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Proactive Policy Planning for Unexpected Student Distress During Simulation

Willhaus, Janet PhD, RN; Averette, Mitzi BSN, RN, CHSE; Gates, Michael PhD, RN; Jackson, Janet MS, RN; Windnagel, Susan MSN, RN

doi: 10.1097/NNE.0000000000000062
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Stress reactions resulting from participation in simulation scenarios are seldom reported in the literature but are often informally discussed by simulation faculty seeking guidance to manage the occurrences. Although simulation faculty members often describe events where a single learner’s distress interrupted learning for all involved, no examples of policies to plan for this kind of occurrence are available in the simulation literature. This article offers suggested best practices for identifying and assisting students who exhibit uncontrolled stress in simulation and includes a sample policy for planning.

Author affiliations: Assistant Professor (Dr Willhaus), School of Nursing, Boise State University, Idaho; Simulation Lab Coordinator (Ms Averette), Fayetteville Technical Community College, North Carolina; Associate Professor (Dr Gates), School of Nursing, San Diego State University, California; Simulation Coordinator (Ms Jackson), Department of Nursing, Bradley University, Peoria, Illinois; Nurse Educator and Nursing Lab Instructor (Ms Windnagel), Whatcom Community College, Bellingham, Washington.

The authors declare no conflicts of interest.

Correspondence: Dr Willhaus, School of Nursing, Boise State University, 1910 University Dr, Boise, ID 83725 (

Accepted for publication: May 8, 2014

Published ahead of print date: June 19, 2014

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.