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Dr. Pauly-O'Neill is Assistant Professor, Dr. Prion is Associate Professor, and Dr. Nguyen is Assistant Professor, University of San Francisco School of Nursing and Health Professions, San Francisco, California.
The authors have disclosed no potential conflicts of interest, financial or otherwise.
Nursing students need to anticipate and confront the challenges that may be presented in the real world upon graduation (Bambini, Washburn, & Perkins, 2009). However, students reported having little to no exposure to deteriorating patient conditions during their pediatric inpatient clinical rotation (Pauly-O'Neill, Prion, & Lambton, 2011). Exposure to stable pediatric patients is not sufficient to confer competence in caring for children with acute illness; therefore, nurse educators have begun to substitute some of the required patient care hours with high-fidelity simulated scenarios. Although state regulations often dictate the maximum time allowed in simulation, it is vital for nurse educators to create a model of simulation that fills the gap between the competencies required of new nurse graduates and what the clinical setting provides for nursing students. The first step in creating the ideal blend of authentic clinical and simulation experience is an exploration of the experiences currently available in both settings.
Study Purpose
This pilot observational study was conducted to answer the following two questions:
Do the pediatric clinical and simulation settings offer the opportunity to practice the six competencies set forth by the Quality and Safety Education for Nurses (QSEN) initiative (Cronenwett et al., 2007): patient-centered care, teamwork and collaboration, safety, evidence-based practice, quality improvement, and informatics?
Are the activities available in each setting comparable?
The findings may also help to answer the commonly asked question: Does 1 hour in the simulation laboratory equate to 1 hour of clinical time?
Observation Tool Development
To categorize what students accomplish in each arena, the QSEN competencies were used as a guide by the authors to create the time-on-task/clinical observation tool (TOT-COT). Although the QSEN competencies operationalize the knowledge, skills, and attitudes (KSAs) needed to demonstrate competence in six main areas (Cronenwett et al., 2007), measurable behaviors that demonstrate application of those competencies were included in the TOT-COT instrument (Table 1 ). Easily observable QSEN behaviors were selected to confirm the feasibility of the TOT-COT instrument in capturing student experiences in clinical and...