therapeutic outcome. However, a theoretical basis is essential
for an effective interaction between patients and nurses.

Available from:
https://www.researchgate.net/publication/289695264_The_importance_of_role-
play_in_nursing_practice [accessed Nov 12 2017].

3. 2015 The Effectiveness of Combining Simulation and Role Playing in Nursing


Education Shari Lynn Redden Walden University

Shari Lynn Redden, Walden University


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Abstract :The profession of nursing is affected by a nursing and nursing faculty shortage
that is impacting the ability to produce adequate numbers of nurse graduates to address
the healthcare needs of the future. Nursing schools are increasingly using simulation
and/or role-playing to supplement the decreased number of nurse faculty and clinical sites
in order to be able to continue to enrol nursing school applicants. The purpose of this
phenomenological study was to examine the experiences of nursing students with role-
playing and simulation and the extent to which role-playing with simulation is perceived
by students as beneficial for learning within the nursing program at the study site.
Constructivism theory and experiential learning theory were the theoretical frameworks
used to evaluate the student perceptions of combining simulation and role-playing. Seven
students from a bachelor’s of nursing program volunteered to participate in the study and
individual interviews were conducted. Interview transcripts were open coded and
analyzed for patterns and themes. The results of the study indicated that the 7 students
preferred the combination of simulation and role-playing over the use of either technique
independently. It is recommended that simulation coordinators use the combination of
role-playing and simulation to enhance student learning in the simulation laboratory. This
study promotes positive social change by providing data to the local site on students’
perceptions of the benefits of a technique that is able to support instruction and maintain
student enrolment during nursing faculty shortage

BIBLIOGRAPHY

 I clement (2010).textbook on Communication and educational


Technology.Bangalore.second edition.Emmens publication.207-210.
 Elsa Santatombi Devi (2008).Manipal manual of Nursing Education. New Delhi.CBS
publication. 213-219
 Jasprect Kaur Sodhi (2017) comprehensive Textbook of Nursing Education. New
Delhi Jaypee Brothers Medical Publishers.74-77
 JC Agarwaal(2011) Essentials of educational technology,Innovation in
Teaching,Learning,Second edition,New Delhi,Vikas Publishing.

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 Shabeer P Basheer(2015).Textbook of Nursing Education,First edition,Emmess
Medical Publishers

JOURNAL REFERANCE
 Arham R, Abdul Hakim Yassi, Burhanudin Arafah(2016) The Use of Role Play to
Improve Teaching Speaking,International Journal of Scientific and Research
Publications,6(3)239-241
 NT Chaharsoughi(2006) Comparison the Effect of Teaching of SBAR Technique
with Role Play and Lecturing on Communication Skill of Nurses, Iranian Journal of
Medical Education. 8(2):275–83
 T Turzák(2017) Role Play as a Method of Improving Communication Skills of
Professionals De Gruyter Open journals 35(1), 95-108.

INTERNET SOURCES
 The importance of role play in nursing practice. FP Babatsikou - 2012
www.hsj.gr/medicine/the-importance-of-roleplay-in-nursing-practice.php?aid=5305
 Effects of applying role playing approach on nursing students. F Vizeshfar - 2016
https://www.researchgate.net/publication/307378846
 Roleplaying-slideshare-march10,2013https://www.slideshare.net/bharatmewara7/role-
playing-17081490
 Role play-slide share,july 14, 2016-https://www.slideshare.net/FIROZQURESHI/role-
play-64022497

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