The NLN Jeffries Simulation Framework
The National League for Nursing (NLN) Jeffries Simulation Framework was developed by Pamela Jeffries in 2005 as a theory supporting human simulation in nursing education as an effective teaching modality (Cowperthwait, 2020). Originally named The Simulation Model, the framework has been updated to reflect the current literature as “there has been significant research that supports the efficacy of simulation-based education” (Cowperthwait, 2020). While some professions, such as emergency medical services and the fire service, have used simulation with human role players as a standard training practice for many years, nursing has only widely adopted this practice in the last two decades. The NLN/Jeffries Framework is comprised of five components: facilitator, participant, educational practices, outcomes, and simulation design characteristics (Adamson, 2015). Using these components in a standardized well-planned simulation can help facilitate a realistic and productive learning experience (Jeffries, 2021).
Discussion: Applying Interdisciplinary Theories to Nursing Practice
Practice Issue
Managing the end-of-life (EOL) journey with critically ill patients can be a complex process. In the field of cardiothoracic surgery there are numerous heart devices that are used to treat patients with heart failure, which can further complicate the EOL process. Effective end-of-life discussions with mechanical circulatory support (MCS) patients and their families require collaboration with team members such as cardiac surgeons, ICU providers, cardiologists, social workers, nursing, and palliative care. In my current practice setting, the cardiac surgery intensive care unit, I have identified the EOL process in MCS patients as an area of opportunity for improvement.
NLN Jeffries Simulation Framework Application to Practice
When it comes to managing patients at the end-of-life, it can be difficult to teach nurses and team members how to navigate difficult
Discussion Applying Interdisciplinary Theories to Nursing Practice
conversations, process intense emotions, and deal with complicated patient and family dynamics. Simulation with human role players provides a safe environment for nurses to work through these challenging scenarios so they are more prepared to deal with these scenarios at the bedside. When it comes to death and dying, “simulation could be a major teaching-learning modality” to help expose nurses and team members to difficult situations in a supportive environment (Jeffries, 2021). Application of this framework in the critical care environment can begin with post-death or code debriefing. This debriefing includes all team members and allows everyone to express concerns, share feelings, and identify strengths and weaknesses of the incident. Using a standardized debriefing tool such as PEARLS can be beneficial to facilitate a productive debriefing (Eppich & Cheng, 2015). Integrating simulated end-of-life conversations into required training, such as ACLS and CPR, could also help expose a larger audience to these challenging conversations.
References
Adamson, K. (2015). A systematic review of the literature related to the NLN/Jeffries simulation framework. Nursing Education Perspectives, 36(5), 281–291.
Cowperthwait, A. (2020). NLN/Jeffries simulation framework for simulated participant methodology. Clinical Simulation in Nursing, 42, 12–21.
Eppich, W., & Cheng, A. (2015). Promoting Excellence and Reflective Learning in Simulation (PEARLS): development and rationale for a blended approach to health care simulation debriefing. Simulation in Healthcare : Journal of the Society for Simulation in Healthcare, 10(2), 106–115. https://doi.org/10.1097/SIH.0000000000000072
Jeffries, P. R. (2021). Simulation in nursing education: From conceptualization to evaluation (3rd ed.). Washington, DC.; National League for Nursing.
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