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 Instructor9,000 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 exhibitsWhat complications the patient
developsWhich 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/SUNNLN 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 simulationDe-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-INFirst 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 scenario
Example….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 studentsQuestion Disagre
eNo 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, [email protected]
936-674-7896DeWitt School of Nursing
Stephen F. Austin State UniversityNacogdoches, Texas