Success Story

Using SimChart® in Skills Lab to Boost Critical Thinking in Nursing

Smiling student learning

At-A-Glance Facts

The nursing program at Kankakee Community College (KCC) in Kankakee, Illinois, offers an associate degree to prepare students to become registered nurses. The program consists of 11 courses for 45 credit hours, and the NCLEX pass rate is consistently around 97 percent. KCC also offers an advanced placement option for licensed practical nurses and a one-year certificate program to prepare students to become a practical nurse.

Students at KCC use SimChart in the skills lab to complete a simulation, which enhances their nursing critical thinking abilities and helps them become more confident with the skill—and with patient communication—in the clinical setting.


“We’ve turned our skills lab into more of a simulation experience through SimChart,” says Kim DeYoung, MSN, RN, CNE, simulation coordinator and professor of nursing at Kankakee Community College (KCC), Kankakee, Illinois. “Students have to use their critical thinking skills just as they would do in a real clinical setting.”

Creating a Real-world Experience

KCC implemented SimChart® in fall 2012 for students in the first and second semesters. “We use it in our classroom, asking students ‘what would the assessment of this patient look like’ and introducing them to electronic care planning versus written forms,” says DeYoung, who has been teaching for 20 years, starting with nursing assistants, then LPNs, and now RNs.

DeYoung says SimChart has proved to be particularly valuable in the skills lab.

Students use SimChart for return demonstration of some skills in their first semester and all skills in the second semester, where skills include nasogastric tube insertion, irrigation, and removal; IV skills such as hanging piggybacks, starting fluids, and operating infusion pumps; intramuscular, intravenous, and subcutaneous injections; inserting a urinary catheter and irrigating it; and removing sutures and staples.

“I built a model electronic health record in SimChart based on a patient scenario that required those types of orders,” DeYoung says. “Then I made that into a simulation so students go into that piece of SimChart when they come into the nursing lab to do their return demonstrations.”

DeYoung notes that patient name bands, allergy bands, and medication labels add to the realistic experience of performing a skill. “Students verify the order in SimChart just as they would with a computer in the clinical setting, complete the whole process, and record their documentation,” she says. DeYoung can check students’ documentation on the spot so they receive immediate feedback.

DeYoung has found SimChart’s electronic health record similar to what the students encounter in clinical settings and adds that having SimChart in the skills lab makes the demonstrations “feel more real to students.”

That realism is key because students in the second semester have their first experience with acute care. “There’s a big jump to go from long-term care to acute care,” DeYoung says. Once in the clinical setting, students “are able to pull from their experience in the skills lab.”

Promoting Critical Thinking and Patient Communication

DeYoung works with students in the classroom, skills lab, the high-fidelity simulation lab, and the clinical setting, something she enjoys. “I remember what they did in the skills lab so I can say, ‘think back to when we did this skill in the skills lab, what did you have to think about?’ That helps a lot.”

Since starting to use SimChart, DeYoung says, “It seems that students think things out more on their own before we go into the patient’s room. I don’t have to guide them as much as I used to.” She credits the improved critical thinking to SimChart, saying, “It really puts them on their toes.”

DeYoung cites the example of the scenario patient who is allergic to latex and shellfish and needs a urinary catheter. “Sometimes students get caught not thinking about it ahead of time when they prep the patient. They’re standing there realizing ‘I’m already sterile, how am I going to handle this?’” She can then talk them through the experience so they learn from it and improve their thinking skills.

Ultimately patients benefit from students’ skills lab experience. Traditionally, “students are so focused on the skill that they aren’t communicating with the patient when they are doing it,” DeYoung says. SimChart not only gives students practice with the skill, but also practice with patient communication.

“Sometimes you have to remind them that this is a patient,” she says, adding that she tells students, “We want you to pretend you are at clinical.” DeYoung serves a dual role—teacher and patient. “I act out the patient’s voice,” she says. “It makes it more fun for me and the students too. Sometimes they’re a little bit nervous, and I think it helps them to relax.”

DeYoung concludes, “We’re hoping that this practice will help them become more comfortable and communicate better with their patients in the clinical setting.”

Achieving Success

“I would highly recommend making a skills lab a simulation type experience because I think there’s a huge benefit to students in bringing clinical to campus more,” DeYoung says, adding that research supports this approach.

She advises those who want to implement SimChart to, “sit down with the instructors, look at the skills, and have them come up with the scenario they would like to use.” DeYoung built her scenario, and plans to train other instructors to do so in the future. “Try to bring everyone on board one semester at a time,” she adds.

To make SimChart a success throughout the program, DeYoung recommends having “one point person who is keeping everything organized and bringing instructors on board.”

Fortunately, adding SimChart to the skills lab doesn’t steal precious minutes from instructors. “We did a time study,” DeYoung says, “We allow 15-minute intervals for skills and as long as students were there and ready with their computer screen up, we didn’t need to increase our time.” Many students bring their own computers and access SimChart through their Evolve account.

Another potential benefit is cost containment. DeYoung says SimChart allows her to know exactly what supplies are needed, which could reduce overhead.

Looking to the Future

In the future DeYoung says KCC will look at implementing SimChart in the third and fourth semester, which she sees as another step in bringing clinical into the classroom. “Simulation in nursing education is a passion of mine,” says DeYoung, “I saw a huge benefit for us to be doing our skills lab as a simulation. It’s a great way to use the product and the product is a great way for us to make sure we’re doing the simulation piece. It’s been good.”