The intertwined elements of practice outlined in the Nursing Professional Development: Scope and Standards of Practice (American Nurses Association & National Nursing Staff Development Organization, 2010) focus on the variety of roles that are a part of nursing professional development (NPD) practice, regardless of where an NPD specialist is employed. For the past several issues of the Journal for Nurses in Professional Development, this column analyzed each of these elements and focused on how the NPD specialist can use simulation while participating in one of these roles. For this issue, this column will focus on two sets of the intertwined elements, Leader/Communicator and Collaborator/Advisor/Mentor, along with approaches to integrate these skills into simulation learning.
The activities related to the Leader/Communicator elements include integrating ethical principles into areas of practice, and providing vision and direction to meet organizational goals. Some of the skills associated with these elements include communicating effectively, giving and receiving feedback, employing effective conflict management skills, modeling professional behaviors, and delegating effectively and efficiently. These skills, which are essential for the NPD specialist to develop, can be integrated into clinical simulations (American Nurses Association & National Nursing Staff Development Organization, 2010).
The activities related to the Collaborator/Advisor/Mentor elements are complementary to the Leader/Communicator elements. They include role modeling professionalism and facilitating lifelong learning for a variety of entities, including individual nurses, healthcare organizations, and academic institutions. The skills include developing partnerships, mentoring, advising, coaching, and collaborating with internal and external entities.
As these elements all revolve around effective leadership capabilities, NPD specialists can use a variety of simulation modalities to target development of these skills. Many of these leadership skills are currently being taught in schools of nursing. Pollard and Wild (2014) discuss using low-fidelity simulation techniques to teach nursing students general leadership competencies, such as communication strategies, effective resource allocation, ensuring patient safety, and effectively asserting their opinions. The authors also discuss using simulation to not only teach leadership, but also effective followership skills, which can often be overlooked. Using simulation scenarios for these skills can add a deeper dimension to the learning, rather than just using traditional lecture and slide presentations.
Anderson and Nelson (2015), also studying nursing students, discuss how high-fidelity simulation can be used to teach effective communication in both interprofessional and intraprofessional settings. The authors note that many nursing student simulations are clinical in nature, yet communication skills can be effectively integrated into these clinical scenarios.
In addition to nursing students, the literature includes other examples of using simulation to teach leadership-related skills for practicing nurses. Shapira-Lishchinsky (2014) describes nursing simulation scenarios related to ethics and ethical decision-making. She discusses how ethical dilemmas arise between nurses and physicians, and how team-based simulations can help overcome these barriers.
Another important aspect of these elements revolves around skills associated with role-modeling professional practice. The NPD specialist can build role-modeling opportunities into clinical simulations so that nurses can learn skills such as conflict resolution, clear communication, and effective teamwork from seasoned professionals. For example, in designing a simulation scenario related to conflict resolution for new graduate nurses, the NPD specialist can stage a poorly done conflict management situation, followed by a well-done situation, each enacted by seasoned nurse role models. The new graduates could observe the interactions of these role models, and debrief with them about how to handle real-life conflict situations that they have faced. Then, the new graduates could participate in role-play scenarios as learners with each other and employ the skills they learned from the seasoned role models. This type of teaching avoids direct lecturing techniques and allows the learner to observe and then practice.
In addition to role-playing, the NPD specialist could also make use of standardized patients (SPs) or trained medical actors. SPs can be trained to play different roles, including patients, family members, and other healthcare providers. Using SPs can be particularly effective if the NPD specialist is trying to truly challenge the learners, as SPs can be realistic and can also provide excellent and pointed feedback (Association of Standardized Patient Educators, n.d.). SPs can be trained to portray clinicians with disruptive behavior, which could focus on communication and conflict resolution skills. SPs could also be trained to be new nurses or other staff and provide opportunities for a developing nurse to practice his or her mentoring or advising skills.
In addition to helping staff nurses, SPs can be used to help new NPD specialists learn their specific roles relating to mentoring and advising. NPD specialists are often called upon to mentor and advise new staff, new managers, and others. Yet, NPD specialists might not have much training in this area. Having an SP help with practice scenarios can be fruitful for new NPD specialists and nurse managers.
The intertwined elements of Leader/Communicator and Collaborator/Advisor/Mentor are rich with opportunities to develop simulations that incorporate general leadership skills. Simulations are appropriate for nursing students as well as practicing nurses and the healthcare team. These two sets of intertwined elements provide a wealth of possibilities for the NPD specialist to employ simulation techniques.
What have you experienced with integrating the elements of practice with simulation in the hospital-based setting? Have you documented your NPD specialist practice as it related to your simulation work? Do you have any suggestions to share with others, particularly related to the Leadership/Communicator and Collaborator/Advisor/Mentor elements? Please e-mail me at mailto:[email protected] to continue the discussion.
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