Simulation as a Nursing Education Disrupter Simulation as an evidence-based pedagogy began emerging at a time when many constraints were being imposed on clinical experiences for nursing students. As research illuminated the advantages of simulation and standards were developed, educators began to recognize the limitations of the clinical setting, such as the inability to provide experiences in teamwork and delegation, and a focus on tasks. Simulations are crafted to provide an experience that matches content that is being taught in class, and debriefing techniques guide learners in a reflective process that promotes the development of clinical reasoning and judgment. The National Council of State Boards of Nursing study concluded that simulation could be substituted for 50% of clinical hours. Simulation-exposed gaps in the curriculum and its pedagogical principles are now extending to adaptations of its use in the classroom and in clinical postconferences. They are also shaping teacher-student conversations in the office and the hallways. Use of simulation for assessment is beginning to evolve. In a little more than 10 years, it has started a revolution that will continue to have a major impact on all aspects of nursing education in the future.

Creativity and Innovation: An Essential Competency for the Nurse Leader Innovation keeps an organization competitive and adaptive to change. Nurse leaders are looking for new ways to innovate and transform, being challenged to influence quality, design new care delivery models, and create workplaces that empower nurses to advance new ideas that lead to innovation. Innovation involves risk as well as new ways of thinking. The workforce must feel confident that a creative approach to problem-solving is valued and supported. The nurse leader must role model use of creative approaches to problem-solving and promote a spirit of innovation among today's workforce. The nurse leader can learn to be more creative and can use education to empower staff to use creative thinking techniques to solve problems in practice. The transformational nurse leader can use any one or more of the tools and techniques offered in this article to inspire and educate the workforce on creative approaches to problem-solving and ultimately to generate innovative solutions to real practice problems.

Disruptive Engagements With Technologies, Robotics, and Caring: Advancing the Transactive Relationship Theory of Nursing Human caring, founded on a Japanese caring perspective and nursing theory, fosters innovative and creative ideas for an aging society. The growing reality of health care dependency on technology presents a temptation to give robots utility as partners in nursing practice. Human caring expressed in human-to-human relationships, and also between humans and nonhumans, is a futuristic model for health care, with humanoid robots as major supporters. The purpose of this article is to explore this disruptive technology, along with its functions and characteristics. Tanioka's Transactive Relationship Theory of Nursing is shared along with its relevance for addressing technological disruptions in health care.

Virtual Nursing: The New Reality in Quality Care The purpose of this article is to report on an innovative new model of care and the effects this model pilot program had on patient satisfaction, staff satisfaction, physician satisfaction, patient quality metrics, and financial metrics. The Virtually Integrated Care team is a model of care that leverages technology to bring an experienced expert nurse into the patients' room virtually. The advanced technology allows the virtual nurse to direct and monitor patient care, interacting with the patient through 6 core roles: patient education, staff mentoring/education, real-time quality/patient safety surveillance, physician rounding, admission activities, and discharge activities.

Evolution of Care and Nursing: Moving With the Patients Health care costs are growing exponentially. They will continue to erode disposable income, especially among those most in need of health care—the poor and elderly. As the baby boomer generation ages, we will see dramatic growth in health care spending, which will influence the health care market in new ways. Increased government intervention and technological advancements will only further this shift. Factors driving the need for health care transformation include fragmentation, access problems, unsustainable costs, suboptimal outcomes, and disparities of care. Nurses now have more tools (ie, mHealth, telemedicine, and electronic health records) that they can use to provide assistance to their practices outside of acute care settings. These realities are all contributors to an evolving trend: retail health.

Disrupt Now for Future Focus Health care organizations are challenged by numerous and rapid changes. Although nurse leaders seldom lead the whole organization's response to these changes, most changes impact the nursing workforce. To be prepared and proactive, nurse leaders need to consider the process of disrupting what the nursing workforce does to keep current with what society expects of nursing.

International Nursing: Use of a Commercially Available Smartphone Application to Solve Information Needs of Orthopedic Scrub Nurses The purpose of this article is to describe the use of a commercially available smartphone application to solve information needs of scrub nurses in orthopedic surgery. A semistructured, focus group interview was conducted with orthopedic scrub nurses. These nurses had solved their information needs about orthopedic surgery by using a commercially available smartphone application. Because of smartphone technology's convenience, accessibility, mobility, ease of use, and use at no charge, it is worth considering in nursing practice, education, and research.