As the country went into lockdown in March this year, the University of West London (UWL), like many other universities, had to dramatically rethink the use of simulation teaching. The university rapidly moved to a virtual learning platform to replace the practice hours of first-year students with theory (Nursing and Midwifery Council, 2020) and create online skills sessions to prepare students going into practice.
To supplement this new approach, a blended learning pedagogical model was introduced comprising three stages:
- Investigate
- Apply
- Consolidate.
The UWL pedagogy seamlessly integrates the use of online learning with technology as a fundamental part of the student experience.
The College of Nursing, Midwifery and Healthcare has developed an anthology of short films, titled The Street, which is bespoke to UWL. Each film presents hypothetical drama-based patient scenarios that enriches simulation teaching. The scenarios follow fictional residents of ‘the street’ through 3 years of their lives, which includes changes in their health conditions and in their socioeconomic circumstances.
The films are being used to bridge the gap between the standardised patient and real patients, providing relevant context that challenges nursing students to consider variables and determinants, such as deterioration in health and socioeconomic factors, alongside clinical considerations, to improve holistic practice and overall patient care.
Three-stage model
Investigate
The films were used as part of virtual sim sessions centred on holistic assessment, communication skills, recognition of the deteriorating patient and reassessment of care. Students were taught key concepts online at the beginning of the session by a lead lecturer as part of the ‘investigate’ phase of a session providing students with the opportunity to consolidate learning in a supported debrief.
Apply
Following patients in the filmed scenarios enabled students to apply theory to practice, with the final phase of a session providing students with the opportunity to consolidate learning in a supported debrief. The narrative pedagogy helps to establish dialogue between members of the groups, enabling students to see the importance of reflective discussion. Subsequent sessions included ‘live’ virtual simulation sessions, with an actor playing the role of a patient and students completing assessments or practising skills with the character. Baseline observations for the patient were displayed on the screen to provide further detail and support assessment.
Consolidate
Student feedback from the virtual simulation sessions has been very positive, highlighting deeper learning through increased student involvement, the ability to identify gaps in knowledge, development of skills required in specific circumstances, improved personal reflection, development and communication skills.
Innovative
This teaching approach draws on experiential learning theory (Kolb, 2014) and uses transformational, pragmatic underpinnings of drama to develop nursing students' assessment and decision-making skills. Coupled with the facilitator's understanding of simulation and techniques in practice, this approach has proved to be a highly successful teaching innovation and has allowed lecturers to overcome some of the COVID-19 restrictions.
This method of teaching is not without flaws or limitations, and the acquisition of some skills can be enhanced in face-to-face environments, within which there is kinaesthetic feedback: there is direct interaction with patients and the opportunity to provide students with immediate feedback. However, the ‘new’ approach in some ways allows greater command over the material than ‘traditional’ classroom teaching and creates options for further untapped possibilities for the future classroom.
‘The scenarios follow fictional residents of ‘the street’ through 3 years of their lives, which includes changes in their health conditions and in their socioeconomic circumstances’
Feedback
The students' response has been positive, with comments including:
- ‘The scenario helped me have a deeper understanding of what activities of daily living are’
- ‘I didn't realise the patient was an actress. I thought she was a real patient.’
Lectures at UWL have fully embraced this new way of teaching and continue to seek enjoyable and innovative ways to teach student nurses throughout the pandemic.