Sharon Stoten DNP, RN, NE-C
As the profession of nursing continues to evolve, from a profession of ensuring that patients are well fed, clean and are healing in a clean environment to one of technical and life-saving interventions, nursing education must also change from a face to face experience to one that delivers information quickly and with a dash of entertainment (Ridley, 2007), Nursing educators today have many different means at their disposal to accomplish this, they can use simulations, distance learning and games to teach skills and technology needed in nursing today.
One of the fastest growing areas of teaching is the use of educational games. Educational games are drawing a great deal of attention and funding and can allow educators another avenue to explore in the constantly changing area of technological education (McGonigle & Mastrian, 2015). People tend to play games due to the fact that games are fun, motivational and contain a fixed set of rules (Salen & Zimmerman, 2003). Games also allow for diversion, and the best games provide a challenge for player and allows for feedback at the end of the game session (Csiksznetmihalyi, 1990). This allows players the opportunity for improvement within the game.
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There are many different types of games that can be used in the educational setting. There are actions games, which often require quick reflexes and the ability to think fast, building and puzzle games, which require critical thinking skills and the ability to look ahead to plan the next move, and strategy games which require the player or student needs to think on their feet, and up-front planning to achieve a positive outcome. Another type of educational game is a learning simulation. Simulations mirror real-life scenarios and allow for nursing students and others to practice in a safe setting without the fear of causing actual patient harm (Alessi, 1988). All games and game genres have the ability and potential to be used in the educational setting (Mastrian et al., 2011).
As education continues to evolve, the use of games in education continues to rise. The use of evidence-based practice along with research and technology will eventually lead to more widespread use of this type of technology for learning (New Media Consortium, 2007). Another aspect of games in education is the cost. Some educators and institutions may balk at using games as an educational tool based on the overall cost.
Today, games and the technology that goes into making them are less expensive to produce and cheaper than in years past. The reasoning for this is that the game development engines are now more widely available and more and more companies are providing development tools within the game itself to further reduce costs (Dyer-Witheford & de Peuter, 2009). Also, more and more independent (indie) gaming studios exist providing a cheaper alternative for games that are less expensive but still provide a high-quality gaming experience (McGonigle & Mastrian, 2015).
As the cost of educational games and simulations continues to decrease, they share the potential to be used as legitimate teaching tools. The use of games as an educational tool will allow nursing educators to supplement current curricula and allow for a new generation of learners to learn in an environment that they are more familiar with, and perhaps replace the current learning methods in use today.
As technology continues to get better and the field of nursing informatics continues to grow, the competency of nurses in informatics becomes important. Nurses must be able to use the technology available to them and be competent in its use to provide safe and competent patient care. The American Association of Colleges of Nursing has stated that all health care professionals must have a good working knowledge and also skills when it comes to the field of informatics (1997). It has also been stated that the field of information technology is a key component for improved patient safety and a key indicator of quality care (American Academy of Nursing, 2003). To achieve informatics competency, it is important for nurse educators to fully integrate informatics as a full time study within nursing programs.
In designing a simulated electronic health record (EHR), I would focus on two main informatics competencies: the ability to use the application to document and the ability to use the application to build a patient care plan. According to Fetter (2009), these were the two competencies student nurses states they had little or no experience with.
The use of a simulated EHR has distinct advantages. First it allows students to use the EHR in an environment suitable for learning and they can also be scaled back to allow for more exploration of the database in timeless environment (McGonigle & Mastrian, 2015). In designing a simulated EHR that focuses on the use of the application to chart patient data and to use the application to build and document against a patient care plan will allow student nurses the ability to feel more comfortable in using an electronic charting system and allow the student to better manage their time while in the clinical setting. Documentation and care plans are two fundamental skills that all nurses must be competent and compliant in. If either of these aspects of nursing and especially student nursing are lacking is substance, then that nurse may not be providing adequate patient care. Also in developing and using a simulated EHR, the nursing instructor can get a better understanding of the knowledge and skills needed to navigate the system and the time constraints involved in actual charting and building of care plans.
Simulations, Scenarios and Virtual Reality
Nursing education continues to evolve as the profession of nursing has also evolved. In using new and more technological methods of teaching, the use of simulations, scenarios and virtual reality have become more and more prevalent.
Simulations range in intricacy from simple computer-based simulations where students interact with a computer program and feedback is received based on the outcome of the simulation, to life-like full scale simulations using mannequins that can talk and mimic real patient problems and conditions. These type of simulations provide students a real immersive experience they might encounter in a clinical situation (Seropian, Brown, Gavailanes, & Driggers, 2004).
Virtual reality training is also becoming more popular among nursing educators. In using virtual reality, students can control the most important aspects of the scenario they are involved in. One aspect of virtual reality programs that make them more attractive to educators is their flexibility and their ability to be customized for any situation (EDUCASE, 2006). Scenarios can also be used in educating students. Scenarios are usually problems laid out in question form that allows students to figure out and use critical thinking skills to solve problems (McGonigle & Mastrian, 2015).
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In the case study in the textbook, Victoria has been wonders about nursing in the big city versus staying where she is in her small hometown. In moving to the city, Victoria could probably expect more technology in use with both day to day elements such as computer charting, medication scanning and other wireless technology. I feel that the need for Victoria to be more information and technology competent would be increased if she were to move to the city. She is studying technology in using scenarios, virtual reality and simulation learning. However, I feel that more training would be required for her to make a smooth transition to the metropolitan medical center.
Nursing educators today, need to advocate for more computer based learning in the nursing classroom. This can be computer scenarios, simulation labs and virtual reality trainers. In doing so, nursing educators are teaching and catering to a new generation of learner that has basically been using a computer for learning since kindergarten. In using this type of educational tool, nursing educators will be teaching the latest and best evidence-based practices to students and allowing students to learn in environment more suitable to their learning needs. This in turn will lead to nursing students giving better quality of care and reduce mistakes made by nursing students and nurses.
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American Academy of Nursing. (2003). Proceedings of the American Academy of Nursing conference on using innovative technology to decrease nursing demand and enhance patient care delivery. Nursing Outlook, 51, 1-41.
American Association of Colleges of Nursing (1997). A vision of baccalaureate and graduate nursing education: The next decade. Washington, DC: Author.
Csikszentmihalyi, M. (1990). Flow: The psychology of optimal experience. New York, NY: Harper Collins.
Dyer-Witheford, N., & dePeuter, G. (2009). Games of empire: Global capitalism and video games. Minneapolis, MN: University of Minnesota Press.
EDUCASE Learning Initiative. (2006, June). 7 things you should now about virtual worlds. http://www.educase.edu/library/resources/7-things-you-should-know-about-virtual-worlds.
Fetter, M. (2009). Graduating nurses’ self-evaluation of information technology competencies. Journal of Nursing Education, 48(2), 86.
Mastrian, K. G., McGonigle, D., Mahan, W. L., & Bixler, B. (2011). Integrating technology in nursing education: Tools for the knowledge era. Sudbury, MA: Jones & Bartlett Learning.
McGonigle, D., & Mastrian, K. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones & Bartlett Learning.
New Media Consortium. (2007). Massively multiplayer educational gaming. The Horizon Report 2007 Edition. Retrieved from: http://www.nms.org/horizonproject/2007/massively-multiplayer-educational-gaming.
Salen, K., & Zimmerman, E. (2003). Rules of play: Game design fundamentals. Cambridge, MA: MIT Press.
Seropian, M. A., Brown, K., Gavilanes, J. S., & Driggers, B. (2004). Simulation: Not just a manikin. Journal of Nursing Education, 43(4), 164-169.
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