SIMULATION IN SCHOOLS OF

NURSING: INTEGRATING SIMULATION

INTO NURSING CURRICULUM

Joanie Selman, MSN, RNMed-Surg Course Coordinator

DeWitt School of NursingStephen F. Austin State University

BACKGROUND DeWitt School of Nursing at

Stephen F. Austin State UniversityNacogdoches, Texas

Joanie Selman, Med-Surg Instructor

9,000 square foot simulation lab opened Jan. 2010

*10 room Med-Surg lab*4 room OB/pedi lab and Nursery*ER with 12 gurney spaces*Assessment lab with 10 exam tables*14-station control room

5-3Gs, 1-SimMan, 1-SimNewB,2-SimBaby, 17 VitalSims, 6-Virtual IVs, SimMom,SimKid

STEPHEN F. AUSTIN STATE UNIVERSITY

WHY DO WE NEED SIMULATION? Shortage of clinical opportunities

Many schools competing same clinical sites/times

Limited cases in smaller hospitals Few deliveries No NICU No neuro, head trauma

Faculty shortage, students/instructor No patients with diseases you want your

students to experience

WHY DO WE NEED SIMULATION?

Up to 30% of students are Tactile/Kinesthetic learners.

Simulation Enhances LearningLecture is not enough, Reading is not enoughCase studies are not enough

WHY DO WE NEED SIMULATION?

Control Instructor has control over what

disease patient exhibits

What complications the patient develops

Which student practices with that patient

COURSES WHICH BENEFIT Practically All Collaborate with other courses

Basic courses in beginning semester(s)

Health assessment Basic Med-Surg Pharmacology

Scenario……..Elderly man s/p surg after he fell and broke his hip needs assessment of surgical incision, inhaler, repositioning, IS, PO antibiotics and teaching about proper protein intake for proper healing.

COURSES WHICH BENEFIT Mid-way Courses

OB/PEDI Med-Surg Mental Health

Scenario…. Schizophrenic pregnant woman with a 2 year old child brought to ER after a MVA. She has a broken leg and is awaiting surgery.

COURSES WHICH BENEFIT Last semester courses

Critical Care Community Health Leadership/Management

Scenario…..Shortage of nurses in ICU, manager must delegate & prioritize pt assignments then take the most critical patient herself for the day.

s/p major stroke with paralysis and concussion from fall. Wife has meeting with home health nurse to discuss at home care after discharge.

COURSES WHICH BENEFIT If you can only do limited simulation….

Med-Surg and Pedi/OB courses are your best bet b/c you can incorporate concepts from other courses into the scenario.

Laerdal Conferences Book Visit other schools Get ideas from others

SIRC-Simulation Innovation

Resource Center http://sirc.nln.org/

SUN website http://www.laerdal.com/us/SUN

NLN scenariosScenarios from textbook publishersCase studies

HOW DO I START THIS?

Simulation in Nursing Education Author: Pamela Jeffries

HOW DO I START THIS?Start simple. Do not overwhelm yourself.

Only one scenario the first semester you start

Common scenario from your practice. Choose problem that is it crucial students

know Not readily available in your area

LITTLE NUGGETS FOR SUCCESS

Lecture on the topicHelp students

prepare Assignment to

complete on topic before the sim

article in a journalcase studyWorksheet

“dress rehearsal” with other students or faculty

Before simulation day

LITTLE NUGGETS FOR SUCCESS

During simulationMake room and mannequin as realistic as

possiblePre-brief students

a learning exercise not a punitive evaluation act exactly like a real life setting give them report – like at a hospital

Give a few minutes after report for them to plan as a team before starting scenario

As mannequin voice give “hints” if student is really struggling.

LITTLE NUGGETS FOR SUCCESS

After simulation

De-brief immediatelyIdentify gaps in knowledgePraise students for positive interventionsRedirect students away from poor

choices.Post-scenario assignment to re-enforce clinical concepts covered

Care plan Assessment values with nurse notes Taking and writing telephone orders on

order sheet

FACULTY BUY-IN

First person to convince is your Director or Dean of the nursing school.As a group

present a video-taped scenarioHave students share their experience Discuss the benefits

Teamwork Delegation Communication Decision-making Time management

Critical thinkingMed administrationInfection controlAssessmentPhysician orders

FACULTY BUY-IN

Individual courses meet with the team have them “attend” one of your

simulations.

Offer to assist them in developing a simulation.

Tell them you will “run” the first one with them

Share your ideas, forms, etc

MEASURABLE OBJECTIVESGeneral for all scenarios

Example…Student demonstrates appropriate

infection control techniques. ….Student identifies client with two identifiers

Specific for individual scenarioExample….Student assesses blood pressure before administering nitroglycerin tablet.

http://www.laerdal.com/us/SUN

MEASURABLE OBJECTIVES

Faculty Objectives for SIMFailure rate will decrease .Does SIM help students learn the

important concepts in my course?

Since SIM the failure rate in the Med-Surg I teach dropped from an average of 10% to 6%.

STUDENT EVALUATION OF SIM

Very important to survey the students

Question Disagree

No opinion

Agree

1. I understand the purpose and objectives of the simulation. 0.00% 0.00% 100.00%

2. The scenario(s) resembled a real-life situation. 1.33% 0.00% 98.67%

3. The simulation provided a variety of ways to learn the material. 0.00% 5.33% 94.67%

4. I had a chance to work with my peers during the simulation. 0.00% 5.33% 94.67%

5. The simulation helped me learn to prioritize. 0.00% 1.33% 98.67%

6. The debriefing session was helpful as a learning activity. 1.33% 0.00% 98.67%

7. I was able to participate in the debriefing session. 1.33% 1.33% 97.33%

8. The feedback was constructive. 0.00% 2.67% 97.33%

9. The simulation will help me better care for healthcare clients. 0.00% 0.00% 100.00%

10. The simulation made me feel more confident in caring for healthcare clients. 2.67% 4.00% 93.33%

STUDENT EVALUATION OF SIM

Have a free text comment section on the evaluation. Actual student comments…….

I really enjoy SIMs and I always learn a lot from them. I wish we had more and I will continue to learn and feel more comfortable when entering a patient's room.

I always learn things that I know I won’t forget. It is good to have these simulations because we don't always come across some of these situations when we are actually in clinicals. Because of these simulations, I know i will be prepared when I come across the same problems.

. The feedback in the debriefing session was very informative without being condemning. Good job!

WHY GO TO THE HASSLE OF USING SIMULATION IN YOUR COURSE? Short answer --- IT’S WORTH IT !!

To the instructor

To the students

To the future employer

To the client

QUESTIONS

THANK YOU SO MUCH !Contact information

Joanie Selman, MSN, RNselmand@sfasu.edu

936-674-7896DeWitt School of Nursing

Stephen F. Austin State UniversityNacogdoches, Texas