Debbie Eremita, MSN, RN Valerie Herbert, MSN, RN

1. Debbie Eremita, MSN, RN Valerie Herbert, MSN, RN

2. “Any replication of a real-life event” Utilized in many professions PILOTS HEALTHCARE

3. Military Training

4. Aviation Simulation Training Hudson River Crash

5. Anesthesia Simulation

6. Healthcare Simulation

7. Low, Moderate and High Fidelity • Fidelity refers to the degree of simulation realism

8. Low fidelity ---basic mannequin • CPR training models • Arm model for IV training • Hip model for IM injection training • Moderate fidelity • Heart and lung sounds • No movement

9. High fidelity has an • Operational airway • Ability to blink and speak • Chest walls visibly expands on inspiration and relax on expiration • Heart, lung and bowel sounds are programmable • Interchangeable gender • IV’s, central lines, chest tubes

10. Features

11. Respiratory Treatments Chest Tubes

12. Use of Simulation in Healthcare and Nursing Education • Teaching strategy • Enhances theory learned from classroom • Psychomotor skills • Practice problem solving • Provides critical thinking • Clinical reasoning skills • Facilitates mastery of clinical skills

13. Demonstrate competence in nursing skills • Critique assessment techniques • Augment clinical experiences • High-risk, low-frequency events • Safe environment

14. Husson University Creation of Simulation

15. Creating the Case Study Simulation • The Case: • Links class concepts to learning objectives • Much like a clinical assignment • Pre-clinical assignments • Pre-clinical Rounds • Divided into sections or scenes • Class of 6-8 students—2 students per scene • Debrief entire case study or Post-clinical Rounds • Evaluation Activities

16. Husson University • Case Study Simulations • Unfolding Scenarios • High Risk-Low Exposure • Practice in Context—Better • outcomes • Bridge Book Learning to • “Real” Patients • Ethical Concerns and • Patient Safety

17. Currently utilized at following levels: • Fundamentals • Med-Surg I & II • Pediatrics • Maternal-Child Health • Psych-Mental Health • Capstone Partnership

18. Learn and practice skills • Scenario testing • Simulated clinical experiences • Fundamentals • Med-Surg • Pediatrics • Obstetrics

19. Collaborate to complement classroom information • Create learning objectives • Identify cognitive and psychomotor skills • Create an electronic medical record • Schedule the simulation

20. Receive information prior • Report from RN • Perform simulation activity with assigned role such as: • Staff nurse • Family member • Respiratory therapist • Observer • Debriefing session

21. Discuss simulation progression • Communication with coworkers, family members, and patient • Performance of technical skills • Patient safety maintained?

22. Benefits • Learning in a non-threatening environment • Practice, practice, practice • Confidence • Better outcomes • Improved patient safety

23. Development of EBP and Best Practice Utilization • Current EBP indicates IF designed and utilized effectively • Improved Critical Thinking • Improved Decision Making • Improved Content Mastery • Costs • Process of changing Educational Practices • Passive to Active Learning

24. WhySimulation???? • Today’s Healthcare Environment • Acuity is Higher • Older Population--multiple co-morbidities • Patient’s are sicker • Length of Stay in Hospital is shorter • ......Yet student’s must learn • …..Staff must be competent

25. Current Utilization • Maine Simulation Programs • Educational • Healthcare • Evidence Based Practice • Research • Pilot Studies

26. Future Needs of Simulation Needs for Maine…… • Initial stages of Simulation use with isolated pockets • More collaborative opportunities for all healthcare students/professions • Best-Practice use of Simulation • Integration of EBP models within Simulation • QSEN Competencies embedded within Simulation • State Regulations

28. Bambini, D., Washburn, J., & Perkins, R. (2009). Outcomes of clinical simulation for novice nursing students: Communication, confidence, clinical judgment. Nursing Education Perspectives, 30(2), 79-82. Brannan, J. D., White, A., & Bezanson, J. L. (2008). Simulator effects on cognitive skills and confidence levels. Journal of Nursing Education, 47(1), 495-500. Cant, R. P. & Cooper, S. J. (2009). Simulation-based learning in nurse education: Systemic review. Journal of Advanced Nursing, 66(1), 3-15. Dreifuerst, K. T. (2009). The essentials of debriefing in simulation learning: A concept analysis. Nursing Education Perspectives, 30(2), 109-114. Fountain, R. & Alfred, D. (2009). Student satisfaction with high-fidelity simulation: Does it correlate with learning style? Nursing Education Perspectives, 30(2), 96-98. Harden, N. (2010). Use of simulation in teaching and learning in health sciences: A systemic review. Journal of Nursing Education, 49(1), 23-28.

29. Jefferies, P. R., Bambini, D., Hansel. D., Moorman, M. & Washburn, J. (2009). Constructing maternal-child learning experiences using clinical simulations. Journal of Obstetrics, Gynecological and Neonatal Nursing, 38, 613-623. Ravert, P. (2008). Patient simulator sessions and critical thinking. Journal of Nursing Education, 47(12), 557-562. Rush, K. L. Dyches, C. E., Waldrop, S. & Davis, A. (2008). Critical thinking among RN-to- BSN distance students participating in human patient simulation. Journal of Nursing Education, 47(11), 501-507. Sears, K., Goldsworthy, S. & Goodman, W. (2010). The relationship between simulation in nursing education and medication safety. Journal of Nursing Education, 49(1), 52-55. Smith, S. J. & Roehrs, C.J. (2009). High-fidelity simulation: Factors correlated with nursing student satisfaction and self-confidence. Nursing Education Perspectives, 30(2), 74-78. Waxman, K.T. (2010). The development of evidence-based clinical simulation scenarios: Guidelines for nurse educators. Journal of Nursing Education, 49(1), 29-35.