1. Forneris, Susan Gross

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During the past two years, the National League for Nursing (NLN) has been working collaboratively with China Laerdal Medical (CLM) to innovate nursing education in China using simulation and debriefing best practices. Invited by the China National Center for Schooling Development Programme, part of the Ministry of Education, the NLN is working with CLM to enhance teaching and learning in nursing education through the use of simulation. The project is part of the One Belt One Road initiative, first announced by President Xi Jinping in 2013, to strengthen trade, infrastructure, and investment links between China and more than 60 other countries. Road refers to the maritime network of shipping lanes running between China, South Asia, Africa, and Europe, whereas Belt refers to the overland routes of Central Asia to Europe. The most visible part of the initiative is the focus on improving infrastructure in Chinese markets.


For more than a decade, the NLN and Laerdal Medical have worked together to promote simulation as a teaching methodology to prepare nurses for practice across the continuum of care. Both organizations maintain that the use of simulation and debriefing, along with other active learning teaching strategies, creates transformational learning experiences for nursing students and provides diverse perspectives on caring for patients. Our strong partnership, within the United States and globally, is grounded in our like missions. The NLN's mission, to promote excellence in nursing education to build a strong and diverse nursing workforce to advance the health of our nation and the global community, strongly aligns with Laerdal's mission to help save lives. Furthermore, the NLN is guided by four dynamic and integrated core values that permeate the organization and are reflected in our work: caring, integrity, diversity, and excellence. It is through these core values that educational innovation is operationalized. Learning in simulation allows for learning in context - a concept at the forefront of contemporary educational reform as teachers and learners move away from content-laden curricula to curricula that emphasize experiential learning.


A rise in undergraduate nursing programs in China has resulted in inconsistencies in teaching strategies and curricula. Practical skills training is not consistent in schools of nursing, and teaching strategies are often not grounded in experiential learning. Transforming nursing education was identified by the China National Center for Schooling Development Programme as one of the Ministry's goals in alignment with the One Belt One Road strategy.


The NLN-CLM three-year pilot project is part of Phase 1, an initial effort to build sustainability for educational reform in China. We are working with four key nursing schools (Peking University School of Nursing in Beijing, Southern Medical University School of Nursing in Guangzhou, Hope University School of Nursing in Wuhan, and Fudan University in Shanghai) to increase both the quantity and quality of nurses through an innovation-driven strategy for nursing education. Using best practices in simulation and debriefing, our strategy has involved cohort-based leadership faculty development to create a team of leaders to influence educational reform. Peking University, under the direction of Dean Shaomei Shang, was identified as the lead school of nursing. Dean Shang has collaborated with deans from the other universities to identify nine key faculty to serve as nurse educator simulation experts.


The NLN has worked in collaboration with these founding schools to develop a model simulation/debriefing faculty development curriculum for use by simulation nurse leaders. Core staff from the NLN have traveled to China every six months to develop and conduct a series of faculty development workshops and evaluate faculty progress, and some of the nine key faculty have visited the United States, even taking part in the NLN Education Summit 2018. Curriculum resources developed by the team have been translated into Mandarin for use by education colleagues and practice partners across the country.


Simulation and other technologies are considered disruptors in nursing education in the United States as well as China. Simulation best practices are creating rich teaching and learning experiences. As educators, we have the knowledge and theory to guide our disruptive innovation in our classrooms in both schools of nursing and in hospitals - an innovation that is necessary for the future. As the NLN and CLM move into the final year of Phase 1 of the One Belt One Road project, the nine key faculty we have worked with will conduct regional faculty development workshops, operationalizing these best practices throughout China.


We are excited about our journey with them and the ongoing conversations with our Chinese nurse educator colleagues. Through this process of collaboration, a cohort of nurse educators will lead nursing education reform efforts in China to thoughtfully prepare their next generation of nurses to enhance nursing practice for improved patient care outcomes. One Belt One Road.