www.advanceweb.com | 2018 | MAGNET EDITION 25 Theoretical Basis for the 2HeadsR >1 Strategy The idiom “two heads are better than one” is well-known and its concept, that two peo- ple working together will outperform either one working independently, is generally accepted as true. The seminal research on this theory dates to the early 1900s. The 2HeadsR >1 strategy is built upon the evidence in support of collabora- tive cognition. When two people combine their sensory information, the resulting performance is oftentimes better than either individual could execute alone. Collective decision-mak- ing can surpass that of either individual and collaborative cognition is enhanced by some degree of diversity among the thinking styles or personalities of the members. Results: Student and Faculty Response to the 2HeadsR >1 Strategy The 2HeadsR >1 strategy for role assignment in simulation was piloted during the fall 2017 semester; a total of 295 undergraduate students participated in 39 scenario-based simulation activities as part of their clinical rotations in medical-surgical nursing, mental health nurs- ing, pediatric nursing, and transition to prac- tice. The response was overwhelmingly positive; comments on the post-simulation evaluation form indicated students experienced decreased anxiety and increased confidence because they had a peer at their side. Simulation facilitators reported richer debriefing sessions as a result of knowing when and how the students’ clini- cal reasoning went astray. Discussions between clinical faculty and simulation educators affirmed the decision to continue implemen- tation of the 2HeadsR >1 strategy during the spring 2018 semester. To date, student encoun- ters with the 2HeadsR >1 strategy total nearly 950 in 119 activities. The 2HeadsR >1 strategy affords clinical faculty members a new perspective for assess- ing critical thinking skills. Clinical instructors gain insight into a student’s decision making. Viewed actions can be linked to verbalized thought processes, revealing levels of clinical reasoning and potential gaps in learning. Assigning two students to operate as one nurse decreases role confusion and empowers both participants to take any nursing action they deem appropriate. Acting alongside a buddy decreases anxiety, which improves learning; students appreciate having a peer by their side to discuss options and to explore questions. Opportunities to practice teamwork, collaboration, and professionalism abound throughout the simulation activity and mimic the role of nurses working as members of inter- disciplinary teams in the clinical setting. The 2HeadsR >1 approach allows additional students to be involved as observers and learn from the thinking aloud of their classmates. It is easier to follow the thinking behind the observed actions and evaluate skills such as communication, prioritization, delegation, and situational awareness. Student observers are better prepared to participate in the debriefing session. Research shows active observation min- imizes stress in the learning process, increases confidence in one’s own thinking, and gives stu- dents the opportunity to see the bigger picture and appreciate other viewpoints. Conclusion: Implications for Nursing Education Teachable moments are sometimes missed in the simulation and clinical practice settings when a student performs the right action for the wrong reason. The instructor may see a stu- dent take the appropriate action in a given sit- uation and assume the student understands why he or she performed that act. However, the student may be operating under an assump- tion based on a previous experience. It is diffi- cult to know how often this occurs, but in every instance, it forfeits a learning opportunity for the student and may also reinforce faulty cog- nition. The 2HeadsR >1 strategy for role assign- ment exposes inaccurate thinking even when the student provides the proper care. Clinical faculty and sim facilitators can capitalize on this teachable moment. The creative nature of simulation allows educators to modify existing strategies and generate new ones to meet learning objectives, while adhering to best practice standards that ensure quality learning experiences. The LHSON Sim Team answered the call for inno- vative educational methodologies in simula- tion with the development and implementation of the 2HeadsR >1 strategy for role assignment. Submitted by Jeanne Carey Team Members: Jeanne Carey, MEd, RN, CHSE - Director of Simulation & Sim Educator Jennifer Woo, PhD, CNM, WHNP - Clinical Assistant Professor & Sim Facilitator Marie Lindley, PhD, RN - Clinical Assistant Professor & Sim Facilitator Breanne Wilburn, MSN, RN, CMSRN - Lecturer & Sim Facilitator Erin Killingsworth, PhD, RN, CNE - Clinical Assistant Professor & Sim Facilitator Jessica Rong, MSN, RN, CCRN-K - Lecturer & Sim Facilitator Ashantà Lewis, MSN, RN, CCTN - Lecturer & Sim Facilitator Kelly Rossler, PhD, RN, CHSE - Assistant Professor & Sim Educator Linda Plank, PhD, RN, NEA-BC - Associate Dean for Academic Affairs MAGNET EDITION | BEST NURSING TEAM The 2HeadsR >1 approach allows additional students to be involved as observers and learn from the thinking aloud of their classmates. It is easier to follow the thinking behind the observed actions and evaluate skills such as communication, prioritization, delegation, and situational awareness. Student observers are better prepared to participate in the debriefing session.