As American Sentinel College of Nursing & Health Sciences student Amber Kool got deeper into her Doctor of Nursing Practice in Educational Leadership program, the former educator and current director of curriculum and instruction at Arizona College of Nursing came to a realization. Virtual clinical simulation was transforming her own education and she wanted to offer the same to students at Arizona College.

Bringing Virtual Simulation Tools to Arizona College

Throughout 2019 and 2020, Amber became familiar with the virtual nursing simulation tools incorporated into her DNP program at American Sentinel College—tools created by Sentinel U. She saw the benefits of this method of learning and wanted to incorporate Sentinel U tools into Arizona College’s programs too.

“I feel very strongly that virtual simulation is a tool that educators need to be using,” Amber says. “In my DNP capstone research, I found that nursing students don’t always learn the high-level cognitive skills they need like prioritization and delegation.” Under the guidance of American Sentinel faculty member Dr. Kris Skalsky, who is doing a national study that identifies clinical judgment in nursing students, Amber is studying the effectiveness of virtual simulation in preparing nurses for real-world scenarios and the impact on clinical judgment. Amber’s DNP capstone project was titled, “Virtual Simulation: Impact on Clinical Judgment.”

Learning in a Safe, Risk-Free Environment

Amber set to work incorporating Sentinel U’s Sentinel City® and Sentinel Town® virtual simulations into Arizona College of Nursing’s pre-licensure community health course in the BSN program. Going forward, Arizona College will also incorporate all Sentinel U virtual simulation products into its BSN program.

“As an educator, I’ve seen students use traditional simulation with varying degrees of success, but I’ve found that virtual simulation truly prepares students to be independent decision makers who are able to come up with the ‘why’ of their decisions and think through them carefully,” Amber says. “But it’s more than that. Nurses learn to make mistakes and learn from them without fear.”

Arizona College of Nursing offers an accelerated BSN program at 8 nursing-only campuses across the United States.

Using Patient Management and Delegation® and Prioritization of Care® virtual nursing simulations found a statistically significant increase in perceived clinical judgment scores from pre-intervention to post-intervention. The mean increased in perceived clinical judgment scores was 1.929 with a 95%.

Studying the Impact of Sentinel U’s Patient Management and Delegation® and Prioritization of Care® Tools on Clinical Judgment

Through her DNP capstone, Amber investigated the impact of virtual simulation (Sentinel U’s Patient Management and Delegation and Prioritization of Care tools) on clinical judgment versus utilizing experiential learning as identified by Kolb’s Experiential Learning Theory (1984). The study exposed the learner to a new experience and required the student to reflect thereby integrating the learning into their knowledge bank (McLeaod, 2017). The sample was pre-licensure BSN students at Arizona College and used the Skalsky Clinical Judgment Scale©. It measured the construct using 10 questions that assessed perceived abilities in prioritization, delegation and communication.

Amber found a statistically significant increase in perceived clinical judgment scores from pre-intervention to post-intervention. The mean increased in perceived clinical judgment scores was 1.929 with a 95%.

Amber summarized her capstone project in an article published in Arizona Nurse, a publication of the Arizona Nurses Association. “The positive results suggest that virtual simulation may be useful to support teaching-learning practices related to clinical judgment development,” she wrote. “Virtual simulation may be a useful addition to direct patient care and high-fidelity human patient simulation to learn clinical reasoning skills. It may be helpful as an additional strategy in addressing the critical nationwide shortage of clinical practicum sites. Also, it may bridge the gap in clinical learning experiences during times when other opportunities may not exist, such as experienced during the COVID-19 pandemic and in times of emergencies and natural disasters.”

Plans for Continued Research

In June 2021, Amber will complete the DNP, Educational Leadership. With that credential, she hopes to continue to research how virtual simulation positively impacts clinical judgment. “I’d love to use this knowledge in my future research and I’m already using it at Arizona College,” she says. “My work with Sentinel U introduced me to virtual simulation as an innovative approach to nursing education.”