Simulation-Based Learning: Improving Knowledge and Clinical Judgment Within the NICU

Background: Neonatal critical care knowledge is beyond that required for nursing licensure. Knowledge gaps among neonatal intensive care unit (NICU) nurses for pulmonary, cardiovascular, and neurology areas were addressed using simulation in an effort to strengthen knowledge, improve clinical judgment, and affect patient outcomes. Methods: The Tanner Model of Clinical Judgment (2006) was used as the conceptual framework. The quasi-experimental preepost test design included n = 130. Participants received three sessions of simulated scenarios and structured debriefing. Results: Overall differences in knowledge scores were noted: p = .0167 (Year 1) and p = .0021 (Year 2). Trended patterns demonstrated improvement over time for clinical judgment (Year 2) for both self-and evaluator ratings using the Lasater Clinical Judgment Rubric (2007). Clinical outcome trends of decreased ventilator days, increased utilization of alternative oxygen delivery methods, and stable intraventicular hemorrhage rate were realized. Conclusions: Simulation-based learning can be effective in advancing knowledge and clinical judgment for NICU nurses as evidenced in preepost assessment scores/ratings. Clinical outcomes have been favorably impacted in areas influenced by nursing knowledge and clinical judgment. (C) 2017 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc. All rights reserved.