Department heading

Two laboratories are continuously available to nursing students. One laboratory is equipped with a so-called control room and audio-visual technology. The control room is spatially separated within the laboratory in such a way that it hides all the technology and does not influence the "natural learning environment". Through a "mirror glass window", persons controlling the technology have a view of the laboratory situation and can steer the simulators from here without being directly part of the training field and disturbing the process. Scenarios carried out by students or teachers are videographed from the control room and, if necessary, video sequences are transmitted to neighbouring teaching rooms for teaching purposes.

The laboratories are set up like rooms in clinics and equipped with furniture and medical technology devices that nurses use in their daily work. This allows nursing situations to be simulated as realistically as possible. The equipment includes:

• Nursing beds, bedside tables, handicapped-accessible washbasins with grab rails, examination couches, dressing trolleys, anatomical models and display boards
• Life-size simulators (Nursing Anne, Nursing Kelly and infant care mannequins)
• Resusci Anne, Resusci Junior, Resusci Baby simulators
• Arm models for venous injections and blood sampling
• Oxygen unit, vital monitoring monitor, ECG unit, mini-Doppler sonography units
• Infusomat, perfusor, suction device

In the near future, a laboratory will be available as a home setting in order to be able to simulate situations in the familiar living environment such as a client's home.

Acts of care are theory-based interactions that are decided between clients and professional carers and are based on scientific knowledge. They basically refer to the individual situation of each client. Care actions are often characterised by direct physical contact between the actors and exceed social distance to a particular degree. Professional action in nursing therefore requires a high level of methodological competence, including nursing skills, in addition to technical and social competence.

In laboratory exercises, students prepare themselves for nursing situations in the real professional field. By interlocking theoretical and practical learning and teaching units, they learn to understand facts and contexts, to practise and reflect on skills and in turn to justify their actions based on theory.

The learning units are explained and controlled by teachers, partially demonstrated and reflected upon. At the same time, self-direction of the learning processes by the students is encouraged but also demanded. Collective (group) learning processes are initiated in action-oriented learning situations. In small groups, students actively practise among themselves (on each other) or on simulation mannequins, models and devices.

Students get to know complex nursing situations that can be threatening for patients as well as for themselves in everyday nursing practice. These include emergency situations, for example.

Against this backdrop, teachers and students have determined that the highest maxim of the clinical-practical study components (laboratory exercises) is to protect and maintain the integrity and safety of patients in every action. In laboratory situations, it is possible to develop a personal and general error culture, i.e. to systematically record, assess and evaluate errors that occur and to look for suitable solutions or possibilities to avoid errors. Errors in practical action but also errors in assessment can be avoided through reflection, guidance, correction and, above all, practice. Especially here, the advantages of laboratory exercises are unmistakable: without exposing patients to danger, students can practise in the laboratory until they feel confident in thinking and acting. Only then do they perform their actions on persons in a care situation, whether patients in the clinic or persons in need of help in home care.

• Simulation Network Education and Training in Nursing (SimNAT Pflege) e.V. www. simnat-pflege.net
• Aktionsbündnis Patientensicherheit http://www.aktionsbuendnis-patientensicherheit.de
• The International Nursing Association for Clinical Simulation & Learning (INACSL) http://www.inacsl.org/i4a/pages/index.cmf?pageid=1
• Clinical Simulation in Nursing; journal of INACSL http://www.journals.elsevier.com/clinical-simulation-in-nursing/
• RADAR(Recognition ofthe AcutelyDeterioratingPatient with AppropiateResponse) http://www2005.hs-fulda.de/index.php?id=12238