(12) Call a QR Code! Transferring Manikins from Low to Moderate Fidelity

Abstract: A pilot use of Quick Response (QR) codes elevated low-fidelity manikins to moderate-fidelity status during a self-directed simulation. Every hour, three accelerated baccalaureate student nurses in their final course at a CT university engaged in an hour-long self-directed experience of receiving report and caring for three patients each, simultaneously. Real-time assessment data via QR code in specific locations on the manikin's body could inform student nurse clinical decision making without requiring additional high-fidelity manikins or simulation staff to operate the manikins. Additionally, the innovation and simulation design contributed to the environmental realism of an acute inpatient unit. Upon learner reflection, time management was an overarching theme that inhibited most from using one to four of the QR codes on the manikin to gather complete and necessary assessment data prior to their interventions, which could compromise patient care. Lessons learned during this pilot intervention include: clarifying the prebriefing since learners have not seen QR codes on our low-fidelity manikins in the past, perhaps by stating: “QR Codes are integral to this simulation by providing crucial information, and the first will be found on the WOW for report" ; consider extending the time for the self-directed experience; create an observation checklist with question(s) to raise observer awareness and curiosity about QR code placement, data, and influence on learner decision making; develop an evaluation survey with specific questions about QR code use; and consider having simulation facilitator attend the debrief to provide insight from the simulation experience related to QR code use.