Empowering Nursing Students to Speak Up BACKGROUND A Simulation Approach Sharon Mann, BSN, RN, MSN Student Anne Kendrick, DNP, RN, CNE Daphne Thomas, DNP, RN, CNE, CHSE, CNML, CEN INTERVENTIONS • This project aims to incorporate simulations designed to promote speaking-up behaviors into the nursing curriculum, empowering students to advocate for patient safety. • Step 1: Obtain IRB approval • Many medical errors can be avoided if nurses speak up when they identify risks to patient safety.1,2 • Step 4: Administer pre-simulation surveys during the simulation pre-brief • Nurses often hesitate to speak up due to fears of conflict, retaliation, harming relationships, or questioning those with authority.3,4 • Step 6: Administer post-simulation surveys at the end of the session • Simulation and associated debriefing sessions enhance student confidence in speaking up.2,3,5 • Step 2: Train the simulation staff how to execute the simulation scenario • Step 3: Secure consent forms from capstone nursing students participating in the program • Step 5: Implement the simulation scenarios and conduct debriefing sessions • Step 7: Evaluate statistical changes in survey scores • Step 8: Consult with faculty to determine whether simulations should be incorporated into the curriculum IMPACTS METHODS The Johns Hopkins Evidence-Based Practice model was used as the framework for this project. Deliverables: • Pre- and post-simulation surveys were created to evaluate students' confidence in speaking up and their sense of responsibility in advocating for patient safety. • Four fifteen-minute simulations were developed to encourage students to speak up for patient safety. • Simulation can empower nursing students to speak up for patient safety.2,3,5 • Nursing students can feel an increased sense of responsibility to advocate for patient safety.3 • Communication in healthcare settings can be improved.2,4 • Medical errors can be prevented as nursing students speak up.1,2 • Speaking-up simulations can be incorporated into the academic curriculum.2,3,4,5 • A culture of safety can be enhanced.4 CONCLUSIONS REFERENCES • Nurse educators can use simulation and debriefing experiences to emphasize the nursing students’ responsibility in advocating for patient safety. 1Peadon, R., Hurley, J., & Hutchinson, M. (2020). Hierarchy and medical error: Speaking up when witnessing an error. Safety Science, 125. https://doi.org/10.1016/j.ssci.2020.104648 2Kuo, S. Y., Wu, J. C., Chen, H. W., Chen, C. J., & Hu, S. H. (2020). Comparison of the effects of simulation training and problem-based scenarios on the improvement of graduating nursing students to speak up about medication errors: A quasi-experimental study. Nursing Education Today, 87(1). https://doi.org/10.1016/j.nedt.2020.104359 3Hemon, B., Michinov, E., Guy, D., Mancheron, P., & Scipion, A. (2020). Speaking up about errors in routine clinical practice: A simulation-based intervention with nursing students. Clinical Simulation in Nursing, 45(1). 23-41. https://doi.org/10.1016/j.ecns.2020.03.003 4Bedgood, A. L., & Mellott, S. (2021). The role of education in developing a culture of safety through the perceptions of undergraduate nursing students: An integrative literature review. Journal of Patient Safety, 17(8), 1530-1536. https://doi.org/10.1097/PTS.0000000000000548 5Hall, N., Seldomridge, L., & Allen, K. (2022). Using toolkits to improve students’ skills in advocacy. Journal of Nursing Education, 61(10), 599-602. https://doi.org/10.3928/01484834-20220417-05 Image 1: Prostock-Studio. (2024). Woman medical professional with time out hand signal [Stock image]. iStock by Getty Images. https://www.istockphoto.com/photo/woman-medical-professional-with-time-out-hand-signalgm1995924272559893045?utm_source=pixabay&utm_medium=affiliate&utm_campaign=sponsored_image&utm_content=srp_top banner_media&utm_term=nurse+saying+time+out Image 2: Andres, R. (2024). Doctor teaching medical students to perform CPR on a dummy at the hospital [Stock image]. iStock by Getty Images. https://www.istockphoto.com/photo/doctor-teaching-medical-students-to-performcpr-on-a-dummy-at-the-hospital-gm2023972408-561599531 Image 1 • Simulations can provide an opportunity for nursing students to practice assertive communication, increasing their confidence in speaking up for patient safety. • Discussions during debriefing sessions can address ways students can overcome barriers to speaking up. Image 2 • Nursing students can apply what they learned in simulation to speak up more frequently in clinical situations.