Legal Simulation in Undergraduate Nurse Education

Abstract

Purpose/Aims

1.      To engage participants, through experiential and intentional learning, in the development of knowledge, skills and abilities related to legal issues in nursing and healthcare.

2.      To evaluate the comparative effectiveness of scaffolding legal simulation, both observational versus participatory, in the junior versus senior year of undergraduate nursing education. 

Rationale/Background

Simulation has been shown to be an effective and rich learning environment for students. However, much of the practice and evidence around simulation focuses on replicating clinical experiences. There is a paucity of evidence regarding civil and legal simulation in nursing education.  However, in the past10 years 20% of all medical malpractice cases with awarded payments involved registered nurses. Legal simulation has the potential to impact students in three areas: raise awareness of causal factors preceding cases, dialogue with ethics in practice, and at least minimally improve courtroom skills should they be required. As such, it may be a highly appropriate learning approach in which to culminate scaffolded learning through the transfer of responsibility towards professional accountability.

Brief Description of Project

We have developed and implemented an interprofessional legal simulation for undergraduate nursing students. The simulation consists of three case based (criminal & civil) learning experiences engaging community partners including the District Attorney’s office, local judges and law school faculty and students. The simulation was conducted in a real courtroom with senior students participating in at least one case as the ‘defendant’, ‘witness’ or jury. Junior students watched the proceedings but did not participate. Both groups debriefed each case together. 

Outcomes Achieved

The outcomes to date include: (a), the ability to identify professional implications when engaged in a criminal/civil case; (b), the ability to thoughtfully integrate ethics in nursing practice; and (c), the lived experience of the professional nurse and the patient/client as they progress through the legal processes.

 

Conclusions/Recommendations

The outcomes highlighted above underscore the value of the legal simulation in nursing education. Student nurses must be given an opportunity to grapple with the reasons why legal and civil cases occur whilst developing competence in their courtroom skills. The value of clinical simulation is not in question but, to adhere to the principles of scaffolding, evidence is needed as to when to introduce simulations such as this into the curriculum. The next phase of the project will explore this issue of timing, and also explore the role of participation versus observation versus participatory learning as we develop our knowledge in these new simulation environments. It is believed that this study will inform strong/best practices in experiential and scaffolded learning within nursing undergraduate education.