I am a clinical nursing director at an acute care hospital. Last year, the leadership team implemented clinical simulation manikins for CPR training ("The Value of Simulation in Nursing Education," AJN Reports, April). The simulation manikins allow for quarterly skills training instead of the usual one day of training every two years.1 They provide real-time audio and video feedback regarding the quality of the student's chest compressions and ventilation skills; the training also offers suggestions for performance improvement.1 I am very supportive of quality initiatives that improve patient outcomes.

My only concern with simulation training is that it can sometimes fail to include all the variables associated with patient emergencies in a live setting. Simulation training is a controlled environment that can be manipulated by an instructor; one can stop and restart as needed. In live and emergent situations, this option does not exist-each decision can influence patient outcomes. At my hospital, staff members individually practice their CPR skills on the manikin, but practicing as a group would be a more accurate representation of our emergency response team. To better promote evidence-based learning and decision-making skills, simulation training in the hospital setting should be customized and replicate a real situation so students have a true picture of an event.

Kevyn Hughes, BSN, RN, CNML

Plano, TX

REFERENCE