It's Critical:

Simulation of High Risk Patient Management for Adult-Gerontology Acute Care Nurse Practitioner Students

Linda Briggs, DNP, ACNP-BC, FAANP

Session Overview:
There is scant literature on use of simulation in Adult-Gerontology Acute Care Nurse Practitioner education.  A quality improvement initiative was undertaken to evaluate the effect of using PEARLS debriefing theory on student satisfaction and knowledge acquisition. Students were assigned course materials to review (readings, narrated slide presentations).  A high-fidelity simulation session consisting of four shock scenarios based on real cases were created to facilitate diagnostic differentiation of the four major types of shock.  Students worked in teams of four and rotated in the designated roles of team leader, registered nurse, scribe, and observer. Each simulation session consisted of a 20 minute pre-brief followed by the case lasting 20 minutes, and a 20 minute debrief utilizing the PEARLS theory.  Students then completed the SET-M evaluation tool for the case.  At the completion of all cases, students took a 10 question quiz designed to measure knowledge of the topic. Fifteen AGACNP students participated in 4 hours of simulation activities. Forty-six SET-M evaluations were submitted via phone app (Qualtrics QR code). The overall response rate was 76.67%. Prebrief subscale mean score was 5.26 (max. 6). The scenario subscale mean score was 32.30 (max. 33). Debrief subscale score was 14.89 (max. 15). The knowledge score mean was 7.2 (10 point quiz). Incorporating PEARLS debriefing lead to high student satisfaction and confidence as evidenced by SET-M subscale scores.  Immediate knowledge assessment scores were lower than expected, possibly due to use of the phone app.  More research is indicated.


  1. Discuss the scaffolding of didactic material and increasingly more complex patient scenarios across the AGACNP curriculum
  2. Describe the application of “real world” patient cases to improve student confidence and expertise in diagnosing and managing critical patient situations
  3. Discuss the results of incorporating the Promoting Excellence and Reflective Learning in Simulation (PEARLS) debriefing.