Simulation is rapidly spreading in the world of nursing education.  Nursing students are said to learn better with simulation or patient simulators, especially in light of the following issues:

• Progressing number of nursing programs
• Limited clinical sites
• Certain healthcare settings that do not allow students to take vital signs or administer medications
• Initiatives for patient safety that cuts back on the number of students that care for patients or limits students to just observing procedures of patient care

• Shortages in members of the faculty
• Facilities that do not allow students to access medical records

Simulation in nursing schools are staying exactly where they are and there is no danger of their not being used, but this does not mean that they are good for learning students. Below are some of the disadvantages of using simulation in teaching nursing skills:

1. It is not real. Even if simulation is done in a realistic setup, it still isn’t real. Because of this, students tend to tense up and freeze during real clinical situations. Nursing students need to see, smell, hear, and feel everything in every situation, so that they can react the right way. Some universities such as the University of Alabama, Huntsville, have already upgraded their simulation program by adding theater students into the experience. They play the role of family members, whom the dying patients have at their bedside. The theater students help expose the nursing students to uncomfortable situations. They ask the nursing students questions about the dying patients.
2. It is expensive. Simulation is not a low-cost effort in training nursing students. Each component is worth tens of thousands of dollars. A study back in 2007 estimated one simulation set up cost about $875,000 USD. Many agreed that the money spent on simulations should just be spent on more fulfilling real experiences for professional nurses. Simulations can also be used in addressing other issues in providing patient care.
3. Simulations are high maintenance. Teaching schools in nursing need to dedicate enough space for their patient simulators. They also must spend money and time in teaching faculty members about using the equipment. When the software and hardware of the simulation break down, money will again be shelled out to repair or replace them.
4. The health educators lack training. Being a simulation educator is different from being an actual healthcare provider. Even if the simulation is high fidelity, the training can never be effective unless the educators are prepared enough in running simulation skills and scenarios. Using simulation technology should be top priority in training the nursing faculty members.

In assisting nursing students, nursing educators are challenged by the fact that the transition from simulation to reality. It remains a concern because in real hospital and clinic settings, the tension and anxiety is far greater. Simulation can only provide a limited amount of preparedness, which is why many nursing students forget what to do and how to behave with real patients.

Nurse educators have the responsibility of updating themselves with the latest simulation technologies. They should do this so that they could understand how they can train future nurses for clinical and hospital practice. Until then, real patients in real healthcare settings should be used in training.

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