Best Practices in High Fidelity Patient Simulation to Enhance Higher Order Thinking Skills

Undergraduate nursing education has begun to use very expensive and time intensive high fidelity simulation activities without making full use of the ability to build higher order thinking skills in students. Current research in high fidelity patient simulation has tended to be subjective and focus on critical thinking. However, reflective thinking habits of mind must be in place before full use can be made of critical thinking skills. A comprehensive search of all reflective thinking literature used in conjunction with simulated patient experiences by healthcare students was undertaken. A guideline was created for nurse faculty to use that outlined current best practices in simulation to maximize reflective thinking. Though the research on which the guideline was based has been mainly subjective, several analytical studies were found that supported the findings. Policy changes to incorporate reflective thinking and the associated activities were recommended for nursing students and continuing nursing education. Nurse researchers and educators should incorporate reflective thinking exercises with their simulated patient undertakings to maximize higher order thinking skills.