Transcript Integrating Simulation Into Nursing curriculum

Joanie Selman, MSN, RN
Med-Surg Course Coordinator
DeWitt School of Nursing
Stephen F. Austin State University
DeWitt School of Nursing at
Stephen F. Austin State University
Nacogdoches, 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
 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
Up to 30% of students are Tactile/Kinesthetic learners.
Simulation Enhances Learning
 Lecture is not enough, Reading is not enough
 Case studies are not enough
Control
 Instructor
has control over what disease
patient exhibits
 What
complications the patient develops
 Which
student practices with that patient
 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.
 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.
 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.
 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


SUN website




Resource Center
http://sirc.nln.org/
http://www.laerdal.com/us/SUN
NLN scenarios
Scenarios from textbook
publishers
Case studies
Simulation in Nursing
Education
Author:
Pamela Jeffries
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

Before simulation day
Lecture
Help


on the topic
students prepare
Assignment to
complete on
topic before the sim
article in a journal
case study
Worksheet
“dress rehearsal” with
other students or faculty
During simulation
 Make
room and mannequin as realistic as possible
 Pre-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.
After simulation
De-brief
immediately
Identify gaps in knowledge
Praise students for positive
interventions
Redirect 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

 First
person to convince is your
 Director or Dean of the nursing school.
 As a group
 present
a video-taped scenario
 Have students share their experience
 Discuss the benefits
Teamwork
 Delegation
 Communication
 Decision-making
 Time management

Critical thinking
Med administration
Infection control
Assessment
Physician orders
 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
General for all scenarios
Example…Student demonstrates appropriate
infection control techniques.
….Student identifies client with two
http://www.laerdal.com/us/SUN
identifiers
Specific for individual scenario
Example….Student assesses blood pressure
before administering nitroglycerin tablet.
 Faculty
Objectives for SIM
Failure 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%.
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%
 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!
 Short
answer --- IT’S WORTH IT !!

To the instructor

To the students

To the future employer

To the client
Contact information
Joanie Selman, MSN, RN
[email protected]
936-674-7896
DeWitt School of Nursing
Stephen F. Austin State University
Nacogdoches, Texas