The evolution of a high-fidelity patient simulation learning experience to teach legal and ethical issues.

A transformative learning activity, in which students participated in a high-fidelity patient simulation (HFPS) scenario, was initiated to help students learn the importance of legal and ethical content in their clinical practice. The authors used the continuous quality improvement process to guide their HFPS implementation strategies from year to year. The plan, do, check, and act model served as the framework by which 3 consecutive years of HFPS evaluations were conducted and findings subsequently implemented. Evaluation data indicated that the HFPS was most effective at the end of the semester to review and apply previous content and that neither the role fulfilled by students in the scenario nor the actual participation in the scenario (vs. observation and participation in the debriefing) made a significant difference in students' pre- and posttest scores, student or faculty evaluations, or student perceptions of the HFPS experience. These findings ensured a quality learning experience for students and helped faculty address the logistics of accommodating an increasing number of students in the HFPS scenarios each year.