There is a reason why clinical rotations have become an essential part of a nursing learner’s education. Being able to experience working hands-on with patients provides insight and awareness that classroom learner alone is unable to fully convey. This is why when COVID-19 placed restrictions on in-person clinical learning, educators and leaders were left questioning how to realistically transition clinical experiences to become remote and virtual. Based on this need, HealthImpact’s California Simulation Alliance (CSA) and NovEx Novice to Expert Learning, LLC sought to provide an online, immersive MedSurg clinical replacement simulation to universities and colleges across the United States.
In addition to providing comprehensive training to nursing learners to increase patient safety outcomes, this program also aspires to simply help them graduate to fill vacancies. If COVID-19 restrictions were to have a lasting impact on the number of nursing learners graduating each year due to the inability to complete mandated rotations, the entire healthcare industry could feel the consequences through staffing shortages.
Serving as an online clinical simulation program by Patricia Benner, RN, PhD, FAAN, NovEx offers several advantages compared to most educational and clinical courses. For learners, these advantages include that cases are “unfolding” authentic clinical simulations with real patient presentations, data, and responses. Each case provides rich opportunities for learners to enter patients’ rooms as nurses and clinically care for them.
Further, learners may reenter the patient situations for deeper learning and for remediation if needed. Extensive care they are able to provide includes individualized patient interventions, such as highest priority and urgent collaborative interventions, comfort care, symptom management, safety, and preventative inventions, and patient education.
During each NovEx case, learners are alerted immediately to any errors in their responses, including problems related to urgency and/or priority of actions. To aid in their progress, learners may work alone, in small groups, or in large groups as assigned by the faculty.
As for faculty benefits, they have a wide variety of NovEx-case patients to select from to form assignments, focusing on the most prevalent patient groups nationally who require care. The solution is robust enough to accommodate common student learning objectives such as, but not limited to, conducting patient assessments, implementing nursing interventions, developing clinical reasoning and judgment, ongoing evaluation of care, and providing patient education.
Another benefit of NovEx use for faculty members is that the solution can enable them to assign their own institution’s SBAR, concept maps or care plans, and journaling as supplemental learning activities to each of the NovEx-cases. Faculty can also track learner progress and provide real-time alerts to staff when a learner commits a serious error. An added feature, NovEx Analytics, reports enable faculty to pinpoint knowledge gaps and problems in learners’ clinical performance early so that immediate coaching to improve their patient safety and performance.
One of a faculty’s roles is to create learning objectives with increasing levels of complexity to learn the practice of nursing and patient-centered care. Here are some learning objectives that can be met with NovEx, based on a review from schools who volunteered their student learning objectives.
- Design and implement nursing care based knowledge upon knowledge of biological sciences, pathophysiology, nutrition, pharmacology, to achieve maximum physiological integrity and reduce potential risks for patients according to the urgency and priorities for the client’s care.
- Assess and make patient-centered clinical judgments with appropriate clinical interventions for patients with unstable and emergent single- and multi-system clinical problems.
- Provide Individualized Patient Education Using Appropriate Teaching-Learning Principles
- Provide Caring, Comfort, Safety and Patient Advocacy Measures that Support Well-Being of Adult Medical-Surgical Clients
- Implement Independent, and Collaborative Actions with the Health Care Team to Facilitate Optimal Evidence-Based Care for Clients.
The solution situations each learner in their clinicals to develop clinical thinking and reasoning skills and to better prepare learners to become practice-ready. Note, NovEx does not present questions to learners; instead, as in real life, they must develop recognition skills to guide their judgment. Ultimately, the solution works to focus on early warning signals and intervention has resulted in consistently improved patient safety outcomes, while reducing failures-to-rescue and medical errors.
NovEx Courses
MedSurg Clinical I (MSCI) Rotation: This clinical “rotation” is intended for Junior Level learners to gain experience assessing, diagnosing, planning, implementing, and evaluating patients across conditions (see Table). Learners gain access to 25 or 50 NovE-cases. Faculty can assign the most appropriate patients for their learners. Additionally, an Advanced Clinical I Patient Group is provided as the last module to improve deep and situated learning while teaching clinical thinking and reasoning.
MedSurg Clinical II (MSCII) Rotation: This clinical “rotation” is intended for Senior Level learners to care for more complex patient situations. To be practice-ready, learners must begin to compare and contrast similar situations. The 25 or 50 NovE-Cases in MedSurg Clinical II Rotation provide higher-level challenges to advance their development. Additionally, an Advanced Clinical II module is provided at the end to ensure learners gain essential experience prior to entry into practice after graduation.
Fundamentals Clinical Rotation: This clinical “rotation” is intended for Entry Level learners to identify which patients and when to use the fundamentals procedures they learned. Procedures are commonly learned outside the context of a patient’s authentic situation. NovEx provides 11 NovE-Cases that focus on helping learners recognize what situations call for the use of particular procedures and when procedures are clinically needed, rather than on the step-by-step teaching of a specific procedure, which can be found in their Fundamentals textbooks. Fundamental NovE-Cases engage learners to begin clinically thinking and reasoning upon entry into their nursing education.
More About HealthImpact
HealthImpact is devoted to improving the health of Californians by promoting a dynamic, well-prepared nursing workforce. In 2001, a group of nurse leaders across California saw the need for comprehensive planning in the field of nursing. They launched HealthImpact (formerly the California Institute for Nursing and Healthcare-CINHC) as a forum for cooperation and sharing best practices across the State.
As healthcare undergoes major changes, nurses play an ever-increasing role in providing care and keeping the public healthy. The organization brings together leaders in nursing, academia, and policy to ensure that nursing stays ahead of the changes in our profession. The organization is a catalyst for innovation and promotes the collaboration of partners from all areas in the field.
