Using Simulations in a Concept-based Curriculum: Closing the Education-to-practice Gap in Nursing

Nursing student practicing CPR

Equipping nursing students with the skills and knowledge that employers desire can be a challenging proposition. While the use of simulation in nursing is not new, a more recent trend towards a concept-based curriculum has added a new wrinkle to the equation. In this blog post, T. Kim Rodehorst, RN, PhD and Susan Wilhelm, RNC, PhD discuss the use of simulations in a concept-based nursing program. Read on to learn more!

1. Why is the use of simulation in nursing education so important?

Simulation learning has become an integral part of nursing education. The National Council of State Board of Nursing (2014) demonstrated that simulations are as effective as traditional clinical experiences for achieving competencies. The International Nursing Association of Clinical Simulation Learning (2014) announced standards for simulation learning which we have incorporated into our simulations.

2. I think everyone has an idea about what constitutes ‘simulation’. Can you define it more clearly for all of us?

Simulations are defined as activities that imitate a real clinical environment and focus on skill development, decision-making, and increasing critical thinking. These can be accomplished through role play, high or low fidelity simulators, virtual simulations, and interactive videos. There are 5 key components of a simulation model including teacher and student factors, educational practices, simulation design, and outcomes. Educational practices that should be included during simulation development include the following: active learning, prompt feedback, interactivity, collaborative learning, high expectations, allowing diverse learning styles, and time on task (Chickering and Gamson, 1987).

3. What prompted your interest in the use of simulations?

We became more interested in developing more simulations when we adopted a concept based curriculum. We have taught Maternal-Newborn nursing for over 30 years and we were worried about how we would integrate critical content into our patient-centered courses. We were also concerned about integrating other specialty areas including pediatrics, psychiatric and gerontology as well. The curriculum map had designated a few concepts and exemplars for each of these specialty areas, however there were additional exemplars that needed to be incorporated. Simulation learning was the perfect strategy to incorporate specialty exemplars across the curriculum.

4. Can you give us some examples of concepts/exemplars that could be used over several semesters?

Semester 1: Safety/ hospitalized adult post-operative patient; Mobility/ hip fracture elderly patient’ Caregiving/ spouse of Alzheimer’s patient; Nutrition/Obesity; Elimination/BPH ; Development/ prenatal patient, pediatric patients, and geriatric ;Stress/Coping:/ Bipolar patient.

Semester 2: Reproduction/ Labor/Delivery patient; Metabolism/ Pediatric diabetic ketoacidosis Infection/hospitalized infant who is postoperative Professional Behaviors & Managing Care/Hospital ward simulation; Infection, Immunity/HIV; Peri-operative/ Gastroschisis infant surgery for volvulus, Mood disorders/ Dementia, Depression

Semester 3: Gas exchange/respiratory (RSV); Stress & Coping/ Anxiety; Reproduction/Premature Labor; Safety/Bio-hazards, Mood and Affect/Psychosis; Grief and Loss/Palliation; Culture & Diversity: Native American culture.

Semester 4: Tissue integrity/Burns (all types across the lifespan), Perfusion/ Shock (all types across the lifespan)/ Acute coronary syndrome; Intracranial regulation / CVA, shaken baby, Ecclampsia; Accountability & Delegation/ Hospital ward simulation.

5. What words of wisdom would you have for someone wanting to get started with simulations or moving to a concept-based curriculum?

We believe that integrating concepts into simulations will facilitate students understanding of how concepts link with their clinical practice. It should also help them identify inter-related concepts through the simulation scenarios. We recommend using the exemplars found in Nursing: A Concept-based Approach to Learning and The Neighborhood™ simulations to help you get started with scenarios, preparation work, and debriefing questions.


Dr. Rodehorst and Dr. Wilhelm will be presenting on Thursday, June 11th, from 3:00-4:00 PM at the 14th Annual INACSL conference. Please plan on attending their session to learn more about their work with simulations in a concept-based curriculum.


About the Authors
Suz Wilhelm, RN, Ph.D.

Suz Wilhelm, RN, Ph.D.

Suz Wilhelm, RN, PhD is an Assistant Professor and Assistant Dean in the University of Nebraska Medical Center College of Nursing, West Nebraska Division, where she has been a faculty member since 1990. She received her bachelor’s degree in nursing from the University of Northern Colorado and her master’s and doctoral degrees from the University of Wyoming. Dr. Wilhelm’s clinical background includes all areas of obstetrics. She has held nursing positions in several states in the mid-western region, and she conducts breastfeeding research in rural areas. Dr. Wilhelm has taught the under-graduate Maternal-Newborn and Women’s Health course. She has taught in a concept based curriculum for the last 4 years. In addition, she has developed inter-disciplinary simulations for Maternity-Pediatrics. A strong advocate for concept-based learning, Dr. Wilhelm lent her considerable Maternity-Child Nursing and inter-disciplinary expertise to ensure that the second edition of Nursing: A Concept-based Approach to Learning effectively threaded these themes throughout its content.

T. Kim Rodehorst, Ph.D.

T. Kim Rodehorst, Ph.D.

Dr. T. Kim Rodehorst is an Associate Professor at University of Nebraska Medical Center College of Nursing, West Nebraska Division, where she has been a faculty member since 1988. Kim received her bachelor’s degree from Loretto Heights College in Denver, CO and her master’s degree is in Parent-Child Health and from the University of Colorado. After working as a pediatric nursing instructor for many years, Kim returned to school to receive her Ph.D. in Adult Education and Technology from the University of Wyoming. Kim has developed numerous pediatric simulations over the past 20 years and often includes simulation learning in the classroom. Additionally, she has used a variety of innovative teaching strategies to engage students in their learning. Her interest in helping others learn more about concept based curricula began four years ago when UNMC adopted a concept based curriculum. Dr. Rodehorst has been involved in review and development of both editions of the textbook: Nursing: A Concept-based Approach to Learning.