Flexible Learning Plan

Executive Summary

• To develop scenario based learning, using simulation to teach nursing assessment skills and critical thinking to students enrolled in Medical/Surgical Nursing, year 2 and year 3

Project Background

• Expensive manikin not been used• It has a vital sim unit and remote control

allowing us to program ‘Annie’ to make realistic noises, take BP’s, pulse, respiration rate, listen to different heart, lung and abdominal sounds and perform many procedures such as catheterisation, naso-gastric insertion etc

• Over the last few years nurses have been encouraged to develop their assessment skills, particularly in the area of physical assessment

• We have responded to this in our undergraduate nursing program and started teaching students a wide repertoire of assessment skills

• Many RN’s in the clinical setting do not know these assessment skills

• Students can find it difficult to access opportunity on clinical to practice listening to lung, breath, abdominal sounds and to distinguish between normal and abnormal

• We want our nurses to be able to take their assessment findings, develop a picture of what is happening and then know what to do with their findings (critical thinking)

• Using simulation to aid student learning has developed greatly over the last few decades. Laerdal is an international company in New Zealand that specialises in simulation and training for staff

• Benefits of simulation include realistic preparation for rare and difficult cases, you can make errors without causing harm to patients and you can keep repeating certain scenario’s until the students has learnt it.

www.simulation.laerdal.com

Example

Using your computer you can program and then load it into the vital sim, a scenario related to a patient going into ventricular fibrillation (VF). You program the event and the interventions you want the students to do. If they don’t do these interventions in certain times you can program the manikin to go into cardiac arrest or if they do correct interventions, patient goes back into sinus rhythm.

• Simulation can add to the students learning because they can see the results of the actions they take or hear what different sounds are like without having to subject the patients to too much inconvenience, while they are learning.

Aim:

To provide realistic clinical situations in our skill labs, using simulation with our manikin ‘Annie”.

•

Objectives: • To continue my training in the use of simulation. I have

already attended one and a half training days this year• To familiarise myself with the online website so I can

access more scenario’s and participate in forums.• Begin to programme simple scenario’s into the vital

sim• Practice these scenario’s with colleagues before using

them in the laboratory.• Next year introduce this onto my BN 233 course with

the potential to extend this into third if the trial is successful

List of performance indicators (outcomes): • The first performance indicator is a timeframe.

That is to have the scenario’s ready to go for my skill labs beginning March 2008.

• The 2nd performance indicator will be evaluating the sessions throughout next year by getting student feedback after lab sessions and course feedback at the end of each semester.

Flexible learning analysis:

Perceived flexible learning needs of the students:

Students have different learning styles and for visual or kinaesthetic students, simulation will be of great value. Also for students who have difficulty accessing learning opportunities in clinical, the use of stimulation exercises with Annie in the lab will give them the opportunity to deepen their learning.

• Eventually I would like to set the manikin up so students can access it out of lab times and practice their scenario’s.

• The flexible learning services I'm providing are mostly learning support strategies to compliment our use of lectures, labs and tutorials which we already offer. It also offers an alternative when clinical placements become harder to source (although this could never replace the need for patient contact)

• We already use scenario’s in labs however adding simulation exercises related to these scenario’s has a great potential to enhance learning opportunities. I am targeting this resource as it is a way of linking theory in lectures to more practical real life situations.

• Lecturer release time will be the biggest sustainability issue. ‘Time’ is a precious resource and this will be needed to develop, load and practice the scenarios. We will need to have more than one lecturer plus our lab technician on board and trained in how to use vital sim.

• To address this I am going to develop this resource at a slow pace, starting with just a few scenario’s and evaluate this by seeking student feedback. I will also apply for funding from the teaching and leaning innovation fund later in year

• Access and equity will be a problem because at this stage we only have one manikin. If the students want to practice scenario’s at flexible times then there will need to be a booking system and a locked room where it can be set up.

• Cultural diversity is addressed very well by using simulation because it caters for various learning needs.

• There is also the opportunity to practice in groups which means students can choose groups who have similar needs to their own. The students can also choose the scenario’s which they need to practice

• This plan aligns with OP's strategic direction of becoming excellent teachers and using and managing our resources effectively. Lecturer contact with students has been decreasing over the last few years as we try to manage within budgets. Stimulation hopefully will enhance the students learning opportunity

• Simulation learning fits in learning theories of situational/context orientation or behaviourist orientation. They will see situations and then also see the results of the behaviour they initiated.

Budget

• Laptop computer to stay with Annie style (hopefully one can be sourced for free from within the polytechnic.)

• 2 weeks leave for 2 lecturers and the lab technician to focus on learning and developing these scenario’s; may need to pay for a casual lecturer to provide cover.

• Possibility of employing some students on a HRC summer scholarship and it could be developed as an action research project.

Timeline

• Next semester focus on developing scenario’s and been trained in the use of simulation

• March 2009 have at least 4 scenario’s ready to go for our skills labs

• July 2009 have ‘Annie’ set up to be used by students at flexible times

• March 2010 If successful begin to implement this with third year students