Moving from Disease-Based to Concept-Based Simulations

By: Alaina Herrington and Tonya Schneidereith

surgical-simulation-training-virtual-reality-future-surgical-trainingHow does one define curricular integration of simulation? The number of answers to this question will most likely equal the number of people asked…especially since there are countless ways for nursing programs to integrate simulation throughout the nursing curriculum. In 2015, a small group of our NLN Simulation Leader cohort found there was no consistent definition of curricular integration in the literature. So, we created and distributed an international survey for simulation educators to learn how they integrated simulation and where they placed particular concepts within their curricula.

Construction of the survey was arduous. The process is clearly explained in our article (Herrington and Schneidereith, 2017), but simply put, we asked a number of questions including these: Are there common concepts that can be addressed through simulation? If so, where can they be placed in the curriculum? Can they be leveled to include multiple programs of study?

We took the concepts that educators identified as important for simulation and, using Benner’s Novice to Expert stages, we leveled and scaffolded the concepts (attachment 1) (Benner, 1982). In doing this, we found that a simulation scenario focused on a single concept can be used for multiple programs of study. For example, a simulation involving medication safety can be used for both prelicensure students and graduate students. For the prelicensure student, an objective would be to incorporate safety checks in the administration of a prescribed medication, while for the graduate student, the objective would include the appropriate dosing and prescription of the medication. This approach can be used to design simulations for learners in multiple programs while maximizing human, space, and financial resources.

So, if this piques your interest and you want to learn more about moving from disease-based simulations to concept-based simulations, have a look at this integration example (attachment 2). Don’t forget, however, that the concept-based approach may require leveling skills after the identification of core course concepts (Ravert 2012).

With this idea in mind, it’s time to rethink the way we integrate simulations into our curricula and look at concepts through a simulation lens. Our challenge for you as a nursing faculty member is to evaluate the current placement of simulation in your curriculum and to consider concept-based simulations.

We love to hear new ways to ease the simulation integration process. Please let us know how you integrate simulation into your curricula.


Benner, P. (1982). From novice to expert. American Journal of Nursing, 82, 402-407.

Herrington, A., & Schneidereith, T. (2017). Scaffolding and sequencing core concepts to develop a simulation-integrated nursing curricula. Nurse Educator, 42(4). doi: 10.1097/NNE.0000000000000358

Ravert, P. (2012). Curriculum integration of clinical simulation. In P. R. Jeffries (Ed.), Simulation in nursing education: From conceptualization to evaluation (2nd ed., p. 82). New York, NY: National League of Nursing.

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