Medication Administration Training & Simulation | Blog | Sim2Grow

High-Fidelity Simulation in Nursing Education: When and Why to Use It

Written by Sim2Grow Staff | Apr 14

Simulation in nursing and healthcare education is a teaching strategy replicating real-world clinical environments and scenarios to provide students and professionals with a safe and controlled space for learning and practicing skills. By using tools such as manikins, standardized patients, virtual reality (VR), and computer-based programs, simulation allows learners to:

  1. Develop Clinical Skills: Practice essential techniques like IV insertion, medication administration, or CPR without risk to actual patients.
  2. Enhance Critical Thinking: Engage in scenarios that require decision-making and problem-solving under realistic pressures.
  3. Improve Communication: Foster effective teamwork and patient-provider interaction through role-play and feedback.
  4. Ensure Safety and Competency: Build confidence and proficiency by allowing repeated practice in a no-consequence environment.

Simulation bridges the gap between theory and practice, preparing healthcare professionals to deliver safe, high-quality care in diverse and complex clinical settings. If you are new to simulation and need to learn five reasons to use simulation, you can check out our blog post here: Top 5 Reasons to use Simulation in Nursing Education.

Fidelity in simulation refers to the degree to which a simulated experience replicates real-life clinical scenarios. Creating an authentic learning environment encompasses physical, environmental, and psychological elements. Real patients in real settings have the highest fidelity. But, for educational purposes, we need to identify which aspects of that real situation need replicating to achieve our specific learning objectives. This answer changes with each simulation.

  • Low Fidelity: Simple tools like static manikins or task trainers focus on individual skills or techniques (e.g., practicing injections).
  • Medium Fidelity: Scenarios involve more realism, such as manikins with limited physiological responses or basic role-playing with fellow students as patients.
  • High Fidelity: Advanced simulations use state-of-the-art manikins, virtual reality, or trained standardized patients with simulated equipment to mimic complex clinical situations, including realistic patient responses, environmental cues, and dynamic changes.

The level of fidelity chosen depends on the learning objectives. Higher fidelity is often used for critical thinking and decision-making skills, while lower fidelity supports foundational skill development.

Benefits and Challenges of Simulation Modalities

  • Standardized Patients
    • Benefits: Human interaction, communication, and empathy training.
    • Challenges: Not suitable for invasive procedures (IV starts, injections, CPR) or specific repetitive tasks.
  • High-Fidelity Manikins
    • Benefits: Advanced physiological responses (e.g., pupil reactivity, cyanosis, chest rise, AI-driven conversations).
    • Challenges: Complex operation, ongoing maintenance, and initial/associated costs.
  • Other Modalities
    • Static Manikins: Basic practice such as bathing, positioning, and dressing changes.
    • Task Trainers: Skill-focused devices for procedures like IV insertion.
    • Virtual Reality (VR) and Augmented Reality (AR): Immersive technology for safe, flexible training.
    • Computer-Based Training: Scalable and accessible for theoretical scenarios.

Our blog post, "The Pros and Cons of Different Simulations in Nursing," discusses the pros and cons of different simulation modalities.

The Trade-Offs of High-Fidelity Simulation

High fidelity doesn’t always mean the best; in some cases, it could be overly complex and hinder learning. For example, physiological modeling on some high-fidelity manikins may distract from core objectives when you would like to change the blood pressure a little bit! 

Take into consideration the price, time investment, and ongoing maintenance and servicing that come with high-tech, high-fidelity equipment. You should also consider the compatibility between equipment and manikins (e.g., ventilators, IV pumps). 

The Use of “Real” Supplies to Increase Fidelity 

Several serious safety considerations must be considered as you consider increasing fidelity by incorporating real equipment and supplies in your simulations.  

Expired medications look very real, but they can be dangerous.  I know of more than one person who accidentally stuck their finger with an expired EPI-Pen donated to a sim lab.  If you plan to use “old” equipment, such as a defibrillator, how are you ensuring that it continues to be maintained by a biomedical tech? And, is your program willing to accept the risks associated with learners using real electricity for defibrillating? Consider using a trainer version!

Be aware of state, local, and institutional regulations that must be followed with “real” supplies to increase fidelity. For example, the requirement for simulation centers to secure intravenous (IV) solutions varies by state. Multiple regulatory frameworks, including those governing IV hydration therapy and the compounding of sterile preparations, influence it. While specific mandates for simulation centers are not uniformly defined across all states, several key guidelines and standards are pertinent. 

This website highlights safety in simulation with many cautionary tales and resources to keep the simulation safe! https://healthcaresimulationsafety.org/ 

Learning Objectives and Simulation Fidelity

It is essential to align the level of fidelity to the established learning objectives. For example, a good rule of thumb is to use task trainers and lower-fidelity manikins for technical skills, high-fidelity manikins for critical thinking, and standardized patients for communication skills. Ask yourself, “Does the fidelity enhance or become a barrier to learning?”

The Fidelity of Sim2Grow

The Sim2Grow team leveraged their extensive expertise, balancing fidelity with learning objectives to design their innovative medication administration training system. This system replicates and represents every critical element of a safe medication pass, ensuring students focus on mastering the essential skills without unnecessary distractions.

Sim2Grow streamlines the learning process by eliminating the complexities of inventory management often associated with automated dispensing units—barriers that can hinder student nurses from practicing this vital skill repeatedly. Additionally, the system removes time constraints by allowing faculty to simulate specific scenarios, such as a 9 a.m. medication pass, at any time that fits their schedule. With Sim2Grow, educators have the flexibility and precision to tailor training to their students’ needs, making practice effective and efficient.

Conclusion

  • High-fidelity is a valuable part of simulation, but not a one-size-fits-all solution.
  • The level of fidelity chosen should depend on the learning objectives, resources, and context.
  • You can explore how Sim2Grow supports nursing educators with a balance of fidelity and practicality: www.sim2grow.com