Use of Simulation in NP and PA Programs

Use of Simulation in NP and PA Programs Posted By:
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In the last several years, both NPs and PAs have sent out surveys on the use of simulation in their programs, and articles have been published with the results. Simulation has been used widely in undergraduate medical students' and residents' education. Medical education uses standardized patients as part of their USMLE Step 2 CS and has also incorporated task trainers as part of the exam. In recent years, other healthcare professionals have incorporated simulation into their curricula for nursing, NP, PA, pharmacy, physical therapy, social work, and dental programs.

While nursing has been integrating simulation into their undergraduate curricula since the early 1980s, advanced practice nurses (APNs) have more recently incorporated task trainers and standardized patients with objective structured clinical examinations; however, they currently do not count for any part of their clinical hours. The National Organization of Nurse Practitioner Faculties and the National Task Force on Quality Nurse Practitioner Education support the use of simulation in APN education as long as simulation hours are not included within the minimum direct patient care hours required. According to Anderson et al, the challenges encountered for NPs include inadequate clinical sites, preceptor pools that do not allow for expansion of programs, and questions regarding the use of clinical hour requirements as a valid measurement of student learning and competency. The National Council of State Boards of Nursing supports substitution of quality simulations for a percentage of clinical hours in undergraduate nursing programs. Currently, 130 APN programs in the United States and Canada report using simulation as an educational pedagogy in physical assessment (91%) and advanced practice skills (68%). The most common simulation used are standardized patients, full-scale mannequins, virtual simulation, task trainers, and interprofessional simulations.

There is limited literature on the use of simulation in PA education. PAs incorporated standardized patients in the late 1990s and had formative objective structured clinical examinations as part of their physical examination course. According to Coerver et al, 90% of PA programs in the United States that are associated with academic medical centers used simulation centers for training, whereas only 56% of private colleges and universities used simulation centers. The most commonly used simulations were standardized patients, full-scale mannequins, and task trainers to assess competencies and participate in interprofessional simulation sessions. The sessions were used for formative and summative assessment. The article did not state if simulation hours were counted for clinical hours. According to ARC-PA, PA students must have supervised clinical practice experience to meet program expectations and acquire competencies.

In summary, simulation offers an avenue for all students to receive standardization of experience, standardized assessment of competencies, and a safe environment in which to perform skills and gain knowledge.

References
  • Accreditation Review Commission on Education for Physician Assistant, Inc (ARC-PA). Accreditation standards for physician assistant education. www.arc-pa.org/wp-content/uploads/2016/10/Standards-4th-Ed-March-2016.pdf. Accessed March 27, 2019.
  • Alexander M, Durham CF, Hooper JL, et al. NCSBN simulation guidelines for prelicensure nursing programs. J Nurs Regul. 2015;6:39-42.
  • Anderson M, Campbell SH, Nye C, Diaz D, Boyd T. Simulation in advanced practice education: let's dialogue!! Clin Simul Nurs. 2019;26:81-85.
  • Coerver D, Multak N, Marquardt A, Larson EH. The use of simulation in physician assistant programs: a national survey. J Physician Assist Educ. 2017;28:175-181.
  • National Organization of Nurse Practitioner Faculty (NONPF). Nurse practitioner core competencies content. c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/competencies/2017_NPCoreComps_with_Curric.pdf. Accessed March 27, 2019.
  • National Task Force on Quality Nurse Practitioner Education. Criteria for evaluation of nurse practitioner programs (5th ed). cdn.ymaws.com/www.nonpf.org/resource/resmgr/Docs/EvalCriteria2016Final.pdf. Accessed March 28, 2019.
  • Nye C, Campbell SH, Hebert SH, Short C, Thomas M. Simulation in advanced practice nursing programs: a North-American survey. Clin Simul Nurs. 2019;26:3-10.

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Filed under: NPs & PAs

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