Lewis Robin, Strachan Alasdair, Smith Michelle McKenzie
Centre for Health & Social Care Research, Collegiate Crescent Campus, Sheffield Hallam University, Sheffield, UK.
Open Nurs J. 2012;6:82-9. doi: 10.2174/1874434601206010082. Epub 2012 Jul 27.
To review the literature on the use of simulation in the development of non-technical skills in nursing
The potential risks to patients associated with learning 'at the bedside' are becoming increasingly unacceptable, and the search for innovative education and training methods that do not expose the patient to preventable errors continues. All the evidence shows that a significant proportion of adverse events in health care is caused by problems relating to the application of the 'non-technical' skills of communication, teamwork, leadership and decision-making.
Simulation is positively associated with significantly improved interpersonal communication skills at patient handover, and it has also been clearly shown to improve team behaviours in a wide variety of clinical contexts and clinical personnel, associated with improved team performance in the management of crisis situations. It also enables the effective development of transferable, transformational leadership skills, and has also been demonstrated to improve students' critical thinking and clinical reasoning in complex care situations, and to aid in the development of students' self-efficacy and confidence in their own clinical abilities.
High fidelity simulation is able to provide participants with a learning environment in which to develop non-technical skills, that is safe and controlled so that the participants are able to make mistakes, correct those mistakes in real time and learn from them, without fear of compromising patient safety. Participants in simulation are also able to rehearse the clinical management of rare, complex or crisis situations in a valid representation of clinical practice, before practising on patients.
回顾关于模拟在护理非技术技能培养中应用的文献
与“在床边”学习相关的患者潜在风险越来越难以接受，因此人们持续寻求不会让患者面临可预防错误的创新教育和培训方法。所有证据表明，医疗保健中相当一部分不良事件是由沟通、团队合作、领导能力和决策等“非技术”技能应用方面的问题导致的。
模拟与患者交接时人际沟通技能的显著提高呈正相关，并且还清楚地表明，在各种临床环境和临床人员中，模拟能改善团队行为，这与危机情况管理中团队表现的提升相关。它还能有效地培养可转移的变革型领导技能，并且已证明能提高学生在复杂护理情况下的批判性思维和临床推理能力，有助于培养学生的自我效能感以及对自身临床能力的信心。
高保真模拟能够为参与者提供一个培养非技术技能的学习环境，该环境安全且可控，使参与者能够犯错、实时纠正错误并从中学习，而不必担心危及患者安全。模拟的参与者还能够在对患者进行实际操作之前，在逼真的临床实践场景中演练罕见、复杂或危机情况的临床管理。
