The Experience at Quinnipiac University Mary Ann Cordeau PhD, RN

     From participating in this presentation the participant should be able to: Discuss the process of starting a clinical simulation program Discuss the process of setting up a simulation laboratory Discuss the process of expanding a clinical simulation program Discuss the process of starting an interdisciplinary clinical simulation program

Moving from a Simulation Room To a simulation suite

       One Mannequin One patient room with a control room One instructor One scenario Eighty students!!!!!

Number for HELP desk Number for Laerdal Some assembly necessary!!!

                 Interested faculty member Supportive Leadership Curriculum plan for incorporating clinical simulation Space Funding Mannequin Faculty Expert(s) (Novice to Expert) Fidelity Environment Accessories Faculty Buy-in Faculty Education Technological Support Maintenance of Lab equipment Management of student experiences Selling the Program Interprofessional use Director of Clinical Simulation

   Department – Chairperson who supports clinical simulation as a teaching learning strategy ◦ ◦ 2005 Janice Thompson decided to purchase a SimMan for the Department and build a simulation lab. 2008 Plans for move to North Haven and Simulation Suite with 5 simulation rooms School – Dean who supports clinical simulation University – Understanding of the potential of clinical simulation as a teaching/learning strategy

      ◦ ◦ Finding a framework to guide the process Orientation No practice sessions Simulation outcomes ◦ ◦ Began in spring semester in our first medical/surgical course with the care of a postoperative client Wrote a scenario which included scenario outcomes Created grading rubric Scenario was related to NU 303 as an add on assignment, Pass/Fail After the second year, I presented a potential plan for incorporating clinical simulation into all courses Research on the Experience of Clinical Simulation

     Look to the literature for information on best practices for clinical simulation Examine program/course outcomes to determine how clinical simulation will be used to meet outcomes The use of clinical simulation needs to be examined for each course ◦ ◦ Number and type of experiences Use of clinical simulation in the class room Teaching content, Practice, Nursing experience, Team work, Evaluation Attach % points, Pass/Fail, Letter, number grade

   Start with a written scenario: Laerdal, International Nursing Association for Clinical Simulation and Learning (INACSL), Colleague Start with one course Conduct a Pilot study ◦ Uncover what needs to be changed Don’t jump into the water unless you know what is there!!

       Current Use: Fundamentals Course – Fall Junior Year ◦ Therapeutic communication, Client Safety Medical/surgical Course – Spring Junior Year ◦ Post-operative assessment, Medication Administration Maternity Course – Spring Junior Year ◦ Assessment Medical/surgical Course – Fall Senior year ◦ Mock Codes, Chest Tubes Leadership Course – Spring Senior Year ◦ Working as a team, Being the nurse SNUAC – Post operative assessment of a client with a C-section, Teaching, New born Assessment

  ◦ ◦ ◦

Future Use

New Curriculum Integrated Lab - more course objectives could be met using clinical simulation Streaming from sim lab to classroom for most courses Integration of Electronic Health Record

   What space is available for setting up a clinical simulation lab?

Renovate existing space Create a space for a clinical simulation suite ◦ Faculty need to work closely with technology to describe technological needs for running a clinical simulation Move to North Haven

  One control room for each simulation room ◦ Use of desk microphones ◦ Debriefing immediately after simulation If using desk microphones do not have rooms set up with patient rooms back to back, sound from one room interfere with sound from other room

  Budget Program/course objectives

   Fidelity depends on learning outcomes A realistic environment as possible is necessary for simulating a patient care scenario and the promotion of clinical reasoning Cost and Waste What is essential for learning?

         Grants, School budget, University budget Cost of mannequin (40-60K) Cost of room construction Cost of AV equipment (20K) Cost of related equipment (bed, etc) Cost of maintenance Cost of training Cost of staff 100,000.00 WOW!!!!!

      At least one faculty must develop expertise ◦ Nursing knowledge ◦ ◦ Teaching knowledge Simulation knowledge Technology knowledge ◦ Literature SUN conferences Laerdal Training Other institutions Practice, Practice, Practice!!!

Super Clinical Simulation Educator

 Faculty education Expert should educate faculty on potential of clinical simulation ◦ Literature ◦ Demonstration ◦ ◦ ◦ Student testimony Outcome measurement Institutional Research

        Laerdal SUN Conferences Mentoring Discussion ◦ Technology ◦ Scenarios Role play Demonstration Return demonstration Technology Support Gonna fly now

    Began with 80 juniors 140 juniors ◦ 45 minute session fall ◦ ◦ 45 minutes session spring Maternity experience spring 50 SNUAC students ◦ 1 hour session 140 seniors ◦ Mock codes in fall ◦ Capstone simulation

       ◦ Where is clinical simulation placed in the curriculum Lab, Course, Clinical Is it used in place of clinical time?

How is credit for preparation and successful meeting of objectives given?

How is faculty time managed, credits?

How does clinical simulation affect faculty work load?

Will full-time and/or adjunct faculty be used for teaching Will simulation technicians be used to run programmed scenarios?

         Clinical Simulation Policy (should be included in syllabus or handbook ◦ Stick to policy unless unusual circumstances Orientation process (video, hands on) Number of practice sessions ◦ Limited, unlimited Evaluation - Number of times student will be allowed repeat experience ◦ How will this affect grade/passing of course or course component Remediation ◦ Opportunities for practice, mandatory/voluntary Single or group/team experiences ◦ Objectives, faculty resources, technology Length of experience ◦ Objectives, type of scenario Number of instructors needed to meet program needs Scheduling ◦ Wiki

     University Administration Students are asking about clinical simulation during open house Parents impressed with simulation as teaching/learning strategy Health care facilities recognize significance of clinical simulation experiences Getting the word out to other departments in the University

     Began with nursing Individuals in other departments (OT, PT) contacted Nursing Physician Assistant students Who will set up faculty training sessions and be responsible for training Once faculty are oriented, nursing signs off

     Concerns – Scheduling Determining departmental needs from all departments Extra workload on current Laboratory Coordinator Need for Development of a Laboratory Manager who is responsible for training, student orientation, troubleshooting, budgeting, scheduling and simulation set up for all departments Approved for 5 extra rooms Roles develop over time To meet needs

 Dr. Barrere

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