- Email: [email protected]
Comprehensive Simulation Program: A Rapid Deployment Success Story
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Poster Abstracts
Comprehensive Simulation Program: A Rapid Deployment Success Story Kim Baily, RN, PhD, Director of Nursing. El Camino College Department of Nursing, Torrance, CA, 310.660.3282, [email protected] El Camino College Department of Nursing (ECCDN) graduates 220 ADN level nurses per year from three separate local campuses. The program is supported by seventeen full-time and forty-six part time faculty, all of whom participate as clinical instructors. Like many other colleges and universities, ECCDN invested heavily in the purchase of simulators and equipment. A few key faculty members were trained in the use of the high technology equipment. Despite good intentions and a strong desire to establish a simulation program, ECCDN struggled to get all faculty on board. They also had difficulty integrating simulation into the curriculum with any consistency or standardization. Additionally, they lacked a method for tracking outcomes. Following an internal assessment, ECCDN identified multiple intersecting needs: space and equipment reorganization, alignment of simulation activities with curriculum, and faculty training. This assessment, in conjunction with research into other simulation programs, prompted a decision to obtain outside expert advice. Under the direction and guidance of simulation expert consultants (Medical Simulation Design, Inc.), ECCDN identified a strategy to ultimately create a comprehensive simulation program. A three-month rapid deployment action plan was initiated with clearly defined roles, responsibilities, and time investment commitments. All faculty participated in an initial planning session to ensure use of common language and definitions, clarification of types, uses, and methodologies of simulation. ECCDN, with the guidance of the outside consultants, created a framework for desired learning outcomes based on integrated cognitive, technical, and behavioral learning. In order to ensure long term success and sustainability, a ‘‘critical mass’’ of faculty and techs were trained in the androgogical methodology for simulation scenario writing, facilitation, and debriefing during an intensive four-day seminar. Over a six week period, a team of trained faculty participated as content experts in the development of a Scenario Library (twenty scenarios) based on the established framework. ECCDN customized the library to the identified desired learning outcomes, curriculum alignment, and best practices of area clinical partners. Each scenario was placed into a functional and user friendly template which included linked debriefing questions. Performance based outcomes were measured with StudioCode software. A one week Pilot Launch was held with twenty faculty and techs in order to practice full operations and methodology techniques with fifty learners. Operational, facilitation, and debriefing mentoring, under guidance of the consultant experts, was extremely valuable in creating confidence for faculty and ensuring scenario consistency. The total time to move from program concept to full implementation for forty learners a week was three months.
Implementing a Teaching Strategy for Advanced Nursing Procedures for Undergraduate Nursing Students Cynthia Barkhouse-MacKeen, BN MS, Kim Hebert, BScN MN(NP), Betty MacIsaac, BScN MN, Shauna Houk, BScN MNÓ, Ellie Bethune, BScN, Barbara Bleasdale, BScN, and Colleen Kiberd, BN MEd MN. Dalhousie University, 5869 University Ave, Halifax, Nova Scotia Canada B3H 3J5, [email protected] Purpose: A common concern of new graduates and stakeholders in the workplace is a lack of confidence and ability to undertake advanced nursing practice. In response to increased patient acuity a workshop was designed to provide an opportunity for students to practice high risk, low frequency procedures. Methods: To address these concerns a three day workshop was designed to provide third year nursing students the opportunity to practice advanced nursing procedures prior to their spring clinical rotation. The emphasis was the application and integration of knowledge, procedures and critical
thinking. The workshop was participative, interactive and included immediate feedback to enhance learning. Prior to the workshop students were given learning packages and completed a post test for all procedures. Three laboratory sites were set up with five stations so that all students (n ¼ 150) were able to rotate to all procedures. Expert clinicians provided information and demonstration prior to student practice. The nursing procedures taught by expert faculty were, Care of Chest Tubes, NG Insertion, IV insertion, Blood Collection and Central Line Care. All students had an opportunity to practice all procedures. Results: The concentrated laboratory experience for advanced nursing procedures enabled small groups of students to practice in a safe, controlled environment with expert faculty. The workshop was valuable in providing hands on learning experiences which enabled students in the clinical setting to participate in advanced nursing procedures with supervision. Evaluation by the students was uniformly positive (range 4.7 to 4.9 on a scale 1-5 with 5 being excellent). Students also identified other areas (Tracheotomy care, EKG readings and Complex dressing care) to be included in future workshops. Informal feedback from the hospital units noted improved student confidence and greater student involvement in patient care. Conclusion: Given the success and feedback the faculty plan to present the workshop annually. Schools introducing this type of learning experience should consider a formal evaluation of their students before and after this intervention. This is a first step towards more clinical simulation and virtual reality scenarios to assist with teaching advanced nursing procedures.
Leveling Simulation for Students in a Baccalaureate Curriculum Karen P. Black, MSN, PhDc, RN, Heather L. Owens, MSN, RN, and Melissa Wilding, BSN, RN. University of Louisville, School of Nursing, Health Science Campus, 555 S. Floyd St., Louisville, KY 40292, [email protected] At the University of Louisville School of Nursing (ULSON), simulation is used throughout the upper division baccalaureate curriculum through varied instructional methodologies. Faculty have the opportunity to use Standardized Patient (SPs) simulations as well as computer enhanced human patient simulation manikins (HPS). Simulation using a variety of instructional approaches allows tailoring of the method of instruction to meet specific learning outcomes at each level of the BSN program. In the junior year, students begin to integrate knowledge and skills through simulation activities and achieve a level of confidence and proficiency. In the senior year students begin to transition to the highest cognitive domain of synthesis and evaluation. First semester junior students are engaged in courses in communication and health assessment. Students use simulation to practice health assessment skills through interaction with the SPs. Many of these first semester students have no experience in health care and have never had physical contact with a patient. This experience allows students to overcome their shyness with patients by performing an actual physical assessment and communication skills on a real person in a non-threatening environment. Students receive feedback from SPs regarding their assessment techniques as well as their communication skills. Second semester junior students are beginning their first in-patient clinical experiences and have simulation experiences in the lab with the HPS practicing many of the psychomotor skills required for clinical. Simulation case studies have been developed in which patients have a variety of needs that require students to practice fundamental nursing skills. A typical case study presented to the student is built around a patient with a variety of health care needs such as dressing changes, bladder catheterization, blood glucose monitoring and insulin administration, medication administration, and enteral feedings. Students not only practice these skills but do so in the context of a patient case study in which they must use the nursing process to prioritize and plan patient care. The third semester senior students are engaged in mother-baby and psychiatric mental health courses. These students have case study experiences with the HPS related to post-partum complications. Again, the case studies developed engage the students in using the nursing process to
pp e129-e155 Clinical Simulation in Nursing Volume 5 Issue 3S
Poster Abstracts
Comprehensive Simulation Program: A Rapid Deployment Success Story Kim Baily, RN, PhD, Director of Nursing. El Camino College Department of Nursing, Torrance, CA, 310.660.3282, [email protected] El Camino College Department of Nursing (ECCDN) graduates 220 ADN level nurses per year from three separate local campuses. The program is supported by seventeen full-time and forty-six part time faculty, all of whom participate as clinical instructors. Like many other colleges and universities, ECCDN invested heavily in the purchase of simulators and equipment. A few key faculty members were trained in the use of the high technology equipment. Despite good intentions and a strong desire to establish a simulation program, ECCDN struggled to get all faculty on board. They also had difficulty integrating simulation into the curriculum with any consistency or standardization. Additionally, they lacked a method for tracking outcomes. Following an internal assessment, ECCDN identified multiple intersecting needs: space and equipment reorganization, alignment of simulation activities with curriculum, and faculty training. This assessment, in conjunction with research into other simulation programs, prompted a decision to obtain outside expert advice. Under the direction and guidance of simulation expert consultants (Medical Simulation Design, Inc.), ECCDN identified a strategy to ultimately create a comprehensive simulation program. A three-month rapid deployment action plan was initiated with clearly defined roles, responsibilities, and time investment commitments. All faculty participated in an initial planning session to ensure use of common language and definitions, clarification of types, uses, and methodologies of simulation. ECCDN, with the guidance of the outside consultants, created a framework for desired learning outcomes based on integrated cognitive, technical, and behavioral learning. In order to ensure long term success and sustainability, a ‘‘critical mass’’ of faculty and techs were trained in the androgogical methodology for simulation scenario writing, facilitation, and debriefing during an intensive four-day seminar. Over a six week period, a team of trained faculty participated as content experts in the development of a Scenario Library (twenty scenarios) based on the established framework. ECCDN customized the library to the identified desired learning outcomes, curriculum alignment, and best practices of area clinical partners. Each scenario was placed into a functional and user friendly template which included linked debriefing questions. Performance based outcomes were measured with StudioCode software. A one week Pilot Launch was held with twenty faculty and techs in order to practice full operations and methodology techniques with fifty learners. Operational, facilitation, and debriefing mentoring, under guidance of the consultant experts, was extremely valuable in creating confidence for faculty and ensuring scenario consistency. The total time to move from program concept to full implementation for forty learners a week was three months.
Implementing a Teaching Strategy for Advanced Nursing Procedures for Undergraduate Nursing Students Cynthia Barkhouse-MacKeen, BN MS, Kim Hebert, BScN MN(NP), Betty MacIsaac, BScN MN, Shauna Houk, BScN MNÓ, Ellie Bethune, BScN, Barbara Bleasdale, BScN, and Colleen Kiberd, BN MEd MN. Dalhousie University, 5869 University Ave, Halifax, Nova Scotia Canada B3H 3J5, [email protected] Purpose: A common concern of new graduates and stakeholders in the workplace is a lack of confidence and ability to undertake advanced nursing practice. In response to increased patient acuity a workshop was designed to provide an opportunity for students to practice high risk, low frequency procedures. Methods: To address these concerns a three day workshop was designed to provide third year nursing students the opportunity to practice advanced nursing procedures prior to their spring clinical rotation. The emphasis was the application and integration of knowledge, procedures and critical
thinking. The workshop was participative, interactive and included immediate feedback to enhance learning. Prior to the workshop students were given learning packages and completed a post test for all procedures. Three laboratory sites were set up with five stations so that all students (n ¼ 150) were able to rotate to all procedures. Expert clinicians provided information and demonstration prior to student practice. The nursing procedures taught by expert faculty were, Care of Chest Tubes, NG Insertion, IV insertion, Blood Collection and Central Line Care. All students had an opportunity to practice all procedures. Results: The concentrated laboratory experience for advanced nursing procedures enabled small groups of students to practice in a safe, controlled environment with expert faculty. The workshop was valuable in providing hands on learning experiences which enabled students in the clinical setting to participate in advanced nursing procedures with supervision. Evaluation by the students was uniformly positive (range 4.7 to 4.9 on a scale 1-5 with 5 being excellent). Students also identified other areas (Tracheotomy care, EKG readings and Complex dressing care) to be included in future workshops. Informal feedback from the hospital units noted improved student confidence and greater student involvement in patient care. Conclusion: Given the success and feedback the faculty plan to present the workshop annually. Schools introducing this type of learning experience should consider a formal evaluation of their students before and after this intervention. This is a first step towards more clinical simulation and virtual reality scenarios to assist with teaching advanced nursing procedures.
Leveling Simulation for Students in a Baccalaureate Curriculum Karen P. Black, MSN, PhDc, RN, Heather L. Owens, MSN, RN, and Melissa Wilding, BSN, RN. University of Louisville, School of Nursing, Health Science Campus, 555 S. Floyd St., Louisville, KY 40292, [email protected] At the University of Louisville School of Nursing (ULSON), simulation is used throughout the upper division baccalaureate curriculum through varied instructional methodologies. Faculty have the opportunity to use Standardized Patient (SPs) simulations as well as computer enhanced human patient simulation manikins (HPS). Simulation using a variety of instructional approaches allows tailoring of the method of instruction to meet specific learning outcomes at each level of the BSN program. In the junior year, students begin to integrate knowledge and skills through simulation activities and achieve a level of confidence and proficiency. In the senior year students begin to transition to the highest cognitive domain of synthesis and evaluation. First semester junior students are engaged in courses in communication and health assessment. Students use simulation to practice health assessment skills through interaction with the SPs. Many of these first semester students have no experience in health care and have never had physical contact with a patient. This experience allows students to overcome their shyness with patients by performing an actual physical assessment and communication skills on a real person in a non-threatening environment. Students receive feedback from SPs regarding their assessment techniques as well as their communication skills. Second semester junior students are beginning their first in-patient clinical experiences and have simulation experiences in the lab with the HPS practicing many of the psychomotor skills required for clinical. Simulation case studies have been developed in which patients have a variety of needs that require students to practice fundamental nursing skills. A typical case study presented to the student is built around a patient with a variety of health care needs such as dressing changes, bladder catheterization, blood glucose monitoring and insulin administration, medication administration, and enteral feedings. Students not only practice these skills but do so in the context of a patient case study in which they must use the nursing process to prioritize and plan patient care. The third semester senior students are engaged in mother-baby and psychiatric mental health courses. These students have case study experiences with the HPS related to post-partum complications. Again, the case studies developed engage the students in using the nursing process to
pp e129-e155 Clinical Simulation in Nursing Volume 5 Issue 3S