Developing a Multi-disciplinary Simulation Hospital

1. Developing a Multi-disciplinary Simulation Hospital Presented by: Lee Jerls MSN, RN and Terri Currie BSN, RN

2. Definition • Simulation • An attempt to mimic essential aspects of a clinical simulation with the goal of understanding and managing the situation better when it occurs in actual clinical practice. • A technique that uses a situation or environment created to allow persons to experience a representation of a real event for the purpose of practice, learning, evaluation, testing, or to gain understanding of systems or human actions (

3. Definition: Fidelity • Fidelity • The degree to which either a simulation encounter or simulation equipment approaches reality (http://sirc.nln.org/mod/resource/view ) • Types: • Low fidelity manikins • Medium fidelity manikins • High fidelity manikins

4. Why Simulation? • “Carnegie Foundation for the Advancement of Teaching Report” (Benner, Sutphen, Leonard, & Day, 2009) • “ From focus on covering decontextualized knowledge…to sense of salience, situated cognition and action in a particular situation; • From a sharp separation of clinical and classroom teaching to integration of classroom and clinical teaching; • From an emphasis on critical thinking to clinical reasoning and multiple ways of thinking that include critical thinking; and • From an emphasis on socialization and role taking to an emphasis on formation.”

5. Learning Theories • Constructivism learning therapy • Adult-learning theory • Brain-based learning theory • Social-cognitive learning theory • Experiential learning theory • Novice-to expert theory • A new pedagogy??

6. The Journey…. LSC-K Hospital • History (2007) • Appreciative Inquiry (early 2008) • Lack-of-realism • Roles and responsibilities • Orientation to the unit and equipment • Faculty continuity • Scenario development

7. Literature Review

8. Jeffries Simulation Model (2005)

9. S.T.E.P. Educator Preparation Plan • S.T.E.P. • Simulation Take Educator Preparation (Jeffries, 2008) • Standardized Materials • Train the Trainer • Encourage the development of a simulation design and integration team • Plan to coordinate the simulation development and implementation activities

10. S.W.O.T. Method • Strengths • Weakness • Opportunities • Threats (Rothgeb, 2008)

11. Integration Into the Program • Identification of a champion • Scheduling • Simple first steps • Flexibility • Debriefing (Leigh & Hurst, 2008)

12. Simulation Design • Objectives • Planning • Fidelity • Complexity • Cues • Debriefing (Jeffries, 2005)

13. Evaluation Process • Debriefing • Reflection • Tools

14. National League for Nursing • The Simulation Design Scale (student version), a 20-item instrument using a five-point scale, was designed to evaluate the five design features of the instructor-developed simulations used in the NLN/Laerdal study. • Educational Practices Questionnaire (student version), a 16-item instrument using a five-point scale, was designed to measure whether four educational practices (active learning, collaboration, diverse ways of learning, and high expectations) are present in the instructor-developed simulation, and the importance of each practice to the learner. • Student Satisfaction and Self-Confidence in Learning, a 13-item instrument designed to measure student satisfaction (five items) with the simulation activity and self-confidence in learning (eight items) using a five-point scale. • http://sirc.nln.org/mod/resource/view • Chickering, A.W., & Gamson, A.F., (1987). Seven principles for good practice in undergraduate education. Racine, WI: The Johnson Foundation, Inc./Wingspread

15. A day in the life of a student nurse at LSC-K Hospital… Lone Star College- Kingwood Hospital

16. Lone Star College- Kingwood Hospital • Mission: to deliver safe and prudent quality care while maintaining ethical, professional, and culturally acceptable standards through utilization of evidence-based practice an innovative technology • Vision: to facilitate the growth of the novice learner to the expert clinician, enhancing critical thinking skills and self-confidence in a safe, realistic, and non-threatening environment.

17. Orientation Process • LSC-K Hospital • Roles and responsibilities • Patient information • Confidentiality form • Scavenger hunt • Equipment • Crash carts • Paging system • Documentation • EMAR I want to insert a picture here

18. Report • Patient Census • Level • Roles and responsibilities • Primary nurse • Secondary nurse • Family member • Observer • Interdisciplinary team

19. Multi-Patient Unit

20. Multi-Disciplinary Unit • Nursing disciplines • Nursing levels • Respiratory therapy • Occupational therapy

21. Debriefing

22. References Benner, P., Sutphen, M., Leonard, V., & Day, L. (2009). Educating nurses: A call for radical transformation. San Francisco: Jossey-Bass. Jeffries, P. R. (2005). A framework for designing, implementing, and evaluating simulations used as teaching strategies in nursing. Nursing Education Perspectives , 96-103. Jeffries, P. R. (2008). Getting in S.T.E.P. with Simulations: Simulations Take educator Preparation. Nursing Education Perspectives , 70-73. Leigh, G., & Hurst, H. (2008). We have a high-fidelity simulator, now what? making the most of simulators. International Journal of Nursing Education Scholarship , 1-10. Rothgeb, M. K. (2008). Creating a nursing simulation laboratory: a literature review. Journal of Nursing Education , 489-494.