Nursing – The ‘5-stage’ approach

International Nurses Day 2021 focuses on ‘A vision for future healthcare’. School Lead for Simulation and Patient Safety, Emily Browne talks about the ‘5-stage’ approach to training for student nurses at Staffordshire University. 

In 2019 we ran several interprofessional simulation events for our nursing and paramedic students involving clinical practitioners (Drs and ACPs from partner trusts). One of the interesting findings from this was the nursing students apprehension about taking part in simulation but also their realisation of its benefits and increased confidence levels after the simulation.

This prompted us to look at the time student nurses spent in skills labs and at what point they were introduced to simulation. We found that there was a very traditional approach to skills and simulation which was often a later addition or only used for CPR style scenarios.

We then looked for how we could better integrate skills and simulation and move away from ‘task training’ skills teaching. We initially surveyed all of our year one and year two students about their experience of skills and simulation and what they would like more or less of. The results found that students wanted more simulation, small skills groups and more time to ‘practice’ and ‘consolidate’ skills learnt.

ASPiH and TEL have provided guidance on simulation-based education and frameworks for development of faculty and delivery of simulation but no evidence of skills and simulation integration for pre reg nursing (or other healthcare professionals) has been found.

We developed the 5-stage approach to create a scaffolding of learning bringing simulation into the curriculum from the very start allowing for a gradual cognitive load. We emphasise a holistic approach to skills and simulation by the early introduction of consolidation and simulation rather than task training. This approach builds on technical and non-technical skills alongside an understanding and exposure to simulation. By year three students should be debriefing their own teams in simulation and understand the use of simulation debriefing tools.

  • Stage 1 – Keynote lectures, including written and video content
  • Stage 2 – Facilitated skills sessions for perfecting technical abilities
  • Stage 3 – Facilitated simulation sessions with a focus on technical and none technical skills
  • Stage 4 – Simulation activity and debrief with a focus on non technical skills and human factors
  • Stage 5 – Practice placement application of knowledge and skills.

We re-surveyed the students in February 2021 and despite the Covid restrictions, the feedback has been positive for the sessions the students have been able to attend, with a desire for more simulation strong in the free text comments. Students also report being better prepared for placement following simulation and the 5-stage approach.

As we move out from the cloud of Covid, we will continue with this delivery method and will re-survey the students in another 6 months.

Emily Browne – School Lead for Simulation and Patient Safety

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