(28) Enhancing Clinical Reasoning and Communication through Simulation-Based-Mastery: A Pilot Project

Abstract: Quality safe patient care is dependent on graduates who are proficient in identifying and communicating critical information to other members of the health care team. Competent skill acquisition and retention have been shown to promote practice readiness, reduce the occurrence of clinical errors and improve patient outcomes.
Traditionally within nursing programs skill acquisition has been reinforced and assessed using summative evaluations, such as checklists and objective structured clinical examinations (OSCE)’s. Elevated levels of learner intimidation and stress, often inherent in OSCE evaluation methods can negatively impact the ability of the learner to meet expected outcomes.
Simulation-based mastery learning offers the learner and educator an outcome based educational model that supports the achievement of very high levels of performance through deliberate practice as established by a pre-determined rigorous evaluation tool.

A pilot project using (SBML) with deliberate practice (DP) supported the scaffolding of learner competencies in the areas of physical assessment, client data interpretation, and communication. Learners' completed head-to-toe assessments for a simulated patient for which they had already become familiar with throughout the semester. This provided the opportunity to identify, uncover and or compare the patient’s current health status to previous patterns as well as effectively communicate these finding to another member of the healthcare team using ISBAR (introduction, situation, background and recommendation).

In small groups instructors provided intentional formative feedback on their performance aimed at supporting their progression toward skill mastery. Students demonstrated significant improvement in clinical performance in their attempts to achieve mastery of the identified skills.