14: LEVERAGING TECHNOLOGY ■ 339patient simulators, standardized patients (simulated patients; patient actors), hybrid simu-
lation, task trainers, virtual reality and much more. The human patient simulator is a simu-
lation mannequin device. There are many different vendors and levels of fidelity available
with the human patient simulators. An example of a low- fidelity human patient simulator
would be a simulator that would be able to portray lung and heart sounds. A high- fidelity
simulator would be a simulator that would be able to demonstrate realistic body functions
such as diaphoresis, crying, and seizures. The varying levels of fidelity coincide with vary-
ing levels of programmable software to be used to develop and run simulation scenarios.
A standardized patient is an actor who is trained to demonstrate realistically a
selected patient condition, disease process, psychiatric disorder, or even a distraught
family member. In this type of simulation, the scenario is developed very similarly to
an actor’s script. This script contains all the information needed by the standardized
patient to act out the scenario included in the following: (a) timing of the scenario;
(b) overview of the scenario; (c) opening line; (d) challenge questions; (e) position at
the beginning of the scenario; (f) patient attire; (g) all questions that can be potentially
asked during the scenario and the appropriate response; (h) personality or emotions to
be portrayed during the scenario; (i) student or nurse items to be evaluated during the
scenario; and (j) specific feedback to be provided to the simulation participant following
the completion of the scenario during the feedback session.
Hybrid simulation is a simulation experience where there is a combined use of
both the human patient simulator and a standardized patient. Examples of a hybrid sce-
nario include the following: (a) a standardized patient portraying the mother of a child
and the child represented by an infant human patient simulator; (b) a human patient
simulator used as a patient and a standardized patient portraying a sibling or a signifi-
cant other; and (c) an obstetrical patient with vaginal complications where the vaginal
area is a simulator or task trainer.
Task trainers are used to evaluate skills (Aebersold & Tschannen, 2013) in all nurs-
ing programs including doctoral nursing. Virtual reality simulation is one of the newer
types of simulation. Virtual reality simulation is used for education and training for a
variety of health care disciplines in varied settings (Fliszar, 2014). We have also seen an
increase in the use of augmented reality with simulation such as the incorporation of
Google Glasses (Cass & Choi, 2015).
SIMULATION TO ENHANCE AND EVALUATE COMPETENCY
The doctoral APN (or student) can use simulation strategies to evaluate competencies
in an academic educational program or in a clinical setting. Competencies for individu-
als, teams, and interprofessional teams can be assessed using human patient simulators,
standardized patients, or task trainers. In each of these types of simulations, specific
competency assessments or expected outcomes must be identified in advance. Then,
depending on the type of simulation used, a competency evaluator must be identi-
fied such as the standardized patient, a faculty member, a clinical manager, or others.
Simulation is a very effective tool that can be used to provide complex situations in a
very safe environment.
SIMULATION FOR RESEARCH
The doctoral APN (and student) can also use simulation strategies in many types of re-
search in the academic setting and the clinical setting. Simulation can be used to portray